University at Buffalo

Center for Clinical Ethics and Humanities in Health Care

Bioethics Bulletin


Editor: Tim Madigan

June 1997
Volume Four, Number Six

Co-Directors: Gerald Logue, MD and Stephen Wear, PhD
Associate Director: Jack Freer, MD
Research Associate: 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

This newsletter can be delivered to you via e-mail or fax or over the internet (forward your request to: Jack Freer, MD at: jfreer@buffalo.edu). If you prefer fax, call 862-3412 and leave your fax number. We encourage and appreciate the use of e-mail and fax distribution rather than paper for the newsletter.

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: BIOETHLIST@listserv.acsu.buffalo.edu. Archives of old BIOETH-LIST messages are maintained at: http://listserv.acsu.buffalo.edu/archives/bioeth-list.html

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.

Upcoming Center Meetings

The Center currently has three committees: Community Affairs, Education and Research. All Center members are welcome to participate in these committees.

Dinner in Honor of Robert A. Milch, MD

Sunday, June 8 at 6:00 PM, the Chabad House of Buffalo presents a dinner honoring Dr. Robert A. Milch. Guest speaker will be Fred Rosner MD, FACP. The topic will be "Physician Assisted Suicide." Dr. Rosner is the Director of Medicine in the Queens Hospital Center in Jamaica, NY and Professor of Medicine at Mount Sinai School of Medicine. He is an internationally know authority in medical ethics. The dinner will be held at the Knesset Center, 500 Starin Avenue, Buffalo, NY. Reservations must be made in advance. The cost is $50 per person. For further details, contact Jack Freer MD 887-4852, jfreer@buffalo.edu.

Joseph Fins Visit

Joseph J. Fins, MD will be in Buffalo on Monday, June 30 for a number of activities, including City-Wide Ethics Grand Rounds. Dr. Fins is on the staff of Cornell University Medical College, is Associate for Medicine at The Hastings Center, and is the Director of Medical Ethics at New York Hospital. 8:30 AM - 9:30 AM: "Clinical Pragmatism: A Method of Moral Problem for Medicine." Millard Fillmore Hospital, Gates Circle, Webster Hall. Department of Medicine Grand Rounds.

10:00 AM- 11:00 AM: City Wide Ethics Grand Rounds. Case Presentations. Millard Fillmore Hospital, Gates Circle, Webster Hall.

11:30 AM - 12:30 PM: "Truth Telling in Clinical Practice: The Evolution of a New Ethic." Erie County Medical Center, Second Floor, Doctor's Dining Room.

3:30 PM - 5:00 PM: Seminar on "Reconstructing Hospital Care for Dying Patients: A Data Based Reform." Buffalo General Hospital, Swift Auditorium. Data from the recent _Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment_ (SUPPORT) indicate that the care of hospitalized dying patients continues to be inadequate. Dr. Fins has proposed a restructuring of hospital care for dying patients through the introduction of a hospice-like alternative-care unit designed to provide palliative care to dying patients who have been transferred from critical-care units. Critics have suggsested that establishing a new unit does not address the core social and cultural issues that stand in the way of improved care for the dying. Dr. Fins will address these issues drawing on data from New York Hospital. A panel of local experts will respond, including:

Susan Krasner, Ph.D.
Clinical Psychologist
University Pain Treatment Program

Catherine Lyons, RN MS
Co-chair Ethics Committee
Vice President for Nursing
Roswell Park Cancer Institute

Robert Milch, MD
Medical Director, Hospice Buffalo
Associate Clinical Professor of Surgery
Adjunct Assistant Professor Family Medicine

Susan Schwartz, MD
Pulmonary and Critical Care Medicine
Head, Department of Medicine Buffalo General Hospital
Professor of Clinical Medicine

For further information, please contact Jack Freer, MD at 871-1571, jfreer@buffalo.edu.

Center Newsletter

The Center for Clinical Ethics and Humanities in Health Care would like to issue, in edition to "The Bioethics Bulletin", a quarterly or bi-annual newsletter, with details about the Center's activities and short articles written by the Center's members. If you would like to be involved with this project, please contact Tim Madigan at 626-5826 (e-mail: timmadigan@aol.com). Any and all suggestions for format and content would be welcomed.

Upcoming Lectures

Thursday, June 5. "Evaluating Medical Learning in a Generalist Practice" in the Ambulatory Setting - Research in Progress. Presenters: Paul James, MD and Donald Pollock, PhD. 7:45 AM - 8:45 AM. Lippshutz Room, Biomedical Education Building, SUNY-Buffalo South Campus. Sponsored by the School of Medicine and Biomedical Sciences, through the Department of Medicine. Approved for 1.0 hours of AMA/PRA Category 1 credit. For further information contact Beverly Horrigan at 887-5016 (e-mail: bhorriga@mfhs.edu).

