‘Goodness of Fit Ethics’ to Promote Health Research for LGBT Youth

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This past November, Public Responsibility in Medicine and Research (PRIM&R), a non-profit organization dedicated to the study and advancement of the highest ethical standards in the conduct of research, held its annual Advancing Ethical Research (AER) Conference featuring Dr. Celia B. Fisher, Director of the Center for Ethics Education and HIV and Drug Abuse Prevention Research Ethics Training Institute at Fordham University. She, along with Janet L. Brody, PhD and Eric Kodish, MD, were panelists on Panel III: Research With Children and Adolescents: Who and How Is the Decision Made to Participate?

Discussing her NIH-funded research on ethical issues in research involving LGBT youth, Dr. Fisher discussed the “interfamilial, regulatory and ethical tensions” that emerge in HIV prevention studies striving to recruit sexual and gender minority adolescents under 18 years of age.

Dr. Fisher discussed the requirement of parental permission for at-risk adolescents to enroll in HIV research and how it, contrary to the assumption that it protects participants, results in low enrollment as adolescents may not wish to share their sexual orientation with their families. Furthermore, she added that the need for parental permission both reduces participation and creates ethical issues as an entire population may now have limited or no access to a potential treatment for HIV.

According to Seth Hall of the PRIM&R blog, Dr. Fisher’s solution was to apply her “goodness of fit ethics” in order to reconsider the adolescents’ characterization as a vulnerable, based on the strengths and weaknesses of this particular population. Dr. Fisher and her colleagues found that potential adolescent participants “sufficiently understood relevant aspects of research, such as random assignment, side effects, and privacy risks, to support their informed consent without the need for parental permission.” Additionally, she argued that a waiver of parental/ legally authorized representatives (LAR) permission (45 CFR 46.408(c)) should be included in consent processes which are “appropriate to the development and informational needs of the participants” to promote adolescent enrollment in HIV and drug use research.

Please visit PRIM&R’s blog, Ampersand, for full coverage of the panel in the post titled, “Assent, Consent, and Goodness of Fit.”

Celia B. Fisher, Ph.D. is the Fordham University Marie Ward Doty University Chair in Ethics and Director of the Center for Ethics Education. Fisher’s  Decoding the Ethics Code: A Practical Guide for Psychologist, is now in its fourth edition from Sage Publications.

 

Fordham University’s Dr. Celia B. Fisher on Bystander Apathy

 

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Since the election of Donald Trump in November, there has been a 35 percent increase in hate crimes across New York City, according to Straus News.  Throughout the presidential campaign, reported NYPD statistics of the city’s hate crime count has doubled in a year with 43 incidents in the 27 days following the election. The rhetoric and tone of the Trump campaign targeted many minorities and could be the reason for this rise.

These hate crimes and incidents included verbal and physical assaults on two Muslim women, a police officer and an MTA employee, and swastika graffiti in multiple places including the NYC subway and inside the elevator of state Senator Brad Hoylman’s apartment building. New Yorkers met for a workshop last month to educate themselves and help others by speaking up for victims of these attacks.

“When you have groups that are being dehumanized or considered the ‘other,’ there’s something else that’s at play when people don’t do anything,” said Dr. Celia B. Fisher, Director of the Center for Ethics Education and psychologist at Fordham University. “People are violent against others because it gives them a sense of power and belonging to a larger group. In order to combat that, it’s a larger cultural issue in terms of beginning to talk about minorities … in terms of Americans who are one of us.”

Please visit Straus News to read the full article, “Responding to Hate Crimes.”

Celia B. Fisher, Ph.D. is the Fordham University Marie Ward Doty University Chair in Ethics and Director of the Center for Ethics Education. Fisher’s  Decoding the Ethics Code: A Practical Guide for Psychologist, is now in its fourth edition from Sage Publications.

 

 

Now Accepting Applications: Fordham University’s Master’s Degree in Ethics and Society and the HIV and Drug Abuse Prevention Research Ethics Training Institute

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Master’s Degree in Ethics and Society: Spring 2017

The Master of Arts in Ethics and Society provides students with a solid grounding in moral theory and ethical practice in fields such as philosophy, theology, bioethics, research ethics, business and law.

Preparation for:
– Doctoral programs in the humanities and biological and social sciences
– Professional degree programs in medicine and law
– Employment in a variety of fields including government, nonprofit, academia, business, and healthcare)

Engage in practicum experiences throughout the New York Metropolitan Area at:
– St. Barnabas Hospital
– Global Bioethics Initiative
– Generation Citizen
– Fordham University Institutional Review Board
– Families and Work Institute
– And more

Continue reading “Now Accepting Applications: Fordham University’s Master’s Degree in Ethics and Society and the HIV and Drug Abuse Prevention Research Ethics Training Institute”

Fordham Study Addresses Health Care of Bisexual Adolescent Girls

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For bisexual female adolescents,  proper sexual healthcare is difficult to obtain due to healthcare providers’ judgmental attitudes and assumptions of patient heterosexuality, and lack of opportunities for HIV and sexually transmitted infections (STI) testing. Additionally, youth openness with healthcare providers is restricted due to stigma experienced within families of bisexual teen girls and concerns of confidentiality. These findings were published in LGBT Health, a Mary Ann Liebert, Inc. publication

Principle investigators of this NIH-funded study, Dr. Celia B. Fisher, Director of the Fordham University Center for Ethics Education and Dr. Brian Mustanski, Director of the Institute for Sexual and Gender Minority Health and Wellbeing, along with Drs. Miriam Arbeit and Kathryn Macapagal, describe these health care disparities in the article, Bisexual Invisibility and the Sexual Health Needs of Adolescent GirlsThe study analyzed bisexual female adolescents’ perspectives on their access to health information and services provided by health care professionals.

