Winter Edition 2015 M EDICAL E THICS I N U TAH Published by the Division of Medical Ethics and Humanities of the Department of Internal Medicine at the University of Utah School of Medicine Welcome to new Division Faculty member, Brent Kious, MD, PhD! Brent Kious joins us from the Department of Psychiatry at the University of Utah, where he is a Clinical Instructor. He is a practicing psychiatrist specializing in hospital-based adult psychiatry and the outpatient management of Tourette Syndrome. He is also engaged in clinical research in psychiatry, including outcomes research for hospital-based psychiatry and clinical trials in major depressive disorder and Tourette Syndrome. He completed his M.D. at the David Geffen School of Medicine at UCLA, his Ph.D in philosophy at the University of California, Los Angeles, and residency in psychiatry at the University of Utah. His philosophical research is focused on the philosophy of psychiatry, including the role of values in psychiatric diagnoses, as well as on the ethics of consent. He hopes to continue exploring these interests in conjunction with other members of the Division. The “Layers of Medicine,” course runs longitudinally over the first two years of the medical curriculum at the University of Utah School of Medicine. Students in each cohort meet every other Friday in a large group, followed by a small group facilitated by faculty from across the Health Sciences Campus. “Layers,” directed by Gretchen Case, PhD and Karly Pippit, MD, covers a wide range of topics, including how sex and gender matter in medicine. Guest speakers are an important part of the course, and one of this year’s most exciting guests was Jeanne Nollman. Ms. Nollman is a past President and Board member for the largest intersex support group in the world, AIS-DSD (Androgen Insensitivity Syndrome-Disorders of Sex Development). She has spent the last 10 years educating doctors, lawyers, therapists, social workers, the criminal justice system, and college students on what intersex is and how people with DSD are impacted physically and psychologically. Jeanne’s own journey of living with Swyer Syndrome has been featured on TV shows, in an online magazine, and recently in an international video campaign by the United Nations. Ms. Nollman spoke to the University of Utah second-year medical students about her experience of learning in her late teens that she is intersex. She spoke knowledgeably about the medical details of her diagnosis and candidly about how being intersex has shaped her life experiences. Ms. Nollman also led discussions of intersex and other sex and gender issues in medicine during a luncheon with medical students and at an Evening Ethics Discussion sponsored by the DMEH. Students at the luncheon asked insightful and thought-provoking questions, showing their great interest. Clinicians at Evening Ethics thanked Ms. Nollman for her positive impact. One piece of written feedback pointed to her talk as instrumental in opening eyes to the “the lack of a standardized approach [to DSD patients], limited knowledge about the many issues that strongly support a more nuanced and less emergency- oriented approach, and limited data re: long-term follow-up of our own [DSD] patients.” In thoughtful response to Ms. Nollman’s visit, these clinicians are planning in the coming weeks to develop a more systematic approach and broader education for themselves re: DSD with relevant clinical stakeholders (e.g., neonatology, genetics, endocrine, pediatric urology, maternal-fetal medicine, social work, behavioral health) to begin to address development of a more systematic and sensitive management approach for infants and others with DSD. Ms. Nollman’s visit was an exemplar of what a guest speaker, especially one with such clear expertise in terms of both knowledge and lived experience, can bring to our medical curriculum and to the wider community at the University of Utah. INSIDE THIS ISSUE: Layers of Medicine Brent Kious, MD, PhD 1 Mercy Killers Writing Group Biolaw Collaboration Genetics Hot Topics 2 Evening Ethics 3 Physicians Literature & Medicine Speakerships 4 Calendar 5 Division Member updates 6 Discussions of Intersex included in Medical Education in “Layers of Medicine” Course By: Gretchen Case, PhD
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W i n t e r E d i t i o n 2 0 1 5
M E D I C A L E T H I C S I N U TA H
Publ ished by the Divis ion of Medical Ethics and Humanit ies of the Department of Internal Medicine at the Universi ty of Utah School of Medicine
Welcome to new Division Faculty member, Brent Kious, MD, PhD!
Brent Kious joins us from the Department of Psychiatry at the
University of Utah, where he is a Clinical Instructor. He is a
practicing psychiatrist specializing in hospital-based adult
psychiatry and the outpatient management of Tourette Syndrome.
He is also engaged in clinical research in psychiatry, including
outcomes research for hospital-based psychiatry and clinical trials
in major depressive disorder and Tourette Syndrome. He
completed his M.D. at the David Geffen School of Medicine at
UCLA, his Ph.D in philosophy at the University of California, Los
Angeles, and residency in psychiatry at the University of Utah. His
philosophical research is focused on the philosophy of psychiatry, including the role
of values in psychiatric diagnoses, as well as on the ethics of consent. He hopes to
continue exploring these interests in conjunction with other members of the
Division.
