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Published by Kirk Johnson and Amelia Barwise
Who we are: We are a collaborative of bioethics scholars interested in creating a more inclusive space to explore topics relevant to bioethics and the medical humanities while advancing equity and social change/restitution. Although we found our shared interests through our membership in the American Society for Bioethics and Humanities Race Affinity Group, we are independent of ASBH and any other organization. The views expressed in this podcast are our own and the speakers and do not represent our employers, institutions, or professional societies. Mission: Bioethics in the Margins aims to include topics, guests and audiences who are not always highlighted in mainstream bioethics discourse. We will focus on structural inequity and the role bioethics can play in social change. We aim to move beyond traditional bioethics frameworks and intentionally draw on intersectionality, social justice, racial justice, disability ethics, women, LGBTQ ethics, and topics specific to Black, immigrant/refugee, Native American, Latinx populations. Hosts: Kirk Johnson, Amelia Barwise Team Members: Gargi Pandey, Creative Director; Madeline Mahoney, Sound Editor; Wendy Jiang, Social Media Manager; Nicolle Strand, Advisor; Liz Chuang, Producer
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In this episode, Dr. Chuang discusses some of her research, which has focused on racial disparities in health care delivery. She shares her journey to this topic starting with her childhood experiences as a witness to structural racism and implicit bias. She discusses how bias and structural inequities are reproduced in many ways, all affecting health and healthcare outcomes. Her work includes several focuses including interpersonal bias in healthcare communication with patients with serious illness and their families, bias in public health practices and bias in Artificial Intelligence. The discussion concludes with the ways that biomedical research has contributed to bias in healthcare over time. The discussion also includes some ways that researchers can move forward even in a challenging funding environment. Chuang E, Hope AA, Allyn K, Szalkiewicz E, Gary B, Gong MN. Gaps in Provision of Primary and Specialty Palliative Care in the Acute Care Setting by Race and Ethnicity. J Pain Symptom Manage. 2017 Nov;54(5):645-653.e1. Chuang E, Yu S, Georgia A, Nymeyer J, Williams J. A Decade of Studying Drivers of Disparities in End-of-Life Care for Black Americans: Using the NIMHD Framework for Health Disparities Research to Map the Path Ahead. J Pain Symptom Manage. 2022 Jul;64(1):e43-e52 . Chuang E, Grand-Clement J, Chen JT, Chan CW, Goyal V, Gong MN. Quantifying Utilitarian Outcomes to Inform Triage Ethics: Simulated Performance of a Ventilator Triage Protocol under Sars-CoV-2 Pandemic Surge Conditions. AJOB Empir Bioeth. 2022 Jul-Sep;13(3):196-204. Binkley CE, Dellavalle NS, Chuang E. From Mitigation to Flourishing: We Must Harness Emerging Technologies to Improve Health of the Most Vulnerable. Am J Bioeth. 2026 Feb;26(2):127-129. Cited in this episode: Barnato AE, Berhane Z, Weissfeld LA, Chang CC, Linde-Zwirble WT, Angus DC; Robert Wood Johnson Foundation ICU End-of-Life Peer Group. Racial variation in end-of-life intensive care use: a race or hospital effect? Health Serv Res. 2006 Dec;41(6):2219-37 . Johnson KS, Kuchibhatla M, Payne R, Tulsky JA. Race and residence: intercounty variation in black-white differences in hospice use. J Pain Symptom Manage. 2013 Nov;46(5):681-90. doi: 10.1016/j.jpainsymman.2012.12.006. Epub 2013 Mar 21 . Ashana DC, Welsh W, Preiss D, Sperling J, You H, Tu K, Carson SS, Hough C, White DB, Kerlin M, Docherty S, Johnson KS, Cox CE. Racial Differences in Shared Decision-Making About Critical Illness. JAMA Intern Med. 2024 Apr 1;184(4):424-432. Dellavalle NS, Ellis JR, Moore AA, Akerson M, Andazola M, Campbell EG, DeCamp M. What patients want from healthcare chatbots: insights from a mixed-methods study. J Am Med Inform Assoc. 2025 Nov 1;32(11):1735-1745 .
