"Wit" Movie Screening and Discussion on End of Life Care

BAHM and Ob/Gyn club are co-sponsoring this event.

All are welcome to attend (no membership required).

Thursday, September 29th 2011  -  6:30pm

The film is 98 minutes.

A discussion will follow with Dr. Ronnie Martin.

Location: Knollwood, 2nd Floor

We'll have popcorn! Bring your own dinner, if you'd like.

Significant others and friends are welcome and encouraged to come.

"Emma Thompson plays a hardnosed English professor who has been diagnosed with terminal ovarian cancer. During the story, she reflects on her reactions to the cycle the cancer takes, the treatments, and significant events in her life. The people that watch over her are Jason Posner, who only finds faith in being a doctor; Susie Monahan, a nurse with a human side that is the only one in the hospital that cares for Vivian's condition; and Dr. Kelekian, the head doctor who just wants results no matter what they are." Modified from http://www.imdb.com/

Aftermath: The Common Reading Experience

In 7 small groups, over 3 days, 44 VCOM students met to discuss the themes in the book My Own Country, by Abraham Verghese, as they relate to our medical school experience.  The discussion leaders were three faculty and two staff members and two 2nd year students.

The group discussions were as different as their participants' backgrounds.  First and second year students from all walks of life shared their understanding of what their "own countries" are, stories of their first encounters with HIV/AIDS, and their worries about maintaining a work/life balance as medical students and future physicians.

Students wondered how they will personally react, as physicians, to issues burdened with stigma.  What issues are they comfortable or uncomfortable confronting?  How can the physician-patient interaction affect the patient's quality of life, regardless of whether or not treatment is available?

Some students indicated in a post-discussion feedback survey that they would like to continue the conversation.  As such, we will plan on hosting follow up discussions in the coming year, honing in on specific topics of interest.  Below is one topic, eloquently expressed by a faculty member, that we would like to further explore, and one which we will leave for your thoughts:

Where do

1. the patient's freedom of choice and individual rights
2. a physician’s obligation to serve man, and
3. the individual physician's beliefs and morals

come together in a collaborative relationship that provides respect for everyone?

Thanks to everyone who participated, including Lucie Monroe's coffee shop and Mill Mountain Coffee & Tea for allowing us to use their space!

The Common Reading Experience

Students, Faculty, and Staff, 

BAHM invites you to VCOM's Common Reading Experience.

With votes from students, faculty, and staff, BAHM has selected 

My Own Country, by Dr. Abraham Verghese  

If you're interested in participating, please sign up on this survey so that you can be placed in a discussion group.  Stay tuned for more detail closer to August. 

Participants in the Common Reading Experience will read the book on their own over the summer and meet in small groups in the first week of August to reflect on its themes.
We'll be meeting at local coffee shops to introduce the class of 2015 to Blacksburg and Christiansburg. 

This will be a great opportunity for members of the incoming class to meet each other and to meet upperclassmen, faculty, and staff in the setting of a reflective and thought-provoking discussion. Likewise, faculty and staff will have the chance to interact with students outside of the classroom. Participating faculty are encouraged to incorporate themes from the book into their lectures, if possible. 

If you have questions, please email vcombioethics@gmail.com.

We look forward to the experience!

Occupational asthma - Inherent conflict of interest?

You’ve been Mary’s physician for 10 years. She is now 28 years old with two young children and a recent divorce.  Mary came to you depressed last year because she felt isolated, was unemployed, and didn’t want to become welfare dependent.  She seems much happier today when she sees you, because she’s excited to tell you she’s had a fairly well paying job for the last 4 months. She works at an employee-friendly domestic cleaning service.

Mary tells you that her childhood asthma, which she had kept under control, has become exacerbated on the job because of the cleaning products she has to use.  Her employer noticed her concerning coughs and wanted a physician to check on her, to clear the company of any liability they have for her health.  She has a form for you to fill out regarding her physical wellbeing.  Mary begs of you to clear her for the job and promises to wear a mask over her nose and mouth from now on. She says she’s likely to be fired and lose her decent income if you document her asthma’s exacerbation.

Define the ethical issues involved and describe what you would do as her physician. 

To reply anonymously when you post a comment, please select "Name/URL" in the "Comment as" box, so that you can come up with a distinct alias. 

Moderator: Anencephalic neonates as organ donors?

Thanks to everyone who responded!  Feel free to continue discussing the topic.  Many of members of the VCOM community who commented on this case evoked the utilitarian argument that harvesting organs from our anencephalic neonate is acceptable because it could save the lives of numerous other infants.  However, we did not reach consensus, as various arguments were presented from the legal, clinical, emotional, biologic, and slippery slope stances.

We raised a lot of important questions: What state of a brain is considered adequate for life, and is there a difference between an anencephalic infant and an adult in a permanent vegetative state? Does the law respect the parents’ right to choose what’s best for their child? What are the parents going through, and how can we help them cope? Will there even be an organ donation team willing to harvest the organs of an anencephalic neonate?

Law makers and clinicians have struggled with these same questions for many years. The first successful infant heart transplant in the US occurred at Loma Linda University Medical Center in 1987. The donor was an anencephalic infant from Canada. In the following nine months, the medical center placed a dozen anencephalic infants on ventilators to await their brain death (which could be prolonged because of the intervention) so that their organs could be donated. All 12 infants failed either to arrive at brain death within one week or to be matched with a recipient infant within one week. As a result, the hospital suspended its anencephalic organ donor program under the current legal definitions of brain death.

