Refusing Medical Treatment: An SPH Panel Discussion

Over the last two years, I have really enjoyed developing and chairing the SPH Jewish Student Association.  It has been an honor to be able to meet wonderful and enthusiastic people who are excited to be involved in the Jewish community at school. I hope that the group continues to grow and strengthen over the next few years and continues to serve the Jewish student population at the University of Michigan School of Public Health.

Students in La Briut enjoying a homemade Shabbat dinner.

Earlier this semester, the Jewish Student Association held a panelist event at U-M SPH.  Professor Ed Goldman, Professor Peter Jacobson, Rabbi Seth Winberg, and Rabbi Kim Blumenthal were panelists.  The evening took a lot of coordination, but it was well worth it. Below is an article I wrote about the event for the Detroit Jewish News. Thank you to the Detroit Jewish News for allowing me to share this on the SPH Student Life Blog.

When I started my master’s of public health degree at the University of Michigan, I noticed that the Jewish students were well represented in the School of Public Health, but did not find a venue within the school to bring us together.

So I decided to form a student organization called La Briut (Hebrew for “to your health”), which has about 30 members. La Briut fosters community among Jewish students of all backgrounds in the school and creates a space to explore health-related issues that affect the Jewish population at large. Since its inception last year, we have organized a number of social, religious, and educational activities together. We recently sponsored a panel about refusing medical treatment.

Ed Goldman, professor of health management and policy at the School of Public Health, opened the discussion with anecdotes about cases involving the refusal of treatment on religious grounds. For instance, what steps should be taken when a Jehovah’s Witness’ child needs a blood transfusion and his parents will not consent to the procedure? He described receiving calls from doctors at 2 or 3 in the morning asking for his advice on these matters.

Professor Peter Jacobson, also from the department of health management and policy, addressed the conscience legislation recently proposed in Michigan. The legislation, which didn’t pass, would have given healthcare providers freedom to refuse to treat a patient if it violated the provider’s moral and religious principles.  Conscience clauses usually relate to issues such as abortion, contraception, and stem cell-based treatments.  In Jacobson’s view, health providers have a duty to fulfill a patient’s legal medical needs, irrespective of their personal position on the issue.

Two rabbis added the Jewish perspective on refusal of treatment. Rabbi Seth Winberg of U-M Hillel explained that today the standard view is that the Jewish tradition of saving life above all limits patient autonomy, and “consequently, a patient would be required to accept medical treatment.”

But he then cited several precedents that challenge such a view, suggesting that there may be reasons for a patient to refuse medical treatment—if, for example, the treatment is experimental or too risky.

Rabbi Kim Blumenthal from Beth Israel Congregation of Ann Arbor shared some of her experiences of counseling congregants.  Her take on the matter was simple: If someone comes to her seeking advice about a difficult decision, she sees her main role as comforting the individual and then guiding him or her through the process of making a decision.

Each viewpoint was unique, nuanced, and interesting.  I do a lot of thinking in my public health courses, but this panel pushed me to think in a different way.  It was provocative and stimulating, and I got the sense that the speakers were enjoying the experience as much as the students. I left the event understanding that we had only begun to delve into this topic and to wrestle with its many intricacies and uncertainties.

Finding the Perfect Study Spot at U of M

Claudia

There are less than 3 months left before graduation and I am still on the search for the perfect studying spot(s) on campus. During my first year, I was lucky enough to have a work space at the Center for Managing Chronic Disease and this became my go to spot for getting some major work done. I rarely ventured outside the walls of the School of Public Health (SPH) my first year for studying purposes. I tried everything from trying to get homework done at the Glasshouse Café, sneaking in to the Organ room, lying around on the couches of the first and second floor study areas, spending hour after hour in the HBHE student lounge, and walking the halls in search of random empty classrooms or meeting rooms. I even looked around the barren halls of the SPH2 building to find a hidden study spot on the second floor in what used to be the old SPH library.

UM SPH Study Lounges on the 2nd Floor. Photo Courtesy of sph.umich.edu

This year I needed a break from SPH and made it a goal to study in other areas of campus. I found this to be more productive for me (but more boring too) because I wasn’t getting distracted by running into as many classmates. Some of my favorite places to study now are the Rackham Reading Room and Study Halls, the lower levels of Hatcher Graduate Library (the internet signal is pretty bad so there are less distractions) and their tiny individual study rooms on the higher floors. I also have been spending time at the Shapiro Undergraduate Library (this place is usually packed, especially late night, but it is so big that I can usually find an isolated study area somewhere). If I can get myself to go to North Campus, then “The Dude” is the place to be…24hrs of the day!

