Center for Clinical Ethics and Humanities in Health Care
Bioethics Bulletin
Editor: Tim Madigan
September 1996
Volume Three, Number Nine
Co-Directors: Gerald Logue, MD and Stephen Wear, PhD
Associate Director:
Jack Freer, MD
Research Associates:
Charles Jack and
Adrianne McEvoy
Address: Center for Clinical Ethics and Humanities in Health Care
Veteran's Affairs Medical Center
3495 Bailey Avenue Buffalo, NY 14215
Telephone: 862-3412 FAX: 862-4748
Website:
http://wings.buffalo.edu/faculty/research/bioethics/
Send E-mail to: wear@acsu.buffalo.edu.
Newsletter Distribution
The Center newsletter can be delivered
to you via e-mail or fax. If you would like to receive the newsletter over
the Internet, please forward your request to Jack Freer, MD, phone: 887-
4852; fax: 887-5186; e-mail: jfreer@buffalo.edu.
If you would like to receive it by fax, call 862-3412 and give us your fax
number. We encourage the use of e-mail and fax distribution rather than
paper for the newsletter. Please let us know if there are any people
you would like to have placed on our mailing list.
Center To Conduct Bioethics Mega-Course For UB Undergraduates
In cooperation with the SUNY-Buffalo Department of Philosophy, the
Center will conduct a bioethics mega-course (listed as PHL337) in
the Spring of 1997. IT will aim especially at offering material
relevant to undergraduates in nursing, health services and pre-
med, for many of whom the course is a degree requirement.
Lectures, panel discussions and clinical presentations by area
clinicians will be a basic staple of the course as well as a
strong clinical orientation. Anyone interested in participating in
the organization and conduct of the course should indicate this by
leaving a message at the Center (862-3412) so they can be placed
on a task group that will design and conduct it.
Welcome To New Center Research Associate
As a result of the new course mentioned above, we also have the
pleasure of welcoming Adrianne McEvoy, a philosophy graduate
student, to the Center as a Research Associate for 1996-1997. She
will, in part, assist in the design and conduct of the course, and
will also be involved in supporting various Center functions and
initiatives.
Farewell
With regret, but also with congratulations and best wishes, we
must bid farewell to Ms. Lisa Bolten, the Center's secretary since
its inception. Lisa has been appointed to a full-time staff
position at the SUNY-Buffalo Medical School. Her assistance in
supporting the Center's various activities has been pervasive and
critical to its development and success; her energy and creativity
will be sorely missed. Bon voyage!
Upcoming Center Meetings
The Center currently has three committees: Community Affairs,
Education and Research. All Center members are welcome to
participate in these committees.
Ethics Grand Rounds
9/17 GRAND ROUNDS CANCELLED:
The Grand Rounds scheduled for Tuesday, September 17, 8:00 AM. Erie County
Medical Center, Staff Dining Room, 2nd Floor has been cancelled. "Health
Care Proxy and Interfacility Collaboration" will be rescheduled and
announced ith the Bioethics Bulletin.
Wednesday, October 16, 8:00 AM. Kenmore Mercy Hospital.
"Considerations Surrounding Brain-death Dilemmas in a Young
Adult." Further information will be given in the October
"Bioethics Bulletin."
Center Reading Group
The Center has established a second reading and research group
(beyond the "Health Care Policy Group"), the purpose of which is
to discuss in-progress publications and encourage new publications
mad allied research activities. There will be two meetings held in
August, at the Center for Inquiry, 1310 Sweet Home Road, between
Maple and Rensch Roads (look for the twin red-and-white gates). On
Wednesday, September 4 at 4:00 PM, local attorney Janet Kaye will
give a presentation on ethical dilemmas related to the cosmetics
industry.
The beginning of the Fall/Spring series of meetings of the reading
and research group will occur at 4:00 PM on Wednesday, September
25. The group has chosen to focus on the general area of “death
and dying” during the year. This will in part proceed on the basis
of earlier discussions of the SUPPORT Study and related materials.
