Capturing the lively discussions, presentations, and other events that make up the daily activities of the Markkula Center for Applied Ethics at Santa Clara University.
Medical Amnesty
Thursday, Nov. 5, 2009 4:50 PM
SCU students have been debated whether the campus should institute a medical amnesty policy, which would protect from University punishment anyone who called emergency services for an incident of alcohol poisoning. Kari Kjos, a senior and one of the Center's 2009-2010 Hackworth Fellows, spoke at an event on the subject co-sponsored by the Ethics Center and Associated Students of Santa Clara. Kjos addressed the issue of medical amnesty and responsibility.
Liza Dadiomov, a Psychology and Environmental Studies major and an Urban Education minor at Santa Clara University, has been named the 2009-2010 Environmental Ethics Fellow at the Markkula Center for Applied Ethics. Dadiomov is vice president of the Green Club and an Environmental Education Intern at the Ulistac Natural Area in the South Bay. For her fellowship project, she will be conducting a survey of the culture of sustainability among SCU students, staff, and faculty. She is from Redmond, Wash.
The ethical aspects of space exploration were the topic of a fascinating panel on "Challenges Raised by Life in Space," sponsored last week by the Ethics Center. (podcast) Panelist Margaret Race, principal scientist at the SETI Institute, introduced the topic of "planetary protection," and the necessity of avoiding "forward contamination"--that is bringing earth's potentially damaging microbes to a new planet--and "backward contamination"--introducing life forms from other planets to Earth
Christopher McKay, planetary scientist from the Sapce Science Division, NASA Ames, focused his remarks on Mars and asked the audience to consider the moral status of alien life forms and the intrinsic worth of the richness and diversity of life
Center Bioethics Director Margaret McLean offered a set of principles which might inform our explorations including:
1) Space Preservation
2) Space Conservation
3) Space Sustainability
4) Space Stewardship
5) Respect for the "truly other other"
Blueshield of California CEO Bruce Bodaken will offer his take on the health care reform debate at a presentation Nov. 5. Bodaken is a distinguished visiting scholar at the Center this fall. He will discuss his proposal for universal coverage based on shared responsibility.
Jonathan Zittrain got a lot of people thinking about crowdsourcing and its ethical ramifications at a talk he gave last week, "Minds for Sale: Ubiquitous Human Computing and the Future of the Internet." A summary of his talk is available here.
Courtney Meehan, a 2009-10 Hackworth Fellow at the Center and SCU senior, commented on the presentation on her blog, The Technological Citizen, as did Eric Goldman, director of the University's High Tech Law Institute, on his Technology and Marketing Law Blog.
The event was co-sponsored by the High Tech Law Institute and the Center for Science, Technology, and Society.
Rich Benjamin, author of Searching for Whitopia: An Improbable Journey to the Heart of White America, told an Ethics at Noon audience today about his 27,000 mile journey around the United States to study the migration of white Americans to primarily white communities. Benjamin visited St. George, Utah; Coeur D'Alene, Idaho; and Forsyth County, Geogia, representatives of primarily white towns that have grown at least 6 percent since 2000. (podcast)
This month, the Ethics Center co-sponsored an event, "Health Care Reform: Have 20-somethings Been Left Behind?" which gave SCU undergraduate and graduate students a chance to explore how various reform proposals might affect them personally.
One of this year's Hackworth Fellows, Kari Kjos, was a panelist for the event and took the opportunity to reflect on the potential impact of reform on the career she hopes to have as a physicians. Here's an excerpt from her remarks:
Yet as I am on the brink of applying to medical school this June, there are huge changes underway in the health care system. Often, when I hear about aspects of this reform, I think about how the health care overhaul will affect me, as a future physician, and alter the very nature of the physician/patient relationship. One key aspect of health care reform is cost control. In 2008, America spend $2.4 trillion in health care. To put that in perspective, that is 1/6 of our national economy. As already enormous health care costs are increasing faster than inflation, cost containment features must become a prominent role in all clinical practices.