I still have a few more places to check out before the year is over, but I highly recommend checking out the many buildings on campus and finding your perfect study spot(s). Here’s a link with a few suggestions: http://www.annarbor.com/news/eight-great-places-to-study-on-university-of-michigans-campus/

What’s your favorite place to study?

MLK – Beyond the Dream

 

Eboni

In an effort to honor Dr. Martin Luther King, Jr., last semester I came up with the idea of having an SPH round table discussion regarding Martin Luther King, Jr., his dream, and where we are today. A goal of SPH is to create a sense of community, therefore, I reached out to student leaders regarding the event. In the end, PHSA, La Salud, and AAPHA agreed to help plan this round table event.

On January, 23rd, two days after Martin Luther King, Jr. Day, we hosted our event. Our goal was to bring awareness to the importance of MLK Day, his dream, why his dream has not been fully recognized, and our duty as Public Health students. About 50 students and faculty members engaged in a dialogue discussing race, ideas, thoughts, etc. It was a very rewarding and enriching discussion due to our diverse audience and our call to action regarding service and mentorship at the end of the event.

All in all, it was a successful event. I felt as if the people that attended understood more about Martin Luther King’s dream and their duty as future Public Health leaders. It is very rewarding to see an idea you have come into fruition. Its my hope that this will be the 1st Annual MLK-Beyond the Dream event at SPH. More collaborative events such as this will be happening in the future!

Students thoughts regarding Martin Luther King, Jr. and his legacy

On February 22nd, PHSAD will be hosting our 26th Annual Minority Health Conference: “Innovative Approaches to HIV/AIDS – Prevention Among Youth”. Register today!

http://tinyurl.com/umphsadconference2013

My Top 4 Things to Consider When Applying to Graduate School

Desiree

Rigor of Program

• Understand that all programs are not created equal. You want to choose a school that will give you the proper training to prepare you to be a leader in your field.  This one can be tricky to assess. While we all love rankings, and top programs are usually synonymous with rigor, I encourage reaching out to students and talking to them to learn more.

Faculty

• You obviously want to go to a place where people are top in the field, however and more importantly, you want to go to a school where the faculty is invested in you as a professional and as a person. If faculty are invested in you, then they will ensure they are supplying you all that you need to develop as a professional. It’s nice to say that you went to a school where ground-breaking Professor X teaches. But more importantly, did you take a course with that professor? Was he or she accessible to you?

Resources

• Are there many opportunities to conduct research? Do events such as guest lecturers, symposiums, and events that help augment one’s educational experience happen on campus? If so, how often? What type of professional and student organizations does the school have? Is there freedom to found my own organization if there is a need? Be sure to check out what types of opportunities are available outside of the classroom. These matter!

School Culture

• What does the school value? Diversity? Health Disparities? Innovation? Is the school student-centered? More importantly, are the values and culture of the schools ones that you agree with or align with? Does the school facilitate personal growth outside of one’s area of academic study?

This Time

Desiree

Hi Everyone,

School is back in full swing and I am exhausted already. Between being a full-time student, having various leadership roles, and job hunting (which is a full time job in itself), I find myself either super late or super early.

I know that I must cherish this time. UM SPH is a special place.

I am looking forward to many great things this semester:

• The 26^th Annual PHSAD Minority Health Conference, which will focus on the importance of effectiveness and best practices of HIV/AIDS prevention among youth. To register, please go here: http://tinyurl.com/umphsadconference2013
• Expanding quality improvement project opportunities for IHI Open School Members
• Completing what I hope will be my terminal degree
• Beginning my career and truly becoming a change agent
• Restaurant Week in Ann Arbor
• Enjoying the rest of my time as a student
• Learning as much as I can and utilizing every resource that I have not used in the past
• Whatever else may come

What are you looking forward to this semester?

“Life Is For Living”

Danielle

“Life is for living, it’s not just for surviving. It’s how we deal with things that either makes us better or bitter. And I refuse to be bitter.” –Joy Kistnasamy

This semester at the University of Michigan School of Public Health, we are lucky enough to have 18 visiting scholars with us from Africa.  The scholars are all either senior scientists or PhD students and they hail from Mozambique, South Africa, Tanzania, Zambia and Zimbabwe. As grad students we—and I include myself in that we—are so focused on our studies and research positions and commitments and life that we often don’t take the time to interact with the amazing people who walk the halls at U-M SPH.  Without a doubt, the students here engage with one another and the faculty, and I so appreciate the commitment the faculty has to getting to know each student who wants to get to know them. But I for one almost missed the exciting opportunity to engage with someone different this semester, someone who will not be here next semester, someone who has an entirely different perspective and comes from a wholly different background from my own. Luckily, several weeks ago I had the privilege of meeting one of the scholars.  Even in the short time we interacted, I had a renewed sense of the importance of staying positive, not taking things—including my education—for granted, and having pride in my country and in what it stands for.

