Answering Hard Questions: Clinical Ethicist Dr. Elizabeth Lanphier

When a patient’s family, caregivers, or medical providers raise ethical questions about how to best balance a patient’s needs, who helps them navigate those conversations and decisions? At the Cincinnati Children’s Hospital Medical Center, a team comprising of doctors and philosophers that all have special training in ethics is prepared to help guide those conversations, hear concerns of families and health care providers, and prepare nurses and other bedside care providers for caring for diverse patient populations ranging from young kids to legal adults.

Dr. Elizabeth Lanphier is part of this team.

As a clinical ethicist, Lanphier is on call to provide counsel about patient care decisions when ethical concerns arise from patients, family, and physicians. Dr. Lanphier addresses questions from families about why an alternate care choice may not be offered, helps doctors and families weigh risks and benefits of medical options, and may work to rectify miscommunications. Much of the time, there is no single clear answer. Lanphier recognizes that families are their own ”experts on their family“ making decisions alongside medical expertise, and provide different perspectives on the risks and benefits of various choices.

Research

Lanphier also researches and writes about bioethics and social and political philosophy, often as it relates to medical care. In addition to being a clinical assistant professor in the Division of General and Community Pediatrics in the UC College of Medicine, Lanphier is a research assistant professor in the UC philosophy department, and affiliate faculty in the UC women, gender and sexuality studies department. In graduate school at Vanderbilt University, from which she earned her PhD in philosophy, she was interested in the intersection of medicine and philosophy, and sought out experiences related to this intersection with the Vanderbilt University Medical Center and its Center for Biomedical Ethics and Society.

Now, she uses moral philosophy to put bioethics into practice, especially as it relates to healthcare access, justice, and inclusion. Her desire to understand and serve vulnerable populations, especially those who have historically been mistreated or neglected, drives her research.  Currently , Dr. Lanphier is working on the connection between  trauma-informed care and ethics consultation and recently published a paper advocating for a trauma informed approach to ethics consultation with neonatologist Uchenna Anani.

Additionally, her community work during graduate school with people incarcerated on Tennessee’s death row has instilled in her research and advocacy a commitment towards the incarcerated population. Last year Lanphier along with colleauges Takunda Matose and Abu Ali Abdur’raham (who is currently incarcerated on Tennessee’s death row) published a paper in the Public Philosophy Journal. In December she advocated for incarcerated persons to be prioritized higher in Ohio’s COVID-19 vaccine allocation. The resulting opinion piece received positive feedback, including from a senator who acknowledged how much work needs to be done. While some public reactions were critical, she was thrilled that it had such a wide impact, as she always aims to reach as broad an audience as possible. She and a colleague are investigating if and how the incarcerated population can take part in studies such as the COVID-19 vaccine trials without risking the coercion or exploitation this population has historically experienced in the medical research leading to tighter research regulations on incarcerated persons and other vulnerable populations.

Trust in Science

COVID-19 has brought important questions about bioethics, healthcare access, and public confidence in medical research to the forefront.  Lanphier sees medical professionals growing frustrated as the public’s trust in science deteriorates. To her, this means that clear communication and approaching medical research in a way that regains that trust is paramount. Part of this includes increasing representation of persons of color (POC) in biomedical research as researchers and participants to help increase confidence in clinical trial outcomes. As her opinion piece in the Columbus Dispatch shows, she has been considering the problem of who should have access to the COVID-19 vaccine, as it is still a limited resource. For example, healthcare workers should be offered it, because we need them to keep us healthy and they are at risk of virus exposure. Beyond that, it gets more complex. How do you designate other frontline workers? Many groups, including store workers and teachers, are needed, but by the time we include so much of the population, we are well beyond the number of available doses, though this number of available doses continues to increase. With this scarcity and the vaccine currently approved for emergency use, we are also a long way from being able to mandate receiving the vaccine for those who work with the vulnerable. She also posed the question of how to approach undocumented populations, who still play a critical role in their communities but may have limited access to healthcare, and also stressed that vaccine roll out needs to also address hesitancy.

Lanphier’s career path leading to her position on a clinical ethics team combined philosophy with practical experience and post-doctoral training working in healthcare environments.  Her role mixes a theoretical, philosophical approach to broader questions with day-to-day interaction with families and care teams related to ethical concerns that come from a diversity of beliefs and backgrounds. She encourages anyone wanting to follow a similar path to seek out a wide variety of experiences and talk to others who are already established in their field.