For this episode, we are joined by Kadija Ferryman, an anthropologist who studies equity and policy in health risk prediction technologies. Dr. Ferryman is Faculty at the Berman Institute of Bioethics and Assistant Professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. Dr. Ferryman traces her path into studying technology through a cultural anthropology lens, beginning with an early curiosity about how different cultures define illness and disease. She explains how the cultural anthropology focus on beliefs, values, and power structures shapes the way she examines modern health technologies. Using examples like the sequencing of the human genome, she highlights how different scientific communities drew strikingly different conclusions from the same discovery, revealing deeper tensions about race, biology, and social meaning that continue to influence biomedical research. Building on this foundation, Dr. Ferryman explores how bias becomes embedded in everyday health technologies, from pulse oximeters to clinical risk prediction algorithms. She describes how known inaccuracies of pulse oximeter readings for darker-skinned individuals persisted for decades and became especially visible during the COVID-19 pandemic. Extending these concerns to emerging areas like generative AI, she raises important questions about how biased data can shape both clinical care and healthcare systems more broadly. At the same time, she offers a more nuanced perspective: these flawed technologies can also serve as powerful windows into the inequities of our society and as opportunities to rethink how ethics is integrated into medicine and technological development. Ferryman K, Mackintosh M, Ghassemi M. Considering Biased Data as Informative Artifacts in AI-Assisted Health Care. N Engl J Med. 2023 Aug 31;389(9):833-838 . Ethical Guidelines for AI: https://healthaipartnership.org/health-equity-across-the-ai-lifecycle-heaal https://www.chai.org/ https://nam.edu/our-work/programs/leadership-consortium/health-care-artificial-intelligence-code-of-conduct/ Select other publications by Dr. Ferryman: Collins BX, Bélisle-Pipon JC, Evans BJ, Ferryman K, Jiang X, Nebeker C, Novak L, Roberts K, Were M, Yin Z, Ravitsky V, Coco J, Hendricks-Sturrup R, Williams I, Clayton EW, Malin BA; Bridge2AI Ethics and Trustworthy AI Working Group. Addressing ethical issues in healthcare artificial intelligence using a lifecycle-informed process. JAMIA Open. 2024 Nov 15;7(4):ooae108. Shachar C, Drabo EF, Iwashyna TJ, Ferryman K. Addressing Racial and Ethnic Bias in Pulse Oximeters-A Wicked Problem. JAMA. 2025 Feb 18;333(7):563-56 4. Ferryman K, Crews DC, Drabo EF, Iwashyna TJ, Kane O, Jackson JW. Adherence to FDA Guidance on Pulse Oximetry Testing Among Diverse Individuals, 1996-2024. JAMA. 2025 Feb 18;333(7):631-632 Also mentioned on the show: Joy Buolamwini Coded Bias
In this episode, we are joined by Dr. Katherine Peeler, founding director of the Peeler Immigration Lab, to discuss her longstanding empirical work on human rights and US immigration systems. Dr. Peeler is an Associate Physician in Pediatrics at the Boston Children's Hospital and Assistant Professor of Pediatrics, Global Health and Social Medicine at Harvard Medical School. She is a faculty member of the Harvard Medical School Center for Bioethics. Dr. Peeler describes her longstanding interest in building an evidence base of health effects of human rights abuses as a means of changing policy. Her interest in this field was initially sparked by the work of Paul Farmer and Partners in Health and their mission to improve direct care to patients. She was drawn specifically to challenges facing asylum seekers in the US and shifted towards policy work with Physicians for Human Rights . She founded the Peeler Lab during the COVID pandemic out of concern for people facing the pandemic in detention. Her lab has focused on writing for a public and policy audience to improve conditions and health of immigrants. More recently, her work has focused on solitary confinement in Immigration and Customs Enforcement (ICE) facilities. She painstakingly documents the multiple human rights violations, record number of deaths in these facilities, and violations of United Nations (UN) minimal standards for treatment of detained individuals. Policies for solitary confinement or "restricted housing" meet UN criteria for torture. She outlines strategies that States and local governments can employ to improve oversight and limit expansion of these facilities. The episode wraps up with a discussion of the role of bioethicists to forge common language across opposition and help parties understand shared values and have more productive conversations. Peeler Lab: https://peelerimmigrationlab.hsites.harvard.edu/ Publications: "Praying for Hand Soap and Masks:" Health and Human Rights Violations in U.S. Immigration Detention during the COVID-19 Pandemic. ” “ Endless Nightmare” Torture and Inhuman Treatment in Solitary Confinement in U.S. Immigration Detention (2024) Cruelty Campaign: Solitary Confinement in US Immigration Detention
In this episode, our previous guest Dr. Daphne Martschenko returns with her co-author Dr. Sam Trejo to discuss their new book What We Inherit: How New Technologies and Old Myths Are Shaping Our Genomic Future. Dr. Martschenko is an Assistant Professor at the Stanford Center for Biomedical Ethics, where she studies how to promote ethical and socially responsible conduct in human genetics and engages the public around controversial science. Dr. Trejo is an Assistant Professor of Sociology at Princeton University whose work examines how social and biological factors jointly influence human development, with a focus on educational and health inequality. Their collaboration began in graduate school, where they approached genomic research from different intellectual traditions. Dr. Trejo, trained at Stanford, became involved with researchers studying polygenic scores, which are genetic indices linked to social and behavioral outcomes. A controversial talk and an unfortunate reply‑all email situation sparked debate about whether this work risked echoing eugenic ideas. His advisor encouraged him to connect with Dr. Martschenko. Dr. Martschenko, who earned her PhD at Cambridge, was studying how genomic scientists understood their motivations, responsibilities, and the risks of their work. More skeptical of the field’s claims and concerned about premature industry