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Topic: Education
October 2, 2013 | Posted By Zubin Master, PhD

I have previously discussed the topic of stem cell tourism in previous AMBI blogs. To provide a brief introduction from another blog, stem cell tourism is used to an internet-based direct-to-consumer advertised industry where clinics offer untested and unproven stem cell interventions as bonafide therapies to patients with a range of diseases and injuries including Parkinson’s disease, multiple sclerosis, ALS, blindness, cancer, cerebral palsy, spinal cord injury and many others. Basically there is no scientific evidence of safety of efficacy of these modalities to offer them on a for-profit basis to patients. The term was originally coined as a form of tourism because patients traveled from countries like the U.S., U.K., Canada and Australia to clinics in countries with lax regulations, but this simply is not the case anymore. There are several clinics within highly regulated countries like U.S. that offer stem cell interventions.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

September 19, 2013 | Posted By Wayne Shelton, PhD

When ethics and humanities were first introduced into the first few medical curricula in the early 1970’s, there was considerable optimism about how the exposure to ethics and humanities could “humanize” young physicians and positively affect their practice habits. Learning about the humanistic areas of medicine from trained experts, sometimes referred to as “humanists”, was perhaps naively assumed to be somewhat of an antidote to the effects of the growing medical industrial complex that had become evident to many. Although we take for granted the place of ethics and humanities in most medical school curricula today, those of us who teach in these areas forget that the1970’s were not that long ago and that we are still learning the ropes of how to integrate our efforts into the medical culture. The field has matured as evidenced in the transition from the early naivety regarding the potential impact of knowledge and ideas presented in the abstract versus the realization of how knowledge and ideas are learned, and indeed embodied, in clinical practice; this growing understanding of the factors at work in medical education also parallels the growth and development of educators in ethics and humanities, who by the 1990’s had become entrenched in the mainstream of U.S. medical centers. Many of these same ethics and humanities faculty had made a huge transition from being isolated in an academic area like philosophy to being deeply involved in the hospital clinical setting.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

August 30, 2013 | Posted By Zubin Master, PhD

Stem cell tourism is a pejorative term used to describe clinics that offer untested stem cell interventions as bonafide therapies to patients with injuries and diseases. This includes Parkinson’s disease, multiple sclerosis, ALS, blindness, cancer, cerebral palsy, spinal cord injury and many others. We used to think about stem cell tourism as potential patients traveling to clinics from countries like the US, UK, Canada and Australia to countries with lax regulations, but this simply is not the case anymore. There are several clinics within the US that offer stem cell interventions to treat back aches or sports injuries. This direct-to-consumer market has more recently attracted celebrity types including several high profile athletes, Hollywood stars, and even a US State Governor.

Clinics generally tend to overemphasize benefits, and use rhetoric terms like “alternative medicine” or “experimental treatment” to explain that it is another form of treatment not offered by conventional medicine. But at the end of the day, there is an almost complete lack of scientific evidence supporting the claims made by clinics in regards to the efficacy of these stem cell interventions. The evidence provided to patients is based only on testimonials by other patients; no other measures are used to determine treatment efficacy. The overemphasis of benefits when patients tell others of how great they feel and how it has helped them and given hope only fuels their frustration and distrust in their domestic healthcare, research and regulatory system. The stem cell clinics play on the hype and power of stem cells and they stand to make money as therapies range from $5,000 to $30,000 and in many cases clinics require patients to have repeated treatments.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

February 14, 2013 | Posted By Wayne Shelton, PhD

Medical educators over the past six decades have designed educational objectives and curricula as though it was the educational process itself that determines students’ values and their behavior as professionals, without considering the influence of the structural environment on medical trainees. From the 1950’s on, asSamuel Bloom observed in 1988, there are examples, continuing to present day, of medical schools devising curricula with the goal “…to repair what were believed to be the dehumanizing effects of scientific specialization, but with the retention of the best of science.” To achieve these goals educators drew from the social sciences and humanities, and by the 1970s, from the growing interest in medical humanism and specifically from the field of medical ethics, which now is mostly referred to as bioethics. Bloom claims these subjects, like science, have been split off from the context of how they impact medical practice and taught mostly as an intellectual activity, thus creating a dualism between theory and practice. The curriculum has been assumed on its own to be an instrument of behavioral change that follows from knowledge. The essential process of social organization is sadly lost from view and deemphasized. How can we account for this rift?