When I arranged to meet with Joy Kistnasamy, a senior scientist from South Africa, she agreed and offered me coffee and cake, even though I had invited her. I immediately told her that while that was so sweet, I couldn’t accept. But then I had to remember that Joy is from a different country with a different culture and customs than my own. It was really lovely to see her generosity and bigheartedness before even meeting her.

When I met with Joy, I wanted to learn about the reasons she chose to be part of the program and what she has gotten out of it so far.  For those of you who don’t know, all of the African Scholars’ work is focused on chronic noncommunicable lung diseases associated with environmental and occupational exposures. Joy explained that there were many different factories in her area in South Africa and she wanted to personally look at the social determinants of asthma and how the factories lead to manifestations of asthma. She said one of the most meaningful aspects of being at SPH has been the mentorship program and the relationship she has been able to form with her own mentor. She said that even though the mentors have such busy lives themselves, they make time to go through their proposals, to give expert opinions, and to ask them about any challenges they’re having.  Indeed, Joy says that she really views mentoring as being “not all about your degrees, but at the end of the day how you can help [students] see where they will be in a few years even if they can’t see it in themselves”.  She hopes that her work with faculty at U-M SPH extends to collaborative work.

Finally, Joy said that sometimes she says “yes” too often and that one of the things she has learned from this whole experience is that “yes you can care, but sometimes you should care enough to close your door.”  From talking to people at SPH, she really learned the true meaning of prioritizing.  They explained how important “me time” really is and that if you can take the time to prioritize and refocus your energies, it makes you really strong.  I think Joy was talking more here about working with students and needing to know when it’s necessary to close her door from time to time.  But when I think about the message of this statement, it really relates to us as students as well.  I agree that sometimes I want to do everything and say yes to everyone.  It’s not a bad thing to want to be very involved and connected.  But sometimes it is so important to reconnect with yourself and to recognize when you have overcommitted yourself.

Joy told me: “I love learning; I love listening to people” and that “you have to have yourself open to learning.”  I have to say that I’m so glad I was open to learning from Joy, because I really learned so much. I encourage you to take some time and introduce yourself to one or all of the African scholars before they leave at the end of the semester in December.

Guide to being an effective graduate student

Andy

How to be an effective graduate student:

1. Be social, even if it pushes the boundaries of your comfort zone. Your peers not only represent the future of healthcare, but also your next two years. Draw on various personalities and backgrounds to enhance your overall experience.
2. Don’t take graduate school too seriously. Nobody gets out alive.
3. Despite what others say, I strongly suggest you work during school. Not only will it provide some income, but more importantly allow you to apply the knowledge gained. This will not only refine your own skills, but also reinforce your reasons for pursuing a degree in public health.
4. Please don’t research to just get published. Research, then use it to solve real problems. My single greatest critique of academia is the exorbitant amount of research that is never applied or implemented to solve a practical solution in the world.
5. Never underestimate your professional background. Literally everything is relevant in public health.
6. Your classmates will make or break your graduate school experience. I’m biased, but I think my friends are the single greatest reason I’m enjoying my experience here at Michigan.
7. Professors are people too. Talk to them.
8. If you were accepted into this program, you are smart. However, so is everyone else. Never underestimate anyone.
9.  DO NOT spend all your time at the School of Public Health. Attend football games, play intramural sports, take classes at the policy school, attend lectures across campus and actively seek out other students from various disciplines.
10. Don’t forget to vote! (Let’s move Forward…)

Andy Mychkovsky is a first year HMP student at the School of Public Health.

Toxic Inspiration

Desiree

You need to attend the Toxic Tour of Detroit, no matter what your discipline of study is. It occurs in the fall semester, and is meant to build awareness around environmental issues that are happening in Detroit.

Yes, I will admit that I am biased. As a native Detroiter, I feel that any issue that Detroit is facing, I am facing. But I promise that if you are completely and unapologetically disinterested in the City of Detroit, that going on the Toxic Tour of Detroit will get you engaged. The environmental issues affecting Detroit are more than likely happening in the area that you are from, or at least not too far from it.

Detroit Institute of Arts

The tour made me think of many things, such as what can be done with industrial structures that are no longer in use, and how communities can organize themselves and successfully get their demand for a healthier environment where they live realized.

Highlighted on the tour were landmarks that have toxic environmental implications such as the Detroit Incinerator, the site of the Old Uniroyal Plant, the Ambassador Bridge, and the Packard Plant in Hamtramck. U of M faculty as well as local environmental activists led the tour.  As a native Detroiter, I was proud to see such a great deal of efforts being organized around environmental issues, many of which were led by locals. The tour showed me the challenges that environmental activists in my city are facing.