applications, she, like Dr. Trejo, was frustrated by polarized academic debates in which opposing sides rarely engaged productively. Their shared desire for more constructive dialogue shaped their collaboration and ultimately their book. In this work, they discovered more common ground than expected. Although disagreements remained, that didn’t hinder their ability to think together about regulatory frameworks that should be in place. They highlight two myths that distort public understanding of genomics: • The Destiny Myth —the belief that genes unilaterally determine life outcomes, historically used to justify harms such as involuntary sterilization. • The Race Myth —the false idea that humanity is divided into discrete biological races whose genetic differences explain behavioral or social outcomes, a misconception that has fueled discriminatory policies and continues to underlie white supremacist ideologies. Their work aims to help the public interpret genomic data and understand both its promise and limits. They note that polygenic scores remain a “black box”: even when predictive in certain contexts, their biological pathways are unclear and may operate differently across environments. Their remaining differences center on how scientific advances might counter—or inadvertently reinforce—social harms, and where scientific effort should be focused to meaningfully reduce health disparities. Find their book here: https://press.princeton.edu/books/hardcover/9780691237756/what-we-inherit?srsltid=AfmBOoppBsKJ5iKykfO2MzqGseQw_3EF028_8tMTrAB9G0trgMdqIUSe Other joint publications: https://pubmed.ncbi.nlm.nih.gov/35047864/ https://pubmed.ncbi.nlm.nih.gov/37695009/ https://pubmed.ncbi.nlm.nih.gov/34493865/
Season 9 is off to an exceptionally strong start with our recent discussion with Dr. Nicholas Freudenberg, Distinguished Professor Emeritus of Public Health at the City University of New York (CUNY) School of Public Health. Dr. Freudenberg is Senior Faculty Fellow and co-founder of the CUNY Urban Food Policy Institute ( www.cunyurbanfoodpolicy.org ). He is a leading expert in Commercial Determinants of Health, authoring two key books in the field; At What Cost: Modern Capitalism and the Future of Health (Oxford, 2021) and Lethal but Legal: Corporations, Consumption, and Protecting Public Health (Oxford, 2014 and 2016). He was a contributor to the landmark Lancet series on the topic: https://www.thelancet.com/series-do/commercial-determinants-health . Commercial Determinants of Health can be understood as the ways that market actors influence health and disease globally. Commercial Determinants of Health are related to Social Determinants of Health and Political Determinants of Health, which together form a system that influences patterns of human health and disease. The term developed in the early 2000s, emerging from an earlier concept of Corporate Determinants of Health, recognizing that a small number of multinational global corporations dominate the world economy. Dr. Freudenberg explains that changing behavior of businesses and corporations can achieve public health gains at a much greater scale that traditional individual behavioral change approaches, citing successful policies regulating the tobacco industry and smaller gains changing the business opportunities to favor alternatives to the fossil fuel industry. One of the largest commercial determinants of health is the food industry, where there are multiple opportunities for change. Dr. Freudenberg discusses the importance of coordination between activists and public health professionals to counterbalance the influence of corporations on policy. What is the role of bioethicists? Listen and find out! Bibliography: https://www.annualreviews.org/content/journals/10.1146/annurev-publhealth-052220-020447 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00011-9/abstract https://global.oup.com/academic/product/at-what-cost-9780190078621?cc=us&lang=en& https://global.oup.com/academic/product/lethal-but-legal-9780199937196?cc=us&lang=en&
We close out Season 8 with a very special episode that is particularly poignant in this holiday season when people of many faiths are called to reflect on our core values. We are joined by Reverend Jackson who is currently the Associate Conference Minister for Justice and Witness Ministries in the Central Atlantic Conference in the United Church of Christ. Reverend Jackson has been the pastor at the United Church of Christ of Seneca Valley in Germantown, Maryland since 2016. She earned her Master of Divinity degree in 2012 from Wesley Theological Seminary. She also holds a Master of Social Work from Fordham University and a Bachelor's in Social Relations and Public Policy from Michigan State University. In this conversation, Reverend Jackson discusses the evolving role of sanctuary churches in the context of immigration and the legal risks they face. Since the withdrawal of federal guidance designating protected locations such as churches went into effect , it is more difficult for churches to provide sanctuary for refugees at risk for being deported to dangerous and life-threatening situations. A coalition of religious organizations has since brought a lawsuit against the Department of Homeland Security arguing that this policy violates the right to expression of faith and freedom of religion. Reverend Jackson discusses the theological and moral imperative to support immigrants that arises from multiple biblical texts, and the calling on Christians to take risks for their faith. Reverend Jackson advocates for a proactive approach to community involvement and the need for churches to educate themselves about local laws and the realities of immigration. Churches must advocate for their rights to practice their faith without government interference. She reminds us that love for one's neighbor is a core tenant of Christian faith. The biblical texts clearly demonstrate that this imperative applies to all people around us, regardless of status. Links to organizations proving support to immigrants: https://www.ilrc.org https://unitedwedream.org