Congress has already allocated money to invested money into cutting health care costs. Over $1 billion of the $787 billion stimulus bill passed in February was granted to government sponsored research into the “comparative effectiveness” of various medical treatments. Comparative effectiveness is research comparing different interventions and strategies to inform patients, providers, and decision makers about which interventions are most effective for which patients under their specific circumstances by assessing a comprehensive array of health related outcomes for diverse patient populations. This research will likely give doctors valuable information, but may also be used to mandate which medical treatments are “cost effective.” A parallel comparative-effectiveness agency in Britain uses their research to classify cost-effective medical treatments, and regularly denies innovative medicines due to expense.
So, how will this proposal affect doctors, and influence my ability to meet my ideal as a physician? For instance, to what extent will this research allow doctors and patients to make their own decisions in each particular case as to what they think works best, and to what extent will this research create constraints on these individual choices? Moreover, will comparative effectiveness research be able to capture the inherent individuality and clinical nuances in patient cases? As doctors are forced to look at the economics of health care, they face new ethical challenges. They must acknowledge that the “opportunity cost” of improving one person’s health might decrease the health of another person due to reduced available resources. Physicians will be forced to act as “double agents,” balancing their vying allegiances to their patients’ medical needs with the monetary costs to society.This duality may undermine the physician’s fiduciary responsibility to the patient, and change the nature of the physician-patient relationship which is built on trust, respect, and honesty.
As health care reform is debated on the Hill, I believe it is important to keep track of how these changes to the health care system will impact the role of physicians, and ultimately the physician/patient relationship.
Santa Clara University alumni from the class of 1925 to the class of 2009 will be attending a Grand Reunion on campus this weekend, and many of them will attend the Ethics Center presentation, "Ethical Dilemmas Confronting SCU Students Today."
The event features three students and three staff members from the Ethics Center commenting on a set of cases that illustrate some issues the older alumni may not have confronted in their years at the University. One example is "Poster Wars":
Mary lives in a college dorm and displays a poster on her door with the text of California Proposition 8: “Only marriage between a man and a woman is valid or recognized in California.”She had supported the successful “Yes on 8” campaign in the 2008 election.James, her dorm neighbor, finds this poster offensive and demands Mary take it down.He worked for the defeat of the measure, which he feels is homophobic and discriminatory.To Mary, the poster is an expression of her beliefs and identity, and she does not think she should have to remove it.
Should Mary take the poster down?Should the dorm director force her to take it down?
Jonathan Zittrain, co-founder of the Berkman Center for Internet & Society, talks about "Ubiquitous Human Computing," Oct. 19, at Santa Clara University.
Zittrain is a professor of law at Harvard University/ His research includes digital property, privacy, and speech, and the role played by private "middlepeople" in Internet architecture.
A new blog offering ethical reflections on modern technology, The Technological Citizen is the brainchild of SCU senior and Hackworth Fellow Courtney Meehan. Keyed to issues that are raised in SCU classes, the blog has already sparked lively discussion on the Internet's effect on deep reading and whether it is ethical for employers to factor in online profiles in hiring decisions.
Is it ever all right to lie, especially in government? Peter Minowitz, SCU professor of economics, has just published a new book, Straussophobia, on political philosopher Leo Strauss and his critics.
Minowitz was recently interviewed for Harper's magazine on some of the issues riased in the book. One question posed by the magazine was this:
"In an interview, the late Irving Kristol stated he was deeply indebted to Leo Strauss for an understanding of the “noble lie.” “There are different kinds of truths for different kinds of people,” he said. “There are truths appropriate for children; truths that are appropriate for students; truths that are appropriate for educated adults; and truths that are appropriate for highly educated adults, and the notion that there should be one set of truths available to everyone is a modern democratic fallacy. It doesn’t work.”
