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Passing the Torch at the UNC Center for Bioethics!

May 27, 2021

I am happy to announce that after 11 years as Director of the UNC Center for Bioethics, I am turning over that leadership role to Arlene Davis, RN, JD, effective July 1, 2021. It has been immensely fulfilling to oversee the flourishing of the C:B over the last decade. I am deeply grateful to the … Read more

Reconsidering Scarce Drug Rationing: Implications for Clinical Research

March 15, 2021

Hospital systems commonly face the challenge of determining just ways to allocate scarce drugs during national shortages. There is no standardised approach of how this should be instituted, but principles of distributive justice are commonly used so that patients who are most likely to benefit from the drug receive it. As a result, clinical indications, … Read more

A New Governance Overnance Approach to Regulating Human Genome Editing

December 10, 2020

For years, genomic medicine—medicine based on the growing understanding of the genetic contribution to many diseases and conditions—has been hailed as the future of medical treatment, but it has thus far had limited effect on day-to-day medical practice. The ultimate goal of genomic medicine has always been the ability not just to identify dangerous gene … Read more

Reconsidering Scarce Drug Rationing: Implications for Clinical Research

November 30, 2020

Hospital systems commonly face the challenge of determining just ways to allocate scarce drugs during national shortages. There is no standardised approach of how this should be instituted, but principles of distributive justice are commonly used so that patients who are most likely to benefit from the drug receive it. As a result, clinical indications, … Read more

Incidental Enhancements: A Neglected Governance Challenge for Human Genome Editing Research

June 25, 2020

The increasing pace and international diffusion of developments in human genome editing research have prompted ongoing efforts to develop responsible governance for such research. One point of broad agreement across these efforts is that human genome editing research should prioritize medical applications over attempts to enhance human traits because of the moral concerns the latter … Read more

Professionalism and Ethics: A Standardized Patient Observed Standardized Clinical Examination to Assess ACGME Pediatric Professionalism Milestones

May 1, 2020

Introduction: The ethical skills fundamental to medical practice encompass a large portion of the Accreditation Council for Graduate Medical Education (ACGME) professionalism milestones. Yet many ethical practices are difficult to reduce to milestone frameworks given the variety of traditions of moral reasoning that clinician-trainees and their colleagues might properly employ. Methods: We developed an observed … Read more

Is Real-Time ELSI Realistic?

May 1, 2020

Background: A growing literature has raised—skeptically—the question of whether cutting-edge scientific research can identify and address broader ethical and policy considerations in real time. In genomics, the question is: Can ELSI contribute to genomics in real time, or will it be relegated to its historical role of after-the-fact outsider critique? We address this question against … Read more

Exploring the Emotional Labor of Medical Trainees in the Setting of Ethics Education

November 2, 2019

Julie Childers and Bob Arnold’s (2019) article, “The Inner Lives of Doctors: Physician Emotion in the Care of the Seriously Ill,” uses Kübler-Ross’s influential work on death and dying to remind us that the experiences contained within her framework relate not only to patients but also to members of their care teams. Childers and Arnold’s … Read more

Clarifying a Clinical Ethics Service’s Value, the Visible and the Hidden

November 1, 2019

Our aim in this article is to define the difficulties that clinical ethics services encounter when they are asked to demonstrate the value a clinical ethics service (CES) could and should have for an institution and those it serves. The topic emerged out of numerous related presentations at the Un-Conference hosted by the Cleveland Clinic … Read more

Perils of the Hidden Curriculum: Emotional Labor and “Bad” Pediatric Proxies

October 11, 2019

Today’s medical training environment exposes medical trainees to many aspects of what has been called “the hidden curriculum.” In this article, we examine the relationship between two aspects of the hidden curriculum, the performance of emotional labor and the characterization of patients and proxies as “bad,” by analyzing clinical ethics discussions with resident trainees at … Read more