This month we are joined by Dr. Karen Meagher, Assistant Professor of Health Justice and Bioethics at the Lewis Katz School of Medicine at Temple University. Recently, Dr. Meagher was the Associate Director of public engagement in the Biomedical Ethics Research Program at the Mayo Clinic. Her research focuses on public health ethics and social implications of advances in microbial and human genetics. She has a PhD in philosophy from Michigan State University. From 2012-2016 she worked as a senior policy and research analyst on the staff of president Barak Obama’s Presidential Commission for the study of bioethical issues. Listen in as Dr. Meagher shares her career journey starting with her undergraduate interest in the philosophy of science and social influences of how science gets done. She describes how she was drawn to the growing field of public health ethics, which blossomed in the early 2000s with increasing publications and dedicated journals. Dr. Meagher describes her Virtue Ethics orientation to public health ethics and shares the inside scoop on what it is like to serve on a Presidential Commission. Later in her career, embedded with Mayo clinic biobank, Dr. Meagher describes her experiences with public engagement with community and how bioethicists can be a bridge between basic scientists and the community when grappling with difficult ethical dilemmas like those dealing with broad consent for future research with banked specimens. Finally, we delve into a discussion of how Dr. Meagher’s work on antimicrobial resistance led her to engage in concepts of One Health Policy, which recognizes the interdependence of people, animals and the environment. She highlights the importance of breaking down silos between researchers in different sectors and how bioethics can bridge disciplines and create shared moral language, while also centering engagement of communities to help define these problems from different perspectives. Selected publications of Dr. Meagher’s which were referenced in the podcast can be found here: Meagher KM. Can One Health Policy Help Us Expand an Ethics of Interconnection and Interdependence? AMA J Ethics. 2024 Feb 1;26(2):E162-170. doi: 10.1001/amajethics.2024.162. PMID: 38306206. https://pubmed.ncbi.nlm.nih.gov/38306206/ Meagher KM, Curtis SH, Gamm KO, Sutton EJ, McCormick JB, Sharp RR. At a Moment's Notice: Community Advisory Board Perspectives on Biobank Communication to Supplement Broad Consent. Public Health Genomics. 2020;23(3-4):77-89. doi: 10.1159/000507057. Epub 2020 May 12. PMID: 32396907. https://pubmed.ncbi.nlm.nih.gov/32396907/ Meagher KM. Considering virtue: public health and clinical ethics. J Eval Clin Pract. 2011 Oct;17(5):888-93. doi: 10.1111/j.1365-2753.2011.01721.x. Epub 2011 Aug 11. PMID: 21834841. https://pubmed.ncbi.nlm.nih.gov/21834841/ Meagher KM, Lee LM. Integrating Public Health and Deliberative Public Bioethics: Lessons from the Human Genome Project Ethical, Legal, and Social Implications Program. Public Health Rep. 2016 Jan-Feb;131(1):44-51. doi: 10.1177/003335491613100110. PMID: 26843669; PMCID: PMC4716471. https://pubmed.ncbi.nlm.nih.gov/26843669/
We are thrilled that this podcast is airing right after the 2025 American Society for Bioethics and Humanities meeting. It is based on a 2024 ASBH workshop “Remaking Bioethics Together.” Our guests are Stephen Molldrem, PhD, assistant professor and the research program director in Bioethics and Health Humanities at the University of Texas Medical Branch School of Public and Population Health, Krishna Chokshi, MD, associate professor of medicine in the division of hospital medicine at the Mount Sinai Hospital in NYC, Jonathan Shaffer, PhD, assistant professor in the department of sociology at the University of Vermont and Zackary Berger, MD, PhD, associate professor at the Johns Hopkins Bloomberg School of Public Health and in the division of general internal medicine at the Johns Hopkins School of Medicine. Our guests discuss what led them to organize that workshop, beginning with an appreciation of how the principlist, individualist approach of bioethics falls short in addressing systemic challenges to equitable healthcare. Dr. Shaffer shared how his interest in remaking bioethics stems from observations of the focus on “fringe science” in ASBH meetings and the relative absence of more politically oriented moral theorizing. He discusses how sociological frames can help think about the production of shared norms and moral values. Drs. Berger and Chokshi discuss clinical systems ethics failures and what it would mean for Bioethics to think of Capitalism as an object of moral inquiry and to consider organizational ethics in relationships between Academic Medical Centers and communities. We discuss how the “imagined neutrality” of the field of Bioethics has evaporated in the recent overlapping crises of academic medicine. Dr. Molldrem discussed political organizing and the need to take power and its functioning seriously. At the 2025 ASBH meeting last week, this group took the next steps to begin organizing the field by recognizing threats and opportunities and considering resources at our disposal to effect change. Next steps include fostering scholarship around these ideas, considering methods of institutional change within bioethics institutions and collaborating within and across disciplines to foster change. Please reach out to us or our guests if you are inspired to join this crucial work.
We welcome everyone back from a beautiful summer to kick off Season 8 with Julia O'Brien, the "grandmother" of geographic information systems (GIS). O'Brien was the Federal Emergency Management Agency (FEMA) Region II Special Geospacial Coordinator before her retirement in 2023. She worked in remote sensing and GIS for over 30 years. Before that she was the Senior Project Manager for a New York City project to complete an accurate GIS dataset for NYC, culminating in the Citywide Street Centerlines (CSCL) database. O'Brien walks us through the importance of GIS in disaster management and how it allows leaders to understand what infrastructure may be in the path of storms or flooding in order to prepare adequately for natural disasters. She discusses the role that FEMA plays to support states and localities during manmade and natural disasters. We delve into how proposed cuts to federal funding will affect institutional knowledge that is critical for disaster relief during this time of increased frequency and severity of disasters due to climate change. O'Brien highlights the importance of diversity in planning for disaster response needs. Finally, she discusses the importance of aid services provided by agencies like FEMA and USAID, noting that when a government does not meet the needs of the people, it will not be supported.