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

November 14, 2012 | Posted By Mae Huo

At the end of the article “Disability and narrative: new directions for medicine and the medical humanities” Rebecca Garden states, “However, rather than ‘coping with’ or ‘overcoming’ their impairments, many disabled people see their impairments as integral to their lives.”  This may have been the most important, and overlooked, message regarding new directions in medicine for working with people with disabilities.  I would like to share a personal story that illustrates this point.

I’ve been short all my life, but always just too tall to be considered disabled.  When I lived in China, every adult was always trying to get me to grow, like I had a choice in the matter.  They’d either bring up the fact that I can’t get a job since there’s a height requirement for pretty much every occupation (I wanted to be a teacher and the height requirement for that was the ability to reach the top of the chalkboard) or they’d have these false hopes and reassured me over and over again that I simply have one last growth spurt to hit (at that time, I was visiting family and already 18 years old).  I was fine with my height and the incessant chatter was extremely discouraging and annoying.  When I came to America and learned that most civilian jobs had no height requirement, I was so happy to be leaving the Chinese thinking regarding height impairment.  Here, in the land of accessibility ramps, being short would not affect my life style and I can go into any career that I’d like.  I will no longer hear people sigh at me or look down upon me, no pun intended. 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

August 29, 2012 | Posted By Bruce D. White, DO, JD

The July 31, 2012, issue of the Chicago Tribune carried an article entitled “Chicago-Based Accretive Health Banned from Doing Business in Minnesota for 2 Years.

Facts in the article are sketchy: (1) The Minnesota attorney general’s office began investigating possible privacy breaches when a hospital account collections company laptop was stolen two years ago. The laptop contained the names and protected health information of 23,000 patients treated at two Minnesota hospitals. (2) The company – Accretive Health – manages billing and collections for hospitals. One hospital in Minnesota accounted for 9.9% of Accretive’s first quarter revenue - $25 million out of $253.7 million.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

August 17, 2012 | Posted By Wayne Shelton, PhD

Sometimes we forget the accomplishments we have made in the Alden March Bioethics Institute since we began almost 20 years ago. We now have a fully integrated set of offerings in both medical education and graduation bioethics.  So I thought it was time to describe them all in a bit more detail.

The Alden March Bioethics Institute began as the Center for Medical Ethics, Education and Research in 1994. Our principal charge was to design and implement a new course as part of the curriculum reform effort that was underway called Health, Care and Society (HCS).  This was a broad course in professionalism, medical ethics and humanities that would become integrated throughout all four years of medical schools. As a required course for all medical students we began in year one, and added a new component each year until the curriculum in all four years were complete. Each year consists of about 40 hours of class work.  In the first two years a little over half the classes are in large groups on topics such as professionalism, special topics in bioethics, medical ethics case analysis, end of life care, effective communication, cultural diversity and alternative/complementary medicine; about a third of so of the classes are small group discussions. In the third and fourth years HCS is integrated into the clinical clerkships and rotations and consists primarily of small groups discussions of a wide range of topics relating to the type of patients students are encountering. One important part of HCS in the third year is in the Medicine rotation, each one consisting of nine meetings where students bring to the table real concerns and issues from cases they are directly experiencing. By now HCS has become normal part of the curriculum and students generally enjoy the chance to discuss these topics that will be so important to their careers as physicians. 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

July 24, 2012 | Posted By Hayley Dittus-Doria, MPH

We are pleased to announce the approval of the Doctorate of Professional Studies, with a concentration in Clinical Ethics Consultation, by the New York State Education Department. This program is, to our knowledge, the first online program of its kind to offer advanced level training in the knowledge and skills of clinical ethics consultation for qualified applicants. The new program is designed specifically for working, health care professionals who possess a master’s degree in bioethics, or equivalent, and who seek a fellowship level, advanced training in clinical ethics consultation. Students will use their professional work environments as the clinical training ground as they complete advanced fellowship courses related to clinical ethics consultation and mediation, elective courses and a doctoral research project.

