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Program on Ethics and Decision Making

Welcome to the Program

The Program on Ethics and Decision Making in Critical Illness is led by Dr. Douglas White, a physician scientist at the University of Pittsburgh.

The practice of critical care medicine requires focused scholarly attention because it brings together several difficult aspects of modern medicine: dying patients, expensive technological care, and uncertainty about how best to deliver care consistent with patients' values and preferences.

Mission

Our overarching mission is to understand and improve how medical decisions are made for critically ill patients who cannot make decisions for themselves.

To accomplish this, we use approaches from decision sciences, bioethics, and health service research to design interventions that go beyond the standard "informed decision making" paradigm.  Specifically, we are developing interventions to overcome the emotional, psychological, and health-systems barriers to making decisions that genuinely respect patients as persons.

The program brings together health services researchers, decision scientists, philosophers, bioethicists, and clinicians in conducting numerous research projects funded by the NIH, charitable foundations, and UPMC.

In addition to our funded research projects, program investigators, post-doctoral fellows and students conduct a variety of internally supported research studies surrogate decision-making, including the development of decision aids and the use of simulation methods to study clinician-family communication.

In the News

Intensive care units are intimidating. It’s crucial that doctors really listen,” The Guardian

July 10, 2018 – The PARTNER research study in the New England Journal of Medicine is highlighted in an article about providing ICU care when faced with challenges communicating with family members.

"Breathing Tubes Fail to Save Many Older Patients," The New York Times

June 22, 2018 – “There are cases where noninvasive ventilation is comparable or even superior to mechanical ventilation,” said Dr. White during an interview with reporter Paula Spa, who wrote an in-depth article about mechanical ventilation in the elderly.

"Doctor Radio Channel Interview," SiriusXM

May 29, 2018 – Dr. White was the guest of Dr. Frank Adams, of NYU Langone Health, who hosts the Pulmonology Show. Dr. White talked about the PARNTER family support program and fielded live questions from listener call-ins.

"Nurse-Led ICU Intervention Improves Family Communication"

May 24, 2018 – Dr. White’s PARTNER study, which was published online by the New England Journal of Medicine at the ATS Conference, garnered news stories in these media outlets: Medpage Today, MedicalResearch.com and GeriPal.

"PARTNER Family Support Program Launched in Transplant ICU"

June 11, 2018 – The ICU Service Center launched the PARTNER family support program in the first of 32 intensive care units—the Transplant ICU— within the UPMC system. “The PARTNER intervention was trialed in five UPMC ICUs in 2017 and the results were so promising that UPMC has fast-tracked the program for a phased rollout across all its ICUs,” said Dr. White.

"Nurse-Led Communication in the Intensive Care Unit"

May 23, 2018 – An editorial in the New England Journal of Medicine about the merit of the ICU nurse-led communication program adds a strong human dimension to the results of the PARTNER study by Douglas White, MD, MAS.

"A Randomized Trial of a Family-Support Intervention in Intensive Care Units"

May 23, 2018 – Families of critically ill hospital patients report higher satisfaction with clinician communication and a better perception of patient-centered care when the care team uses a low-cost strategy involving intensive emotional support and frequent meetings, according to the results of Dr. White’s PARTNER study. The results were published online in New England Journal of Medicine during the 2018 ATS Conference.

"Conflicts on Prognosis Occur Over Half the Time Between Physicians and Surrogate Decision-Makers"

November 2016 – In this article from Medical Ethics Advisor focusing on the reasons behind the prognosis expectations of a patient's family versus their physician, Dr. White explains the conflict is not always due to a misunderstanding.

"An Elderly Parent May Struggle to Recover from a Stay in the ICU, But You Can Help," The Washington Post

October 2016 – In this Washington Post article on how to help elderly patients have a meaningful recovery from an ICU stay, Douglas White emphasizes the need for good communication and regular meetings with the doctors.

"Tough Talk: Difficult Conversations in the ICU and Beyond," PittMed Magazine

Summer 2016 – “'The same thing we do in medicine is what you do when you analyze a novel—you look for what’s there, what’s said,' says Douglas White, an MD, who holds the UPMC Chair of Ethics in Critical Care Medicine at Pitt. It’s the doctor’s job to examine the person’s character and consider, 'What is the patient complaining of? What are they not complaining of? How are they saying it? And what clues might we get as to what’s going on?'"

