Mara Buchbinder to speak at the National Academies of Medicine Workshop on Physician-Assisted Death

Physician-Assisted Death: Scanning the Landscape and Potential Approaches– A Workshop February 12–13, 2018 National Academy of Sciences Building 2101 Constitution Avenue NW, Washington, DC This National Academies of Sciences, Engineering, and Medicine workshop will explore the evidence base and research … Continued

New Visiting Scholar: Matthias Eggel

The UNC Center for Bioethics would like to welcome our new Visiting Scholar from the University of Zurich, Institute for Bioethics, Matthias Eggel. Dr. Eggel will be with us from January 16 – March 10, 2018. Currently, Dr. Eggel is … Continued

Serial Participation and the Ethics of Phase 1 Healthy Volunteer Research

Rebecca L. Walker, Marci D. Cottingham, Jill A. Fisher
The Journal of Medicine and Philosophy
January 12, 2018

Phase 1 healthy volunteer clinical trials—which financially compensate subjects in tests of drug toxicity levels and side effects—appear to place pressure on each joint of the moral framework justifying research. In this article, we review concerns about phase 1 trials … Continued

The Ethics of General Population Preventive Genomic Sequencing

Rights and Social Justice

Clair Morrissey, Rebecca L. Walker
The Journal of Medicine and Philosophy
January 12, 2018

Advances in DNA sequencing technology open new possibilities for public health genomics, especially in the form of general population preventive genomic sequencing (PGS). Such screening programs would sit at the intersection of public health and preventive health care, and thereby … Continued

Brandy Elsenrath, our new Center Coordinator

The UNC Center for Bioethics would like to welcome our new Center Coordinator, Brandy Elsenrath, starting with us on January 8. Brandy started working at UNC-CH in 1999. She has held positions within the UNC School of Medicine, UNC Property … Continued

New Clinical Ethics MS4 Elective for Spring 2018

A new clinical ethics elective joins the TEC Individualization Phase curriculum this spring. It offers medical students an opportunity to focus their interests in clinical ethics on a particular practice area, using mentorship, scholarly readings, and practical experience with the hospital ethics committee … Continued

Of Pain and Childbirth

Anne Drapkin Lyerly
Narrative Inquiry in Bioethics
2017

Childbirth is often understood as a paradigmatically “happy” event where good outcomes are expected and the process anticipated as a reason for celebration. Yet the narratives in this volume reflect sadness and grief, even when a healthy child is born. … Continued

2nd Annual HIV Cure Research Day

The Durham County Board of Commissioners and the state of North Carolina officially proclaimed December 14, 2017 as HIV Cure Research Day. This is the second year celebrating the official proclamation of HIV Cure Research Day. Dr. Allison Mathews, founder … Continued

Ethical Considerations in Developing an Evidence Base for Pre-Exposure Prophylaxis in Pregnant Women

Kristen A. Sullivan, Anne D. Lyerly
Reproductive Health
December 14, 2017

Though many women in need of access to HIV preventive regimes are pregnant, there is a dearth of data to guide these care decisions. While oral pre-exposure prophylaxis (PrEP) has been shown to prevent HIV infection in numerous high-risk populations, … Continued

Genomic Screening: What’s Age Got To Do With It?

Harvard Law Bill of Health Blog Margaret Waltz, PhD R. Jean Cadigan, PhD Anya E. R. Prince, JD, MPP Debra Skinner, PhD Gail E. Henderson, PhD Age is an important consideration in medical screening, but calls for population based preventive … Continued

Traditional, Complementary, and Alternative Medical Cures for HIV

Rationale and Implications for HIV Cure Research

Xin Pan, Alice Zhang, Gail E. Henderson, Stuart Rennie, Chuncheng Liu, Weiping Cai, Feng Wu, Joseph D. Tucker
Global Public Health
December 13, 2017

Traditional, complementary, and alternative medicine (TCAM) has been used by some people living with HIV (PLHIV) in an attempt to cure HIV. This article reviews the main factors influencing their decision to choose TCAM to cure HIV and discusses implications … Continued

Prince and Davis Article Honored by JOTWELL

The Journal of Things We Like A lot (JOTWELL), a compendium of law review articles designed to select and recognize the best recent academic legal literature, has honored former C:B trainee Anya Prince and C:B faculty member Arlene Davis by … Continued

ELSI 2.0 meetings in Kyoto, Nov. 13-16, 2017

Eric Juengst participated in two workshops on behalf of the ELSI 2.0 International Collaboratory for Genomics and Society Research in Kyoto, to discuss cross-cultural perspectives on clinical genomic sequencing, research data-sharing, and dynamic consent, with colleagues from Japan, Australia, Singapore, … Continued

Dr. Stuart Rennie Presents Paper at 2nd Annual Kenya Bioethics Society conference