This episode of Bioethics in the Margins features a panel of bioethicists: Danielle Pacia of The Hastings Center, Sana Baban of UMass Chan Medical School, J. Wesley Boyd of Harvard Medical School, and Ryan Dougherty of Kaiser Permanente. They are the co-authors of a national survey exploring the role of social justice in their field, published in the American Journal of Bioethics: Empirical Bioethics. In this conversation, the authors discuss their key findings on what social justice obligations bioethicists feel they have, the concept of "social bioethics," and the duty of the field to address systemic injustice. We start by defining the term "social justice" and discussing how it relates to the four principles of bioethics. We spend some time unpacking the methods of the study including strengths and limitations. The main finding - that >80% of bioethicists surveyed believe that social justice should be part of their work - is contextualized by exploring how social justice can add information and objectivity to our work. The episode ends with some reflections by the authors on how we can move forward in the field with these important tools. Work cited in this episode: Pacia DM, Baban SS, Fletcher FE, Mithani Aziz Z, Cooper JF, Boyd JW, Dougherty RJ. A Survey of Attitudes Toward Social Justice Obligations in the Field of Bioethics. AJOB Empir Bioeth. 2025 Apr 17:1-12. doi: 10.1080/23294515.2025.2474915. https://pubmed.ncbi.nlm.nih.gov/40244571/ Fletcher, F. E., Ray, K. S., Brown, V. A., & Smith, P. T. (Eds.). (2022). A critical moment in bioethics: Reckoning with anti-black racism through intergenerational dialogue. Hastings Center Report , 52(S2), S1-S68. https://doi.org/10.1002/hast.1363 Pierson, L., Gibert, S., Orszag, L., Sullivan, H. K., Fei, R. Y., Persad, G., & Largent, E. A. (2024). Bioethicists today: Results of the views in bioethics survey. The American Journal of Bioethics , 24(5), 4-22. https://doi.org/10.1080/15265161.2024.2323869 Dougherty RJ, Fins JJ. Toward a Social Bioethics Through Interpretivism: A Framework for Healthcare Ethics. Camb Q Healthc Ethics. 2024 Jan;33(1):6-16. doi: 10.1017/S0963180123000452. Epub 2023 Aug 25. PMID: 37622652. https://pubmed.ncbi.nlm.nih.gov/37622652/
Dr. Carlos Smith, a general dentist and ethicist, is the Associate Dean of Ethics and Community Engagement and an Associate Professor in the Department of Dental Public Health and Policy at Virginia Commonwealth University School of Dentistry. His work focuses on professional identity formation, dental ethics, and oral health justice. In this episode, Dr. Smith discusses his unique path blending dentistry, theology, and bioethics. He begins by discussing the importance of seeing other Black health professionals in his community and observing the professional contentment of dentists while exploring career options. He also cites the crucial piece of advice of one mentor who encouraged him to see the paths of dental school and seminary as not an either/or, but a both/and. Dr. Smith encourages us to think about some of the basic principles in bioethics – beneficence and maleficence – with a broader lens. For example, he talks about the professional duty to understand the reality of racism of all forms in order to think about harms and benefits more systematically and wholistically. He also pushes the envelope on the long-standing medical ethical imperative to place patients’ interests above physicians’ interests by pointing out that the political interests of patients should also be placed above the political interests of health professionals in order to uphold that principle with integrity and trustworthiness. Dr. Carlos provides some clear-headed definitions of diversity and equity and engages with Kirk and Amelia on a must-listen discussion of the ethical dilemmas institutions are facing regarding the precise use of language in this political climate and the critical need to engage with communities and to advocate during these times. Works cited in the podcast can be found here : Teeth , by Mary Otto https://a.co/d/j68ePPQ Smith, C. S., Kennedy, E., Quick, K., Carrico, C. K., & Saeed, S. (2021). Dental faculty well-being amid COVID-19 in fall 2020: A multi-site measure of burnout, loneliness, and resilience. Journal of Dental Education , 85(12), 1956-1965. https://pubmed.ncbi.nlm.nih.gov/34780060/ Smith, C. S. (2023). Applying a systems oriented ethical decision making framework to mitigating social and structural determinants of health. Frontiers in Oral Health , 4, 1031574. https://pubmed.ncbi.nlm.nih.gov/37521174/ Smith, C. S., & Simon, L. E. (2025). To do good and refrain from harm: Combating racism as an ethical and professional duty. The Journal of the American Dental Association , 156(2), 91-94. https://pubmed.ncbi.nlm.nih.gov/39269381/ Smith, C. S. (Guest Editor). (2021). A Clarion Call to Leaders in Dentistry - A Professionalism Ethic for Diversity, Equity, and Inclusion. Journal of the American College of Dentists , 88(2), 1-48. https://issuu.com/college1920/docs/ejacd_vol88-2_2021-07-22_f/s/12896517 Smith, C. S. (Guest Editor). (2021). The Beauty of Many Voices: Unlocking A Growth Mindset Towards Diversity and Inclusion. Journal of the American College of Dentists , 88(3), 1-48. https://issuu.com/college1920/docs/ejacd_vol88-3_10-21_f4/s/13713999
