Wednesday, September 11, 2013

Bioethics/Health Policy Club: Gender Pay Gap in Medicine, 12-1pm on 9/12 in Learning Studio

Hello everyone!

The Bioethics/Health Policy Club, in collaboration with the Women in Medicine Club, invites you to attend our first discussion of the year on the topic of the Gender Pay Gap in Medicine. This event will be held on Thursday, 9/12 from 12-1pm in the Learning Studio. A limited amount of pizza and cookies will be provided to attendees.

We are honored to have the presence of two faculty experts on the issue at this event: Dr. Susan Pollart, who works on women's issues at the AAMC, and Dr. Sharon Hostler, who serves on UVA's Committee on Women in Medicine.

Subject areas that we hope to cover include the evidence for a pay gap, the proposed explanations for a pay gap, and solutions to the pay gap. Please join us for a respectful and informative discussion on this important issue!


The Bioethics/Health Policy Club
Austin Sim, Mazvita Simoyi, Danielle Carroll, Long Vinh

The Women in Medicine Club
Molly Davis, Melissa Ogden, Olivia Moskowitz, Veronica Sudekum

Hi everyone,

This is just a friendly reminder that the Bioethics/Health Policy Club and the 1920 Society will be hosting a discussion on the Gender Pay Gap in Medicine from 12-1pm in the Learning Studio tomorrow, 9/12. We will be joined by Drs. Susan Pollart and Sharon Hostler, and limited pizza and cookies will be available for attendees.

In preparation for this discussion, we recommend reviewing two articles related to the issue:
1. JAMA: Trends in the Earnings of Male and Female Health Care Professionals in the United States, 1987 to 2010 (Sep 2013)
2. Health Affairs: The $16,819 Pay Gap For Newly Trained Physicians: The Unexplained Trend Of Men Earning More Than Women (Feb 2011)

(If you don't have time to read anything else, take a quick look at the Discussion section of the Health Affairs article, which may surprise you).
Lastly, if you're interested in bioethics and/or health policy, want a copy of notes from the meeting, or wish to be notified of future smaller-scale events like Bioethics Bar Nights, let me know and I'll add you to our email list.


Tuesday, May 31, 2011

Wednesday, 6/1 - The Ethics of Social Media

Dear fans of bioethics,

This Wednesday at noon in the Learning Studio, we'll be gathering to discuss the issue of doctors using social media, and all of its potential benefits and pitfalls. If you own or are thinking about starting a medical blog, you should definitely come. Michelle Knoll found this article to familiarize you with the diverse perspectives on the subject:

In addition, please take a look at UVA's current policy on medical blogging:
Hint: This is actually a tip sheet for current and prospective bloggers. However, we will have the opportunity to suggest improvements to it and even begin to draft the first official policy.

Sound exciting? Well, announce it discreetly on your Twitter and Facebook statuses, and I'll..

See you there!

Wednesday, April 27, 2011

Thursday, 4/27 - Physician-assisted Suicide

Hi everyone,

To tie-in with last week's discussion of suicide, Bioethics Club will be examining Physician-assisted Suicide on Thursday at 12pm in the Learning Studio.

For a brief overview of the topic, the University of Washington SOM's Ethics page has a very concise summary of the arguments for and against:
Did you know that PAS is legal in several states? The aforementioned website quotes two studies showing that one out of five physicians report receiving a request from a patient for aid in dying, so even if you can't make the meeting, it may be worth your time to reflect on the issue.

Also, I'd like to recommend this chilling, anonymous short essay published in JAMA to great controversy, entitled, "It's Over, Debbie":

The following additional articles or websites were found and recommended by Prof. Chen to supplement our investigation into the topic:

* The following website discusses PAS in conjunction with euthanasia and tries to give equal attention to all sides of the issues. This site also points folks to two other websites that are updated more frequently -- one that supports PAS and another that opposes it.