In a recent trip to Kenya, Professor Stuart Rennie visited the capital city of Nairobi with the purpose of participating in and presenting a paper at the 2nd Annual Kenya Bioethics Society conference. The paper was entitled ‘Perceptions of benefit among … Continued

Ethical Inclusion of Pregnant Women in the HIV/AIDS Research Agenda workshop in Bangkok

In November 2017, the Pregnancy and HIV/AIDS: Seeking Equitable Study (PHASES) project convened an international workshop in Bangkok, Thailand to address ethical issues in the inclusion of pregnant woman in HIV/AIDS research. This one-day series facilitated sessions and discussions in … Continued

Research on HIV Cure

Mapping the Ethics Landscape

Karine Dubé, Laurie Sylla, Lynda Dee, Jeff Taylor, David Evans, Carl Dean Bruton, Adam Gilberston, Lisa Gralinski, Brandon Brown, Asheley Skinner, Bryan J. Weiner, Sandra B. Greene, Amy Corneli, Adaora A. Adimora, Joseph D. Tucker, Stuart Rennie
PLoS medicine
December 8, 2017

In an essay, Karine Dubé and coauthors discuss the ethics of preclinical and clinical studies relevant to achieving an HIV cure.

Age and Perceived Risks and Benefits of Preventive Genomic Screening

Margaret Waltz, R. Jean Cadigan, Anya E. R. Prince, Debra Skinner, Gail E. Henderson
Genetics in Medicine
December 7, 2017

PurposeAs genome sequencing moves from research to clinical practice, sequencing technologies focused on “medically actionable” targets are being promoted for preventive screening despite the dearth of systematic evidence of risks and benefits and of criteria for selection of screening subjects. … Continued

CEDG and HEC Welcome Kelly Olsen and Austin Bath

Kelly Olsen and Austin Bath will join the Clinical Ethics Discussion Group as student leaders, and Hospital Ethics Committee as student members, in January 2018. Center for Bioethics faculty members Arlene Davis and Eric Juengst are advisors to the student group … Continued

Ethics of Treatment Interruption Trials in HIV Cure Research

Addressing the Conundrum of Risk/Benefit Assessment

Gail E. Henderson, Holly L. Peay, Eugene Kroon, Rosemary Jean Cadigan, Karen Meagher, Thidarat Jupimai, Adam Gilbertson, Jill Fisher, Nuchanart Q. Ormsby, Nitiya Chomchey, Nittaya Phanuphak, Jintanat Ananworanich, Stuart Rennie
Journal of Medical Ethics
November 10, 2017

Though antiretroviral therapy is the standard of care for people living with HIV, its treatment limitations, burdens, stigma and costs lead to continued interest in HIV cure research. Early-phase cure trials, particularly those that include analytic treatment interruption (ATI), involve … Continued

Online Education and E-Consent for GeneScreen, a Preventive Genomic Screening Study

R. Jean Cadigan, Rita Butterfield, Christine Rini, Margaret Waltz, Kristine J. Kuczynski, Kristin Muessig, Katrina A. B. Goddard, Gail E. Henderson
Public Health Genomics
November, 2018

BACKGROUND: Online study recruitment is increasingly popular, but we know little about the decision making that goes into joining studies in this manner. In GeneScreen, a genomic screening study that utilized online education and consent, we investigated participants’ perceived ease … Continued

Responsible Care in the Face of Shifting Recommendations and Imperfect Diagnostics for Zika Virus

Ilona Telefus Goldfarb, Elana Jaffe, Anne Drapkin Lyerly
JAMA
October 30, 2017

The US Centers for Disease Control and Prevention (CDC) recently released updated interim guidance for when pregnant women should receive serologic testing for the Zika virus. The circumstances within which these recommendations emerge are complex: the public concern about the … Continued

Center for Bioethics Intramural Faculty Workshop (at the beach!)

On September 18-21, 2017, the C:B faculty decamped to Emerald Isle,  NC,  for three days of intellectual engagement with each other’s work in progress.   Participants submitted manuscripts in advance and, after a “reading day” on Thursday, spent Friday and Saturday … Continued

Wylie Burke, MD., Ph.D., Delivers 2017 UNC Merrimon Lecture

The Center was honored to host Wylie Burke, MD, Ph.D., Emeritus Professor and former Chair of the University of Washington Department of  Bioethics and Humanities, as our 2017 Merrimon Lecturer,  the School of Medicine’s oldest and most prestigious endowed lectureship.,  … Continued

From Fantasy to Reality

Managing Biomedical Risk Emotions In and Through Fictional Media

Marci D Cottingham, Jill A Fisher, Marci D. Cottingham, Jill A. Fisher
Health, Risk & Society
October, 2017

In this article, we explore the role that fictional media (film and television) play in evoking and managing collective and individual anxieties towards biomedical research. We draw on two data sets: fictional media depictions of human research subjects and interviews … Continued

