Ethics Grand Rounds
Permanent URI for this collectionhttps://hdl.handle.net/2152.5/1292
This collection contains Grand Rounds material (videos, presentation slides, or handouts) submitted to the Library from the Ethics Program. This collection also contains material from the annual Daniel W. Foster, M.D., Visiting Lectureship in Medical Ethics.
The annual Daniel W. Foster, M.D., Visiting Lectureship in Medical Ethics brings distinguished scholars in medical ethics to the UT Southwestern Medical Center campus to present and discuss the challenging moral issues in biomedicine. Established in 2007 in honor of UT Southwestern’s Daniel W. Foster, the Lectureship also offers opportunities for faculty, staff, and trainees to discuss medical ethics in an intimate setting.
All lectures are held on the second Tuesday of every month in the academic year (September – May) from 12 noon to 1 p.m. For more information, contact Ruth Vinciguerra.
Unless otherwise noted, videos and presentation slides are publicly-accessible.
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Information about the most recent Daniel W. Foster, M.D., Visiting Lectureship in Medical Ethics is now available.
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Item UT Southwestern Medical Center Ethics Grand Rounds - 2005/2006(2005)This document lists the schedule of Ethics Grand Rounds events for September 2005 through May 2006.Item UT Southwestern Medical Center Ethics Grand Rounds - 2006/2007(2006)This document lists the schedule of Ethics Grand Rounds events for September 2006 through May 2007.Item UT Southwestern Medical Center Ethics Grand Rounds - 2007/2008(2007)This document lists the schedule of Ethics Grand Rounds events for September 2007 through May 2008.Item UT Southwestern Medical Center Ethics Grand Rounds - 2008/2009(2008)This document lists the schedule of Ethics Grand Rounds events for September 2008 through May 2009.Item UT Southwestern Medical Center Ethics Grand Rounds - 2009/2010(2009)This document lists the schedule of Ethics Grand Rounds events for September 2009 through May 2010.Item UT Southwestern Medical Center Ethics Grand Rounds - 2010/2011(2010)This document lists the schedule of Ethics Grand Rounds events for September 2010 through May 2011.Item UT Southwestern Medical Center Ethics Grand Rounds - 2011/2012(2011)This document lists the schedule of Ethics Grand Rounds events for September 2011 through May 2012.Item UT Southwestern Medical Center Ethics Grand Rounds - 2012/2013(2012)This document lists the schedule of Ethics Grand Rounds events for September 2012 through May 2013.Item How can a safety net be the catalyst for creating a healthier community?(2012-09-11) Anderson, Ron J.The Parkland Health & Hospital System is one of the Nation's largest and most complicated safety net institutions. It provides care for over 40,000 admissions, 12,000 deliveries and 1.3 million outpatient and ED visits per year. It is a Level 1 Trauma and Burn Center, a Level 3 Neonatal Unit (one of the largest in the US), and it is part of the UTSW campus NCI designation for Cancer Care. Parkland has achieved many firsts as an innovator of the safety net, but must now rise to the challenges of "moving upstream" to invest in prevention, health promotion, earlier interventions in primary care, and care management in a fashion that is lead by a spirit of servant leadership, evidence based practice (competency) and the ethical tenets of beneficience, nonmaleficience, promotion of autonomy, distributive and social justice. The next evolutionary steps for Parkland involve collaboration with our competitors (so-called Co-optician) through a 1115 Medicaid Waiver to find and address gaps in service delivery for our most vulnerable residents. It requires the discipline to study health disparities, population health outcomes and the impact of the socioeconomic determinants of health. We have and will continue to use appreciate inquiry, dialogue and "deep listening" to guide us so as to avoid paternalism or exploitation and get the community's buy-in and participation. Enormous strength, innovation and vitality can come from the community's partnership with the safety net to effect health delivery reform at the local and regional level. We can, and must, do better by being better stewards of scarce resources, by putting quality and safety in both process and outcome at the forefront of our efforts. These efforts must be patient and community centered, not just provider centered to achieve an accountable, sustainable and affordable future.Item What makes killing wrong?: and why it matters(2012-10-09) Sinnott-Armstrong, WalterWhat makes an act of killing morally wrong is not that the act causes loss of life or consciousness but rather that the act causes loss of all remaining abilities. This account implies that it is not even pro tanto morally wrong to kill patients who are universally and irreversibly disabled, because they have no abilities to lose. Applied to vital organ transplantation, this account undermines the dead donor rule and shows how current practices are compatible with morality.Item Politics and the ethics of health care reform (The Daniel W. Foster, M.D., Visiting Lectureship in Medical Ethics)(2012-11-13) Brennan, Troyen A.In the wake of the Supreme Court decision in June, and the election in early November, we will have a good view of the arc of health care reform for the first time. Reform should be judged from economic, political, and also ethical grounds; this lecture will concern the latter viewpoint.Item UT Southwestern Medical Center Ethics Grand Rounds - 2013/2014(2013)This document lists the schedule of Ethics Grand Rounds events for September 2013 through May 2014.Item Physician stewardship of healthcare resources(2013-01-08) Goold, Susan DorrStewardship may be defined as the judicious management of resources that others entrust to one's care. Physicians are entrusted with decision-making authority in health care; decision making that often draws on pooled community resources, whether through private insurance or government programs. Physicians' roles and responsibilities in stewardship are a matter of intense and pressing concern for professional organizations, physicians, policy makers and patients. Most agree that physicians should play a leadership role in controlling costs through, for instance, identifying unnecessary services and developing evidence based practice guidelines. The proper role for physicians as stewards when caring for individual patients "at the bedside," however, remains in dispute. Knowledge of clinical alternatives and of patients' preferences and needs enable physicians to individualize recommendations and minimize harms, unlike decision-makers who are more distant from the bedside. On the other hand, allocation decisions should be transparent and open to critique, and limits on individual patient advocacy could undermine trust. This presentation will first describe and justify existing professional norms and values related to stewardship. Second, it will review existing empirical research on doctors' knowledge, attitudes and behaviors related to practicing within