"What Doctors Know About How Bad It Is, and Won’t Say," The New York Times

July 1, 2016 – Dr. White's recent study on discordance ("Prevalence of and Factors Related to Discordance About Prognosis Between Physicians and Surrogate Decision Makers of Critically Ill Patients," published May 17 in JAMA) is referenced as an example of one of the communication breakdowns that can often prevent frank end-of-life discussions.

"Decision-Makers Hold Overly Optimistic Expectations for Critically Ill Patient Outcomes"

May 17, 2016 – Dr. White led a research team that found that more than half of surrogate decision-makers have significantly different estimates, compared to their doctor's, of the chances that their critically ill loved one will survive. Moreover, the research found, this discordance is most often due to the decision-maker holding fundamentally different and overly optimistic beliefs about the patient's prognosis. The findings were published on May 17 in the Journal of the American Medical Association, and were discussed in multiple media outlets including CBS News and the Los Angeles Times.

"Shared Decision Making in ICUs"

January 2016 – Dr. White co-chaired the writing committee for this policy statement from the College of Critical Care Medicine and the American Thoracic Society.

 

March 2, 2015 A Surgery Standard Under Fire, The New York Times

 

Program Members


Douglas B. White, MD, MAS – Program Director

Dr. White is Vice Chair and Professor in the Department of Critical Care Medicine, University of Pittsburgh. He received his medical degree from University of California, San Francisco in 1999 and completed a residency in Internal Medicine and a fellowship in Pulmonary and Critical Care Medicine at UCSF. While at UCSF, he also completed a Master’s degree in Epidemiology and Biostatistics and a fellowship in Bioethics under Bernard Lo. He joined the faculty at UCSF in 2005 as an Assistant Professor of Medicine and a Core Faculty of the Program on Medical Ethics. In 2009 he joined the faculty of the University of Pittsburgh in the Departments of Critical Care Medicine and Medicine. He is also a core faculty member in the Center for Bioethics and Health law at the University of Pittsburgh. 

 

Anne-Marie Shields, MSN, RN - Program Manager

Anne-Marie joined the Program on Ethics and Decision Making in April 2012 as the Program Manager. She earned her Master's Degree in Nursing Research at the University of Pittsburgh, School of Nursing in 2011. She has broad research experience, including overseeing and coordinating multi-site studies. She has extensive experience in the clinical setting as a nurse, and training as an advance care planning facilitator.

 

Deepika Mohan, MD

Dr. Mohan joined the faculty in the University of Pittsburgh Departments of Critical Care Medicine and Surgery in 2009, after completing a residency in general surgery at Emory University and a fellowship in surgical critical care medicine at the University of Pittsburgh. She joined the Program on Ethics and Decision Making in 2009, and has subsequently pursued research in determinants of physician decision making, in particular the influence of intuitive judgments (heuristics) on decision making, and the implications for quality improvement efforts. Having received a 2015 NIH Director’s New Innovator Award from the National Institutes of Health, Mohan is now using serious games to develop and test a new intervention to recalibrate physician heuristics.

She joined the Program on Ethics and Decision Making in 2009 and her current projects include studying regionalization in trauma triage, time pressured decision making in trauma triage, and validating the use of vignettes to study physician decision making.

 

Jennifer B. Seaman, PhD, RN

Dr. Seaman is an Assistant Professor at the School of Nursing with the Department of Acute and Tertiary Care.  She obtained her PhD from the University of Pittsburgh, School of Nursing, where she studied care quality outcomes and patterns of palliative care consultation among critically ill, mechanically-ventilated patients. Her research interests are in the integration of palliative care and end of life care into ICU practice. Mentored by Dr. Doug White, she is working to develop interventions to identify and address the palliative care and end-of-life care needs of critically-ill patients, especially older adults. She joined the program full-time in January 2015.