The first session will be both organizational (i.e. regarding what
reading/specific topics the group will focus on in subsequent
meetings) and also introductory (i.e. we will start with a general
presentation of legal guidelines and issues within the area of
death and dying). Further materials will be sent to past group
members. Newcomers are welcome. Contact Chuck Jack at the Center
(862-3412) for information and materials.
Center Listservers
The Center now maintains two automated e-mail listservers. BIOETH-LIST
is primarily designed for those in the Greater Buffalo area and permits
subscribers to post to the list. This list is available for posting
local announcements, as well as a medium for discussion of relevant
topics. It will also distribute the Center newsletter, "Bioethics
Bulletin." If you are on this list, you can send a message to the
entire list by addressing the message to:
BIOETH-LIST@listserv.acsu.buffalo.edu.
BIOBUL-LIST is strictly used for distribution of "Bioethics Bulletin"
and is mainly for those outside of Western New York. If you have
further questions about this service, contact Jack Freer at 887-4852 or
at: jfreer@buffalo.edu.
Center to Co-Sponsor Lectures
IMPORTANT: NOTE DATE CHANGE FOR ADMIRAAL LECTURE
Pieter Admiraal, MD, one of the leading exponents of the Netherlands'
euthanasia policy, will be giving a public lecture on Thursday,
October 3 (NOT September 26 as originally scheduled) at 7:00 PM, at the
Center for Inquiry, 1310 Sweet Home
Road, Amherst. He will be joined by Marilynne Seguin, RN, executive
director of the Canadian organization Dying With Dignity. Further
details, including the lecture topic and time, will be given in the
next "Bioethics Bulletin."
The Center for Clinical Ethics and
Humanities in Health Care will also be sponsoring a presentation on
Friday, October 18 at 7:00 PM by Olgierd Lindan, MD, on "Medical
Quackery and New Age Medicine." Dr. Lindan is a longtime collector of
controversial medical devices and is the proprietor of his own museum
in Cleveland, Ohio. He will be demonstrating several bogus cures from
his own collection. For details on these two events, please contact Tim
Madigan at 636-7571 or timmadigan@aol.com
Upcoming Lectures
Friday and Saturday, September 6 and 7. "Health Care: History and
the Future, A Conference on Chronicling Your Health Care History."
Hinshaw Medical Education Center, Rochester General Hospital,
Rochester, New York. Friday, 8:30 AM - 4:00 PM; Saturday, 8:30 AM
- 2:00 PM. The aim of the conference is to bring members of the
health care community together and demonstrate the how, why and
uses of institutional archives and historical collections. Anyone
with an interest in preserving their organization's history should
attend. Cost of registration: $50.00 (covers lunches, coffee
breaks and parking). Please mail conference fee to: Baker-
Cederberg Museum & Archives, Rochester General Hospital, 1425
Portland Avenue, Rochester, New York, 14621.
Wednesday, September 11. "The Role of Conditioning in
Pharmacotherapy: The Placebo Response?" Presenter: Robert Ader,
Department of Psychiatry, University of Rochester. 280 Park Hall,
SUNY-Buffalo, 2:00 PM - 3:30 PM. In classical (Pavlovian)
conditioning terms, the therapeutic actions of an action drug (an
unconditioned stimulus, UCS) are unconditioned responses.
Therapeutically netural environmental stimuli that are
coincidentally associated with and reliably precede drug actions,
such as the pill itself, are conditioned stimuli (CS). Repeated
pairing of CS and UCS eventually enables the CS, alone, to elicit
a conditioned response, an approximation of the unconditioned
response. Thus, the "placebo effect" has been described as
a conditioned response. Desptie the literature on conditioned
phamacologic effects, however, few studies have attempted to
manipulate the placebo effect as a conditioned response or to
examine the therapeutic potential of conditioned
pharmacotherapeutic responses. Studies evaluating drug effects
involve two basic groups: a treated group that has received a drug
(100% reinforcement schedule) and a placebo group that received
the CS but not the UCS (0% reinforcement schedule). If the
response to the placebo is a conditioned response, there is an
alternative to the administration of drug and placebo - a
partial schedule of reinforcement. In effect, reinforcement
schedule, or the "active drug: placebo ratio" represents an
additional dimension of drug treatment protocols and an
alternative means of titrating cumulative drug does that may
enable one to maintain some physiological responses within
homeostatic limits using lower cumulative amounts of active
medication. The evidence in support of this conceptualization, the
implications for the design of crossover studies and for
evaluating therapeutic drug effects, the predicted effects of
adding a behavioral dimension to pharmacotherapies, and the
advantages of adopting conditioningstrategies in some
pharmacotherapeutic regimens will be elaborated.
