Mara Buchbinder has launched the Study to Examine Physicians’ Pandemic Stress (STEPPS) with funding from the Greenwall Foundation and the National Institute for Occupational Safety and Health. The COVID-19 pandemic has intensified ongoing stress, overwork, and disillusionment among the healthcare workforce. Healthcare professionals responding to the pandemic are experiencing crises of moral integrity and personal and professional wellbeing. STEPPS integrates qualitative interviews with conceptual analysis to investigate moral and occupational stress experienced by physicians working on the front lines of COVID-19 care in four American cities: New York City, New Orleans, Los Angeles, and Miami. The project will result in evidence-based recommendations, with input from an expert advisory panel, to guide systems-level changes urgently needed to protect physicians’ moral integrity and occupational wellbeing. Co-Investigators on the project include Dr. Tania Jenkins (UNC Sociology), Dr. Nancy Berlinger (The Hastings Center), and Dr. John Staley (UNC Occupational Safety and Health Education and Research Center).

The Research for Ethical Data Science in Southern Africa (REDSSA) project has the overall aims of producing new knowledge regarding the ethical, legal and social implications (ELSI) of conducting data science research to develop evidence-based, context specific guidance for the conduct and governance of data science initiatives such as DS-I Africa, and to strengthen the culture of responsible data science in Southern Africa. The project will be conducted in three phases. Phase 1 is research intensive and will obtain empirical data on key stakeholder views regarding the development of data science guidance to inform governance of DSI-Africa Research Hubs in Southern Africa. This phase will start with conceptual research and normative analysis of the ELSI issues related to data science.  In Phase 2, we will develop guidance documents informed by Phase 1 research and by best practices in international data science research guidance, the limited experience and existing literature to date concerning data science research and governance of data management in Southern Africa. In Phase 3, we aim to amplify the impact and enhance the sustainability of our research and governance activities by creating ELSI networks and communication channels focusing on data science in Southern Africa. This will involve establishing an ELSI Data Science Southern African Network (EDSSAN) to respond to evolving ELSI concerns in DS-I Africa Research Hubs beyond the funding period, hosting annual conferences, and leveraging existing local networks.

This is a U01 grant in response to the NIH funding opportunity RFA-RM-20-017: Harnessing Data Science for Health Discovery and Innovation in Africa (DS-I Africa): Ethical, Legal, and Social Implications Research. The purpose of the funding opportunity is to support research on the Ethical, Legal, and Social Implications (ELSI) associated with a new program entitled Harnessing Data Science for Health Discovery and Innovation in Africa (DS-I Africa). The goal of DS-I Africa is to spur new health discoveries and catalyze innovation in healthcare, public health, and health research on the continent through application of data science.

Co-PIs:

Stuart Rennie and Keymanthri Moodley.

Jill Fisher has recently been awarded a 3-year grant from the National Science Foundation that is focused on university hiring practices for and job market experiences of dual-career academics. With long-time research collaborator Prof. Torin Monahan, this Co-PI project will provide a comprehensive analysis of universities’ dual-career policies and practices and will generate resources for increasing the representation of women and minorities in science. With more than one-third of US-based academic researchers being in personal relationships with other academics, recruitment and retention of top talent depends upon universities meeting the dual-career needs of researchers. This challenge is especially important for diversifying the scientific workforce, as prior studies have pinpointed problems with academic appointments as a major contributor to the leaky pipeline causing attrition of women and minorities in biomedical and STEM fields. The project will develop evidence-based guidance for university administrators and critical resources for dual-career researchers in order to support greater inclusion of women and minorities in scientific careers. These objectives will be met through a rigorous research project designed to produce new empirical knowledge about dual-career policies, their application, and perceptions of them.

Specifically, the project has three aims: (1) assess researchers’ perceptions of dual-career academic job searches and the effects of university partner-hire policies upon research productivity and career advancement, (2) document the formal mechanisms used by universities to support dual-career hires, and (3) establish innovative resources for the larger academic community to visualize and share information about universities’ dual-career policies and practices. These aims will be accomplished through a mixed-methods approach that includes a quantitative online survey of US-based dual-career academic researchers’ perceptions and employment decisions at critical transition points in their careers, qualitative content analysis of the dual-career policies of all 131 R1 (“very high research activity”) universities in the US, and the publication of an online “scorecard” of the dual-career-friendly status of all R1 US universities, along with an accompanying report for university officials and academic associations.