Speakers Hosted by Science Policy Ambassadors this Spring

The University of Cincinnati’s Science Policy Ambassadors are excited to host a series of talks this semester. Below is the schedule with links to the virtual talks, along with the speakers who will be presenting. Descriptions will be available shortly before each talk. Follow @SPAUCS for updates!

Tuesday, February 2nd at 5:30pm: Naomi Charalambakis, PhD (FASEB)   

Registration link: https://us02web.zoom.us/meeting/register/tZUqc-GrqzwjH9GY0Fo-Jvu6gor5RKoKk98n  

Naomi Charalambakis, PhD, is a Senior Science Policy Analyst for the Federation of American Societies for Experimental Biology (FASEB), a coalition of 29 scientific societies collectively representing over 130,000 individual biological and biomedical researchers. In this role, she leads efforts of FASEB’s Animals in Research and Education working group, developing policy statements, tracking congressional legislation and agency directives related to animal use in federal research, and creating resources for the lab animal community.  

Monday, March 1st at 5:00pm:  Sheeva Azma, MS (Former Legislative Intern) 

Registration link:  

https://us02web.zoom.us/meeting/register/tZwuceGgqTwpG9YEtUeev2B21xY7hIflaFaV

A freelance science writer since 2013, Azma recently founded her own science writing company, Fancy Comma, LLC (www.fancycomma.com). She has also advocated for science on Capitol Hill and has served as a legislative intern in a House office. Sheeva’s work has been published in The Motley Fool, The Xylom, The Kim Komando Show, and LifeWire. 

Tuesday, March 23rd at 5:00pm: Cameron L. Tracy, PhD (Kendall Global Security Fellow)  

Registration link:https://us02web.zoom.us/meeting/register/tZAudu6uqTMrHtyaRHt_ltPlZLD4gkEppv27 

Cameron Tracy on nuclear arms control and the interface between science and security policy. His current research involves analysis and modeling of the flight conditions of hypersonic weapons in order to determine their effects on global strategic stability. 
 

Monday, April 12 at 4:00pm : Matt Robson, PhD (Assistant Professor at UC College of Medicine)  

Registration link:https://us02web.zoom.us/meeting/register/tZcvduyhqzIvE9PxETt1_Z6XpDx7RGbfD9gg 

Affiliate Spotlight: Dr. Arnie Miller

Arnold Miller

This week, we highlight the work of Dr. Arnie Miller. Dr. Miller is an Advisory Board member of the UC Center for Public Engagement with Science, as well as Professor Emeritus, former Head of the UC Geology Department, and former Senior Associate Dean of the UC College of Arts and Sciences.  

Dr. Miller is an evolutionary paleontologist and paleoecologist. His research has focused on mass extinctions and their impacts on global biodiversity, environmental gradients, and anthropogenic effects on modern coastal communities. Dr. Miller differs from a lot of paleontologists in that his passion did not stem from a childhood interest in dinosaurs or other fossils. He grew up in New York City, and with the exception of the American Museum of Natural History, there are not a lot of fossils to be found there. Dr. Miller found became interested in geology while living among geology majors in college. He took a course in geology to learn more about what his peers were talking about, ultimately leading to him pursuing majors in geology and biology. During his studies, he was inspired by a professor who introduced him to using fossils as data to study biodiversity and mass extinctions, which is when he first became passionate about paleontology.  

In 2007, Dr. Miller was elected as a Fellow of the Paleontological Society for, among other work, being instrumental in the Paleobiology Database (PBDB). This website is a compilation of  fossil data, where they were found, the publication that described them, and where they can be found now. It is used by paleontologists with an interest in “big data”- the use of multiple collections to piece together an understanding of broad trends in space and time. However, this database is open source, and is also used by instructors to give their students experience processing data.  