Thursday, September 12. "Living Wills: From Legislatures to Living
Rooms."Presenter: Peter Singer, director, Joint Centre for
Bioethics. The Toronto Hospital, General Division, Norman Urquart
Wing, Main Lecture Theatre, Room NUW-G-110.
Thursday, September 19. "Caring for Yourself as a Person in
Grief," an educational workshop for those who are grieving which
will include stress management and relaxation techniques, tips on
nutrition and more. 7:00 PM. This workshop is offered by the Life
Transitions Center. To register, call 836-6460.
Friday, September 20. Hospice Buffalo and Roswell Park Cancer
Institute will host the 2nd Combined Conference on Palliative Care
Issues. 8:00 AM - 4:00 PM, Hospice Mitchell Campus Education
Center, 225 Como Park Boulevard, Cheektowaga. Neil MacDonald, MD,
world renowned author of _The Canadian Palliative Care
Curriculum_, will discuss the development of palliative care
curricula in the health care professional’s training. Deborah
Gordon, RN, MS, who was instrumental in developing Clinical Care
Pathways and has written many articles on this topic, will discuss
implementation of pathways for palliative care. The pre-
registration fee for physicians is $40 ($50 at the door); fees for
nurses and other health care professionals will be $20 ($30 at the
door). There is no fee for Hospice or Roswell Staff, SUNY-Buffalo
School of Medicine residents, fellows or SUNY-Buffalo nursing and
graduate students. For more information, contact Missy Danahy at
686-8291.
Friday, October 4. Hospice Clinical Education Day. "Healing Words:
Communicating with the Seriously Ill or Dying Patient." A series
of workshops will be offered featuring J. Donald Schumaker, Psy.D,
president & CEO of the Hospice Association; Robert Milch, MD,
medical director of Hospice Buffalo; Lauren Michalakes, MD,
Hospice physician; Robert Stall, MD, medical director
of Kresge Residence; Judith Skretny, vice president, Life
Transitions Center; and Robert Fink, Hospice chaplain. To
register, contact Joyce Ortman at Life Transitions Center,
836-6460.
The 8th Annual Conference of the Canadian Bioethics Society will
be held from October 17-20 at the Hotel Delta Montreal in
Montreal, Quebec. The theme of this year’s conference is "Deciding
for Others: Power, Politics and Ethics." For more information,
please contact Professor Rachelle Keyserlingk at 514-398-7043.
Society For Health And Human Values Conference
The Society for Health and Human Values (SHHV) will be holding a
joint meeting with the Society for Bioethics Consultation in
Cleveland, Ohio from October 10-13, 1996. Last year about a dozen
members of the Center attended. For details, please contact Jackie
Kenney at SHHV (telephone: 703-556-9222; fax: 703-556-8729; e-
mail: shhv@aol.com).
Symposium on Ethics and Values in Medicine
and the Biomedical Sciences
In conjunction with the SUNY-Buffalo Sesquicentennial celebration, the
Center is helping to sponsor a major symposium, to be held from
November 14-16. Speakers include H. Tristram Engelhardt, Jr.
(Rice University and Baylor University School of Medicine),
Lawrence McCullough (Baylor University School of Medicine), E.
Haavi Morreim (University of Tennessee Medical School),
Eric Juengst (Case Western Reserve University, Dorothy Nelkin (New
York University), Kathryn Montgomery Hunter (Northwestern
University Medical School), Julie Rothstein (Yale University), and
Howard Brody (Michigan State University. For registration
information and further details, contact:Professor James Bono,
phone: 645-2282; e-mail: hischaos@acsu.buffalo.edu.
