Siste episoder av Bioethics in the Margins podcast

1. What bioethicists should know about FEMA with Julia O'Brien23.09.2025 (00:41:00)

   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.

2. "A Survey of Attitudes Toward Social Justice Obligations in the Field of Bioethics" a discussion with AJOB article authors30.06.2025 (00:49:03)

   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/10.1080/15265161.2024.2323869Dougherty 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/

3. Dental Ethics and Oral Health Justice with Dr. Carlos Smith27.05.2025 (01:04:49)

   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/j68ePPQSmith, 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/12896517Smith, 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

4. Capital Punishment and the Physiology of Nitrogen Gas Executions30.04.2025 (00:44:54)

   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 NetworkThe 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

5. Solidarity with Immigrants with Dr. Rachel Fabi31.03.2025 (00:39:12)

   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 Kuczewski2. Link to “red cards” to inform people of their rights3. Immigration Policy Tracking Project4. The Health of Newcomers by Patricia Illingworth and Wendy E. Parmet

6. Structural roots of firearm violence with Dr. Tanya Zakrison28.02.2025 (01:08:45)

   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/28922206https://pubmed.ncbi.nlm.nih.gov/30484899/https://pubmed.ncbi.nlm.nih.gov/35300858/Link to Practical Radicals: https://thenewpress.com/books/practical-radicals

7. Centering Reproductive Health of Black Women with Sickle Cell Disease with Dr. Shameka Poetry Thomas28.01.2025 (00:57:48)

   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.

8. Diversification of Bioethics with Donald Carter24.12.2024 (00:40:39)

   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.

9. Understanding and Responding to Book Bans with Laureen Cantwell-Jurkovic27.11.2024 (00:57:51)

   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.orgFreedom to Read Foundation (FTRF): https://www.ftrf.org/Data:Banned Books Week data: http://www.ala.org/advocacy/bbooks/book-ban-dataAbout Banned Books: https://www.ala.org/bbooks/aboutbannedbooksBanned Books Week 2025: https://bannedbooksweek.org/ALA Censorship by the Numbers site: https://www.ala.org/bbooks/censorship-numbersPreliminary data for 2024: https://www.ala.org/news/2024/09/american-library-association-reveals-preliminary-data-2024-book-challenges

10. Immigrant Health and the Work of Bioethics with Dr. Brian Tuohy30.10.2024 (00:41:54)

    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/soz048Rocco, 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/10.1080/15265161.2021.2001105Tuohy 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.

11. Bodily Autonomy, Reproductive Justice, and Tear Gas with Asha Hassan 15.07.2024 (00:42:44)

    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%20utilizationhttps://carhe.umn.edu/research-library/more-tears-associations-between-exposure-chemical-agents-used-law-enforcement-andhttps://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.

12. Medical-Legal Partnerships and Social Determinants of Health with Lynette Martins18.06.2024 (00:48:50)

    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.pdfhttps://medical-legalpartnership.org/wp-content/uploads/2020/10/Health-Center-MLP-Toolkit-FINAL.pdf

13. Racial Inequities, Shared Decision-Making, and Trauma-Informed Critical Care with Dr. Deepshikha Ashana06.05.2024 (00:39:13)

    In this episode, Kirk and Amelia speak with Dr. Deepshikha Ashana about her research on racial disparities present in shared decision-making practices in critical care. Dr. Ashana shares how her research interests were motivated by her personal observations of racial disparities, from her childhood in India, her experience moving to the US, and her education in Philadelphia. Her recent research thematically analyzed audio recordings of conversations between families and clinicians of critical care patients, using inductive analysis to identify four ways that communication behaviors differed in clinicians’ engagement with racially minoritized families. She discussed the racialized empathy gap, how cultural health capital is received differently from Black versus white families, and the striking disagreements in self-reports of conflict between clinicians and family members that fall along racial lines. She also discussed the importance for critical care clinicians to be trained in trauma-informed practices. In thinking about what is next in her research, she highlighted the importance of finding effective ways to mitigate the effects of structural racism on the healthcare system which go beyond the limitations of implicit bias training, and she emphasized her passion for empowering clinicians to offer the best care possible. Dr. Ashana is an assistant professor of medicine in Duke’s Division of Pulmonary and Critical Care and a practitioner in the Duke University Hospital medical intensive care unit and at Duke Health Center at Southpoint. Her research focuses on understanding and addressing mechanisms of differences in critical illness care among underserved patients. She uses mixed methods to study epidemiologic trends in national health claims data and understand patient perspectives on serious illness care, with a particular focus on modifiable clinician and health system factors. Her work can be found here: https://medicine.duke.edu/profile/deepshikha-ashana Referenced articles: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2815259https://www.atsjournals.org/doi/10.1513/AnnalsATS.201909-700IP

