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dd_1With the support of the Center for Bioethics, Health, and Society, Dining Dilemmas was begun in the fall of 2012 to encourage students interested in healthcare careers to explore ethical decision making in healthcare. An Executive Steering Committee of students from many different majors and backgrounds in consultation with Dr. Pat Lord, Biology, and Dr. Ana Iltis, Philosophy choose the ethical discussion for each semester. Through a variety of

stepsprograms followed by facilitated discussion over dinner, students are better able to address bioethics issues they may encounter during their education and career. Upon completion of four Dining Dilemma discussions, students are awarded a certificate of completion of the program.


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We also appreciate support which began in the Spring of 2016 from the Department of Biology.

Telehealth: The Computer Will See You Now Dining Dilemmas Fall 2016

The Fall 2016 Dining Dilemmas will be a discussion of Telehealth on Tuesday November 8th from 6-8 pm.  As always, over a wonderful meal, we will discuss ethical issues of Telehealth.  For example, using a computer or a cell phone, patients can access medical care from the convenience of their home.  While telehealth allows for greater mobility and access to healthcare providers, does it sacrifice the relationship between physician and patient?  Telehealth certainly allows access to healthcare in rural areas, particularly specialized care, but does this expanded access guarantee improved healthcare?  Also, telehealth is allowed across state lines, but it is regulated at individual state levels so physicians may be working under different state regulations.  Telehealth is also about the business of healthcare.  For example, since 2011, Teledoc and Texas Medical Board have been involved in litigation as to whether the Texas Medical Board can require a “face to face” relationship with a patient to prescribe medications (News article on litigation).  Teledoc maintains that this regulation limits competition from telehealth companies.  As you can see, this is a complex topic with lots of ethical implications. To join us for the Fall 2016 Dining Dilemmas, please RSVP to http://tinyurl.com/za82zob


Ethical issues related to healthcare by Nancy M. King, JD, Co Director of Center for Bioethics, Health, and Society

As you are aware, health is influenced by many factors, including but not limited to individual priorities, choices, and behavior, environmental factors, genetics, socioeconomic status, and the demands of job and family.  In a prosperous, autonomy-oriented society like ours, physicians, the public, and policymakers struggle to decide how to balance caring for those whose needs are great with encouraging prudent decision-making about health behavior.

Policymakers have long debated how much assistance to give those with health care needs, and how to determine what constitutes need.  This policy debate has grown hotter than ever in light of the Affordable Care Act and the continuing controversial nature of assistance programs like Medicaid.  At the individual and institutional levels, health care providers are often frustrated by the complex problems of emergency department “frequent flyers” and the inability or unwillingness of some patients to do what seem like basic things: improve their diets; stop smoking; lose weight; keep appointments; seek counseling.  Yet at the same time, we have a profound sense that the duty to rescue does not permit us to abandon people who make poor choices – we aren’t going to leave the uninsured, helmetless motorcycle rider to die of his head injury.  Thus, health care providers are also often frustrated by the barriers they face that prevent them from providing necessary care and treatment; many of these barriers are produced by the health care system itself.

How should the responsibilities of individuals for maintaining their own health be balanced with societal responsibilities to treat those in need?  And how should physicians regard and respond to patients who seem to believe that there must just be a pill that can fix whatever needs fixing – and to a system that sometimes seems unmoved by preventable suffering?

A Few Questions:

(1)  Providing assistance to those with great medical need is regarded by some as fundamentally fair and beneficent, but by others as paternalistic.  Those who favor helping to meet others’ medical needs may see this as simply what we should do to help people who cannot help themselves.  Those who disagree argue that people should have to face the consequences of their poor choices, or they will never become self-reliant.  Are these two perspectives incompatible when it comes to health care?  Can you think of any way to reconcile them?

(2) How do we know what counts as a wise choice in health care? If a person has decision-making capacity, on what grounds can we challenge his or her choices without imposing our own views?