Center for Bioethics Trainees Enhance ASBH 2017 Program

UNC C:B trainees and former fellows were ubiquitous at the 19th Annual Meeting of the American Society for Bioethics and Humanities in Kansas City on Oct. 18-22! Their contributions included: Elana Jaffe, BA participated in a “Forging a New Paradigm for Public Health Emergency Research that Includes Pregnant … Continued

Current Second Year Medical Student Electives by C:B faculty members

This semester UNC Center for Bioethics faculty members Stuart Rennie, Jill Fisher, Mara Buchbinder, and Eric Juengst are all teaching Advanced Seminars in the Humanities and Social Sciences for MS2 students in the UNC School of Medicine. These seminars offer … Continued

HIV Cure Research Community Engagement in North Carolina

A Mixed-Methods Evaluation of a Crowdsourcing Contest

Allison Mathews, Samantha Farley, Meredith Blumberg, Kimberley Knight, Lisa Hightow-Weidman, Kate Muessig, Stuart Rennie, Joseph Tucker
Journal of Virus Eradication
October 1, 2017

Objectives The purpose of this study was to evaluate the feasibility of using a crowdsourcing contest to promote HIV cure research community engagement. Methods Crowdsourcing contests are open calls for community participation to achieve a task, in this case to … Continued

Ethics, Pregnancy, and ZIKV Vaccine Research and Development

The Ethics Working Group on ZIKV Research and Pregnancy

Anne D. Lyerly, Ruth R. Faden, Carleigh B. Krubiner, Margaret O. Little, Allison August, Richard H. Beigi, Anna P. Durbin, Ruth A. Karron, Nancy E. Kass, Florencia Luna, Ricardo Palacios, Alexander Roberto Precioso, Carla Saenz, Jeanne S. Sheffield, Beatriz Thomé
Vaccine
October 19, 2017

The rapid spread of the Zika virus (ZIKV) has galvanized the global public health community toward development of ZIKV vaccines. The most dire consequence of ZIKV infection, Congenital ZIKV Syndrome (CZS), results from infection during pregnancy. As a consequence, pregnant … Continued

The Ethics of Public Policy RCTs

The Principle of Policy Equipoise

Douglas MacKay
Bioethics
October 11, 2017

In this article, I ask whether a principle analogous to the principle of clinical equipoise should govern the design and conduct of RCTs evaluating the effectiveness of policy interventions. I answer this question affirmatively, and introduce and defend the principle … Continued

The Paywall as Metaphor and Symptom

Stuart Rennie, Keymanthri Moodley
The American Journal of Bioethics
October, 2017

Chattopadhyay and colleagues basically present two lines of argument in regard to access to bioethics journals by those working in this field in low- and middle-income countries (LMICs). The first is a harm-based argument: poor access to bioethics literature in … Continued

Perceptions of Equipoise, Risk-Benefit Ratios, and “Otherwise Healthy Volunteers” in the Context of Early-Phase HIV Cure Research in the United States

A Qualitative Inquiry

Karine Dubé, Lynda Dee, David Evans, Laurie Sylla, Jeff Taylor, Brandon Brown, Veronica Miller, Amy Corneli, Asheley Skinner, Sandra B. Greene, Joseph D. Tucker, Stuart Rennie
Journal of empirical research on human research ethics: JERHRE
October 1, 2017

Early-phase HIV cure research is conducted against a background of highly effective antiretroviral therapy, and involves risky interventions in individuals who enjoy an almost normal life expectancy. To explore perceptions of three ethical topics in the context of HIV cure … Continued

Mara Buchbinder Receives Hettleman Award

Four highly promising Carolina faculty members in diverse fields have been awarded the Philip and Ruth Hettleman Prizes for Artistic and Scholarly Achievement by Young Faculty. The recipients, who were recognized at the Sept. 8 Faculty Council meeting, are: Mara … Continued

Healthy Volunteers as Model Organisms

Comparative Research Ethics and Policy for Phase I Trials Principal Investigators: Jill A. Fisher and Rebecca L. Walker This project addresses the need for a novel evidence-based approach to the protection of Phase I healthy volunteers. Phase I clinical trials test … Continued

Surgery in Shackles

What Are Surgeons’ Obligations to Incarcerated Patients in the Operating Room?