14. Nonprofit Healthcare, Virtue, and Mission with Dr. Mark Kuczewski08.04.2024 (00:54:14)

    Amelia and Kirk chat with Dr. Mark Kuczewski, Professor of Medical Ethics at Loyola University, Chicago. In this episode, they discuss his recent article https://www.healthaffairs.org/content/forefront/nonprofit-health-care-behaves-badly-case-mission-leaders-ombudsmen in which Dr. Kuczewski elucidates the challenges nonprofit healthcare employees face as workplace culture becomes increasingly corporatized and the importance of counterweights– in the form of ombudsmen, better-designed incentive structures, and virtuous local board members– who can potentially help promote the nonprofit mission for patients. They also discuss Dr. Kuczewski’s publication on organizational ethics and the importance of hiring for mission (https://www.researchgate.net/publication/6121839_Is_Organizational_Ethics_the_Remedy_for_Failure_to_Thrive_Toward_an_Understanding_of_Mission_Leadership).Dr. Kuczewski describes the “patchwork” of healthcare available to undocumented immigrants and the need to sever the tie between immigration status and healthcare access and talks about his work with Loyola University Chicago Stritch School of Medicine to accept DACA recipients into its program.Dr. Kuczewski is the Father Michael I. English S.J. Professor of Medical Ethics at Loyola University, Chicago, the director of the Neiswanger Institute for Bioethics and Health Policy, and a Fellow of the Hastings Center. His current interests include the bioethical issues related to immigration. He served as the project manager of the Loyola University Chicago Stritch School of Medicine effort to include Dreamers in medical education, wherein Stritch became the first medical school in the nation to welcome applications from Dreamers of DACA status. https://www.luc.edu/stritch/bioethics/aboutus/facultydirectory/profiles/kuczewskimark.shtml

15. Deliberative democracy, social justice and the Black Opticon: a discussion with Dr. Anita Allen01.03.2024 (00:55:21)

    Kirk and Amelia had the pleasure of speaking with Dr. Anita L. Allen, the Henry R. Silverman Professor of Law and Professor of Philosophy at the University of Pennsylvania. In this episode, they discuss Dr. Allen’s experiences working on President Obama’s Presidential Commission for the Study of Bioethical Issues where she engaged in deliberative democracy approaches to explore challenges with advances in biomedicine, technology and synthetic biology. A highlight of her time there included a report titled “Ethically Impossible” that documented and acknowledged gross human research subject abuses that occurred in Guatemala from 1946-1948, overseen by the US Public Health Service. (https://bioethicsarchive.georgetown.edu/pcsbi/sites/default/files/Ethically%20Impossible%20(with%20linked%20historical%20documents)%202.7.13.pdf). Other aspects of Dr. Allen’s prolific career that they discuss include her work on the concept of privacy, reproductive justice and racial justice concerns in what Dr. Allen has termed “The Black Opticon” (https://www.yalelawjournal.org/forum/dismantling-the-black-opticon). Dr. Allen is an internationally renowned philosopher with over 120 articles and chapters published at the intersection of bioethics, privacy and data protection law, women’s rights, and diversity in higher education. She is a graduate of Harvard Law, currently serving on the Board of the National Constitution Center, the Future of Privacy Forum and the Electronic Privacy Information Center.