Since then, Dr. Miller has served as the President of the Paleontological Society; he is currently finishing his term as Past President. In this position, he has strived to champion diversity, equity, and inclusion. He has encouraged the scientific community to acknowledge our previous shortcomings in these areas. He is co-chair of the Society’s ethics committee, dedicated to ensuring that Society is inviting, safe, and inclusive for all participants in its activities. He and his colleagues are working to improve opportunities for people with diverse backgrounds to enter all fields of science. The Society has been developing financial opportunities for underrepresented minorities, and Society representatives now regularly attend  meetings focused on minority inclusion in science, such as the Society for Advancement of Chicanos/Hispanics and Native Americans in Science (SACNAS). They also work to increase education and outreach that specifically targets underrepresented audiences.   

Dr. Miller also addressed outreach and community involvement in science in his role as Head of the Geology Department and as A&S Senior Associate Dean. When the Cincinnati Museum Center (CMC) closed for renovations a few years ago, he was a part of a group that worked to bring some of the exhibits to the University of Cincinnati campus. Along with this, they scheduled programs such as a panel on global climate change that drew in community members in Cincinnati. CMC exhibits were also set up at the airport, and the teams behind this and the University exhibits held a townhall at a conference for museum professionals about their experiences setting these up. These exhibits being in different environments effectively brought the museum to people who might not normally visit, resulting in more engagement than may normally be possible.  

Dr. Miller also has had the opportunity to engage in debates about evolution and creation. He thinks that engaging people of all backgrounds and belief systems is important without being perceived as condescending. As part of the 2009 North American Paleontology Convention hosted at UC, Miller, who was chair of the organizing committee, took 75 paleontologists to visit the Creation Museum to give them a firsthand look at what and how ideas were being communicated there. Members of the group found the visit to be eye-opening, with respect to how professionally ideas were presented from a strictly technical standpoint, even though those ideas diverged from accepted science. Responding to dissent is important, but scientists do not always communicate well, and doing so well with humility and respect is crucial. Every year while teaching an introductory-level course on the history and evolution of life , he spent a week on the creationism-versus-evolution question, including inviting a representative from the Creation Museum to speak to the class at the end of the semester ; this was followed by extensive, in-class discussion . While Dr. Miller does not think that direct debates with creationists are helpful or productive, he does encourage scientists be aware of  and understand the bases of other views. Through the study and discussion of creationism, he hoped that students would come to understand what information was being taken out of context. He also encouraged them to listen, rather than making wholesale judgements about what others think; everyone’s beliefs and ideas have multiple dimensions and need to be taken seriously. 

As an emeritus professor, Dr. Miller is continuing to work with the Paleontological Society and University. Besides his work on the Center’s Advisory Board, he is also helping to develop a Digital Futures Consultant program for new and young faculty at the University of Cincinnati. He’s also becoming more politically involved; in the most recent election, he served as a poll watcher and on a “Protect the Vote” hotline for people who had questions about how to vote.  

Dr. Miller’s message is one of encouragement. He wants people to keep their minds open to other people and opportunities around them, especially those outside of the classroom. Had it not been for the experiences he had in college, especially those that focused on working with data  , he likely would have taken a different path. In recruiting diverse participants to paleontology and geology, he advocates speaking  about the diverse opportunities there are for people who want to work in these areas.  “Field work and adventures in the out of doors can be off-putting, at least initially, to people who grow up in  urban settings, for example, and yet we do other things that aren’t field work, such as working on computers and in geochemistry labs.” Paleontology and geology are not just for those who enjoy field work and dinosaurs; these fields, and science in general, are diverse and have something for everyone.  

Affiliate Spotlight: Dr. Abel Gustafson

Abel Gustafson

This week, we highlight the work of our newest Faculty Affiliate with the Center for Public Engagement with ScienceDr. Abel Gustafson, Assistant Professor in the UC Department of Communication.  

Dr. Gustafson studies public opinion and strategic communication in science and environmental issues. Using surveys and communication experiments, he assesses how various demographic and political groups think about and respond to these issues. For example, his research has identified how political polarization develops on environmental issues, and how the public reacts to portrayals of uncertainty in science.  His findings help develop more effective strategies for communicating science to the public  

Dr. Gustafson became interested in science and environmental communication as a graduate student. At the time, he was studying theories of persuasion and social influence. However, he wanted his research to make a positive impact on society. This led him to study persuasive communication related to climate change and other environmental issues. 

Dr. Gustafson has collaborated with a wide range of scholars (from political scientists to geographers and literary scholars) and a wide range of organizations (from nonprofit advocacy groups to media companies). A primary goal of his work is to help these different groups improve the way that they communicate about science issues to the public.

