Message from the President & CEO
We begin February watching closely as the new Biden administration appoints bioethics experts to key leadership and advisory posts in science and health. Some of these professionals have worked with the Greenwall community in the past, and we wish them all well as they work to bring thoughtful solutions to some of the country’s most pressing challenges in health, health care, and the life sciences. We are grateful to our Scholars and grantees who continue to produce vital research to guide the best way forward. I invite you to read more from our community below. |
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Spotlight
As COVID-19 dominated the headlines in 2020, drug overdoses were rising to alarming levels. Last year, nearly every state reported increases in opioid related deaths, and 10 western states reported a dramatic 98% increase in opioid deaths. Opioid Use Disorder has been made worse by the COVID-19 pandemic. Social distancing measures make it difficult for those struggling with addiction to find the help and support they need. Hospitals have had to refocus most of their attention on COVID-19, making fewer doctors and resources available for addiction treatment. Some of The Greenwall Foundation's Making a Difference Grantees are working to address complicated bioethical problems associated with this national public health emergency, including how medical professionals treat overdose patients who refuse to stay in the hospital to receive potentially life-saving care.
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From Our Blog
The Greenwall Foundation is seeking two driven and thoughtful individuals to join its small, dynamic staff in Washington, DC: an experienced Program Director who will manage the Foundation’s grantmaking activities and participate in the development of programs and projects that support the Foundation’s vision, and a motivated Communications Manager with strong digital communications, marketing, and writing skills who will help expand the Foundation’s reach and visibility, champion the importance of bioethics, and highlight the excellent work of our Scholars and grantees. Applications are due February 12, 2021.
The unprecedented public health crisis caused by COVID-19 raises many complex ethical issues – from putting in place public health restrictions, to allocating protective equipment, critical care beds, and vaccines when the need far exceeds supply. Many Greenwall Faculty Scholars and Alums are on the front lines caring for those affected by the novel coronavirus, working to develop policies to provide practical recommendations on ethical issues. Here we provide links to their work, which we continue to update.
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Monica E. Peek, MD | University of Chicago
Greenwall Faculty Scholar Alum
Brownsyne Tucker Edmonds, MD | Indiana University School of Medicine
Greenwall Faculty Scholar Alum
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As the COVID-19 pandemic has unfolded across the United States, troubling disparities in mortality have emerged between different racial groups, particularly African Americans and whites. With their coauthors, Drs. Peek and Tucker Edmonds recognize troubling knowledge gaps and a need to act to address disparities. In a recent American Journal of Public Health article, they present evidence-based recommendations for how healthcare providers and policymakers can address these disparities in the areas of data collection, COVID-19 exposure and testing, health systems collaboration, human capital repurposing, and scarce resource allocation.
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Andrew Peterson, PhD | George Mason University
Greenwall Faculty Scholar
Jason Karlawish, MD | University of Pennsylvania
Greenwall Faculty Scholars Program Committee Chair and Board Member
Emily Largent, JD, PhD, RN | University of Pennsylvania
Greenwall Faculty Scholar
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Prof. Peterson, Dr. Karlawish, and Prof. Largent argue that supported decision making is ideal for people with dynamic cognitive and functional impairments that place them at the margins of autonomy. In The American Journal of Bioethics, they review alternative decision-making frameworks and then present a conceptual foundation for supported decision making that integrates the social model of disability with relational accounts of autonomy. They also propose a three-step model that specifies the necessary conditions of supported decision making and identify potential challenges.
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Alexander A. Kon, MD | University of California San Diego School of Medicine
Greenwall Faculty Scholar Alum
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Pain management has a complicated history in medical practice. Pain treatment gained prominence in the 1990s, as doctors and medical professionals began recognizing the importance of palliative care and instituted standards for managing pain, the “fifth vital sign.” However, a confluence of problems led to opioids being overprescribed, and the resulting epidemic of opioid use disorder has left some medical professionals wary of overtreating pain. In The American Journal of Bioethics, Dr. Kon and his coauthor explore how healthcare ethics consultants can consider a range of ethically appropriate pain management options for a patient and help resolve treatment dilemmas that arise when trying to balance pain management with the risk of addiction.
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Neal W. Dickert, MD, PhD | Emory University School of Medicine
Greenwall Faculty Scholar Alum
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Out-of-pocket costs for expensive medications may be an important part of shared decision making for certain patients with heart failure, but cost has generally been excluded from clinical discussions. Dr. Dickert and his coauthors studied patients’ perspectives on a decision aid that explicitly addresses out-of-pocket medication cost. Publishing their findings in Circulation: Cardiovascular Quality and Outcomes, they conclude that patients were receptive to the inclusion of out-of-pocket cost in a decision aid and identify key challenges to the effective integration of cost in these decisions, including developing mechanisms for acquiring reliable patient-specific cost estimates and addressing patients’ difficulties applying trial evidence to their own situation.
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"Those unknowns are why some people say, ‘We should stick with what we know. By all means, do the trials to test [varied regimens], but don’t just wing it.’ Others say, ‘We are in a race against the virus.’ " He added, “I’m not going to come down on one side or the other.”
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Image Credit: Alejando A. Alvarez / Staff Photographer
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A divided Senate may struggle to address rising drug prices, but the Biden White House can fix one of the most broken aspects of our drug system with no help from Congress. It can give out fewer bad patents.
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Image credit: Elise Amendola / AP
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Outside a few special cases, it's tricky business to prioritize people based on their importance to society.
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“I just don’t think you can draw a line between genealogically relevant data and medically relevant data with any amount of precision.”
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Image credit: Miragec / Getty Images
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Coming Up
Program Dir. & Communications Mgr. Applications Due | Feb. 12, 2021
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