Alumni Magazine Fall 2016 - page 6-7

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Fall 2016
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Clarkson
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Fall 2016
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“That we are not limited by geography benefits
our students,” says Philpott-Jones. “We’ve had
students from 27 states and 15 countries. Diversity
— geographic and professional — is a strength of our
program. There is a multitude of voices and that makes
the learning experience that much richer. When we
bring the students together on campus, they develop
closer relationships with each other and our faculty.”
“Without an on-site location requirement we
can also attract the best faculty, world-renowned
experts working in the field,” he adds.
The program’s focus is on practical training.
“We want students to go out and work as clinical
ethics and research ethics professionals.” One way
students get practical training is by working in
clinical scenarios at Mt. Sinai with standardized
patients, trained professional actors who mimic
symptoms and memorize detailed medical histories.
That emphasis on practical training, along with the
opportunity to focus on research ethics, is what attracted
Dr. LindsayMcNair ’13 UGC (MS) to the program.
[See below.]
McNair, who is trained as a general surgeon
and also holds a master’s degree in Public Health,
spent much of her career in the biotechnology
and pharmaceutical industries providing medical
guidance and designing protocols for clinical trials.
She had also been involved in ethics committees
and in human subject protection work.
“Getting the master’s degree in bioethics
Innovative Surgery or Research without Consent?
was a way of bringing my medical and research
ethics backgrounds together and advancing
professionally,” she says. “It also gave me a level
of academic credibility in ethics that people don’t
expect from someone who spent many years
working in pharmaceuticals.”
Today, McNair is chief medical officer of WIRB-
Copernicus Group, the world’s largest provider of
regulatory and ethical review services for clinical
research. She started at the company in 2013, two
weeks after she completed her bioethics degree.
For medical personnel and researchers, a
grounding in bioethics is becoming a necessary
component of their training, as they navigate
a complex world of medical innovation, legal
compliance, and the social and moral implications
of treatment for their patients.
But its benefits extend well beyond the medical
community.
For Clarkson Provost Chuck Thorpe, the
addition of Bioethics is a natural fit for a university
that educates engineers and scientists, business
leaders and healthcare professionals. “Ethical
considerations come into play in all of the things
that our alumni deal with in graduate school and
in their careers — the technology and systems they
design, the research they perform, the healthcare they
provide, and the policy they influence, ” he says. “We
need leaders who consider the broader implications
of what they do and the decisions they make.”
For her thesis in the Bioethics M.S. program,
Lindsay McNair ’13 UGC (M.S.), M.D., M.P.H.,
M.S.B., surveyed Surgical Department Chairs at
academic institutions to assess awareness levels
of surgical innovation recommendations and the
distinctions among surgical practice, innovation and
research.
“In medicine, the introduction of a new drug
or a medical device is subject to extensive review,”
says McNair. “In contrast, when surgeons modify or
deviate from standard surgical techniques, they are
not subjected to any formal oversight.”
“A surgeon who tries something new, once
or even twice, to improve a patient’s outcome
is operating within the scope of professional
discretion. But if he or she tries a new procedure multiple
times with the intent of generating data so that information
can be shared with others to inform changes in practice, at
that point it is no longer surgery, but research, that is being
performed on the patient.”
And that, she says, is where ethical issues of
informed consent and patient protection come in.
Back in 2008, the Society of University Surgeons
(SUS) recommended the creation of institutional surgical
innovations committees (SICs) to ensure appropriate
oversight and disclosure of innovations. McNair’s
research focused on the level of awareness of the SUS
recommendation and the existence of SICs or other
mechanisms for oversight.
Her conclusion: Only a minority of Surgery
Department Chairs is aware of the SUS recommendation
and less than 25% of departments had an SIC.
As it stands today, most institutions still rely primarily
on the professionalism and ethical standards of their
medical faculty to oversee surgical innovations rather than
an internal peer committee or review board.
In 2014, her research was published in the Annals
of Surgery.
ssistant Professor of Biology Andrew David
found something big while looking at something
very small: microscopic polychaetes. These are
worms that can be found in almost every region of
the world’s oceans but can also act as a parasite to
abalone and oysters, the shellfish that are valued for
both their meat and iridescent mother-of-pearl.
Abalone is farmed and has become an important
part of aquaculture in communities dotting the
southeast and west coasts of southern Africa.
Polychaetes are well-known pests of the
commercially reared abalone. “The worms can
inhibit growth, deform shells and dramatically reduce
abalone yields that farmers depend on for profit,”
David explains. “So there can be significant effects on
the fisheries industry where this type of aquaculture is
practiced.”
But there are other concerns.
The polychaete-infested water from the
farms flows into the ocean, and human-assisted
movement of the worm — in this case, famers
buying and selling their stock to one another up
and down the coast — has unintentionally added
to its introduction and spread in multiple regions
across southern African waters. This has resulted in
some species occupying a much wider range than
would be possible if they were dispersed naturally.
The Parasite and the Oyster
“The original purpose of the research was not climate-related at
all but the results have made it almost impossible to ignore the
implications of climate change.”
David collected samples of infected shellfish
along the coast of South Africa and then cultured
the worms for over a year in the lab, studying
their development patterns under a variety of
temperatures. “Our findings suggest that polychaete
ranges can expand into regions that were historically
colder and therefore inhospitable. This could
upset community dynamics through interspecific
competition, in which different species compete for
the same resources in an ecosystem.”
Shellfish are very sensitive to environmental
changes especially in temperature and pH levels. “If
the worms can adapt to these conditions but their
hosts cannot,” David says, “then the shellfish and the
industrial aquaculture that revolves around them
could be hit with a ‘two-pronged’ attack: climate
change and adaptable parasites.”
To date, there have been no multi-factorial
studies to assess the effects of the parasite load on the
physiological performance of shellfish under a climate
change scenario. But such a study, David says, “is ripe
for investigation considering the implications for food
security and the aquaculture industry.”
There are lessons here for just about all species on
the upper end of the food chain — especially humans.
“Climate change is not necessarily a death
sentence for ocean life,” he says. “But we have to
acknowledge that other species can adapt more quickly
and, in most cases, far better than others and that the
results of that adaptation can directly affect us.”
Prof. Andrew David
Prof. Andrew David (r) and a fellow researcher
inspect shellfish.
Polychaetes infecting a shell.
By Jonathan Brown
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