Praewpannarai (Pearl) Buddadhumaruk, MS, RN

Pearl graduated summa cum laude from Carlow University in 2010 with a Bachelor of Science in Biology and mathematics minor. Before that, she had earned an Associate degree in Nursing from the Community College of Allegheny County in 2006 and worked as a registered nurse in a cardiothoracic surgical unit for a year. She received her Master of Science in Biostatistics from the University of Pittsburgh, Graduate School of Public Health in December 2012. Her Master’s thesis was a statistical genetic research focusing on locating candidate genes in the mother that are responsible for meiotic nondisjunction errors and subsequently lead to Down’s syndrome development in the baby.

Pearl joined the program in September of 2012 while she was a biostatistics graduate student. Currently, she serves as the biostatistician for all the projects in the Ethics and Decision Making program statistically analyzing the collected quantitative data.

Elke H. P. Brown, MD

Elke joined the Program on Ethics and Decision Making in November 2014. She received her medical degree from Catanduva Medical School in Sao Paulo, Brazil and completed a residency in Internal Medicine.  Upon completion of her residency, she spent the next 10 months at the University of California, San Diego as a research fellow in the osteoradiology section. She returned to Brazil and practiced as a physician for 3 years.  For the past 61/2 years, she was a post-doc and clinical researcher  in the department of Physical Medicine and Rehabilitation at the University of Pittsburgh. In the White Program, she is Project Manager of the PARTNER II R01; “Improving Patient and Family Centered Care in Advanced Critical Illness.”

 

Kristyn Felman, MPH, CPH, LSW

Kristyn joined the Program on Ethics and Decision Making in 2015 as a Family Support Specialist. She holds advanced degrees and licensure in both public health and social work and is an alum of the University of Pittsburgh’s Graduate School of Public Health.  She has over ten years of experience providing health education and decision-making support to families navigating the healthcare system.  Within the “4 Supports Study” she provides emotional support and education to study participants, manages research activities, and actively enrolls subjects in ongoing research.

 

 

 

Rachel Butler, MHA, MPH

Rachel joined the Program on Ethics and Decision Making in Critical Illness in February 2017. She is the Senior Project Manager for the Family Support Tool (FST) and the Prediction of Functional Outcomes from Chronic Critical Illness (ProFOCCI) studies and lends support to other ongoing projects in the EDM program. She earned master’s degrees in health administration and public health from Indiana University and is currently a doctoral student in the Health Services Research and Policy program at the University of Pittsburgh Graduate School of Public Health. Rachel was a 2017 fellow of the Jewish Healthcare Foundation’s Fellowship on Death and Dying, and she has had training as an advance care planning facilitator. Outside of the program, Rachel is a co-organizer and facilitator for Death Café Pittsburgh, a founding member of Pittsburgh Community Deathcare, a hospice and grief support volunteer, and a member of the Coalition for Quality at the End of Life (CQEL).

 

Mary Callahan, MD

Mary Callahan, MD, is a Clinical Instructor of Medicine, Division of General Internal Medicine, Section of Palliative Care and Medical Ethics at the University of Pittsburgh. She completed her medical school training at Rush Medical College in 2014 and residency in Internal Medicine at Tulane University School of Medicine in 2017. She completed her Hospice and Palliative Medicine fellowship at the University of Pittsburgh in 2018 and is currently pursing a Masters Degree in Medical Education at the University of Pittsburgh.

Her clinical time is spent on the inpatient palliative care consult services at UPMC Presbyterian-Shadyside and Magee Women’s Hospital. Her academic interest is in teaching communication and primary palliative care skills.

 

 

Menna Abaye, MS

Menna Abaye joined the Program on Ethics and Decision Making in August 2018. She works as a Clinical Research Coordinator for the Prediction of Functional Outcomes from Chronic Critical Illness (ProFOCCI) study and will also be involved in the Family Support Tool Study (FST). She received her Master’s of Science in Biomedical Informatics from the Department of Biomedical Informatics at the University of Pittsburgh School of Medicine weeks before she joined the team. She has experience in clinical research and biomedical research as she worked as a research assistant and graduate student researcher for three years. She enjoys working in clinical settings and interacting with patients and clinical staff. Menna has interests in clinical/biomedical research, human-computer interaction and behavioral decision theory. She has enthusiastically participated in a web development boot camp to build on her programming skills.