Minowitz recently led the Center's Emerging Issues Group in a discussion of this idea. (podcast)
Universities like Santa Clara have plans in place to address the possibility of a swine flu outbreak on campus. Center Director of Bioethics Margaret McLean talks about what individuals and church communities can do to prepare in this article, written for "The Valley Catholic" and "The Catholic Herald."
Health Care Reform: Have 20-somethings Been Left Behind?
Friday, Oct. 2, 2009 3:11 PM
Kari Kjos, a 2008-09 Hackworth Fellow at the Ethics Center, will be one of the speakers at Health Care Reform: Have 20-somethings Been Left Behind?, a program of the Santa Clara University School of Law and the National Coalition on Health Care, co-sponsored by the Ethics Center. The event is scheduled for Oct. 8, 4-6 p.m. on the SCU campus.
Kjos, a biochemistry major and economics minor at SCU, hopes to pursue a career in medicine and will address the question from the point of view of a potential health care provider. Other students, as well as public officials and health care advocates will also speak. The closing address will be given by Health Law Professor and Center Scholar Michelle Oberman.
The Ethics Center is very sad to be losing our associate director of Health Care Ethics, Sr. Joan Marie Steadman, who leaves the University to assume the presidency of the Sisters of the Holy Cross.
Filling in for the leadership of the Health Care Ethics Internship Program, which Sr. Joan had supervised, will be two old friends of the Center. The interim coordinator position will be assumed by Karen Peterson-Iyer, who has been our health care ethics program specialist. The interim program administrator will be Anna Kozas, herself a graduate of the program.
Many elected and appointed officials are involved in community service long before they enter public life. Serving as a volunteer or officer of a non-profit or public benefit organization is often what leads these individuals into political life.
But membership in the Rotary Club, volunteering for Little League of Habitat for Humanity, or serving on the board of the Chamber of Commerce can create ethical dilemmas for both the public official and the agency.
At the recent annual conference of the League of California Cities, “Successfully Serving as a City Council Member and Non-profit Board Member” was a breakout session generating a large audience and active discussion.
A three-member panel led the session: Robin Lowe, City Councilmember from the City of Hemet (and new president of the League of California Cities); Eric Vail, City Attorney for the cities of Hemet and Temple City, and Judy Nadler, Senior Fellow in Government Ethics at the Markkula Center for Applied Ethics.
After presenting the Ethics Center’s “Framework for Making an Ethical Decision,” Nadler emphasized the importance of considering the appearance of a conflict, not just relying on the city attorney’s interpretation of the law. “The law is the floor, not the ceiling,” she said, “and public servants should aspire to exceed what is simply required by an ordinance or ethics code.
Center Executive Director Kirk O. Hanson returned this week from a conference of state legislators, "Doing the Right Thing: Restoring Institutional Integrity and Regaining Public Trust."
Hanson offered a session on "A Framework for Thinking Ethically in Government." He took participants through several cases developed by Center Senior Fellow in Government Ethics Judy Nadler. Much of the discussion focused on making budget decisions in an ethical way.
As a Hackworth Fellow at the Ethics Center last year, Noelle Lopez focused on the issue of social justice and how it is defined and acted on within the SCU community. As a final project, Lopez created a set of questions to spark dialogue about the what the University means creating an educational environment with a commitment "to fashioning a more humane and just world." Lopez is now on at Oxford University as a Rhodes Scholar.
Controversy about a provision in the health reform plan to pay physicians for advance care planning sessions was so fierce that the proposal is no longer being considered as part of the final package. But advance care planning is frequently a part of end-of-life decision making for Catholic clergy and religious.
A recent op-ed in the Washington Post by Richard Cohen, "Torture's Unanswerable Questions," was the focus of today's meeting of the Center's Emerging Issues Group. The group focused on the "ticking bomb" scenario Cohen presents and discussed whether this is the right approach to the moral issues behind torture. Podcast
The Center's quarterly Government Ethics Roundtable focused recently on conflicts that arise when officials also volunteer for or serve on the boards of non-profit institutuions. Cases and responses on that issue are online.
Medical Amnesty