resource constraints and analyze how that evidence compares to existing professional ethical norms and values. Finally, questions will be posed to the attendees about professional ethics, trust and stewardship.Item Expanding living kidney donation: ethical and policy considerations(2013-02-12) Ross, Lainie FriedmanIn 1954 the first successful living donor kidney transplant was performed between identical twins. With the improvement in immunosuppression, ABO compatible friends, spouses and even strangers can now donate kidneys to waitlist candidates. In this lecture, Lainie Friedman Ross, M.D., Ph.D., will discuss some of the ethical and policy challenges that arise by the expansion of living donor kidney transplants including 1) when strangers serve as non-directed donors; 2) when ABO-incompatible donor-recipient pairs trade kidneys; and 3) the new practice of asynchronous kidney chains catalyzed by nondirected donors. But all of these expansions must be understood with a caveat: she concludes by discussing the ethical concerns raised by the practice of living kidney donation, as well as what is known and what is not known about the short- and long-term risks that living donors face and what research is needed to ensure that prospective donors give an informed and voluntary consent.Item On wealth and wrongdoing: how social class influences unethical behavior(2013-03-12) Piff, Paul K.Social class exerts a significant influence on ethical decisions and behavior. Psychological research finds that individuals from higher social class backgrounds are more likely to prioritize themselves---their individual needs and desires relative to individuals from lower social class backgrounds, who are more likely to be sensitive to others. Guided by this work, Paul K. Piff, Ph.D., will report studies showing that higher social class is associated with increased unethical behavior, decreased altruism, and increased utilitarian moral reasoning, as well as provide data to shed light on the reasons for these class differences. The talk highlights that social class is a powerful force in the realm of ethics.Item The need for evidence and values-informed policy making: the case for public engagement(2013-04-09) Bernier, Roger H.We are living in a very angry and divisive time in our national life. The polarization is preventing us from reaching agreements about needed solutions to important and urgent public problems, including many public health challenges. Examples are disagreements about how best to lower obesity rates, respond to climate change, achieve gun control, provide vaccinations on time, screen appropriately for prostate and breast cancer, and many others. We are failing to translate our investments in research into useful policy actions, and public health is severely diminished because of it. Such policy disagreements can persist despite the existence of a large body of compelling evidence for action. The stalemates reveal that data alone are insufficient to produce effective and sustainable solutions to public health problems. Such solutions must take into consideration both facts and core public values, yet we have no established methods for uncovering relevant public values and working through values differences on science policy issues. A more team-oriented vision of science and policy development is needed that can produce the meaningful exchanges between scientists and members of the affected populations which can lead in turn to effective translation of research into policy and practice.Item Meeting the challenges: bringing evidence-based treatment to the pregnant patient(2013-05-14) Brandon, Anna R.Because of the ethical challenges of conducting randomized controlled clinical trials with women who are or may become pregnant, there is insufficient information regarding the risks to the fetus for the majority of prescription medications, leaving pregnant women with a difficult choice between using a medication with an unknown safety profile or suffering from untreated illness. Three major stakeholder groups in perinatal research -- clinical investigators, Institutional Review Board representatives, and pregnant women seeking treatment in a major medical institution -- highlight the limitations of human subjects protections guidelines to address ethical grey areas in research and the need for greater flexibility in accepting women's competence to balance the risks and benefits of research participation for themselves and their fetuses.Item Alternatives to whistleblowing, or how to intervene effectively and still have a career and life afterwards(2013-09-10) Sieber, Joan E.We have learned that scientific misbehavior (that is, any scientific conduct that causes the scientific record to be inaccurate, not just plagiarism, falsification and fabrication), is very widespread and that persons who report such misbehavior on the part of their colleagues are likely to suffer serious consequences. In-depth interviews of 135 NIH Principal Investigators who have witnessed research wrongdoing illustrates the ineffectiveness of direct confrontation or reporting of wrong-doers, but illustrates effective ways to stop them in their tracks. Although persons who engage research wrong-doing may not have in mind to reform, they are concerned to save face and can often be shamed into behaving properly. Wise and responsible mentoring that involves providing evocative stories about how to effectively shame miscreants is likely to be more effective than reciting rules of proper research conduct. Examples are provided.Item Physician accountability for torture: emerging standards for practice(2013-10-08) Miles, Steven H.Physicians are complicit with torture in many countries. They develop methods that leave no scars, keep prisoners alive who are not supposed to die, and falsify medical records and death certificates to conceal tortures. Since 1975, there has been an increasingly rapidly accelerating trend to hold these physicians accountable either by criminal courts or by medical licensing boards. This talk will review this trend and its implications.Item Avoiding harm and improving care near the end of life: what good can ethics do? (The Daniel W. Foster, M.D., Visiting Lectureship in Medical Ethics)(2013-11-12) Berlinger, NancyPatient care situations in which there is uncertainty about how to relieve suffering, make medical decisions on behalf of others, work with families in conflict, resolve disagreements among team members, or respond to institutional priorities and pressures are frequently described as ethically challenging situations. Why do these situations present themselves so often in care near the end of life? How can "ethics," including clinician education, ethics consultation services, and institutional policy development, help professionals and organizations involved in the care of seriously ill patients to anticipate these challenges, avoid harms, and prevent care problems? As our nation's health care system changes, what steps should we take to improve care near the end of life? The publication of a new edition of the landmark Hastings Center Guidelines offers an opportunity to explore these questions.