With funding from the National Institute of Allergy & Infectious Diseases (NIAID), Dr. Jill Fisher is conducting a research study on pediatric clinical trials for food allergies, focusing primarily on peanut allergy. Using ethnographic research methods, the project investigates the on-the-ground ethical challenges that emerge in these clinical trials. In particular, the project explores how stakeholders—investigators, caregivers, adolescents, patient advocates, FDA officers, and pharmaceutical company representatives—define and understand acceptable risks and benefits from food allergy treatments, both in terms of research protocols and the eventual products to be used in clinical practice. The empirical findings from the project will be mobilized to develop a framework for the ethical conduct of peanut allergy clinical trials that attends to the myriad interests that drive biomedical research, including the search for therapies that meaningfully improve the lives of children with food allergies, the need to design and conduct clinical trials to meet the regulatory standards required by the FDA for the approval of products, and the commercial context in which investigators and companies have financial conflicts of interest that motivate the successful development of new therapies. Collaborating with Dr. Fisher on the project are Drs. Anne Drapkin Lyerly and Edwin H. Kim.

Professor Jill A. Fisher’s book, Adverse Events Race, Inequality, and the Testing of New Pharmaceuticals has been awarded the prestigious Robert K. Merton Book Award. The award, given by the Science, Knowledge, and Technology Section of the American Sociological Association. The Merton Award is given annually in recognition of an outstanding book on science, knowledge, and/or technology published during the preceding three years.

Adverse Events focuses on healthy volunteers’ participation in Phase I clinical trials. Healthy volunteers gain no health benefits and expose themselves to risks for the stipends that pharmaceutical companies pay for their time. NYU Press published Adverse Events in 2020.

Jill Fisher is a social scientist with a Ph.D. in Science and Technology Studies from Rensselaer Polytechnic Institute and expertise in medical sociology. Her research interests include social studies of the pharmaceutical industry, clinical trials, political economy, healthcare, and social inequalities, and research ethics. Dr. Fisher, Professor of Social Medicine in the UNC School of Medicine, is a core faculty member in the UNC Center for Bioethics.

2020 was a strange summer to start medical school. In order to help incoming students adjust, meet their peers, and learn about UNC School of Medicine, rising MS2 students created “Summer Seminars” based on a wide variety of topics. After a summer of successful seminars, the SOM decided to continue these student-led groups. This year, one of the seminars is: “Well, It’s Complicated: Exploring Medical Ethics at UNC,” co-led by Konan Beke, Celia Mizelle, and Cambray Smith.

“I participated in the Palliative Care Summer Seminar last year, which led to a year of involvement with palliative care. I thought it would be a great idea to help students interested in ethics get acclimated to the incredible resources at UNC prior to starting their first year,” says Cambray Smith, MD-PhD student and rising MS2. Cambray worked in biomedical ethics research at Mayo Clinic for 2 years prior to starting medical school at UNC, and she intends to incorporate ethics into her graduate research. Konan and Celia, rising MS2s, are the co-leaders of the School of Medicine’s Clinical Ethics Discussion Group (CEDG). They also serve as medical student representatives on the UNC Hospital Ethics Committee.

Eight students took the course, and the meetings were structured around the following topics: introduction to moral philosophy and ethics, clinical ethics and case discussion, conducting ethics research, and student-led projects on biomedical ethics topics. The group is also planning an in-person picnic near the end of the summer.

During one session, students discussed clinical ethics cases alongside faculty co-chair of the Ethics Committee Arlene Davis, and committee members Drs. Amy Bryant and Daniel Moseley.

“Everyone exercises ethical reasoning throughout their lives whether or not they have ever formally studied ethics. As future physicians, it is essential to understand the underpinnings of our ethical reasoning and its impact on patient care. The UNC SOM curriculum does a great job of incorporating such topics in our education, and we were excited to delve into it even more with such an engaged group of students,” says Konan.

The group’s goals are to introduce students to resources within the Department of Social Medicine, create a foundational appreciation and understanding of biomedical ethics, and to cultivate relationships among peers and student leaders.

Dr. Jost was one of five residents selected to receive the 2021 Cefalo House Officer Awards

The Robert C. Cefalo, MD, House Officer Award recognizes members of the Hospitals’ House staff for exemplary service to patients and families, professional performance, and compassionate patient care. This award is intended to honor Robert C. Cefalo, MD, PhD, professor emeritus of obstetrics and gynecology and assistant dean, head of the Office of Graduate Medical Education, Emeritus, UNC School of Medicine. Dr. Robert C. Cefalo served with distinction for 25 years as director of the residency and fellowship programs at UNC Hospitals. Dr. Cefalo passed away in 2008 after a battle with cancer, and this award was renamed the Robert C. Cefalo House Officer Award in 2008 as a permanent memorial to the legacy he left behind. A selection committee of physicians, nurses, and other clinical and administrative staff selected this year’s five honorees, who will each receive a monetary award of $1,000 to cover expenses associated with professional development.

Diya Jost, MD, Medicine-Pediatrics

Dr. Jost was praised for her commitment to her work, compassion for her colleagues and patients, and her advocacy for the highest standards of clinical care and professional practice.