(3) We know that there are many influences on health that lie outside our direct control.  Does government – local, state, or federal — have a duty to step in and make up for what people cannot do for themselves? Or is it up to non-governmental organizations like charities, churches, and civic or advocacy groups?

(4) Does it matter whether the people who lack access to health care services are currently healthy or already ill? What does it mean to “need” a health care service?  Are there different kinds of needs for health care?  If so, are some more important to satisfy than others?

(5) How much attention should we pay to health care in comparison to other basic needs that raise similar questions of responsibility, like employment, housing, and education?

Life, Liberty, and ……Healthcare?

Dining dilemma final jpbOur spring 2016 Dining Dilemma is rapidly approaching…March 30 from 6-8 pm in the Magnolia Room at Wake Forest University.  I am very pleased that our presenters are well respected in the healthcare field AND volunteering their time to participate in our Dining Dilemma .  Dr. Aaron Saguil is physician in the military and has served in Afghanistan.  He also has served in Germany and understands the healthcare delivery system in Germany.  Ms. Elizabeth Seely is the Executive Director of Hospital East, one of the Ohio State University’s Medical System Hospitals.  Ms. Nancy King is one of the co-Directors of the Center for Bioethics, Health, and Society and will challenge us about the ethics of providing healthcare.  And yes, Richard is my husband, but is a healthcare economist as well as physician.    All of these participants are coming because they are passionate about helping you learn about the ethics of healthcare costs.  Over the next week, I will post items here that will help prepare you for our discussion on the 30th.  Don’t forget to RSVP to http://tinyurl.com/hduy5lm

Escape Fire Screening

On Sunday March 20th, we will be screening the documentary, Escape Fire, as a prequel to Life, Liberty, and …..Healthcare? , our Dining Dilemma on March 30th.  We will be in Winston Hall 126 from 5-7 pm with SNACKS. Come learn about costs of healthcare and what issues are involved in changing payment systems.  Escape fire picture

D. Buchen

A dinner dilemma

Students discuss medical ethics topics over dinner

By BONNIE DAVIS Office of Communications and External Relations

Almost three years ago, students in Lord’s virology class came up with the idea of creating “Dining Dilemmas: Bioethics in the Pre-Health Professions.” Held once a semester, it’s a program that is sponsored by the Center for Bioethics, Health and Society and designed to encourage students, especially those planning a career in health care, to talk about medical ethics.

Attendance continues to grow, doubling since the first event, and students are lobbying Iltis, director of the Center, and Lord, who is on the Center’s faculty core, to consider expanding it to twice a semester. To date, a total of 275 students have participated in at least one program and those who attend at least four are awarded a certificate.

“The Dining Dilemmas program has really taken off,” said Lord, associate teaching professor of biology and director of the Pre-Health Professions Program. “Students tell me all the time that they learn a lot, they get to meet other students interested in health professions, and the topics challenge their own thought processes about ethics in medicine.”

Click here to read the full story at the WFU News Center

D. Buchen

Daniel Buchen addresses the pre-health students at Dining Dilemma gathering in 2015

Dinner and an ethical dilemma

Stephanie Skordas, Office of Communications and External Relations

Her Bio 367 Virology class took on the challenge, coming up with “Dining Dilemmas: Bioethics in the Pre-Health Professions.” It’s a new program designed to encourage students, especially those planning a healthcare career, to talk about medical ethics.

Here’s how it works. One event will be held each semester and Wake Forest students who attend four events will receive a certificate at a special spring dinner.

“We wanted students to consider the social, psychological and biological aspect of behavior when it comes to important medical decisions,” said Pat Lord, senior lecturer in the biology department and director of the Pre-Health Professions Program. “So I turned to my students and asked them to help develop a series of events designed to start these conversations.”

— Pat Lord, Associate Teaching Professor, Department of Biology

Click here to read the full story at the WFU News Center

Students attending the Dining Dilemmas program watched the movie Contagion then discussed the medical ethics behind several issues the film illustrates.

Students attending the Dining Dilemmas program watched the movie Contagion then discussed the medical ethics behind several issues the film illustrates.