Bioethics in the Margins

Podcast episodes

• Season 6

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  Bodily Autonomy, Reproductive Justice, and Tear Gas with Asha Hassan

  Bodily Autonomy, Reproductive Justice, and Tear Gas with Asha Hassan

  S06 E05

  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%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.

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  Medical-Legal Partnerships and Social Determinants of Health with Lynette Martins

  Medical-Legal Partnerships and Social Determinants of Health with Lynette Martins

  S06 E04

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

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  Racial Inequities, Shared Decision-Making, and Trauma-Informed Critical Care with Dr. Deepshikha Ashana

  Racial Inequities, Shared Decision-Making, and Trauma-Informed Critical Care with Dr. Deepshikha Ashana

  S06 E03

  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/2815259 https://www.atsjournals.org/doi/10.1513/AnnalsATS.201909-700IP

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  Nonprofit Healthcare, Virtue, and Mission with Dr. Mark Kuczewski

  Nonprofit Healthcare, Virtue, and Mission with Dr. Mark Kuczewski

  S06 E02

  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

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  Deliberative democracy, social justice and the Black Opticon: a discussion with Dr. Anita Allen

  Deliberative democracy, social justice and the Black Opticon: a discussion with Dr. Anita Allen

  S06 E01

  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.