The “Layers of Medicine,” course runs longitudinally over the first two years of the medical curriculum at the
University of Utah School of Medicine. Students in each cohort meet every other Friday in a large group, followed
by a small group facilitated by faculty from across the Health Sciences Campus. “Layers,” directed by Gretchen
Case, PhD and Karly Pippit, MD, covers a wide range of topics, including how sex and gender matter in medicine.
Guest speakers are an important part of the course, and one of this year’s most exciting guests was Jeanne
Nollman. Ms. Nollman is a past President and Board member for the largest intersex support group in the world,
AIS-DSD (Androgen Insensitivity Syndrome-Disorders of Sex Development). She has spent the last 10 years
educating doctors, lawyers, therapists, social workers, the criminal justice system, and college students on what
intersex is and how people with DSD are impacted physically and psychologically. Jeanne’s own journey of living
with Swyer Syndrome has been featured on TV shows, in an online magazine, and recently in an international video
campaign by the United Nations.
Ms. Nollman spoke to the University of Utah second-year medical students about her experience of learning in her
late teens that she is intersex. She spoke knowledgeably about the medical details of her diagnosis and candidly
about how being intersex has shaped her life experiences. Ms. Nollman also led discussions of intersex and other
sex and gender issues in medicine during a luncheon with medical students and at an Evening Ethics Discussion
sponsored by the DMEH. Students at the luncheon asked insightful and thought-provoking questions, showing
their great interest. Clinicians at Evening Ethics thanked Ms. Nollman for her positive impact. One piece of written
feedback pointed to her talk as instrumental in opening eyes to the “the lack of a standardized approach [to DSD
patients], limited knowledge about the many issues that strongly support a more nuanced and less emergency-
oriented approach, and limited data re: long-term follow-up of our own [DSD] patients.”
In thoughtful response to Ms. Nollman’s visit, these clinicians are planning in the
coming weeks to develop a more systematic approach and broader education for
themselves re: DSD with relevant clinical stakeholders (e.g., neonatology, genetics,
endocrine, pediatric urology, maternal-fetal medicine, social work, behavioral health)
to begin to address development of a more systematic and sensitive management
approach for infants and others with DSD.
Ms. Nollman’s visit was an exemplar of what a guest speaker, especially one with
such clear expertise in terms of both knowledge and lived experience, can bring to
our medical curriculum and to the wider community at the University of Utah. I N S I D E T H I S I S S U E :
Layers of Medicine
Brent Kious, MD, PhD
1
Mercy Killers
Writing Group
Biolaw Collaboration
Genetics Hot Topics
2
Evening Ethics 3
Physicians Literature
& Medicine
Speakerships
4
Calendar 5
Division Member
updates
6
Discussions of Intersex included in Medical Education in “Layers of Medicine” Course By: Gretchen Case, PhD
Mercy Killers Performance
Writing group for Residents and Fellows
Biolaw Collaboration
UCEER Hot Topics
This year, the DMEH is collaborating with the College of Law’s new Center for Law and
Biomedical Sciences to sponsor a Center fellow. The fellow is Annika Hoidal, a second year
law student at the College of Law who also has a graduate degree in social work. Her
responsibilities are to aid DMEH faculty with research needs, especially for legal or public
policy research. So far, she’s helped Leslie Francis with her article on the Americans with
Disabilities Act and accommodations within the health care work force, forthcoming in a
special issue of the St. Louis University Journal of Health Law & Policy devoted to the ADA
at 25 and health care workers. She’s also been working with Peggy Battin on her chapter on
male contraception for the Oxford Handbook on Reproductive Ethics. We hope this
collaboration will enhance research possibilities for the DMEH, as many issues in bioethics
and the humanities are linked inseparably to important legal questions.
The poetry of Ruth Stone provided insight into gerontology while the work of physician-writer
Oliver Sacks prompted reflection upon the dual professions of medicine and writing during
recent discussions of a new monthly writing group for residents and fellows.
Launched last August, the group meets in the evening in the Cartwright Conference room to
read the work of professionals writers, write in response to prompts, and to share members'
own writing. Leading the group is Susan Sample, Ph.D., M.F.A., program associate in the
Division of Medical Ethics and Humanities, and Writer-in-Residence at Huntsman Cancer
Institute, and Russ Johnson, M.D., M.Sc., PGY3 Internal Medicine/Pediatrics.