Sara Scarlet, Elizabeth Dreesen
AMA Journal of Ethics
September, 2017

Incarcerated patients frequently require surgery outside of the correctional setting, where they can be shackled to the operating table in the presence of armed corrections officers who observe them throughout the procedure. In this circumstance, privacy protection—central to the patient-physician … Continued

History of the Merrimon Lecture

“What I have in mind may be briefly expressed. To give to medical students and others interested an insight in the history, traditions, philosophy and ethics of medicine. To help restore, in some degree, a sense of responsibility to medicine’s … Continued

Clinical Ethics Discussion Group CEDG Launches a New Academic Year

Drew Cutshaw and Keren Eyal, second year medical students who are members of the Hospital Ethics Committee and leaders of the Clinical Ethics Discussion Group, launched a new academic year for CEDG at the 2017 Student Activities Fair. More than … Continued

Stellenbosch Bioethics Leadership Program Selects First Trainees

The Stellenbosch Bioethics Leadership Program has selected it’s first trainees. Dr Geremew T. Tsegaye has a doctoral degree in medicine (MD). He specialized in public health (MPH) and bioethics (EMMB) and advance Research Ethics. Dr Theresa Burgess started her career … Continued

Ethics of HIV-Related Research Involving Adolescents in Kenya

Despite the high social value of adolescent HIV prevention research in sub-Saharan Africa, investigators are reluctant to involve adolescents in studies with HIV testing and disclosure of results because of ethical concerns about the risks of their participation. This study … Continued

Preoperative Communication Promotes Opioid Stewardship

Sara Scarlet, Christopher F. Mcnicoll, Christina Colosimo, Edward S. Shipper, Heather J. Logghe, John C. Hardaway
Bulletin of the American College of Surgeons
August 2, 2017

Strategies for improving communication at the preoperative stage are summarized, and the role of informed consent in opioid stewardship is described.

Penile Transplantation as an Appropriate Response to Botched Traditional Circumcisions in South Africa

An Argument Against

Keymanthri Moodley, Stuart Rennie
Journal of Medical Ethics
July 29, 2017

Traditional male circumcision is a deeply entrenched cultural practice in South Africa. In recent times, there have been increasing numbers of botched circumcisions by untrained and unscrupulous practitioners, leading to genital mutilation and often, the need for penile amputation. Hailed … Continued

Exploring Moral Distress Within the Context of Our Health Care System

This study employs survey, focus group and interview data to examine moral distress among clinicians. Moral distress was first described within the context of nursing in the 1980s as a situation in which “one knows the right thing to do, … Continued

Using Simulation to Assess Ethical Skills in the Context of ACGME Residency Milestones

This project is funded through an AHEC Campus Innovation Grant and is a collaborative project by members of the Center for Bioethics, the Hospital Ethics Committee, and the School of Medicine’s Clinical Skills and Patient Simulation Center. It uses simulation to assess ethical skills as … Continued

Weighing Obligations to Home Care Workers and Medicaid Recipients

Paul C. Treacy, Douglas MacKay
Nursing Ethics
July 25, 2017

In June 2016, a US Department of Labor rule extending minimum wage and overtime pay protections to home care workers such as certified nursing assistants and home health aides survived its final legal challenge and became effective. However, Medicaid officials … Continued

Izzy Brassfield

Izzy Brassfield is a student in UNC’s MD-PhD program who just completed her second year of graduate school in the philosophy department. She first became involved with the Center for Bioethics as a medical student in the summer of 2013, … Continued

Rohit Jaswaney

Rohit Jaswaney is a second year medical student at New York Medical College interning with UNC’s Center for Bioethics and Department of Social Medicine for the summer of 2017. Rohit received his bachelor’s degree in Biology at Washington University in … Continued

Sara Scarlet Awarded American College of Surgeons Surgical Ethics Fellowship

We are proud to announce that Sara Scarlet, MD a fourth year UNC general surgery resident who has joined the Center for Bioethics for a year-long practicum experience, has been awarded the American College of Surgeons Surgical Ethics Fellowship for … Continued

C:B Faculty Project Releases Zika Research Guidance

Under the co-leadership of C:B Associate Director Annie Lyerly, the Welcome Trust-funded PREVENT (Pregnancy Research Ethics for Vaccines, Epidemics and New Technologies) has released ethical guidelines for investigators conducting ZIKA research with pregnant women The inclusion of pregnant women in Zika virus vaccine … Continued

Stellenbosch Awarded NIH Fogarty Grant for Research Ethics Doctoral Program

The Center’s long-standing collaboration with the Centre for Medical Ethics and Law at University of Stellenbosch, Capetown, South Africa has been awarded a D43 grant from the NIH Fogarty International Center to establish the first ever African doctoral program on research … Continued

Arlene Davis and Jean Cadigan win AHEC Campus Innovation Award

Center faculty Arlene Davis and Jean Cadigan, in a collaboration with Benny Joyner from the Department of Pediatrics, have won a “Campus Innovation Award” from the NC Area Health Education Centers to fund a new project entitled “Using Simulation to … Continued

New Core Faculty Member Appointed: Jean Cadigan, PhD

Jean Cadigan, PhD, a medical anthropologist in the UNC Department of Social Medicine, has been appointed as the tenth member of the Center’s Core Faculty,  in recognition of her sustained involvement in Center research projects,  teaching efforts, and consultation services.