In this episode of Bioethics in the Margins, we delve into the topic of capital punishment by nitrogen gas. Dr. Robert Glatter is Editor at Large for Medscape Emergency Medicine and Assistant Professor of Emergency Medicine at Zucker School of Medicine at Hofstra/Northwell. Dr. Peter Papadakos is Professor of Anesthesiology, Surgery, Neurology and Neurosurgery at the University of Rochester, and a Professor of Internal Medicine at Mercer University School of Medicine. Drs. Papadakos and Glatter dissect the harsh realities of suffering and injustice surrounding the execution of Kenneth Smith in Alabama, the first person executed using nitrogen gas. They explore what nitrogen is and its physiological effects and reflect on the inhumane nature of nitrogen hypoxia. The conversation also touches upon the broader issues of botched executions, delayed executions as psychological torture, the absence of definitive DNA evidence in some death row cases. They highlight the point that both the American Medical Association and the American Society of Anesthesiologists as well as many nursing associations state that participating in executions is not the practice of medicine and is prohibited by their members. This means that executions are conducted by non-medical personnel. They also point out that delaying executions, sometimes for decades, falls under the definition of torture under the Geneva conventions. This conversation poses the question; if our society continues to condone these practices, are we civilized? The JAMA editorial mentioned during the podcast can be found here: Evidence Against Use of Nitrogen for the Death Penalty | Neurology | JAMA | JAMA Network The editorial authored by Drs. Glatter and Papadakos can be found here: https://www.anesthesiologynews.com/Commentary/Article/02-25/Capital-Punishment-by-Nitrogen-Gas-The-Harsh-Reality-of-Suffering-and-Injustice/76074
Our first ever repeat guest is Rachel Fabi, PhD, Associate Professor of Bioethics and Humanities at SUNY Upstate Medical University. She is a Faculty Research Affiliate at the Syracuse University Lerner Center for Public Health Promotion. She received her Ph.D. in Health Policy and Management, in the Bioethics and Health Policy track, at the Johns Hopkins Bloomberg School of Public Health, and served as the 2019-2021 National Academy of Medicine Greenwall Fellow in Bioethics. Dr. Fabi had previously joined us in September of 2023, on Season 5 Episode 2 of Bioethics in the Margins. She joins again today to discuss the timely topic of the effect of recent Executive Orders rescinding the 2021 guidance designating schools, churches and healthcare institutions as "safe zones" exempt from immigration enforcement. Dr. Fabi outlines specific strategies that institutions can adopt to protect students and patients, particularly designating areas clearly as private spaces, which require a judicial warrant for ICE agents to enter. She highlights the importance of proactive planning on the part of institutions. Kirk, Amelia and Dr. Fabi reflect on our moral obligations towards immigrants as a society and the specific obligations of ethicists in practice and discuss the importance of immigrant communities to the fabric of our society. Several resources that were mentioned in the episode are linked below: 1. Toolkit for healthcare institutions curated by Mark Kuczewski 2. Link to “red cards” to inform people of their rights 3. Immigration Policy Tracking Project 4. The Health of Newcomers by Patricia Illingworth and Wendy E. Parmet
In this episode, we are joined by Dr. Tanya Zakrison, MD, PhD, Professor of Trauma and Acute Care Surgery and Director of Critical Trauma Research at the University of Chicago Medical Center. Her work focuses on the connection between interpersonal trauma, critical race theory and racial capitalism. In this podcast, Dr. Zakrison shares how her personal experiences in young adulthood helped her make connections between violence experienced in the United States and global patterns of violence resulting from capitalism and colonial histories. She describes how structural, cultural and social violence causes the trauma-based violence we experience locally, nationally and globally. She describes the incessant gun violence in the U.S., especially affecting schoolchildren, as a critical problem that requires attention beyond making arrests and treating the physical wounds of the victims. Dr. Zakrison points out how we have normalized abnormality in the U.S. through the culture of individualism and social violence. She introduces the concept of “hate” as a public health disease and discusses the importance of deep understanding of history as a means to disrupt cycles of hate. In this broad-ranging discussion, we also explore the importance of medical-legal partnerships and their role in supporting victims of violence, framing them as one methodology for violence prevention as well. In discussing her work on firearm violence, Dr. Zakrison shared a poignant experience of being told as a scientist in the United States that she was not allowed to ask a particular question, highlighting the contrast between legislation such as the Dickey Amendment and our national ideals of freedom. She recommended building bridges of solidarity, joy, love and communal support systems to counteract the effects of discrimination, exclusion, and hate. At personal level, she encouraged us to use our power to help people develop their human potential so that we can all benefit from the genius that everyone holds inside themselves. Some of Dr. Zakrison's work can be found here: https://pubmed.ncbi.nlm.nih.gov/28922206 https://pubmed.ncbi.nlm.nih.gov/30484899/ https://pubmed.ncbi.nlm.nih.gov/35300858/ Link to Practical Radicals: https://thenewpress.com/books/practical-radicals
