• Corporate Influences on Science and Health—the Case of Spinal Cord Stimulation

    Dec 18, 2023
    JAMA VIEWPOINT: Adrian C. Traeger, PhD, School of Public Health at University of Sydney and Lisa Bero, PhD, at the Center for Bioethics and Humanities found that over the past 3 years, several independent studies have questioned the safety and efficacy of spinal cord stimulation to manage pain.

    The spinal cord stimulator industry was swift to respond by creating counterevidence (original studies and reviews), supporting researchers to write criticisms in industry-sponsored journals. These tactics have historically extended into the tobacco industry, pharmaceutical, lead, vinyl chloride, and silicosis-generating industries, to protect profits.

    Bero and Traeger conclude that to maintain independence, professional organizations and publications should not accept industry funding and should have strict policies to actively manage financial conflicts of their members.
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  • Why Dropping Most COVID-19 Vaccine Mandates Is Now Ethical

    Dec 7, 2023
    HEALTH AFFAIRS: The American Board of Bioethics Program Directors (APBD) approved a new position this fall, that universal COVID-19 vaccine mandates are not presently ethically supportable. Matthew Wynia, MD, MPH, and colleagues state that the values and principles that guided their earlier position remain the same, but the context has evolved.

    Today, although the benefits of updated vaccination to individuals remain considerable, the relative value of universal vaccination against COVID-19 for achieving safety for others seems considerably lower than it was in fall 2021. This is why the APBD now supports policy decisions to lift most COVID-19 vaccine mandates but continues to call for freely available access to updated vaccines against COVID-19. They also recognize that vaccine mandates could again become ethically justifiable should circumstances change.
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  • Spheres of Morality: Is There a Point?

    Nov 27, 2023
    AMERICAN JOURNAL OF BIOETHICS: When and how are physicians obligated to patients, colleagues and the community? Drs. Matthew Wynia and Brian Jackson examine 125 years of thought on physician ethics. and how the new concept of "spheres" might help physicians better understand the reasons they feel conflicted in some cases, and become better equipped to negotiate their roles in an increasingly complex and interconnected healthcare system.
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  • New Interactive Evidence Based Mapping Tool Gives Policymakers More Insight into Highly Concentrated Cannabis Products

    Nov 8, 2023
    CU ANSCHUTZ NEWS: After conducting the first scoping review of its kind, AMC researchers Lisa Bero, PhD, Rosa Lawrence, BA, Jon Samet, MD, MS, and colleagues developed an evidence based interactive mapping tool that can be used to find the studies that have been done on high concentration cannabis products, to assist lawmakers as they consider regulating the concentration of THC in cannabis products and as more potent products move into the marketplace.

    This State of Colorado funded scoping review was published in the American Journal of Public Health. “During the review we discovered that research on cannabis is out of sync with the higher concentrations found in today’s products. While many of these studies need to be expanded to keep up with current trends, it opens up a conversation that could lead to broader research and collaboration between medical experts and state governments as well as close the knowledge gaps about these products,” says Professor Bero.
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  • Health as a Human Right: A Position Paper From the American College of Physicians

    Oct 31, 2023
    ANNALS OF INTERNAL MEDICINE: Authors Matthew DeCamp, MD, PhD, and Lois Snyder Sulmasy, JD, recognize health as a human right based in the intrinsic dignity and equality of all patients and supporting the patient–physician relationship and health systems that promote equitable access to appropriate health care. They propose the U.S. should move closer to respecting, protecting, and fulfilling for all the opportunity for health.

    The ACP Ethics Manual states, “The principle of distributive justice requires that we seek to equitably distribute the life-enhancing opportunities afforded by health care. How to accomplish this distribution is the focus of intense debate.”
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  • How Artificial Intelligence is Changing Health Care

    Oct 25, 2023
    CU ANSCHUTZ NEWS: As articifical intelligence (AI) technology evolves, ethical questions and challenges arise. CBH faculty Matthew DeCamp, MD, PhD, asks, ‘Who are we forgetting? Who is left out by these tools?’ There’s a place in ethics that puts special emphasis on the way we treat those who are or who may be in the minority and are harmed by what we’re doing,” he says. “It’s important to not assume that just because something is better overall it’s better for everyone. There may still be individuals and groups who are harmed by the technology.”