The fellowship courses include clinical practica in coordination with AMBI faculty and agreed upon mentors at the student’s home institutions.  At the end of the program, graduates will have a portfolio of 32 case consultation reports and will have demonstrated advanced level mastery of the ASBH Core Competencies in Clinical Ethics Consultation.

For more information, visit our website or contact Wayne Shelton at sheltow@mail.amc.edu or 518-262-6423.

The Alden March Bioethics Institute offers Graduate Certificates, a Master of Science in Bioethics, and a Doctorate of Professional Studies in Bioethics. For more information on AMBI's online graduate programs, please visit our website.

July 23, 2012 | Posted By Hayley Dittus-Doria, MPH

As the world knows, obesity has become a public health epidemic over the last several years in the United States, with over 35% of US adults falling into the obese category.  But when public health experts and lawmakers try to “do the right thing” by forcing people to engage in healthier behavior, are they going too far?

In a June 8th article on CNN.com, Harriet Washington believes that the ban on sugary drinks that New York City mayor Michael Bloomberg has proposed is the wrong way to go about encouraging healthy eating and drinking habits.  She also disagrees with “sin taxes,” stating that they often have unintended consequences.  In the sugary beverages ban proposal, restaurants, street carts, and movie theaters would not be able to sell any sugary drinks over 16 ounces.

While I don’t necessarily support an outright ban of sugary drinks, I do think that, for the most part, taxes imposed on items (such as those for tobacco and alcohol) are a great step toward  discouraging people from partaking in these unhealthy behaviors and increasing state revenue at the same time.  Many states have implemented a tax on sugary beverages in recent years, and many others have tried, but failed, for a soda tax to catch on.  Mayor Bloomberg even proposed a soda tax in 2009 for NYC, yet this proposal was eventually abandoned and never came to fruition.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

June 27, 2012 | Posted By Posted By David Lemberg, M.S., D.C.

“Human speech is like a cracked kettle on which we tap crude rhythms for bears to dance to, while we long to make music that will melt the stars.” — Gustave Flaubert, Madame Bovary

“The chances of factual truth surviving the onslaught of power are very slim indeed … ” — Hannah Arendt, Between Past and Future

Although this may be more apparent than real, it seems as if the lying and the lies are increasing in frequency on the national level. Politics has long been characterized as a blood sport, but the escalation of vicious contentiousness since 2008 is unusual and extreme. Factual truth has been cast aside, casually thrown to the wind as if one were systematically ripping the petals off a roadside wildflower and tossing them into the air as so much refuse. The losers are the public, of course, the citizens who depend on the government for sound fiscal policies, welfare for those unable to care for themselves, and protection in the form of national defense.

None of this is a surprise. As Arendt states in her essay “Truth and Politics”, modern ideologies “ openly proclaim them to be political weapons and consider the whole question of truth and truthfulness irrelevant”. Further, “it may be in the nature of the political realm to deny or pervert truth of every kind”. As the nature of truth as such is limiting (in other words, it is what it is) , politicians will naturally bend the truth to fit their purposes. As citizens, we need to be on our guard and strive to identify factual truth or the lack thereof in political pronouncements. But such activity requires substantial effort. Thinking is required, as is the concomitant ability to simultaneously hold two contrasting concepts or points of view in mind. A broad education is required, as is a good facility with language. Sadly for us, most of these requirements and capabilities are now in short supply.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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