Dr. Shameka Poetry Thomas is a medical sociologist with special interest in reproductive justice and genetics technology as well as the intersection of maternal healthcare with sickle cell disease. After receiving her Ph.D. from the University of Miami, she completed her two-year postdoctoral fellowship at the National Institutes of Health (NIH)/National Human Genomics Research Institutes (NHGRI). In this episode, Dr. Thomas centers the experiences of pregnant Black women with sickle cell disease, who, despite advances in medicine, genetics and reproductive technology, have been neglected by research communities due to intersecting marginalized identities despite high mortality during pregnancy and childbirth. Dr. Thomas walks us through what non-invasive prenatal testing (NIPT) is and how it relates to sickle cell disease specifically. Her work comes to life by illustrating the converging effects of colonialism, racism, bias and stigmatization through moving real-world stories. Her research sheds light on the lived experiences of patients who are left to integrate complex information from multiple specialists to interpret meanings for themselves, their families, their finances and their communities in the setting of collective and individual trauma. She describes the importance of using qualitative research methods to explore a range of experiences within groups rather than treating groups as a monolith. She also acknowledges the heaviness of this type of qualitative work and the importance of dissemination of findings to spark action. Dr. Thomas connected the long history of research abuses in the US to current-day research practices that continue to disrespect Black women. For example, recent sickle cell disease NIPT research was conducted without incorporating the unique lived experiences of the affected women to understand whether and how to incorporate these technologies into practice. She emphasized the urgent need for the development and implementation of more comprehensive ethical guidelines in the field of reproductive health. These guidelines should specifically address the ethical dimensions of research on sickle cell disease and the burgeoning field of genetic technology, ensuring that the rights, dignity, and well-being of those affected particularly within marginalized communities. Finally, Dr. Thomas called for more robust advocacy efforts aimed at amplifying the voices of Black women and other marginalized groups in the creation of healthcare policies and research priorities. Such advocacy must not only challenge existing inequities but also ensure that affected communities have the power and agency to influence decisions that impact their lives, fostering a healthcare system that is equitable, inclusive, and just. Read Dr. Thomas's work here: Thomas SP, Fletcher FE, Willard R, Ranson TM, Bonham VL. Patient Perceptions on the Advancement of Noninvasive Prenatal Testing for Sickle Cell Disease among Black Women in the United States. AJOB Empir Bioeth. 2024 Apr-Jun;15(2):154-163. doi: 10.1080/23294515.2024.2302996. Epub 2024 Feb 13. PMID: 38349128 . Thomas SP. Trust Also Means Centering Black Women's Reproductive Health Narratives. Hastings Cent Rep. 2022 Mar;52 Suppl 1:S18-S21. doi: 10.1002/hast.1362. PMID: 35470876. Fletcher F, Thomas SP, Lapite FC, Ray K. Bioethics Must Exemplify a Clear Path toward Justice: A Call to Action. Am J Bioeth. 2022 Jan;22(1):14-16. doi: 10.1080/15265161.2021.2001113. PMID: 34962203; PMCID: PMC9302876.
Happy holidays from BITM! We are delighted to share this episode with you this week. Kirk and Amelia sat down with Dr. Donald Carter III, assistant professor at Mercer School of Medicine. Dr. Carter earned his Doctorate in Bioethics from Loyola University after earning a Masters in Divinity from Vanderbilt and an MBA from Tennessee State. He is a Sadler Scholar with the Hastings Center and the co-chair of the Race and Culture and Ethnicity (RACE) affinity group of the American Society for Bioethics and Humanities (ASBH). Dr. Carter began his career as a musician after earning a BA in music from Fisk University, one of the many Historically Black Colleges and Universities (HBCUs) in the United States. This episode is a great one for those who are curious about pursuing a career in Bioethics. Dr. Carter shared how he explored several career paths before ultimately finding his professional home in Bioethics. Dr. Carted discussed his work exploring the impacts of the 1910 Flexner report, which, while contributing to creating uniform standards for medical education, also resulted in the closing of 5 of the 7 medical schools within HBCUs. This is one of the reasons for the shortage of Black physicians that persists today. He discussed the importance of diversifying the field of Bioethics and the positive changes he has observed within ASBH over the past few years. He shared how he views HBCUs as an important resource to tap to help diversify the field. He recommends building up bioethics education at HBCUs as a way of fostering lasting change. He also discussed the importance of humanities in medical education, sharing his experiences using visual training strategies (VTS) in medical education, reminding us that the arts have a way of returning us to a place where we can see each other as full humans again. Dr. Carter pointed out that one of the superpowers of the field of Bioethics is that we have a large tent. He examined specific ways in which racial, cultural and professional diversity can enhance the value our field brings to patients and communities.