    Addressing those challenges should come in the design process of new AI tools. “We need to start demanding that AI proactively reduce disparities and equities, not design it and wait for that to happen later,” DeCamp says.
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  • How Aid in Dying Became Medical, Not Moral

    Oct 24, 2023
    NEW YORK TIMES: The debate over aid in dying still rages in the language that medicine and the media use to describe the practice. “There is a significant, a meaningful difference between someone seeking to end their life because they have a mental illness, and someone seeking to end their life who is going to die in the very near future anyway,” said Dr. Matthew Wynia, Director of the Center for Bioethics and Humanites.
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  • Next Steps for Addressing Conflicts of Interest in Residency Programs

    Oct 16, 2023
    JAMA NETWORK OPEN: In an invited commentary, Matthew K. Wynia, MD, MPH, Christine M. Baugh, PhD, MPH, and Eric G. Campbell, PhD, note that academic settings are where physicians-in-training establish their habits and form lifelong professional identities, and interventions to reduce or eliminate gifts from medical and device companies to trainees have long been known to have durable effects. The authors suggest that academic institutions should be exemplars of avoiding COI, by prohibiting gifts from medical and device makers.
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  • Lee Gelernt from the ACLU Recounts Fight to Keep Migrant Families Together

    Oct 3, 2023
    CU ANSCHUTZ NEWS: ‘It’s almost impossible to fully describe the harm,’ lawyer says during his keynote address at the Advocating for Children in Migration symposium on September 21st.

    It all started with the asylum-seeking mother who escaped violence in the Democratic Republic of Congo in 2018, arriving barefoot and hungry at the border. By the time Lee Gelernt, JD, arrived in San Diego to represent the woman placed in a makeshift detention center, her 6-year-old daughter had been taken from her, shipped off to Chicago four months earlier.

    Gelernt, a lawyer with the American Civil Liberties Union (ACLU), promptly filed a lawsuit for her return and began collecting numerous heart-wrenching stories from other affected families. That kicked off his successful class-action lawsuit against the Trump administration’s policy of separating immigrant families at the U.S.-Mexico border.

    “There are still some people who think that policy should be reenacted. “The family separation lawsuit is a good lens through which to look at how we try and shape the narrative and how we reach the public: what works, what doesn't work and what are the real challenges.”
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  • Prenatally-diagnosed renal failure: an ethical framework for decision-making

    Sep 26, 2023
    JOURNAL OF PERINATOLOGY-NATURE: Jackie Glover, PhD and colleagues in the Pediatrics Department at Children's Hospital Colorado, developed an ethical framework to guide patient care and research for prenatally diagnosed severe renal anomalies. The authors identifiy ethical challenges in communication, timing of decisions and scarce resources.

    The framework addresses shared decision-making, establishing trust, managing disagreements, the child’s best interests, the harm principle, and a zone of parental discretion. Glover and co-authors believe that operationalization of this framework affords the support needed to provide comprehensive patient and family-centered care for these complex patients. Read article>>
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  • Deciding Who Is Dead: Physician Group Issues New Statement

    Sep 5, 2023
    MEDPAGE TODAY: In a paper published in the Annals of Internal Medicine, Matthew DeCamp, MD, PhD, and co-authors seek to help practicing physicians understand, even more clearly than they already do, just how important the standards for the determination of death are.

    Advances in re-establishing postmortem circulation through extracorporeal membrane oxygenation (ECMO) or normothermic regional perfusion -- a transplant protocol emerging in U.S. hospitals -- have made the dichotomy between the circulatory and brain criteria of the 1980 definition in the Uniform Determination of Death Act more consequential.

    "The determination of death is something that happens every day. It is a profound and solemn act that physicians and other clinicians engage in," DeCamp said. "They intersect the fundamental values of the profession -- values like honesty, transparency, integrity, and respect."
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  • Texas med schools increasingly turn to unclaimed bodies for student education

    Aug 30, 2023
    DALLAS MORNING NEWS: “It raises questions about justice and fairness, because now the burden of providing medical education is falling disproportionately on vulnerable and marginalized members of society,” said Matthew DeCamp, MD, PhD. “Anatomy lab is often one of the most profound and important experiences a student can have, not just because of learning anatomy but also because of learning some of the fundamental values of the medical profession and respecting human dignity,”

    Just how many unclaimed bodies are used in medical education is difficult to pinpoint. DeCamp co-authored a 2019 study that surveyed 146 U.S. medical schools on the use of unclaimed bodies, of which only 89 responded. Eleven schools reported possible use of unclaimed bodies, although programs differed on whether they believed students should be informed of unclaimed body use.
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  • Black/African American communities reveal challenges to COVID-19 testing in Colorado

    Aug 17, 2023
    RADx-UP/NIH: "Research, Engagement, and Action on COVID-19 (REACH-OUT) is a community-based study,” said Matthew DeCamp, MD, PhD. “We involve the community in both design and the implementation of our study to address social, ethical, and behavioral barriers to COVID-19 testing.”

    The team, including Quatisha Bailey, MA, from Children’s Hospital Colorado, conducted 250 surveys in a three-week timeframe,” and found themes that stuck out were trust and distrust, health care access, and awareness around COVID-19. “Trust is everything,” said Bailey. “And how to establish trust, regain trust, and maintain trust is language. We have to speak in a language that people understand.”
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  • Abortion reversal ban chock full of complexities

    Aug 16, 2023
    COLORADO SUN: When the state of North Dakota passed a law requiring abortion providers to inform patients that it may be possible to “reverse” a medication abortion, Center Director, Matthew Wynia, MD, MPHspoke out against it. “It's a terrible idea to try to legislate medical practice.” says Wynia.