16. Gun Violence Prevention and Treatment with Dr. Stephen Hargarten27.11.2023 (00:42:37)

    Dr. Stephen Hargarten is a Professor of Emergency Medicine, Associate Dean for Global Health, Director of the Global Health Pathway, and Director of the Comprehensive Injury Center at the Medical College of Wisconsin. His research interests reflect an intersection of injury and violence prevention and health policy to address the burden of this biosocial disease. He was the founding President of the Society for the Advancement of Violence and Injury Research and has served on the Violence and Injury Prevention Mentoring Committee for the World Health Organization. In his conversation with Amelia and Kirk, he makes a compelling argument for considering firearm injury as a disease and a public health crisis. They discuss state and federal policies that can and do affect this primarily political disease. Dr. Hargarten also explains the use of a biopsychosocial model for healing from firearm injury and calls for medical educators to include firearm injury mechanisms, prevention and treatment in curricula. Selected publications are included below. Commentary: Moving Emergency Medicine Toward the Biopsychosocial Disease Model (Hargarten S.) Annals of Emergency Medicine. November 2019;74(5):S52-S54 SCOPUS ID: 2-s2.0-85073691318 11/01/2019 Gun Violence Education in Medical School: A Call to Action (Barron A, Hargarten S, Webb T.) Teaching and Learning in Medicine. 2022;34(3):295-300 SCOPUS ID: 2-s2.0-85104939062 01/01/2022 A scoping review of patterns, motives, and risk and protective factors for adolescent firearm carriage (Oliphant SN, Mouch CA, Rowhani-Rahbar A, Hargarten S, Jay J, Hemenway D, Zimmerman M, Carter PM.) Journal of Behavioral Medicine. 15 August 2019;42(4):763-810 SCOPUS ID: 2-s2.0-85069995818 08/15/2019

17. Dignity of Risk with Adira Hulkower30.10.2023 (00:41:20)

    Amelia and Kirk have a broad-ranging discussion with Adira Hulkower, the Director of Clinical Ethics at the Montefiore Einstein Center for Bioethics in the Bronx. She shares her experiences as a clinical ethics consultant applying the concept of Dignity of Risk to better understand the ethical implications of discharge planning for patients experiencing homelessness. They discuss healthcare institutional responsibilities related to social determinants of health broadly as well as to individual patients. The importance of intersectionality and patient narratives are explored.

18. Immigrant Health Policy with Rachel Fabi26.09.2023 (00:39:57)

    We are joined by 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 shares her insights on policies that affect the health of immigrants and refugees in the United States, and discusses her research on a broad range of topics such as access to care, reproductive health and treatment in ICE detention. Listen to the end for her insights into the role of physician advocacy.

19. Teaching about Institutional Racism with Dr. Keisha Ray28.08.2023 (00:44:19)

    We kick off Season 5 with the phenomenal Dr. Keisha Ray, who received her PhD in philosophy, with a focus on bioethics, from the University of Utah. She is currently a tenured Associate Professor with the McGovern Center for Humanities & Ethics at UT Health Houston, where she also serves as the Director of the Medical Humanities Scholarly Concentration. Kirk and Amelia chat with her about new book Black Health. Listen to our discussion with Dr. Ray on the importance of writing for pre-health students, undergraduates and high school students to teach folks early on about institutional racism. We take a deep dive into some topics such as the role of sleep in overall health and health disparities and the concept of weathering.

20. Diversity and Equity in Clinical Care with Dr. David Kountz22.05.2023 (00:49:45)

    In this episode, we are joined by Dr. David Kountz, MD, MBA, FACP who is the Chief Academic Officer and Vice President of Academic Diversity for Hackensack Meridian Health, a 17 hospital network in Northern and Central New Jersey. Kirk and Amelia explore a range of strategies to promote equity in clinical care with Dr. Kountz, including the importance of pipeline programs to enhance the diversity of the clinician pool and tying organizational quality metrics to equity outcomes in order to enhance quality of care. We also explore what ethical obligations physicians may have to advocate for equity in public policy.