All residents and fellows are invited to join the group. The only requirement is an interest in writing creatively-
personal essays, creative nonfiction, fiction, poetry—and in sharing your work. No prior writing publication or
experience is necessary. Check the DMEH website for the next meeting in November. For more information,
*The Physicians Literature and Medicine Discussion Group 6:00-8:30 pm
The Rosie Project by Graeme Simsion, Facilitated by Aden Ross, PhD
LDSH Pugh Boardroom
The Children Act by Ian McEwan, Facilitated by Rachel Borup, PhD
LDSH Pugh Boardroom
Wed. Nov. 4
Wed. Dec. 2
*Evening Ethics Discussions
“Continuing the “Native Voices” Conversation in Utah: How can professionals trained in Western
medicine work with Native communities to improve the health status of members?
5:30-7:30 pm RAB 117
“When a patient requests a white doctor”: Where do we draw the line on allowing patient requests?
5:30-7:30 pm RAB 117
Tues. Nov. 3
Tues. Dec. 1
C A L E N D A R O F A C T I V I T I E S A N D P R O G R A M S
CME Statements Accreditation: The University of Utah School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical educa-
tion for physicians. AMA Credit: The University of Utah School of Medicine designates these live activities for a maximum of 1.5AMA PRA Category 1 Credit(s)™. Physicians should claim only the
credit commensurate with the extent of their participation in the activity. NONDISCRIMINATION AND DISABILITY ACCOMMODATION STATEMENT: The University of Utah does not exclude,
deny benefits to or otherwise discriminate against any person on the basis of race, color, national origin, sex, disability, age, veteran’s status, religion, gender identity/expression, genetic information, or sexual orienta-
tion in admission to or participation in its programs and activities. Reasonable accommodations will be provided to qualified individuals with disabilities upon request, with reasonable notice. Requests for accommoda-
tions or inquiries or complaints about University nondiscrimination and disability/access policies may be directed to the Director, OEO/AA, Title IX/Section 504/ADA Coordinator, 201 S President’s Circle, RM 135,
Salt Lake City, UT 84112, 801-581-8365 (Voice/TTY), 801-585-5746 (Fax). 1.5 CME for Evening Ethics and Literature & Medicine.
Division of Medical Ethics & Humanities Retreat
DIVISION OF MEDICAL ETHICS
AND HUMANITIES
75 South 2000 East #108
Salt Lake City, Utah 84112
DIVISION OF MEDICAL ETHICS AND HUMANITIES
Division Faculty: Margaret P. Battin, M.F.A., Ph.D. Jeffrey R. Botkin, MD, M.P.H. Samuel M. Brown, MD, M.S. Teneille R. Brown, JD Gretchen A. Case, Ph.D. Leslie P. Francis, Ph.D., J.D. Brent Kious, MD, Ph.D Erin Rothwell, Ph.D James Tabery, Ph.D. Jay Jacobson, M.D. (Emeritus)
Program Associates: Howard Mann, MD Mark Matheson, D. Phil. Susan Sample, M.F.A.
Division Associates: Rebecca Anderson, RN, Ph.D Philip L. Baese, M.D Maureen Henry, JD Thomas Schenkenberg, Ph.D
Academic Program Manager: Linda Carr-Lee Faix, M.A., Ph.C
Executive Assistant: Heather Sudbury
Phone: (801) 581-7170 or (801) 587-5884 Fax: (801) 585-9588
D I V I S I O N M E M B E R S O N T H E R O A D A N D I N P R I N T
Sam Brown was interviewed by Good4Utah regarding the ICU at IMC
working to help patients and families during trying times
Brent Kious presented "Physician-Assisted Suicide: Legal Changes in Utah
and Their Implications for Mental Health Practice" at the Critical Issues
Facing Children and Adolescents conference on October 8, 2015. He was also
recently appointed Chair of the Utah Psychiatric Association Ethics Committee.
Peggy Battin is speaking to the American Society for Pharmacy Law, meeting in Miami,
Nov. 14; giving Clinical Ethics Grand Rounds at University of North Carolina, Chapter Hill,
January 7, 2016; and has an entry on "Responding to Requests for Physician-Assisted
Dying," co-authored with Timothy Quill MD, now online in UpToDate, a reference service for
physicians.
Peggy Battin’s October 5th book and digital archive event at the Marriot Library, The Ethics
of Suicide: Historical Sources, is rebroadcast here.
An article commenting on Peggy Battin’s book, by Rick Anderson, Associate Dean for
Collections and Scholarly Communications at the Marriott Library, and the president-elect
of the Society for Scholarly Publishing, can be found here.