* Quill T. Death and Dignity -- A case of individualized decision making. NEJM 1991. (sparked enormous controversy)

* Miller FG. A planned death in the family. Hastings Center Report 2009. (written by a philosopher-bioethicist about his sister, really makes one think about the distinctions we make between withdrawing treatment and PAS.)

* And finally, a recent newpaper article about Vermont's PAS bill interviewed the brother of the man whose death was responsible for Kevorkian's jail term.


Wednesday, January 12, 2011

Leland Stillman on Agricultural Policy and Antibiotic Resistance

Classmate Leland Stillman has kindly shared with us his undergrad honor's thesis, which is highly relevant to our discussions of agricultural policy and antibiotic resistance. I've included his email below:


I have pasted in my abstract, followed by my conclusion, and preceding both, a link to the paper itself. I also must recommend the first page or so of my introduction, which to this day I find screamingly funny, and in particular the first two lines: "In 1522 Ferdinand Magellan completed his first circumnavigation of the world, proving to the Western world that the earth was in fact round. Though perhaps few noted it at the time, this implied a disturbing corollary; the resources of the earth were limited. "

Environmental factors play a major part in human health. Environmental pollutants are often as poisonous to humans as the environment. Presently, much time and energy is dedicated to keeping pollution apart from human society, with varying success. But as global population densities rise, current levels of pollution will become inviable due to public health concerns. An emergent example of this is in the concentration of livestock operations. Recent changes in the structure of U.S. hog farming have resulted in an industry-wide shift from small or medium production farms to high capacity, “concentrated animal feeding operations” (CAFO). These operations have become the subject of intense debate due to air and water pollution, including odor, that can be nuisances or outright public health threats to their communities. In addition, the quantities of animal wastes produced and seasonally sequestered by these operations can be accidentally released via natural processes like floods, often with catastrophic results. Finally, the animals live in conditions of high stress and poor hygiene that are conducive to disease and so most operations therefore feed their animals antibiotics on a regular basis. Recent studies have found increased incidence of antibiotic resistance resulting from this chronic application of antibiotics. Current regulations have failed to resolve these problems, and in 2003 the American Public Health Association issued a call for a moratorium on CAFO construction. The purpose of this paper is to explore economic and legal solutions to this harmful shift in industry structure.

IV. Conclusion: Final Recommendations and Summary of Research Findings
CAFOs represent a severe hazard to the public health. Previous attempts at regulation have only curtailed symptoms rather than eliminating core problems. Yet neither scientists nor economists, who often oppose one another in such debates, believe CAFOs are the best method of animal agriculture. Decades of research have shown the CAFOs are not only unsustainable and wasteful in scientific terms, but economically as well. All that is required is a dismantling of current policies that enable the CAFO industry to out compete smaller operations. But as Nigel and Key (2003) note, changes to policy must be gradual or compensated so that farmers and other industry workers, and society at large, do not suffer from bankruptcy, unemployment, and sudden shortages in food products. To that end, it is recommended that government subsidies which would otherwise directly benefit CAFOs should be used to transition these operations to diversified farms. Indirect subsidies should be, if not cut altogether, then assessed to CAFOs at purchase; feed in the form of grain is the principle example of this. 55
Regarding externalities, the same gradual and compensated approach should be taken. A Coasian approach should be incorporated into the current regulatory frameworks, both to ease the regulatory burden and to allow individuals to reach efficient solutions of their own volition. Property rights should be delimited closely and firmly, with specific regards to farming, and keeping in mind that a certain amount of pollution, from noise to odor to runoff, is inevitable from agricultural processes. These measures would take effect over the course of years. In the meantime, the American Public Health Association's recommendation for a moratorium on CAFO permits should be honored by state and federal government, regardless of industry complaints. Furthermore, attention should be paid to specific populations at risk, populations in CAFO dense areas. If CAFO densities are seen to pose an acute public health risk in these areas, officials should identify key operations to shut down, if necessary. For decades, scientists, citizens, government officials, and industry professionals have recognized the problems posed by CAFO production methods. Free markets and well established property rights provide a solution that allows for efficient markets and protects public health. Hopefully, policy will catch up to the scientific research and recognize the expediency of this solution, and policy makers will put the public first and make the necessary changes. Hopefully, CAFOs will be a thing of the past in a few years, agriculture will have returned to its idyllic roots.