In addition to attitudes and assumptions of healthcare providers and stigma within families, the findings also included limited school-based sexual health education as an important factor contributing to insufficient health care for bisexual adolescent girls.

“The findings from our study are consistent with the unfortunate fact that sexual health care of adolescent girls has largely been absent or focused primarily on birth control tools that do not prevent risk of HIV and other STI – especially if male partners refuse to use condoms,” notes Fisher, Director of Fordham Center for Ethics Education, “and this problem is exacerbated for bisexual girls who may be unprepared for sexual experiences with male partners or who engage in such experiences to avoid social stigma.”

The researchers concluded that practitioners must improve standard sexual health practices involving female youth by integrating nonjudgmental questions regarding bisexuality. According to Fisher, the study “underscores the need for additional training of family physicians and gynecologists to engage in patient centered discussions that help to overcome bisexual invisibility and fears of medical discrimination that are barriers to bisexual girls sexual health.” In a recent article about the study, William Byne, MD, PhD of LGBT Health, adds, “Knowledge of a patient’s sexuality is essential to the biopsychosocial model of clinical practice.”

According to the study, other forms of support of bisexual health among adolescent girls include addressing stigma, increasing sensitivity to privacy and expansion of school-based sexual health education.

Read more about this research in the News Medical Life Sciences article as well as in LGBT Health.

Welcome Fall 2016 Master’s Students!

The Ethics and Society blog is delighted to welcome the following candidates to Fordham University’s Master of Arts in Ethics and Society:

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Kelly Collins

Kelly Collins graduated in 2011 with a BS in Philosophy and Political Science from Florida State University.  After moving to New York City shortly after graduation, she began working as a legal assistant in a well-known international law firm.  While pursuing her MA in Ethics and Society, Kelly hopes to utilize real-world skills to analyze and reflect upon today’s moral dilemmas.

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Tim Colvin

Tim Colvin is currently a senior at Fordham University from Kings Park, New York. He is a dual major in Political Science and Classical Civilization with a minor in Philosophy. Tim is interested in attending law school and hopes to apply a background in ethics in practice after completing the MA in Ethics and Society.

Continue reading “Welcome Fall 2016 Master’s Students!”

Medical Training for Transgender Patients Needs to Include Sensitivity to Social Stigmas for both Gender and Sexual Orientation

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The recently published article on doctor’s lack of expertise in treating transgender patients in The Guardian is an important step forward in highlighting current disparities in healthcare services for this population.  The study, based on interviews with sample of 23 physicians and psychologists who chose to work with transgender patients, focused on current challenges in providing gender affirming care for individuals who are seeking medically supported transitioning treatments, such as hormonal replacement therapies (HRT).

A recently completed study by Celia B. Fisher, Ph.D. and her colleagues, funded by the National Institute for Minority Health and Health Disparities (NIMHD) confirms the need for greater medical training, based on the reports of 228 transgender males, females and gender non-conforming youth ages 14 – 21.  “Fear of stigmatization is a significant barrier to healthcare among these youth,” notes Fisher, Director of Fordham University’s Center for Ethics Education, “and in our study, 51% reported they did not discuss their transgender identity with their primary health care providers out of fear that the provider would not be accepting.”

Continue reading “Medical Training for Transgender Patients Needs to Include Sensitivity to Social Stigmas for both Gender and Sexual Orientation”

Relying on Psychological Assessments do not Right Death Penalty Wrongs for the Intellectually Disabled

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Although the death penalty is on the decline in the United States, the case of James Rhodes highlights the ethical quagmire facing forensic psychiatrists and psychologists whose evaluations contribute whether persons with intellectual disabilities convicted of murder will live or die.

In addition to the increasingly familiar racial biases and legal flaws in death penalty convictions and use of lethal injection, according to Celia B. Fisher, Ph.D. Director of Fordham University’s Centerfor Ethics Education, little attention has been paid to the lack of professional consensus surrounding the validity and reliability of IQ tests in general and for racial minorities in particular, disagreement over the use of absolute cut-off scores to determine intellectual disability, and the inherent fallibility of tests to determine the probability of future violence.

“Professional evaluations are not a panacea for inconsistent, uninformed and often racially biased jury decisions,” notes Fisher, “rather than providing a fair and neutral assessment of mental ability forensic assessments are contributing to inconsistencies that lethally violate the human rights of convicted criminals in capital cases.”

For more information on the ethics of psychologists’ involvement in death penalty evaluations – particularly for defendants with mental disabilities Dr. Fisher’s 2013 article in Ethics & Behavior entitled “Human Rights and Psychologists’ Involvement in Assessments Related to Death Penalty Cases.”

Celia B. Fisher, Ph.D. is the Marie Ward Doty University Chair, Professor of Psychology, and Director of Fordham University’s Center for Ethics Education. She chaired the 2002 revision of the American Psychological Association’s Ethics Code and is the author of Decoding the Ethics Code: A Practical Guide for Psychologists, now in it’s fourth edition, from Sage Publications.