For those of you interested in further reading, here are two excellent reviews:

Meinke, SA: Anencephalic infants as potential organ sources: Ethical and legal issues. National Reference Center for Bioethics Literature. 1989. Full article

Bard, JS: The diagnosis is anencephaly and the parents ask about organ donation: Now what? A guide for hospital counsel and ethics committees. Western New England Law Review. 1999. Full Article

Sources: 
Goldsmith, MF: Anencephalic organ donor program suspended; Loma Linda Report expected to detail findings. The Journal of the American Medical Association. 1988.
Annas, GJ: From Canada with love: Anencephalic newborns as organ donors? Hastings Center Report. 1987.

Speaker Event: Syphilis Studies in Tuskegee and Guatemala

If you attend the talk, we'd love to hear your thoughts on it!  Leave comments below or email us. 

Susan Reverby, Marion Butler McLean Professor in the History of Ideas at Wellesley College, will be at Virginia Tech on Thursday, April 14, 7 PM, in 3100 Torgersen Hall, Virginia Tech to give a lecture entitled  

"Escaping Melodramas: Reflections on How to Think about the Syphilis Studies in Tuskegee and Guatemala." 

Prof. Reverby  is the author of Examining Tuskegee: The Infamous Syphilis Study and Its Legacy, and recently uncovered U.S. government involvement in a similar "study" in Guatemala. Reverby's work brings together issues of race, gender, and class as she explores the implications of the Tuskegee study in modern memory and modern medicine. Sponsored by the undergraduate Minor in Medicine and Society in the Department of Science, Technology, and Society.

Anencephalic Neonate – A potential organ donor?

Case: Angela and Bruce discovered from Angela’s high serum alpha-fetoprotein level that their child had a neural tube defect. Ultrasound confirmed a case of anencephaly. Three months later, baby Katherine beat the odds and was born alive, though with severe brain defects. She responded to external stimuli but had no sense of hunger, pain, or discomfort. She had an uncoordinated suck/swallow reflex that made breathing difficult when Angela tried to feed her.

The physician expected baby Katherine to die within hours or days. In the wake of their infant’s poor prognosis, the parents’ only wish was for her organs to be donated to another infant in need.

Background: The law states that organs can only be removed from a patient who is declared to be brain dead. For adult patients, a “brain dead” state is an irreversible absence of brain activity. “Brain dead” adults can be placed on a ventilator for their vital organs to remain well-conditioned until they are surgically removed. Anencephalic infants who survive birth currently do not meet the “brain dead” criteria, though they undoubtedly have an irreversible and deteriorating condition. As their brainstem slowly loses its primitive function, so do their organs, until the heart stops. While initially in good condition, their organs are generally not accepted for donation at the time “brain death” is declared.

Questions: Should Angela and Bruce have the authority to demand “premature” extraction of their infant’s organs? In this case, should an “absence” or severe underdevelopment of a brain be considered “brain death?”

Bioethics cases are back!

Join the discussion!

Ground Rules:
1. Feel free to post anonymously if you wish, but please use a consistent pseudonym so that people can respond to your comments without having to scroll up to see which anonymous/time stamp they are referring to.
2. Discussion is moderated - no posts will be edited, and all posts will be accepted UNLESS the author is grossly off topic (i.e., the case is on abortion and you write about how you hate the military), is using ad hominem arguments (insulting other people instead of addressing their arguments), or uses profane language.

Enjoy :)

New Writing Contests Posted

• The Kaiser Family Foundation 2011 Essay Contest- Feb 28


• Arnold P. Gold Foundation Humanism in Medicine Essay Contest- March 31

Both contests offer cash prizes and would make a great addition to your CV.
More details on our Get Published page or the contest websites.

New Officers

We had elections this evening and are proud to announce the new leadership of BAHM:

Chair: Shokoufeh Dianat
Lore Master: gabe Edmondson*
Events Chair: Preethi Kumar
Webmaster: Joe Fields-Johnson

*From the Grammar Department: This is not a typo. Student Doctor Edmondson prefers his first initial to be lowercase.

***Don't forget to check out our photos from Recess Arts Night!***

Thank You

Thanks to everyone who came out to Recess Arts Night on Saturday. It was amazing to see so much student talent all in once place!

PICTURES!!!!

Also, for anyone interested in getting involved with BAHM, we will be having officer elections soon. Check this blog and your email for information on that.

RECESS Arts Night: Jan 8, 2011, 7-10pm

Come out to Main Lee Art Gallery in downtown Blacksburg this Saturday night to see original paintings, photography, fashion design, and more by your classmates and the staff of VCOM.

Live student performances start at 7:30 pm and feature the Rocktologists, singer-songwriters Stephen Morse & Eddie Brown, Preethi Kumar on Indian drums, and VCOM's first and only improv comedy troupe Somatic Dysfunction.

***Click HERE for a full list of featured artists***

Local artists in residence from the community will also be present in their studios upstairs from the main gallery to take questions and show off their work.

All are welcome! No RSVP is necessary. Wine, cheese, hot chocolate, and cookies will be served.

Questions? Contact Lisa Mitchell or Emily Holt.