Created 09/10 04:05 PM Modified 09/10 12:07 PM
VISITING SPEAKERS AND SPECIAL PRESENTATIONS

In a typical year, University Studies will sponsor or facilitate the visits of distinguished visitors to campus. Priority is given to visitors of interdisciplinary interests, those cosponsored by other academic units, and to those who are able to spend flexibly structured time with faculty in addition to making formal presentations. Individuals whose visits may result in linkages to other campuses, and specially those abroad, are of special interest.

2007-2008 Speakers and Special Presentations
Univsersity Studies' guests and other speakers announced in weekly US NewsLetter
|
.
FRIDAY SEPT 14: University of Tennessee Department of Philosophy - Fall 2007 Colloquium Series 3:30 PM (UC, SHILOH)

PHILOSOPHY & PUBLIC POLICY FEST
Further Lessons from ECMO:
The ethics and epistemology of clinical research
Dr. Robyn Bluhm
Postdoctoral Fellow–Neuropsychiatry
University of Western Ontario

Evidence-based medicine (EBM) posits a hierarchy of evidence on which the “best” evidence for
the efficacy of a therapy comes from randomized controlled trials (RCTs). Moreover, there is an ethical obligation to conduct the best possible research in order both to provide the best care to future patients and to make sure that the efforts of current research participants are put to the best possible ends. On this view,
exceptions to a randomized study are justifiable only when stronger ethical reasons exist for not
randomizing participants to study groups, generally when the balance of benefits and harms is very
different in the two groups. Thus, it is ethically justifiable to sacrifice methodological rigor when stronger
ethical concerns demand it.
A rare exception to the general rule that both ethical and methodological concerns support the use
of RCTs is described in Robert Truog’s analysis of the controversial RCTs of extracorporeal membrane
oxygenation (ECMO) therapy in newborns. Truog offers both epistemological and ethical reasons in
support of his claim that ECMO should not have been tested using RCTs, but that a long-term, large-scale
observational study should have been conducted. Central to Truog’s argument, however, is the idea that
ECMO is an unusual case. Thus, it is an open question whether Truog’s conclusions can be extended to
other areas of medical research. In this talk, I look at epistemological and ethical issues arising in the care
of patients with chronic diseases, using ECMO as a starting point. Both the similarities and the
dissimilarities of these two cases highlight important issues in biomedical research and support a
conclusion similar to Truog’s. Research on the treatment of chronic disease should rest primarily, not on
RCTs, but on observational studies of the type described by Truog. I conclude by examining the
implications of this claim for EBM.
Co-Sponsored by the Howard Baker Center for Public Policy
For more information contact: hdouglas@utk.edu
*Proposals for suggested visitors are welcomed and can be sent to the chair of University Studies. The proposal should include a plan for the visit, the visitors resume', and a dollar estimate of the support needed. Sometimes in conjunction with one of the colloquia, sometimes as part of an "Open Forum" series.
[last update 09/06/07]