    “This misrepresentation will serve to mislead or coerce patients who want to ‘undo’ a medication abortion to participate in an unethical experiment without their knowledge,” Wynia wrote in a declaration filed in a lawsuit seeking to stop the law. “For physicians who are forced to deliver a misleading and inaccurate message that might cause their patients to enroll in an experiment without their full knowledge, doing so is highly unethical.”
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  • Program Merges Bioethics and Public Health in Search of Justice

    Aug 15, 2023
    CU ANSCHUTZ TODAY: “The laws we have and the laws we don't have… have an enormous impact on who gets sick to begin with. And they determine, literally, who lives and who dies sometimes, and who lives with what degrees of preventable illness." said Daniel Goldberg, JD, PhD, director of education at the Center for Bioethics and Humanities and director of the new Public Health Ethics & Law Program (PHEAL) at the Colorado School of Public Health.

    The experience of living and breathing through a pandemic brought many ethical and legal issues to the forefront, and we have to deal with these as a society in order to try to keep ourselves and the world healthy and protect the most vulnerable. That's why now is precisely the right time for the Colorado School of Public Health and Center for Bioethics and Humanities to launch the Public Health Ethics and Law Program.
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  • Matthew Wynia, MD, MPH delivers keynote address to CU School of Medicine Class of 2027

    Jul 28, 2023
    CU SCHOOL OF MEDICINE WHITE COAT CEREMONY: Matthew Wynia, MD, MPH, FACP Professor, Department of Medicine and Director of the CU Center for Bioethics and Humanities delivered the keynote address to the incoming 184 aspiring physicians, as well as hundreds of family, friends, and faculty who will join them on their journey. Dr. Wynia also was recognized with the 16th Annual Faculty Professionalism Award, which was presented by Abigail Lara, MD, Associate Professor, Department of Medicine Director, Office of Faculty Relations.
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  • Medicine is plagued by untrustworthy clinical trials. How many studies are faked or flawed?

    Jul 18, 2023
    NATURE: Investigations suggest that, in some fields, at least one-quarter of clinical trials might be problematic or even entirely made up, warn some researchers. They urge stronger scrutiny. Lisa Bero, PhD and colleagues acknowledge trustworthiness checks are sometimes unfair to the authors of randomized controlled trials, and exactly what should be checked to classify untrustworthy research, is still up for debate. Bero and a team of research-integrity experts have developed a set of red flags that might serve as the basis for creating a widely agreed method of assessment.
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  • Mitigating bias in AI at the point of care

    Jul 13, 2023
    SCIENCE: Artificial intelligence (AI) shows promise for improving basic and translational science, medicine, and public health, but its success is not guaranteed. Numerous examples have arisen of racial, ethnic, gender, disability, and other biases in AI applications to health care. Co-authors Matthew DeCamp, MD, PhD and Charlotta Lindvall, MD, PhD write that ensuring equity will require more than unbiased data and algorithms. It will also require reducing biases in how clinicians and patients use AI-based algorithms—a potentially more challenging task than reducing biases in algorithms themselves.
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  • Matthew Wynia recognized as one of 11 doctors that are moving medicine forward.

    Jun 10, 2023
    AMERICAN MEDICAL ASSOCIATION: Center Director Matthew Wynia, MD, MPH, received the AMA Foundation Award for Leadership in Medical Ethics and Professionalism. Matt is one of 11 physicians to recieve an Excellence in Medicine Award at the AMA's June, 2023 meeting in Chicago, where he was recognized for his altruism, advocacy and professional skill, The award honors people dedicated to the principles of medical ethics and the highest standards of medical practice and who have made an outstanding contribution through active service in medical ethics activities.

    Dr. Wynia also was named as co-chair, along with Niva Lubin-Johnson, MD, MPH, of a task force to guide organizational transformation within and beyond the AMA toward restorative justice to promote truth, reconciliation, and healing in medicine and medical education.
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  • Instituting Children’s Full Political Participation and Representation in the 21st Century United States

    Jul 12, 2023
    HARVARD HUMAN RIGHTS JOURNAL: As we approach the 100th anniversary of children’s rights, in which the Geneva Declaration of the Rights of the Child stated that humanity “owes to the child the best that it has to give," this commentary by Warren Binford, JD, Ed.M, affirms the U.S. has a moral duty to more fully integrate children into our national priorities and decision-making.

    Children comprised 22.1 percent of the U.S. population in 2020 and yet just 7.4 percent of the federal budget was allocated for their needs. It is only when children are able to fully exercise their political rights that their needs will start to be addressed by a system that too often has dismissed them as merely children, and as a result, under-resourced them and their future.
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