We are so excited to have our very first librarian, Laureen Cantwell-Jurkovic, on the show to discuss the impact of and potential responses to the onslaught of book challenges and bans that have exponentially increased since 2022. Dr. Cantwell-Jurkovic is head of access services and outreach at Colorado Mesa University. She has researched and published on information literacy instruction and critical thinking activism. Amelia and Kirk explore with Dr. Cantwell-Jurkovic many consequences of book bans and challenges, which have increased more than 100-fold over the past several years, including "soft censorship" and self-censorship that result from the large administrative burden that results from responding to thousands of challenges, even when a particular book is ultimately not banned outright. Dr. Cantwell-Jurkovic walks us through how local activities at the level of school districts and municipalities ultimately influence policies at the county, state and even potentially national level. She emphasized the danger of these limitations which can come from people on all parts of the political spectrum. She then explored the unique properties of books, which have a special ability to build empathy through reading fiction, and Kirk explored how lack of access to books could have downstream effects when healthcare professionals are not exposed to diverse narratives as children. Finally, the importance of protecting libraries and books at the local level was highlighted. Being a librarian, Dr. Cantwell-Jurkovic shared many resources with us. Some are included here and more will be available on our website in the show notes. Organizations to Know: American Library Association (ALA): www.ala.org Freedom to Read Foundation (FTRF): https://www.ftrf.org/ Data: Banned Books Week data: http://www.ala.org/advocacy/bbooks/book-ban-data About Banned Books: https://www.ala.org/bbooks/aboutbannedbooks Banned Books Week 2025: https://bannedbooksweek.org/ ALA Censorship by the Numbers site: https://www.ala.org/bbooks/censorship-numbers Preliminary data for 2024: https://www.ala.org/news/2024/09/american-library-association-reveals-preliminary-data-2024-book-challenges
We are back with season 7, chatting with Brian Tuohy, PhD, a sociologist of immigration and health, assistant professor of bioethics, and co-director of education at the Lewis Katz School of of Medicine at Temple University. We use the lens of immigrant health to delve into some deeper questions like "What does bioethics mean?" Dr. Tuohy generously shares his own personal and professional journey into the field, highlighting the interdisciplinary nature of bioethics. He discusses his own family's immigration story and research with Mexican immigrants to the United States to bring out contrasts and nuances in the experiences of different groups based on language, age at immigration and a multiplicity of immigration status categories. We touch on some issues in ethical conduct of research with immigrant communities and conclude with a deep reflection on the power that bioethicists have as insiders in the healthcare industry and the importance, joys and responsibility of teaching the next generation of physicians. Some of Dr. Tuohy's work can be found here: Brian Tuohy, Health Without Papers: Immigrants, Citizenship, and Health in the 21st Century, Social Forces , Volume 98, Issue 3, March 2020, Pages 1052–1073, https://doi.org/10.1093/sf/soz048 Rocco, P., & Tuohy, B. (2021). A New Dawn of Bioethics: Advocacy and Social Justice. The American Journal of Bioethics , 22 (1), 23–25. https://doi.org/10.1080/15265161.2021.2001105 Tuohy B, Jatres J. Researching Those in the Shadows: Undocumented Immigrants, Vulnerability, and the Significance of Research. Am J Bioeth. 2023 Jun;23(6):106-109. doi: 10.1080/15265161.2023.2204053. PMID: 37220350.
In this episode, Kirk and Amelia speak with Asha Hassan, MPH, a doctoral candidate at the University of Minnesota School of Public Health. Together, they discuss her recent work on the link between exposure to tear gas during the 2020 protests for racial justice and consequent reproductive health issues. Asha explores the lack of sufficient policy innovation about banning chemical agents in protest settings as well as how systemic racism and ableism lead to patterns of healthcare underutilization. They also discuss the intersection of structural racism, disability justice, and abortion access. Asha identifies the legal challenges that the Dobbs decision poses to healthcare providers and how these legal challenges exacerbate the racial, ableist and classist barriers to abortion and all elements of reproductive justice. Asha encourages listeners in the wake of the Dobbs decision to consider Latin America’s recent reproductive justice wins as an example of successful grassroots, consensus- building and community-led change, urging us to consider policy that moves beyond Roe v. Wade to frame reproductive justice through the lens of bodily autonomy particularly for those who are most marginalized. Mentioned articles: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10859-w#:~:text=Conclusion,often%20led%20to%20healthcare%20utilization https://carhe.umn.edu/research-library/more-tears-associations-between-exposure-chemical-agents-used-law-enforcement-and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9836943/ Asha Hassan is a doctoral candidate at the University of Minnesota School of Public Health in the Center for Antiracism Research for Health Equity who focuses on reproductive health equity, abortion access and policy, and police violence as a manifestation of structural racism. She was named a Society of Family Planning Emergent Scholar in 2020 and a National Birth Equity Research Scholar in 2021. Asha’s current doctoral research focuses on analysis of the relationship between racism and abortion access in Minnesota, and she hopes to continue working on issues of disability justice with a focus on community and provider education.
In this episode, Amelia and Kirk speak with Lynette Martins who is co-leader of the ASBH immigration affinity group with Dr. Brian Tuohy and a recent graduate from Georgetown Law’s O’Neill Institute in national and global health law. Ms. Martins highlights the importance of Medical-Legal Partnerships in identifying and addressing both direct and indirect impacts that legal issues and policy have on health and healthcare access and outcomes. MLP’s are particularly helpful for addressing the Social Determinants of Health, the non-medical conditions in the environments in which we live, learn, work, and play that can negatively influence patient outcomes. MLP’s provide collaborative spaces for interdisciplinary dialogue, enhancing individual patient care while also helping healthcare institutions address recurrent issues that may be impacting specific patient populations. Further reading can be found here: https://medical-legalpartnership.org/wp-content/uploads/2019/04/Financing-MLPs-View-from-the-Field.pdf https://medical-legalpartnership.org/wp-content/uploads/2020/10/Health-Center-MLP-Toolkit-FINAL.pdf
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