A key player in public science communication is the news media. In a forthcoming report, Dr. Gustafson and his colleagues at Yale and George Mason Universities use public opinion data to show that many Americans want the news media to do more to address the issue of climate change. Dr. Gustafson says this study is particularly important, because many people get their information about science and environmental issues from the news. If news organizations are made aware that their audience wants more and better information about important issues like climate change, this may lead to increased news coverage, which can in turn have large impacts on public support for climate action.

Dr. Gustafson noted that the current COVID-19 pandemic is a fascinating example of the oftentimes fraught and polarized relationship between science and the public. Currently, opinions about the dangers of pandemic and participation in recommended preventative actions show a sharp divide along party lines. Dr. Gustafson noted that this is a clear example of the need for clear, effective science communication from trusted experts. In a study conducted earlier this spring, Dr. Gustafson and his colleagues found that the CDC’s official recommendation to wear masks resulted in an immediate and dramatic increase in mask-wearing behavior.

You can read more about Dr. Gustafson’s publications and work here

Affiliate Spotlight: Dr. Nate Morehouse

This week, we want to highlight the work of one of the Center’s affiliates, Dr. Nate Morehouse

Dr. Morehouse leads a lab that studies insects and spiders. He has a special interest in how they see the world, and how their vision influences the choices they make. He was drawn to the University of Cincinnati because the school has a strong community working on the biology of vision, philosophy of perception, and other fields related to sight. He is currently part of an effort to create a central place for this community through the Institute for Research In Sensing (IRIS). Planning is ongoing, but programming is staged to begin by Spring 2021. 

Dr. Morehouse is partly interested in the vision of spiders and insects because of the diversity of ways that their eyes function. Vertebrates all have eyes similar to a camera; they have a single lens in front of a cavity above a sheet of cells that receives light. Arthropods have a wider diversity of types of eyes. In insects, the most common is the compound eye, which has thousands of individual flat lenses that are all sensitive to light. The information from these pieces together a clearer mosaic image. They also have a lens that gives them separate information about which way is up and helps them make quick decisions important to flight. Spiders are even more complex; they have 8 eyes. 6 of these evolved from compound eyes, derived from a common ancestor with insects. However, these have lost their ability to create a detailed image, likely because spiders lived underground for a large part of their evolutionary history. These eyes have a very low resolution and cannot see color, much like our peripheral vision. Their other eyes collect information for a more complex color image. They form at a different stage in the spider’s development, and even connect to a different part of their brains. This pair of eyes has a single lens, with a long cavity behind it, like a Galilean telescope. This is called a diverging lens, and magnifies anything they focus on. This means that despite having eyes that are only ½ mm wide, they can see patterns as well as an elephant can and can see better than most other animals their size. 

One of the overarching questions Dr. Morehouse and his lab are pursuing is “why?” Spiders have 3-color, vision like humans do, although the exact colors they see are different. Some can see even more than 3 colors. Their interactions, especially during mating, are very reliant on visual cues and color. However, it is unlikely that these displays evolved until after their vision did; after all, why show off if no one can see it? So why did they evolve such complicated vision in the first place? To help them hunt? To avoid something toxic? This research has taken them around the world. 

Ongoing research in the lab includes whether the male and female audacious jumping spiders see the world differently. Both sexes track each other’s movements closely during mating and develop in similar ways. One notable difference is that the females have an extra stage or two of development (instars) before maturity, which might allow their eyes to get bigger. There are some differences in the way genes linked to vision are expressed, but the physical effects of that expression are still being figured out. Dr. Morehouse also has students working on the evolution of illusions and how non-human animals discriminate faces. Such studies are possible with arthropods because the lab has technology that can track the movement of their eyes.  

Dr. Morehouse was inspired to study arthropods when he was three years old; he would go into his backyard and pick up bumblebees, get stung, and pick them back up. He tries to foster the curiosity of children through long term mentoring programs. He participates in the STEM Girls programs at the Cincinnati Museum Center, afterschool programs, and summer camps. Most recently, he ran a summer camp that allowed students to write their own superhero persona, including a disguise, personality, and power, that was inspired by the natural world. At the end of the week, he showed up in disguise as a supervillian with his own powers, and challenged them to defeat him with their own creativity.  

