The Law-Medicine Center
The Law-Medicine Center





Case Western Reserve University School of Law

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The Law-Medicine Center presents

“New Technologies, New Challenges: Women and Prenatal Genetic Testing in the 21st Century”

Co-Sponsored by:
- Cleveland Clinic Center for Ethics, Humanities and Spiritual Care
- Center for Genetic Research Ethics and Law (CGREAL)
, Case Western Reserve University

Thursday: April 12, 2012, Noon – 6:00 p.m.
Friday: April-13, 2012, 8:30 a.m. – 12:30 p.m.
Moot Courtroom (A59)

Free and open to the public. Register now.
7.5 hrs. CLE credit available for a $200 fee (School of Law alumni pay $100)
7.5 CME Credits available (7.5 AMA PRA Category 1 Credit.TM)

Webcast live and available afterward for viewing on demand: /lectures

While genetic research has opened up new possibilities to assess fetal health, the sheer volume of information generated by prenatal testing also raises unique medical, ethical, legal, and social questions for patients and healthcare providers. The ability to conduct genome-wide analyses of the developing fetus magnifies the intensity of our uncertainties and, in some cases, our comfort with integrating the newest genetic technologies to patient care. This symposium will examine these issues as they affect the care of pregnant women both in the present and in the future with as the fields of clinical genetics and maternal-fetal medicine advance.

Day 1 - Thursday, April 12, 2012

11:30 am-Noon Registration
Ground Floor Rotunda

Noon-1:00 pm Lunch
Please pick up a box lunch on your way into the Moot Courtroom (A59)

Noon-12:30 pm Introduction
Ruth M. Farrell, MD, MA,
Department of Bioethics and Obstetrics & Gynecology, Cleveland Clinic Foundation
Professor Jessica Berg, JD, MPH, Professor of Law, Bioethics, & Public Health, Case Western Reserve University School of Law

12:30-1:00 pm Setting the Stage
Elizabeth Thomson, RN, MS
, National Institutes of Health (NIH), National Human Genome Research Institute (NHGRI)

Session 1: Expanding Technology, Expanding Options?
A discussion of the leading ethical, legal, and social issues that arise for women with the growth of new prenatal genetic testing options.

Moderator:
Ruth M. Farrell, MD, MA, Cleveland Clinic

1:00-1:30 pm Lecture Presentation
Speaker: Professor Anne Drapkin Lyerly, MD, Department of Social Medicine and Associate Director, Center for Bioethics, University of North Carolina

1:30-2:30 pm Panel discussion
a. Shift in ethical and moral landscape around pregnant women, fetuses, and prenatal genetic testing
b. Changing notions of parenthood, disability and family
c. Shifting paradigms of levels of expected obligation and choice
d. Eugenics and enhancement
e. The role of women as a community (within growing array of social networks) in pressures to undergo or decline prenatal genetic testing

Panelists:
Deborah Driscoll, MD, Hospital of the University of Pennsylvania
Professor Jaime S. King, JD, University of California, Hastings College of the Law
Professor Michelle McGowan, PhD, Bioethics, Case Western Reserve University
Professor Eric Juengst, PhD, Director University of North Carolina Center for Bioethics

2:30-2:45 pm BREAK

Session 2: Making Informed Decisions Patient Education and Informed Consent
A discussion of the challenges that patients face in trying to make an informed decision about the use of new prenatal genetic tests. 

Moderator:
Professor Patricia A. Marshall, PhD, Co-Director, CGREAL, Case Western Reserve University

2:45-3:15 pm Lecture Presentation
Speaker: Ruth M. Farrell, MD, MA, Cleveland Clinic

3:15-4:15 pm Panel discussion
a. Education, access to information, and health literacy
b. Values as a core element of decision making
c. Cross cultural issues of testing, parenthood, pregnancy, and disability
d. Addressing barriers in medical education
e. Health literacy
f. Access to information

Panelists:
Dena S. Davis, JD, PhD, Presidential Chair in Health-Humanities/Social Sciences, Lehigh University
Georgia Weisner, MD, Department of Genetics, Case Western Reserve University School of Medicine
Elliot Philipson, MD, Chair, Department of OB/GYN of Hillcrest Hospital; OB/GYN and Women’s Health Institute, Cleveland Clinic
Barbara Biesecker, PhD, National Institutes of Health

4:15-4:30 pm BREAK

Session 3: Navigating the Options: Evolving Prenatal Genetic Technologies and their Impact on Pregnant Women
This session will cover the ethical, legal, and social challenges that will arise for pregnant women as choose between the novel prenatal genetic technologies ((genomic, multiplex, non-invasive diagnostic, direct-to-consumer).