 

Emeritus

Leslie P. Scheunemann, MD MPH

Dr. Scheunemann is a Clinical Instructor in Pulmonary and Critical Care Medicine and Geriatrics. She is also a Post-Doctoral Scholar on an NIA-funded F32 entitled, “Communicating with Surrogate Decision Makers about Incapacitated ICU Patients' Values.” The main focus of her research is understanding and improving how ICU clinicians and families talk about patients’ values during treatment decisions about life support.  She attended medical school at the University of North Carolina at Chapel Hill, which was where she first recognized the difficulties clinicians and families have making decisions for ICU patients who cannot speak for themselves. Her interest in this problem grew during her residency in Internal Medicine and fellowship in Geriatric Medicine there.  She earned a Masters in Public Health from the Gillings School of Global Public Health in 2011.  Then, she moved to Pittsburgh to begin her clinical fellowship in pulmonary and critical care medicine.  She had been working with Dr. White for several years, and joined the Program on Ethics and Decision Making full time in February 2013. 

 

Jared Chiarchiaro, MD

Dr. Chiarchiaro joined the Program on Ethics and Decision Making in 2012.  He attended medical school at the University of Texas Medical Branch from 2005-2009 where he was first introduced to the intensive care unit and participated in research with the critically ill on implementation of early goal directed therapy for sepsis.  He completed internal medicine residency training at Duke University Hospital from 2009-2012 where he became interested in communication and decision making in patients with advanced, critical illness.  During his residency he was mentored by James Tulsky and completed work on trajectories of well-being in patients with advanced chronic illness after a stay in the ICU.  He completed his fellowship in Pulmonary and Critical Care Medicine and joined the faculty as Assistant Professor of Medicine in the Division of Pulmonary, Allergy and Critical Care Medicine in 2015. He is currently a KL2 multidisciplinary clinical research scholar. His research focus is on helping patients with advanced lung disease and their families prepare for future medical decision making.

Students

Hannah Callahan

Hannah joined the Program on Ethics and Decision Making in 2015 as a Student Research Assistant. She is currently in her third year at the University of Pittsburgh studying biology, chemistry, and social work with plans to go into Genetic Counseling. In the White Program, she is adding program support to the multiple projects being run by the team.

 

 

Brett Curtis

Brett joined the Program on Ethics and Decision Making in May 2017 prior to matriculating to the University of Pittsburgh School of Medicine in August 2017.  He currently assists with chart abstraction and data collection and completed an intervention fidelity monitoring project for the PARTNER II study.  Brett graduated summa cum laude with a Bachelor of Science in Neuroscience and minors in History and Chemistry from the University of Pittsburgh, where he was a member of the Phi Beta Kappa honorary society.  Recently, he was a Fellow in the Jewish Healthcare Foundation's 2018 Fellowship on Death and Dying and was awarded the UPSOM Class of 1972 Medical Student Research Award for the summer of 2018 for work on delirium in sepsis under Dr. Timothy Girard.  He is interested in the human and behavioral aspect of critical illness.

 

Emma Holt

Emma joined the Department of Critical Care Medicine as a Student Research Assistant for the Long-Term Follow Up Core in October of 2016. In April of 2017, Emma began taking on a greater role in the Partner II program, trained on chart abstraction of Family-Clinician communication. In April of 2018, Emma graduated from the University of Pittsburgh with a BS in Neuroscience and Sociology, and transitioned from follow-up work to full time support for any projects in the Ethics and Decision-Making program that need assistance. After a year or two, Emma hopes to take the experience and skills she has gained from this program and apply them to Medical School.

 

Noah Morse

Noah joined the Program on Ethics and Decision Making in 2018 as a Student Research Assistant. He is a fourth-year undergraduate student at the University Pittsburgh studying Information Science.  Noah works as a programmer, developing new tools to help organize and analyze data.

 

 

 

 

Abagale Gibson

Abagale joined the Department of Critical Care Medicine as a Student Research Assistant with the Undergraduate Research Mentorship Program in May 2018. She is going into her senior year as an undergraduate student at the University of Pittsburgh studying nursing. Abby currently assists with chart abstraction for the PARTNER II Study.