Dr. Morehouse continues to be excited about his field. It has incredible implications for technology; understanding how animals process information could inspire biomedical advances, the engineering of computers that can process information as quickly as arthropods, and programming for the decision making of autonomous cars. In his words, “the natural world has had millions of years to figure out the answers to questions that we are only beginning to ask.” But Dr. Morehouse’s main mission is more philosophical.  

“To be honest, those [questions] aren’t what motivate me. Its cool, but it doesn’t drive me. I would feel like my life had been wasted if I didn’t spend it in the pursuit of curiosity. …I actually think that to be curious is an essential part of what it means to be human. If we forget …it as a basic human pursuit, we’re lost. We should encourage healthy curiosity. In part, what I’m doing is art: I want to spark the curiosity of others. Have I changed how people view their world? Is there more magic to their backyard? If I can just move people’s feet from where they were before, that’s success.” 

To read more about on-going research in the Morehouse lab, click here.

When Science isn’t Simple

One of the earliest lessons we learn in our training as scientists is to accept the simplest explanation of evidence, rather than assuming a more complicated solution. We call this “Occam’s Razor,” and it is repeated in class after class.

But the world is complicated. What happens when our simple explanations don’t capture the entire picture? Dr. Angela Potochnik, Director of the Center for Public Engagement with Science, explores this complexity in her new article “Constructing an Ideal Reality.”

“Idealizations like these make it possible for scientists to focus in on one or a few factors in a sea of complexity in order to get a handle on how those factors are relevant and perhaps to use them as ‘levers’ for change. Where we go wrong—and “we” here includes many scientists, philosophers, policy-makers, and others—is in assuming that our simple explanations provide the full story. “

New Affiliate Spotlight: Dr. Eduardo Martinez

This semester, we are excited to welcome Dr. Eduardo Martinez to the University of Cincinnati philosophy department and as an affiliate of the Center for Public Engagement with Science. Drawn to UC by the interdisciplinary philosophy community and by an interest in the current environment of the midwest, Dr. Martinez is a philosopher with an interest in democratic theory. 

Democratic theory is the way that philosophers evaluate institutions, elected officials, and the groups that influence them. It also models their decisions and actions. Dr. Martinez is particularly interested in understanding the influence of non-elected officials. Democratic theory research results in debates over how to better represent the population, assess the ideas of the public, and hold officials accountable. Early on, papers are aimed at other researchers. However, Dr. Martinez wants his research to influence how he communicates and teaches. He also encourages people to make themselves heard in ways beyond voting and surveys by joining advocacy groups and being active in their communities. For example, one ongoing discussion encompasses climate change; because it is slow, it might not be the drive behind the public’s vote. However, it is still important that it be acted on. 

One idea that democratic theory addresses is how government agencies writing policies interact with the public. When these agencies ask for public opinion, there is potential for the answers they receive to not lead to actions that the public wants. Partly, this might be the result of who answers the survey if only those who are passionate about a topic will respond. Additionally, the way that information is presented before a question is asked, and how the question is asked, may influence how people answer. They may also respond based on how they identify with a political party, religion, race, or other group. Dr. Martinez is currently working on co-authoring a paper that examines the role that such identities play. Although many theorists describe and model actions in simple or “ideal” situations, Dr. Martinez is more focused on more complicated scenarios. Work like his can be used in further discussions that lead to policy writing. 

Dr. Martinez was drawn to philosophy because it gave him the flexibility as a student to ask questions and do interdisciplinary research, combining empirical data and abstract ideas. During his time in graduate school, he coached an ethics bowl team at a local high school. He plans to pass his enthusiasm on to students at UC by teaching classes on civics. Civics classes, he said, need to communicate more than the basic process of bills becoming laws; he intends to teach classes that involve students discussing current events, as well as collecting information and taking action in their communities. He hopes to encourage students, who are also citizens, to actively work to solve problems around them, rather than merely regurgitating facts. He also hopes to communicate his work to his new community in Cincinnati in partnership with the Center for Public Engagement with Science, increasing people’s exposure to new groups and ideas. He is participating in the Center’s efforts to write a series of papers that is meant to give researchers guidance in science communication. He hopes to continue to work with scientists who are doing work related to current politics to promote communicating this work to the public.