November 2018

Making a Difference Grantees, Fall 2018

We are pleased to announce the Fall 2018 Making a Difference awards.

Kata Chillag PhD (Macalester College)
2 years / $162,715

International Medical Graduates at the Crossroads: Ethics of Immigration Policy and Health Care in Underserved Areas

 This qualitative project focuses on questions of justice related to international medical graduates (IMGs) and underserved populations in the U.S. at a time of changing immigration policy and increased anti-immigrant sentiments. Methods include 1) analysis of literature and media and 2) interviews with staff of national medical organizations, and IMGs and staff from the institutions where they practice and train in West Virginia, a rural, underserved state heavily reliant on IMG labor.

Mildred Cho PhD (Stanford University)
18 months / $300,607

Identifying Potential Barriers to and Enablers of Development of Ethical Machine Learning for Health Care

Machine learning (ML) is increasingly being used by doctors and hospitals to make important health care decisions. ML can harm patients if it is inaccurate or biased. However, ML cannot be evaluated or regulated easily because its algorithms “learn” and are constantly evolving. ML development now involves players that are new to health care and thus may not recognize the ethical issues or pitfalls of ML in medicine. The research team seeks to identify potential barriers to development of safe and ethical ML.

Sondra Crosby MD (Boston University)
1 year / $93,751

Ethical Responsibilities of Physicians Who Care for Immigrants in Federal Immigration Detention

Physicians working with immigrant families at the Mexican border and in detention centers with separated parents and children face complex medical ethics problems.  The research team will identify and interview physicians to identify any ethical dilemmas faced by the physicians, and the manner in which the physicians dealt with them to determine (1) the ethical issues faced by physicians caring for immigrants and asylum seekers in custody; (2) the ethical and legal principles physicians relied on that helped them make treatment decisions in this context; (3) structural mechanisms that could make it more likely that decisions made in the best interests of patients can be consistently acted on. 

Insoo Hyun PhD (Case Western Reserve University)
2 years / $148,997

A Collaborative Ethical Approach to Advancing the Science of Synthetic Living Models of Human Biology

Stem cell scientists and bioengineers are now capable of generating new synthetic living models of human biology. These quasi-human entities do not fit into any of the existing approaches for bioethics guidelines and review. Professor Hyun will collaborate with three major labs working in this field to create a normative framework for defining ethical bioengineering goals and practices in synthetic modeling research. This will help promote the ethical advancement of this new area of biomedical research.

Art Rai JD (Duke Law School)
1 year / $196,605

Explainability and Trade Secrecy in AI-Enabled Clinical Decision Software

The goal of this study is to craft empirically grounded, practical policy proposals that address tensions between ethical needs for explainability and legitimate commercial needs for trade secrecy raised by AI-based clinical decision software, including diagnostic, treatment, and predictive software.  The study will examine both AI-enabled software that is regulated as a medical device by the FDA as well as unregulated software.

Harald Schmidt MD, MA (University of Pennsylvania)
18 months / $192,437

Understanding Key Stakeholder Attitudes Towards Novel Methods of Remotely Monitoring Medication Adherence after Transplantation

Medication adherence after transplant is critical to prevent organ rejection. Novel adherence monitoring approaches can assist patients and provide certainty about adherence, but may also be experienced as intrusive or questioning. The research team will analyze attitudes of patients, caregivers and transplant clinicians towards emerging monitoring approaches in interviews and focus groups to optimize the potential for patient-centeredness in clinical care, research studies, and policy.

Margaret (Gretchen) Schwarze MD (University of Wisconsin)
3 years / $336,771

What We Talk about When We Talk about Surgery: Redesigning the Conceptual Framework for Preoperative Communication about Surgical Intervention

The current structure and content of informed consent routinely fails to generate a treatment plan that is deliberately aligned with patient preferences because this conversation is dominated by explanations of disease and treatment, lacks focus on outcomes and trade-offs, and fails to situate the proposed treatment within the larger context of the patient’s overall health. The research team aims to develop a framework for surgeon-patient communication to better support patient autonomy in decision-making.