Community Dialogue to Identify Ethical Issues in PCOR - Patient Centered Outcomes Research in the Elderly at UTMB

Research Project 3: Community Dialogue to Identify Ethical Issues in PCOR

Dr. Jerome Crowder

PROJECT DIRECTOR:
Jerome Crowder, PhD

Dr. Crowder is a medical and visual anthropologist who has worked in Bolivia (since 1989) and Perú (since 2003) and most recently in East Houston (since 2006) and Galveston (since 2010). He received his Ph.D. in Anthropology from the University of Pittsburgh in 1998 and then held a National Cancer Institute Post-Doc at the U-Texas Health Science Center-Houston, School of Public Health for a year through (2000). Crowder then moved to the University of Houston as a Lecturer in the Department of Anthropology and by 2006 became an Assistant Research Professor with several federally sponsored grants, including two from the National Science Foundation, as well as the Associate Director of the Visual Studies program at U. Houston. In 2009 Crowder was made Assistant Dean for Technology and Communication in the College of Liberal Arts and Social Sciences where he served until coming to UTMB in the fall of 2010. Crowder has published in professional journals, including Medical Anthropology Quarterly, as well as Visual Anthropology Review and most recently in the Journal for Empirical Research on Human Research Ethics. . In 2013 he published Visual Research (Bloomsbury Academic Press) with colleague Jonathan S. Marion (U. Arkansas). View Dr. Crowder's bio at the UTMB Institute for Medical Humanities.

The co-investigator for Project #3 is Peggy Determeyer, PhD, MBA, MDiv, BCC, who completed her doctorate at the Institute for the Medical Humanities in August 2016. In this role, Ms. Determeyer assisted in revamping the materials for the PCOR/CER dialogues; led the effort in aggregating materials for the dialogues on seniors and aging; and served as the facilitator for one of the groups. Dr. Determeyer's dissertation is entitled Health Care, Aging, and End Of Life: Using Community Bioethics Dialogues to Promote Individualized Personal Decisions and Advance Care Planning. As part of this work, Dr. Determeyer used the Community Bioethics Dialogue format to conduct a three-week session on Personhood, Aging, and End of Life for a separate group. Dr. Determeyer is currently serving as the McGee Fellow in Bioethics and Aging at the Hope and Healing Center and Institute in Houston, Texas. As part of her fellowship, Dr. Determeyer is working with additional community groups to offer dialogues on the topic of Health Care, Aging, and End of Life. She is the co-author with Dr. Howard Brody, MD, PhD, of "Medical Futility: Content in the Context of Care" in Palliative Care and Ethics, edited by Timothy E. Quill and Franklin G. Miller, New York: Oxford University Press (2014), 199-208


SPECIFIC AIMS

Develop and evaluate the feasibility of models for bioethics dialogue in diverse communities in the Texas Gulf Coast region.

Elicit stakeholder ethical values and priorities and refine understanding of the ethical issues in PCOR.

SIGNIFICANCE

Click to Enlarge: Diagram describing how the dialogue process unfoldsCommunity bioethics dialogue is a proven method for allowing members of community groups to engage in extended, informed dialogue around bioethics issues and develop a list of ethical values that reflect the community perspective and that can then be used to guide health policy. In the past, most community dialogue projects addressed a single topic (such as access to healthcare or genetic screening and privacy) and then disbanded. The current project is designed to answer questions such as:

  • Can we elicit ethical values related to PCOR?
  • Will the ethical values differ among community groups drawn from diverse cultural, ethnic, and socioeconomic backgrounds?
  • Is there a “training effect” if the same dialogue group stays together and addresses other ethical issues in future dialogues?

STATUS

Photo by J. Crowder (IMH) obtained during research activities  in Research Project 3: Community Dialogue to Identify Ethical Issues in PCORAs of September of 2016, our project has partnered with six different community groups, held dialogues with each, and produced six reports (see above links). Two groups represent African-American communities on the island; the other communities are Caucasian and Latino. Each dialogue group indicated enthusiasm for the process and expressed a desire to continue to meet and to address further ethical issues. In the spring 2016 two of the original groups engaged in an additional round of dialogues, and selected the topic of "seniors and mental health". We are grateful for all of the individuals and community members who participated and made this work possible!

Site managed by UTMB Sealy Center on Aging • Last updated September 2016

Participant photos above by J. Crowder (IMH).

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Funding for the UTMB Center for Patient-Centered Outcomes Research in the Elderly is provided by the
U.S. Agency for Healthcare Research and Quality (grant #1R24HS022134).