Here’s what her nominators had to say: “Dr. Jost is the only resident who serves as a lead consultant on the Clinical Ethics Service (CES) for UNC Hospitals. Dr. Jost displays both her humility and excellent communication skills in her work as a consultant; she is adept at discussing difficult topics in a constructive manner. She also highlights the voices of patients who are particularly vulnerable or marginalized, perhaps by disability, poverty, literacy, minority status, or other concerns.”

“There is no doubt, Dr. Jost is seen as a leader at UNC. We all want her to be a part of our team. Her natural empathy compared with her ability to just listen to our patients provided a level of trust and confidence in the patient-physician relationship that many physicians take years to build, let alone sustain, and she accomplished this as a medical student. She was able to provide compassionate and evidence-based care to the most vulnerable patients in our hospital and did so with grace and humility.”

Arlene M. Davis, JD, associate professor in the UNC Department of Social Medicine and director of the Clinical Ethics Service at UNC Hospitals, has been named director of the UNC Center for Bioethics, effective July 1.

“I look forward to my director role in Center. Our core faculty members are outstanding and the Center’s research, educational, and service missions benefit for the depth of their scholarship and experience and their commitment to the field of bioethics. During my term I plan to concentrate on new ways to build upon our work and sharpen our focus on efforts that directly impact the School of Medicine, UNC Health, and the people of North Carolina. In my own service work, given that the Center serves as an academic home for the Clinical Ethics Program and thus the hospital’s Clinical Ethics Service, I hope to further our Center’s missions through my familiarity with and experience in a variety of medical education and clinical settings here at UNC and with the support of my colleagues in clinical ethics.

The center’s previous director, Eric Juengst, PhD, is stepping down from the director’s position but will continue as a professor in the UNC Department of Social Medicine and the UNC Department of Genetics and as core faculty in the Center.

“Eric has directed the Center since 2010 and has overseen its amazing growth and extraordinary success during the past decade,” said Jonathan Oberlander, PhD, professor and chair of the UNC Department of Social Medicine. “Social Medicine is very proud of its partnership with the Center for Bioethics and all that the Center has achieved in its research, service, clinical ethics, and teaching missions.”

“I want to thank Eric Juengst and the center’s associate director, Annie Lyerly, for their Center leadership over the past 10 years and Jon Oberlander for the support of our department. In regard to the Clinical Ethics Program’s growth over the same 10 years I would also thank Gary Gala and Benny Joyner who join me in leading our clinical ethics work within the hospital,” Davis said.

Davis is an attorney and a core faculty member in the UNC Center for Bioethics. She is also a member of the North Carolina State Bar. Davis’s work focuses on practical ethics in both clinical and research settings, drawing upon her prior experience in private practice and in pediatric and public health nursing. Within the School of Medicine and elsewhere, Davis teaches on topics related to ethics and to health law. She is an active member of the UNC Academy of Educators and has served on several educational committees within the School of Medicine. At UNC Hospitals, she co-directs the Hospital Ethics Committee. As Director of UNC Hospitals’ Clinical Ethics Service, she conducts or supervises ethics consultation for patients throughout the quaternary hospital system, offers educational programs for GME and hospital staff, and helps develop policy guidance at the intersections of law and ethics.

I am happy to announce that after 11 years as Director of the UNC Center for Bioethics, I am turning over that leadership role to Arlene Davis, RN, JD, effective July 1, 2021.

It has been immensely fulfilling to oversee the flourishing of the C:B over the last decade. I am deeply grateful to the Center faculty and staff whose energy and collegiality have fueled our emergence as a home for first-class research, teaching, and service in bioethics, and I am so proud to see our mentees seeding and reshaping the field, nationally and internationally.  Moreover, we could not have hoped for a better foundation than our institutional context in the Department of Social Medicine,  with the Center for Health Equity Research and the Center for Genomics and Society as our neighbors and collaborators.

Now, I look forward to doing more to add my own scholarship to this mix as a member of the faculty and letting someone else take the wheel as we move into our second decade.

Fortunately, that someone will be Arlene Davis, RN, JD, who is well known to our newsletter readers as the director of our Clinical Ethics Program and long-term co-chair of the UNC Health System’s Hospital Ethics Committee.  Arlene joined the UNC School of Medicine faculty in 1998,  and her wide, deep network of clinical ethics collaborations across the UNC Health System and the UNC Health Affairs campus has been invaluable in fostering goodwill amongst our health professional colleagues and opening doors for the Center programming.  She knows the ropes of cultivating ethics work in academic medical settings, and she is a sought-after teacher and advisor across the waterfront of issues in clinical, research, and public health ethics.  In particular, Arlene’s expertise, experience, and outlook equips her especially well to guide us as the field of bioethics turns more towards institutional and systemic issues of social justice in biomedicine.

Please join me in congratulating Arlene on her selection as our next Director, and stay tuned to hear from her in the months to come about the interesting new ideas she has for us here at UNC!

Eric Juengst