Mar 8, 2022

ANNALS OF INTERNAL MEDICINE: When a detained person refuses food, their medical team faces ethical challenges. Center Director Matthew Wynia, MD, MPH and co-authors affirm that hunger strikes by immigrants and asylum seekers are constitutionally protected, nonviolent protests of last resort, which occur with remarkable frequency (2,500 during the first 6 months of the pandemic) in ICE detention facilities. Medical care in private prisons operated by GEO Group illustrate disregard for the ethical standards, by using force-feeding for punitive rather than medical reasons. Wynia says force-feeding and other involuntary medical procedures on people who choose to undertake hunger strikes should stop, and health care professionals.
Medpage Today also interviewed Dr. Wynia about this topic and article.

Mar 1, 2022

MEDICAL ETHICS ADVISOR: Most physicians are willing to talk with patients about medical aid in dying (MAiD) but fewer are willing to serve as an attending or consultant, according to a survey of more than 500 Colorado physicians, conducted by Eric G. Campbell, PhD and co-authors.
“Given that MAiD almost universally occurs outside of the inpatient setting, and given that ethics consults are almost universally within the inpatient setting, there’s a need for someone to provide ethical guidance to MAiD. “Education needs to be unbiased and should not be colored by entrenched beliefs about the acceptability, or lack thereof, of medical aid in dying.”

Feb 11, 2022

AMERICAN MEDICAL ASSOCIATION: In a recent CDC webinar, “Ethics and Equity in Crisis Standards of Care,” Matthew Wynia, MD, MPH, underscored how complicated—and imperfect—medical ethics can be during disaster response. “This is why ethical dilemmas arise—because you have a circumstance in which you cannot optimize all of your key ethical principles,” Dr. Wynia said. “You have to pick some that are going to exceed the value of others.” For example, equity is important—even when trying to maximize the number of lives saved. In the rollout of vaccines, public health authorities sometimes prioritized older populations over people who have been historically marginalized.

Feb 9, 2022

CU ANSCHUTZ TODAY: Christine Baugh, PhD, MPH, studies the risk for and outcomes of traumatic brain injury in football. “In the lab I’ve worked with people suffering from longer-term effects of traumatic brain injury. What’s emerged is that in addition to improving individual health outcomes, we also need to think about this from a population and policy level,” she says. “We need to be asking what we can do to reduce the negative effects of this game?"
Football participation and its potential for long-term injury also exacerbate existing health disparities, if schools in lower-income areas don’t have the resources to hire trainers or other health professionals to work with athletes. “Or, it may be a situation where football is the primary way to have your child in an activity after school until you finish your job,” Baugh says. “You want them to do something that’s safer than alternatives that aren’t sanctioned by the school, but then they’re exposed to risk for injury. ”Baugh emphasizes that she and other researchers balance evidence with pragmatism, knowing that people aren’t going to suddenly stop playing or loving football, “so we’re asking how we can leverage this growing awareness of risk to make the game safer,” she says. “How can we improve outcomes for athletes across all levels of play?”

Jan 6, 2022

JOURNAL OF ADVANCED NURSING: Quinn Grundy, PhD, RN and co-authors conducted a global analysis of sponsorship of national nursing professionals associations and their major conferences. They found sponsorship is concentrated in North America and Europe and among specialties that have a high rate of technology adoption. Notable was that the medical device industry has a much stronger presence than the pharmaceutical industry, which does show up strongly among oncology associations.

Jan 27, 2022

DENVER GAZETTE: "One key lesson from the pandemic is that states should have criteria they follow that would automatically prompt the issuance of (crisis standard) guidance, rather than hoping that the Governor will recognize a crisis in time and have the political will to act on it," said Center Director Matthew Wynia, MD, MPH. "We’ve seen over and over that most governors won’t."

Jan 28, 2022

COLORADO PUBLIC RADIO: “Medical aid in dying was enacted a few years ago, and it's one of the most contentious health policy and bioethics issues,” said CBH Research Director Eric G. Campbell, PhD. Campbell and colleagues surveyed 300 Colorado physicians, revealing that while an overwhelming majority of physicians were willing to refer patients for MAiD, less than half (48 percent) were willing to act as a consulting physician. And only 28 percent were willing to act as an attending physician.
A key finding from the respondents was a lack of knowledge. That was followed closely by concerns about emotional and time investment. “One of the conclusions of our research is that there's a need for physician education," Campbell said.

Jan 25, 2022

The CUT: "Western cultures have long been obsessed with the idea of other people malingering," says Daniel Goldberg, JD, PhD, a public-health ethicist and faculty at the Center for Bioethics and Humanities. "This fixation on separating “real” suffering from “fake” has led doctors, psychotherapists, policymakers, and even friends and family to dismiss the reality of others’ chronic pain, especially when it has afflicted women, children, the elderly, the poor, and people of color."