Free Treatment For Depression
The SUNY-Buffalo Department of Psychiatry is offering treatment
for depression and premenstrual syndrome. For information, call
898-5089.
Memorial Society Meeting
The Greater Buffalo Memorial Society, Inc. will hold its annual
membership meeting on Sunday, October 13 at 2:30 PM, in the Parish
Hall of the Unitarian Universalist Church of Buffalo, 695 Elmwood
Avenue, Buffalo. Dr. Thomas T. Frantz, Chairman of the Department
of Counseling and Educational Psychology at SUNY-Buffalo, will
speak on "Bringing Comfort to Grieving People." Refreshments will
be served, and attendance is open to anyone. The Memorial Society
is dedicated to simplicity, dignity and economy in funeral
arrangement.
Does the Body Matter?
As part of next fall's 150th anniversary celebration, SUNY-Buffalo is
sponsoring a major academic symposium entitled "Does the Body Matter? A
UB Sesquicentennial Symposium on Frontiers of Knowledge in Nature,
Society and Culture.", on Friday, October 4 at the Slee Concert Hall,
North Campus. This will bring together a distinguished group of
scholars: Gerald Edelman, Nobel-Prize winning neuroscientist; N.
Katherine Hayles, leading cultural critic of changing technologies;
Bruno Latour, sociologist of science; Richard Lewontin, biologist-
critic of the human genome project; Margaret Locke, anthropologist of
non-Western cultures; and a panel of notable SUNY-Buffalo faculty. The
symposium will address the ongoing redefinition of the human body in
contemporary society. The "Bioethics Bulletin" will have further
details in future issues.
Anti-Euthanasia Web Page
Patrick Pullicino, a neurologist at Buffalo General Hospital, has
set up a web page for physicians against euthanasia:
http://www.wp.com/JMV/Anti-Euthanasia
If you would like further
information, contact Pullicino at 859-7521, or pager 629-1284.
Call For Papers
The Association for Practical and Professional Ethics invites
submissions for its sixth annual meeting, March 6-8, 1997,
Washington, D.C. at Washington National Airport Hilton.
Submissions can address ethical concerns in various fields such as
public administration, law, the environment, accounting,
engineering, computer science, research ethics, business,
medicine, journalism, the academy, and on issues that cut across
professions. Demonstrations in ethics teaching, discussion of
moral education, and curriculum development are welcome. Deadline
for presentation submissions is October 31, 1996. Presenters will
be notified by November 30, 1996. For details, contact the
Association for Practical and Professional Ethics, 410
North Park Avenue, Bloomington, IN 47405. Telephone: 812-855-6450;
fax: 812-855-3315; internet address:
appe@indiana.edu.
Visiting Fellowships At Stanford University
The Program in Genomics, Ethics and Society (PGES) is inviting
applications for Visiting Fellowships. PGES addresses the
compelling social, ethical, legal and political implications of
advances in human genetics. Each year, a multidisciplinary PGES
Working Group will examine a different theme related to genomics.
For information, please contact Barbara Koenig (phone: 415-723-
6103; e-mail:
mr.bak@forsythe.stanford.edu).
Members Corner
The Members Corner is designed to note research, presentations and
published articles and books by Center members. Please send all
such information to the newsletter editor so that the Center can
keep members informed about the work occurring in this area.
Wear, S.E.: "Sanctity of Life and Human Dignity at the Bedside" in
Sanctity of Life and Human Dignity, edited by Kurt Bayertz;
Dordrecht, Holland: Kluwer Academic Publishers, 1996, pp. 57-71.
Wear, S.E. and Logue, G.: "Informed Consent for Organ
Transplantation: Mandating the Participation of the Family", Law
and Policy, Vol. 17, No. 2 (April 1996), pp. 210-216.
Comments and Suggestions
Your comments and suggestions regarding this newsletter are encouraged.
Please send them to the Center address, or by e-mail to the newsletter
editor, Tim Madigan - timmadigan@aol.com. We also need
information on upcoming events that would be of interest to Center
members. The deadline for the next newsletter is September 15th.