Sunday, January 9, 2011

Thursday, 1/13 - Antibiotic Resistance and Public Policy

Hello all,

This week, to tie in with our study of bacteria and viruses, we're going to talk about antibiotic resistance and the public policies that influence it.

The main reading is a piece from AP about how Norway has dealt with the problem of MRSA and how other countries could do the same:

Next, we have a study relating changes in the strictness of Norway's infection control policy to the incidence of MRSA cases:

On a different note, here is an article written by some investigative reporters who found ways to get antibiotics over the counter in the US:

This article in The Economist takes a more international perspective, exploring the link between trade barriers and demand for antibiotics:

But wait, we're not done yet! Nicholas Kristof writes in this article about the connection between agricultural policy and antibiotic resistance:

Lastly, a final consideration to make. Here's a report suggesting that antibiotics in livestock can even leak out into crops:


P.S. Justin Barr recommends the following book-length treatment of the issue:
Levy, Stuart B. The Antibiotic Paradox: How Miracle Drugs are Destroying the Miracle. New York: Plenum Press, 1992.

Monday, November 1, 2010

Wednesday, October 27, 2010

Opportunity: AMA Ethics Journal Issue Editors

Hi Everyone,

Prof. Donna Chen pointed out a wonderful opportunity in Bioethics to me today. Check it out here:

From the site:

Virtual Mentor [] is the American Medical Association's online ethics journal. Its mission is to promote the ethical and professional development of tomorrow's physicians, and its primary audiences are medical students, residents, other physicians, and medical educators.

VM serves as an educational resource for a rapidly growing number of readers. We invite medical students and resident physicians who are AMA members to apply to serve as theme issue editors. If you are not yet an AMA medical student or resident physician member and would like to join, you can do so online at

Each theme issue editor undertakes, with help from VM staff editors, responsibility for: (1) selecting a theme for one issue and defining the ethical and professionalism concerns inherent in that theme, (2) generating case narratives that provide opportunities for examining those concerns in clinical and educational contexts, (3) identifying, securing, and corresponding with contributors to the issue, (4) editing copy and reviewing page proofs before the issue goes live on the first working day of the month. These tasks will be accomplished at each editor's "home" location.

Theme issue editors, selected in late November, will be flown to Chicago to meet with Virtual Mentor staff some time in February. Each theme issue editor receives a $1,000-stipend.

Experience in editing or journalism is desirable. The abilities to critique an argument or article, work well with authors, and meet deadlines are essential. To apply, send a short letter stating your current medical student or resident program status and your reason for wishing to be a theme issue editor for VM. Attach to the letter the following:

1. A curriculum vitae
2. A writing sample of not more than 1,000 words
3. Your response to the following exercise in 800 words or fewer.

Virtual Mentor is planning an issue that examines disparities in medical care that are due to non-clinical factors such as ethnicity, uninsured status, living in a particular part of the country. Considering VM's mission and primary audiences, what ethical and professionalism concerns specific to this theme should VM develop? Look at the table of contents in one or more issues of VM. What cases and articles would you develop for each of the sections that appear in a typical issue—the clinical cases and commentaries, journal discussion, policy forum, op-ed piece, medicine and society, or medical humanities. How would you go about identifying prospective contributors to this topic?

Be as specific as possible in your reply to this part of the application. It serves as our best indicator of how you would approach your editing responsibilities.

Send your letter of application and attachments by e-mail to:

The deadline for applications is midnight CST on Saturday, November 13, 2010.