In between going from one environmental hazardous area to the next, were attractions such as the DIA, but also some of the most beautiful, historic neighborhoods on the planet.

Detroit Incinerator

I felt a sense of personal obligation after going on the tour. Now that I am aware of the environmental issues that are facing Detroit, I can no longer ignore what I am no longer ignorant to. Although I do not know what my role in environmental activism in Detroit will be, I am certain that I will have one.

Prospective Students Day for HBHE

Danielle

Last Saturday I participated on a panel of students for Prospective Students Day.  We were four students from HBHE, asked to speak in front of a group of about 70 students. Each of these students was coming to see if the HBHE program at the University of Michigan School of Public Health is a proper fit for them.  When I walked into the building I suddenly felt very old.  I would finally be on the other side of things; I was finally not the one applying.  I did not need to frantically write down every last word about how to perfect my application and look in awe at the students who were already halfway through their master’s degree.  Instead, I was one of those students.   Instead, I would be the one answering questions, ready to bring forth my greatest wisdom.  The students would—in theory—be hanging onto my colleagues’ and my every word.  So, the pressure was on.  I wanted to represent the school well and help the prospective students get a better idea of whether public health, Health Behavior and Health Education, and a public health degree at the University of Michigan would be a good choice.

Before the prospective students piled into the auditorium in the School of Public Health building, Dr. Marc Zimmerman, Dr. Woody Neighbors, the other student panelists and I casually chatted and joked around, mentally preparing ourselves for approaching the morning session.  Finally the students came in.  I was amazed to see the large number of people—mostly girls—who were in attendance.  I realized then that I really am concerned with who will carry the school into the future and how well the students of the future will maintain the reputation of the program.

Marc Zimmerman made a speech about HBHE and the program, which included an analogy between the Karate Kid’s lessons from Mr. Miyage and underlying lessons learned throughout the MPH degree program.  It was an entertaining moment, but also very true.  As students we often do not realize how much we’re learning on a day-to-day basis until we go out into the field and apply the skills we’ve developed and the knowledge we have absorbed in the classroom.

Next Woody Neighbors spoke about the things he, as the head of HBHE admissions, and the admissions committee look for in student applications.  Overall, he said that there is not one factor or item in the application that the admissions committee pays most attention to or that carries the most weight.  The committee really looks for a candidate that is strong overall.  This means the devilish GRE that you didn’t do as well on as you’d hoped doesn’t have to be the end of a future career in public health.  So, all of the prospective students out there can hopefully now breathe a bit more easily.

Then it was our turn.  Marc Zimmerman and Woody Neighbors left the room to give us a comfortable space to speak openly about our experiences and allow the students to ask the “big” and “burning” questions.  I was amazed at the interesting and thought-provoking questions the prospective students, who were mostly undergraduates from the University of Michigan, posed.  How does the workload compare to your workload during undergrad? How do you maintain relationships during the program? Can you do international internships? What has your favorite course been so far?

Following the panel session, we went to have lunch with the students.  One eager student approached me and asked if I had one moment in which I knew I wanted to be in the field of public health.  I told her it was really a compilation of experiences that led me to pursue this degree. I sat with her at lunch so she could continue to pick my brain.  She seemed unsure about what field was the right one for her, but I could tell she was on her way to figuring it out.

Detroit is where it’s at

The University of Michigan’s School of Public Health program is unique in that Ann Arbor is in such close proximity to the City of Detroit.  Many of the projects that our professors run, whether they involve research or programming, are set in Detroit and tailored to the needs of the local population.  It’s great to not only be able to develop projects for a specific nearby city, but to also then be able to visit and work there.  I have now had three classes that involved working on projects in Detroit.  Each of these courses has a different goal in mind when sending its students there.  For Needs Assessment I ran a focus group surrounding food choices with Hispanic young adults.  For Program Planning I helped create a youth program to beautify their neighborhood.  And now in Community Organizing I am helping to recruit youth advocates for policy change in their schools.  They have all involved youth, but with a different purpose and through different methods.

I’ve lived in Michigan my entire life, but I have seldom gone to Detroit and had never before interacted with the people who call it home.  Even though it’s a challenge to drive out there when we have so much going on on campus and are so busy during the week, it’s really rewarding once I’m there and I always remind myself of that.  There’s a city that’s so close to us that can use our help.   I want to contribute by working directly with the city’s residents and aiding them in creating change.

Today’s young people are highly invested in addressing the needs of the city, getting involved, and transforming Detroit.  I only hope individuals’ interests in supporting initiatives in the city lead to a healthier and safer community.