21. Mental Health and the Carceral System with Dr. Nathaniel Morris24.04.2023 (00:55:14)

    We reached out to Dr. Nathaniel Morris after reading his recent article in the New England Journal of Medicine; Injustice Disorder. Dr. Morris is currently an Assistant Professor of Clinical Psychiatry at the University of California San Francisco and provides care to incarcerated patients in the San Francisco jail system. He has published numerous journal articles on mental health care in jails and prisons, the criminalization of people with mental illness and addiction, and other topics in psychiatry and the law. Other publications include; Cell Front: The House Calls of Mass Incarceration in Annals of Internal Medicine; From Crime to Care - On the Front Lines of Decarceration in NEJM; and Addressing Shortages of Mental Health Care Professionals in U.S. Jails and Prisons in the Journal of Correctional Health Care.

22. Philanthropy as Power with Tim Schwab28.03.2023 (00:43:58)

    Amelia and Kirk speak with Tim Schwab, an investigative journalist based in Washington DC whose work has appeared in The Nation, the Columbia Journalism Review, the British Medical Journal and other outlets. https://about.me/tim_schwab. Today's episode is all about philanthropy and power, and the ethical implications of this facet of concentrated wealth. We discuss implications for public health https://www.thenation.com/article/society/gates-covid-data-ihme/, vaccine distribution and more, while examining how this type of philanthropy perpetuates existing power structures and undermines health in insidious ways https://www.thenation.com/article/society/gates-foundation-colonialism/.Amelia's article When Generosity Harms Health Care and Public Health can be found here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603488/Tim Schwab is currently writing a book (Henry Holt Books) about Bill Gates and the Gates Foundation---"The Bill Gates Problem"----which is available for pre-order anywhere you buy books. https://www.amazon.com/Bill-Gates-Problem-Reckoning-Billionaire-ebook/dp/B0BTX5FWNF/ref=sr_1_1?keywords=bill+gates+problem+tim+schwab&qid=1679948365&sr=8-1

23. More on Epistemic Injustice with Ryan Felder27.02.2023 (01:04:44)

    Kirk and Amelia continue our discussion of Epistemic Injustice with Ryan Felder, PhD. Ryan is a Clinical Ethics Fellow at the Stanford Center for Biomedical Ethics. He earned his PhD in philosophy from the City University of New York in 2021. He shares his thoughts on the practical applications of Epistemic Injustice in clinical ethics consultation as well as how Epistemic Injustice relates to our understandings of cannabis efficacy and long COVID among other things. Ryan's other work can be found here: https://onlinelibrary.wiley.com/doi/full/10.1002/hast.1248.

24. Pain Talk: Beyond Epistemic Injustice with Jada Wiggleton-Little26.12.2022 (00:56:27)

    Amelia and Kirk interview Jada Wiggleton-Little who is a PhD Candidate at UC San Diego working primarily in philosophy of mind, social epistemology, and clinical ethics. Ms. Wiggleton-Little unpacks her theory called pain-related motivational deficit. Pain-related motivational deficits occur when a self-reported pain is believed but fails to motivate concern because ideologies distort either features of the speaker in pain (e.g., obese people deserve their pain) or distorts the kind of pain being expressed (e.g., excruciating period pains are normal). To resist these oppressive distortions, patients often adopt performative strategies that cater to gender and racial expectations and the medical gaze. It is a way of reclaiming one's agency in the clinic, but it is also a laborious task for patients already suffering with chronic pain. Listen for practical solutions and find out what it would look like to be an epistemically humble clinician.

25. Live from the American Society for Bioethics and Humanities Conference in Portland, OR28.11.2022 (01:17:07)

    Listen to the whole team discussing the process of developing the Bioethics in the Margins podcast, where we've been on our podcast journey and where we hope to go. Amelia Barwise, Liz Chuang, Kirk Johnson and Nicolle Strand met each other in person for the first time ever this October in Portland, Oregon for the ASBH annual meeting. We heard some great ideas from attendees and had a lot of fun. Don't hesitate to tweet us @BEInTheMargins with your ideas for topics and guests.