Moderator: Richard Sharp, PhD, Center for Ethics, Humanities and Spiritual Care, Cleveland Clinic; Co-Director, CGREAL, Case Western Reserve University

4:30-5:00 pm Lecture Presentation
Speaker: Steven J. Ralston, MD, MPH, Division Director, Maternal-Fetal Medicine, Beth Israel Deaconess Medical Center

5:00-6:00 pm Panel discussion
a. Rapid change in prenatal genetic testing options
b. Increasing access to prenatal genetic testing: recommendations for universal genetic testing
c. Impact of increasing ways to conduct prenatal genetic testing: microarray and multiplex
d. The tentative pregnancy-then and now

Panelists:
Professor Elena Gates, MD, Division Director and Vice Chair, Obstetrics & Gynecology, University of California San Francisco
Deborah Pergament, JD, Managing Attorney, Children's Law Group, LLC
Barbara Bernhardt, MS, CGC, Division of Medical Genetics, University of Pennsylvania Health System

6:00 pm Adjourn Day 1

________________________
Day 2 - Friday, April 13, 2012

8:00-8:30 am Registration
Ground Floor Rotunda

Session 4: The Post-Test Landscape: Options and Implications for Pregnant Women
This session will look at choices s/p testing, discussing the implications of having a growing number of in utero diagnostic options but limited post-test fetal therapy options.

Moderator
: Professor Jessica Berg, JD, MPH, Case Western Reserve University School of Law

8:30-9:00 am Lecture Presentation: "The Mixed Message"
Speaker: Karen Rothenberg, JD, MPA, Marjorie Cook Professor of Law, University of Maryland School of Law

9:00-10:00 am Panel discussion
a. Maternal-fetal therapy: status, limitations, options for women
b. Pregnancy termination: issues of access
c. Therapeutic conception
d. Conscience clause-professional obligations
e. Impact of pregnancy loss/termination on women
f. Fetal surgery
g. At birth-EXIT procedure

Panelists:
Professor Jessie Hill, JD, Case Western Reserve University School of Law
Mary Mahowald, PhD, Department of Obstetrics & Gynecology, University of Chicago
Donna Patno, CNM, Fetal Care Coordinator, Cleveland Clinic Children’s Hospital
Professor Rachel Rebouche, JD, University of Florida Levin College of Law

10:00-10:15 am BREAK

Session 5: Challenges on the Horizon: Looking Ahead to Advances in Genetic Technologies
Advances in genetic technology will cause a shift in ways of thinking about the integration of new prenatal genetic technologies in patient care. This session will begin to discuss the ethical, legal, and social challenges that women will face with advances in prenatal genetic technology.

Moderator:
Ruth M. Farrell, MD, MA, Cleveland Clinic

10:15-10:45 am Lecture Presentation
Speaker: Mildred Cho, PhD, Pediatrics – Center for Biomedical Ethics, Stanford University

10:45-11:45 am Panel discussion
a. Multiplex and microarray technologies
b. Non-invasive diagnostic procedures
c. Continued push of direct-to-consumer testing
d. Growing emphasis on in utero health as an indicator for adult chronic disease, epigenomics and genomics

Panelists:
Maxwell J. Mehlman, JD, Arthur E. Petersilge Professor of Law, Case Western Reserve University School of Law
Rocio Moran, MD, Clinical Geneticist, Genomic Medicine Institute, Cleveland Clinic
Professor Lisa Parker, PhD, Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh
Professor Nancy Press, PhD, School of Nursing and Department of Public Health & Preventive Medicine, School of Medicine, Oregon Health & Science University and School of Nursing Portland


11:45 am-Noon Break

Noon-12:30 pm Wrap-up:
Summary of discussions and closing remarks

12:30 pm Adjourn Day 2

Case Western Reserve University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Case Western Reserve University School of Medicine designates this live activity for a maximum of 7.5 AMA PRA Category 1 Credit.TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. CME credit sponsored by the Cleveland Society of Obstetricians & Gynecologists.

The Center sponsors frequent lunch-time lectures.