Thursday, June 5. "HIV/AIDS: Medical, Legal and Clinical Aspects." Presenters: Michael M. Lederman, MD: "Pathogenesis of HIV Disease: Implications for Clinical Management"; Ross G. Hewitt, MD: "Clinical Aspects of AIDS"; Jennifer A. Coleman, Esq.: "Legal Aspects of HIV Illness." 3:30 PM- 6:00 PM. Buffalo Marriott Hotel, 134 Millersport Highway. City-Wide Grand Rounds, SUNY-Buffalo Department of Medicine and Biomedical Sciences. Approved for up to 2.25 hours of AMA/PRA Category 1 credit. For information, contact Marie Wysocki at 898-3941; fax 898-3279.

Monday, June 23. "Research Involving Breast Cancer Predisposition Genes in the Toronto Jewish Community: An Approach to Community Involvement at One Institution." Speaker: Dr. Pamela J. Goodwin, Director, Marvelle Koffler Breast Centre. Noon-1:00 PM, Seminar Room 968, Samuel Lunenfield Research Institute, 9th Floor, Mount Sinai Hospital, 600 University Avenue, Toronto. For information, contact Charles Weijer, MD at 1-416-586-4800.

Thursday, July 24. "Cancer and Genetics." Noon. Buffalo Marriott Hotel, 1340 Millersport Highway. Quarterly Grand Rounds - Sponsored by the SUNY-Buffalo School of Medicine and Biomedical Sciences, through the Department of Family Medicine. Approved for AMA/PRA Category 1 credit. For further information contact Holmes McGuigan at 898-5212.

Joint Meeting Announced

The American Association of Bioethics, the Society for Bioethics Consultation, and the Society for Health and Human Values will be holding a joint meeting November 5-9, 1997 at the Baltimore Marriott Inner Harbor Hotel, Baltimore, Maryland. The theme is "Visions for Ethics and Humanities in a Changing Healthcare Environment." This theme is meant to provoke reflection on both the perils and possibilities inherent in the rapid changes now taking place in the American healthcare system, and to some extent in healthcare systems throughout the world. Can ethics and humanities assist our society in gaining the wisdom and the political will necessary to realize the possibilities and avoid the perils? As traditional assumptions change about the way medicine and healthcare can be organized, delivered, and financed, does that mean the traditional frameworks of humanistic and value-based thinking will lose their capacity to inform our social decisions? Or will traditional norms and expectations become more important than ever? Under this broad topic, three themes will organize many of the sessions featured at the meeting. These are "Institutions, Technology, and Culture." Presentations will be grouped around the relationship between ethical and humanities perspectives on institutional and organizational change, new developments in medical science and technology, and the cultural diversity and changing moral attitudes that are of growing importance in American society. For further information, please contact: Joint Meeting, 6728 Old McLean Village Drive, McLean, VA 22101; fax: 703-556-8729; e-mail: shhv@aol.com.

Call for Papers

The Center for Multicultural Nursing & Health and African-Americans for Humanism will sponsor a conference on "Ethical Dilemmas Arising from Multicultural Differences in Health" in late Fall of 1997. To submit abstracts and/or manuscripts for possible presentation, or for additional information, contact: Essie Alberta Riley Eddins, PhD, RN, SM, PO Box 889, Chautauqua Institution, Chautauqua, New York 14722; phone and fax: 357-2479.

The State Society on Aging of New York announces its 25th Annual Conference, October 22-24, 1997, at the Desmond in Albany, New York. The conference theme is: "Building Generational and Cultural Bridges: A 25th Anniversary." Deadline for abstracts is June 2, 1997. Questions about the program and abstracts should be addressed to: Duane A. Matcha, PhD, SSA Program Chair, Department of Sociology, Siena College, 515 Loudon Road, Loudonville, New York 12211-1462; telephone: 518-783-2944; fax: 518-783-4293; e-mail: matcha@siena.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.

The Medical Director of Hospice Association, Dr. Robert Milch, co-wrote an article with Geoffrey P. Dunn, MD, the medical director of Great Lakes Hospice in Erie, Pa. Entitled "The Role of the Surgeon in Palliative Care", it was published in the April 1997 issue of The American College of Surgeons Bulletin. The article focuses on the lack of attention given to the topic of surgeons and their role in palliative medicine, the valuable role surgeons can play in palliation and the importance of offering pain and symptom control as part of surgical training.

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 June 15th.