Jan 25, 2022

CALIFORNIA NEWS TIMES: Daniel Goldberg, JD, PhD explains, “The stigma is upstream, a structural phenomenon, caused by the same kind of thing that promotes structural inequality throughout our society. Things like racial and gender discrimination, class discrimination and disability discrimination-all these kinds of things that generally promote inequality also promote stigma.“

Jan 20, 2022

THE ATLANTIC: “It’s an understandable response out of frustration and anger, and it is completely contrary to the tenets of medical ethics, which have stood pretty firm since the Second World War,” said Matthew Wynia, Director of the Center for Bioethics and Humanities. “We don’t use the medical-care system as a way of meting out justice. We don’t use it to punish people for their social choices.”
Historian, ethicist and CBH Associate Professor Daniel Goldberg, JD, PhD concurs, "It is a fundamental principle of modern medicine that everyone has an equal claim to relief from suffering, no matter what they’ve done or haven’t done,”

Jan 19, 2022

NATIONAL INSTITUTES OF HEALTH: Each year, The NIH Office of Disease Prevention recognizes one early-career prevention scientist who has made outstanding research contributions to their respective field and is poised to become a future leader in prevention research.
Christine Baugh, PhD, MPH is th 2022 ODP Awardee.. Dr. Baugh is an Assistant Professor at the Center for Bioethics and Humanities. She conducts multidisciplinary research at the intersection of health, policy, ethics, and sport. Much of her work focuses on the primary, secondary and tertiary prevention of concussions and other sports injuries. Dr. Baugh is the author of 70 peer-reviewed research articles that have been collectively cited over 8,000 times in literature

Jan 13, 2022

STAT: Harvard researcher and CBH collaborator Lisa I. Iezzoni, studies health care disparities for people with disability. In this First Opinion, Dr. Iezzoni shares her personal experiences of feeling dissatisfied, not recieving the same quality health care as people without disability. Her recent research in Health Affairs, co-authored by Eric G. Campbell and Julie Ressalam, found that just 56.5% of doctors strongly agreed that they welcomed patients with disabilities into their practices, and only 40.7% of doctors surveyed reported feeling very confident about their ability to provide the same quality of care to patients with disabilities.

Jan 10, 2022

WASHINGTON POST: Intensive care units are full and regular hospital floors are “bursting at the seams” as people stream into emergency departments. But not all cases that arrive are true emergencies. Center Director Matthew Wynia, MD, MPH, who helped write Colorado's crisis standards of care said, “What’s changed is EMS can now come and say, ‘You know, we’d normally bring you into the emergency department, but you don’t meet the criteria given the current surge.' Patients with less-urgent needs may be taken to urgent-care centers and other alternative sites when appropriate, according to the guidelines."

Jan 14, 2022

THE OREGONIAN: “It’s human nature that people don’t want to acknowledge that terrible things are happening,” said Dr. Matthew Wynia, Director of the Center for Bioethics and Humanities. “Particularly in a competitive system, you’re not going to have one of them say, ‘Look we’re harming patients right now because we’re overwhelmed.’ Everyone ends up saying we’re close but we’re not hurting anyone yet, when in fact patients are being hurt right now.”

Jan 11, 2022

NATURE: CBH Senior Scientist, Lisa Bero, PhD, suggests universities, journals and publishers should implement data checks sooner rather than later. This means sharing information as well as technical resources, such as expertise in statistical and software tools to detect anomalies. They must also make fraud-detection tasks routine. Too often, investigations focus on pinning down blame, or sweeping misconduct under the rug. Only through a widespread community effort can we ferret out fraud.

Jan 11, 2022

JOURNAL OF GENERAL INTERNAL MEDICINE: Eric G. Campbell, Matthew DeCamp, Hilary Lum and co-authors surveyed 543 physicians to understand the experiences and perspectives of MAiD providers in Colorado. Their findings show that while those who have participated in MAiD largely report the experience to be emotionally fulfilling and professionally rewarding, both those who have participated and those who have not report several critical barriers to participation, especially around clinical knowledge, time and emotional investments, and professional ethics concerns.

Jan 6, 2022

NEW YORK TIMES: There is a greater menu of Covid pills and infusions now than at any point in the pandemic. The problem is that the supplies of those that work against the Omicron variant are extremely limited. Unvaccinated people are at far greater risk of hospitalization or death from Covid. But giving them priority access to treatments leaves people feeling “like you are rewarding intransigence,” said Center Director Dr. Matthew Wynia.

Dec 28, 2021

AMA JOURNAL OF ETHICS: Why Does Medical Participation in the Holocaust Still Matter? by Tessa Chelouche, MD and Matthew K. Wynia, MD, MPH, was the 6th most read article in the AMA Journal of Ethics Top Ten of 2021. The #6, #7 and #8 most read articles all were from the January 2021 issue, "Legacies of the Holocaust in Health Care."

Jan 4, 2022

HEALTH AFFAIRS: Lisa I. Iezzoni, Eric G. Campbell, Julie Ressalam and co-authors surveyed of 714 US physicians in outpatient practices, 35.8 percent reported knowing little or nothing about their legal responsibilities under the ADA, 71.2 percent answered incorrectly about who determines reasonable accommodations, 20.5 percent did not correctly identify who pays for these accommodations, and 68.4 felt that they were at risk for ADA lawsuits.

Jan 3, 2022

AMERICAN JOURNAL OF BIOETHICS: Authors Rachel Fabi and Daniel S. Goldberg contend that bioethics funders’ focus on genetics, genomics, neuroethics, and the ethics of other emerging technologies disproportionately harms People of Color, who are more likely to experience inequities in health care and the social determinants of health. Neglecting to fund bioethics research into questions of population health in favor of flashier topics means that ethical questions about the root causes of, for instance, the egregiously high rates of maternal mortality among Black women in the United States are less fundable and therefore less likely to receive scholarly attention. They conclude that our community must endeavor to lift up the voices of those most affected by health inequities, including through community-based participatory research and other methods that bring to the fore the lived experiences of the victims and survivors of social injustice.