What are the physical and ethical
boundaries to the frontiers of
health and medicine?
Recent studies suggest that, for those
born in the 21st century, living to 100
won't be an unusual occurrence. What
will be the impact of having so many
people living so long? The use of
performance-enhancing drugs in athletics has
caused controversies and raised many questions
about what should and shouldn't be allowed.
What are the limits of human performance, and by
what means should they be achieved? Advancements
in genetics offer parents the possibility of
pre-selecting gender and other features of unborn
children. How might this impact the human race?
Continuous advancements in the medical field offer
miraculous, life-saving treatments -- often at a very steep HONORS IN ACTION
financial cost. Who gets treatment? Who pays? Rapid advances THE RIGHT TO LIVE (OR DIE): FRONTIERS OF
in health and medicine are tempered by ethical debates over HEALTH AND MEDICINE
access, personal choice and appropriateness.
Would you like to live to old age? Scientists have speculated that
EXPLORE MORE! babies born in the second decade of the 21st century have the
Chopra, Deepak (2009). Quantum Healing: Exploring the possibility to live to 100 years and beyond. What if well before your
Frontiers of Mind/Body Medicine. 100th birthday you needed to make a decision about your health care
Chopra explores the relationship of mind, body and spirit, seeking in a crisis situation? Do you have an advance directive letting relatives
to understand miraculous recoveries from life-threatening disease and health care professionals know your choices regarding
-- recoveries that were not "supposed" to happen. extraordinary life-saving measures? For many people illness and death
are difficult subjects to address. What are the benefits and drawbacks
Kress, Nancy (2012). Future Perfect: Six Stories of Genetic of having an advance directive?
Kress presents six works of short fiction based on the frontiers of PREPARATION
genetic engineering. SELECTION OF THEME At a meeting to talk through the Honors
Program Guide, conversation picked up among our team when we
Topol, Eric (2012). The Creative Destruction of Medicine: How came to the Frontiers of Health and Medicine theme. The
the Digital Revolution Will Create Better Health Care. conversation initially focused on the impact of medical advances on
Cell phone technology can already do things like monitor heart lifespan, but then veered to the cost of health care. At first, the group
rhythm, blood glucose and brain waves. Topol looks for cell phone feared that they had strayed from the focus on advances
technology to go even further, detecting cancer cells, forecasting resulting from exploration in the medical field. One member,
heart attacks and myriad other possibilities. however, took the position that the cost of health care is very much a
result of the cost of exploration and advancement. The debate helped
Welch, H. Gilbert, Lisa Schwartz & Steve Woloshin (2012). the team choose the Frontiers of Health and Medicine and begin their
Overdiagnosed: Making People Sick in the Pursuit of Health. research focused on medicine's impact on lifespan.
Welch, et al. make the case that overdiagnosis is a problem as
medical professionals feel compelled to run every test and DEVELOP RESEARCH QUESTIONS
explore every possibility in evaluating patients. They address the _ What impact are advancing medical and health frontiers
downside to our constantly evolving advances in the diagnosis having on human lifespan?
and treatment of disease. _ How is a growing elderly population impacting the health
For more sources related to this theme, go to ptk.org/honors.
_ What is the impact of increased lifespan on access to health care? _ meet with a communications instructor for a workshop on sending
_ How have advances in medical technologies affected health care the best possible verbal and non-verbal messages, particularly while
access? discussing sensitive topics.
_ How are decisions made regarding health care access? What are the
ethical implications of these decisions? IMPLEMENTATION
LEADERSHIP ROLES In completing this project, the team took on the
ACADEMIC RESEARCH We began with the frontier of lifespan -- following leadership roles:
exploring the impact of advances in health and medicine on length of _ organized a research team and developed a research strategy;
life. The literature revealed multiple problems resulting from increased _ guided a discussion and analysis of the research with members;
lifespan: greater demand for access to health care and eldercare; _ planned and organized the logistics of the awareness event;
increased costs; increased pressures on the health care industry to treat _ recruited volunteers for the awareness event;
more patients; and questions of when, if ever, it is appropriate to cease _ provided volunteer training for proper ways of discussing a sensitive
heroic measures regarding the preservation of life and how those topic, like advance directives, with the public; and
decisions should be made. Taking an interest in the latter issue, the _ planned marketing and communication tools and publicized the
team further researched how expanding frontiers in health and awareness event.
medicine have impacted the end of life. As research and develop-
ment yield new treatments and technologies to preserve life, ethical COLLABORATION In implementing their project, the team collaborated
questions arise as to when and how such treatments and technologies with others in the following ways:
should be applied. Do patients decide for themselves? What if they _ recruited members to research, develop and execute the project;
are unable to do so? What about family members or medical pro- _ worked with area health care providers to promote advance
fessionals? Do terminal patients have the right to die? What roles do directives for their patients;
government and the insurance industry play? Are "death panels" an _ worked with local media to build community awareness;
inevitable result of advancements in medicine and the costs associated _ worked with the visual communication program at school and the
with those advancements? Among the findings from this research was local community theater to create a video on the topic;
a discussion of the use of advance directives -- legal documents that _ partnered with nursing students and faculty to implement the
allow individuals to proactively dictate their requests regarding medical project; and
treatment in situations where they are unable to make those requests _ shared research findings and project details with members at a
clear (e.g., in a coma or otherwise unresponsive). regional meeting.
ANALYSIS AND CONCLUSIONS An analysis and discussion of the ACTION The team prepared a display on the topic of advance
research generated the following questions: directives. Working with a local health care provider, the Visual
_ How are decisions to take heroic, life-saving measures made for Communication Department at school and the local community
patients who cannot speak for themselves? theater, they scripted and filmed a video illustrating the importance of
_ How prevalent is the use of an advance directive for the preparing an advance directive. Working with the health care provider,
communication of end-of-life decisions? the team gathered audience-appropriate literature on the topic. They
_ How are advance directives put into action in the event of a identified three locations where the display could be set up and
life-threatening situation? Is access time a factor? Is location a factor? literature set out to their target audience and determined dates and
_ What are the potential legal implications if a health care provider times for staffing the display. The project ran for three consecutive
fails to follow a patient's advance directive? weekends, one weekend at each location.
_ What are the ethical concerns regarding the creation and execution
of an advance directive? REFLECTION
_ How do advance directives impact health care costs, and what are EVALUATION After the event, the team reflected on the following
the implications of this? questions:
_ What were our successes in organizing the event? What didn't go as
DETERMINATION OF ACTION Based on the research, the project team planned, and/or what could have been more effective?
decided to implement a project that included the following: _ What were our successes in marketing the event? Did we get the
_ the development and implementation of a community awareness turnout that we expected? Did the media get involved? What might
campaign encouraging people to complete advance directives; we have done differently to achieve better results?
_ work with area health care providers to help community members _ How did visitors react to our display, presentation and information?
take the necessary steps to complete an advance directive. What went well? What could have been better?
LEADERSHIP DEVELOPMENT The team created the following "to do" FUTURE IMPLICATIONS Finally, the group discussed whether this was
list for leadership development: a one-time project or whether there were future possibilities. Was there
_ meet with a college reference librarian for guidance in conducting a need for continued awareness of advance directives? If so, was the
scholarly research on the topic; chosen strategy effective? Should it be repeated? Are there other
_ contact area health care providers to conduct a workshop on approaches that should be implemented? Is it something that the
their patients' advance directives and how they are used effectively; chapter should consider remaining involved with? Are there other
_ meet with a medical ethicist to learn strategies for introducing the groups/organizations that would be better positioned to continue/
concept of advance directives to people; and advance the work?