 

 
Former Program Members


Amanda Argenas, BS


Natalie C. Ernecoff, MPH


Veronica Kozar, PhD, MSW


Suzanne MacKenzie RN, BNSc, MPA


Alyssa Majesko, MD


Apoorv Narang, MHCI, BT


Wendy Newdick, MSN, RN


Rachel Palkoska, MSN, RN


Rachel San Pedro, LSW, RN


Rachel Schuster, MD, MS


Kaitlin J. Shotsberger, BSN, RN


Rebecca Vanderwall, BS


Melissa L. Vendetti (McCullough), MS


Louise Vongphrachanh, BA

 

 

Collaborators

Wendy Gabrielle Anderson, MD, MS

Derek C. Angus, MD, MPH, FRCP

Robert M. Arnold, MD

Amber E. Barnato, MD, MPH, MS

Cindy Bryce, PhD

Shannon Carson, MD

Elizabeth Chaitin, DHCE, MSW

Christopher E. Cox, MD, MHA, MPH

Farr A. Curlin, MD

J. Randall Curtis, MD, MPH

Cynthia Gries, MD

Scott D. Halpern, MD, PhD, MBE

Mary Beth Happ, PhD, RN, FAAN

Catherine L. Hough, MD, MSC

Jeremy M. Kahn, MD, MS

Charles Seth Landefeld, MD

Bernard Lo, MD

Susan Martin

Kelly N. Michelson, MD, MPH

Cynthia Paner, MSN

Michael W. Peterson, MD

Carrie Pidro, BS

Thaddeus Pope

Yael Schenker, MD, MS

Mi-Kyung Song, PhD, RN, FAAN

Jay S. Steingrub, MD

Mark R. Wicclair, PhD

Donald D. Wolff, Jr. Center for Quality, Safety, and Innovation

 

Current Research Projects

 

Prediction of Functional Outcomes from Chronic Critical Illness

Principal Investigator: Shannon Carson, MD

Co-Investigator: Douglas White, MD, MAS

Funding Source: NIH/NINR 1R01-NR016459

The purpose of the study is to 1) establish clinical determinants of poor cognitive and physical functional outcome in CCI patients, and 2) provide a new tool to more effectively inform decision making earlier in the course of ICU care. We hypothesize that multiple premorbid and acute factors measured early in the course of CCI will have strong independent associations with functional recovery. We further hypothesize that social and economic factors are associated with long-term functional outcomes independent of the acute clinical problems.

 

Family Support Intervention in Intensive Care Units: A randomized trial to improve surrogate decision-making for critically ill elders

Principal Investigator: Douglas B. White, MD, MAS

Funding Source: National Institute on Aging - R01AG045176

The goal of this study is to conduct a multicenter efficacy trial of the Four Supports Intervention among 400 critically ill older adults to reduce their long term symptoms of depression and anxiety. The Four Supports Intervention is a multifaceted intervention in which a specially trained nurse intensively provides four types of support to surrogates in coordination with the clinical team: emotional support, communication support, decision support, and anticipatory grief support.  The central hypothesis is that by intensively supporting surrogates in this highly stressful circumstance, the Four Supports Intervention will improve key elements of decision making, decrease long-term psychological distress among surrogates, and achieve more patient-centered care near the end of life.

PARTNER II: Improving Patient and Family Centered Care in Advanced Critical Illness

Principal Investigator: Douglas B. White, MD, MAS

Funding Source: NIH/NINR - R01NR014663

PARTNER II is a comparative effectiveness trial with the overarching goal of this research project to ensure patient-centered decisions about the use of intensive treatments for patients with advanced critical illness. In a prior project, we developed the PARTNER program (PAiring Re-engineered ICU Teams with Nurse-driven Education and OutReach), a 4-facet, team-based intervention that re-engineers how surrogates are supported in ICUs, including: 1) changing care “defaults” to ensure clinician-family meetings within 48 hours of enrollment and frequently thereafter; 2) protocolized, nurse-administered coaching and emotional support of surrogates before and during clinician-family meetings, 3) increased use of palliative care services for patients with a poor prognosis; and 4) structured communication at care transitions about patient’s health care preferences and goals. We expect to achieve the following project goals:1. To increase the patient-centeredness of end-of-life decisions, and to increase the quality of clinician-family communication.2. To decrease the psychological burden on family members acting as surrogates.3. Lower costs: To reduce total health care costs by increasing the use of palliative care and hospice services and decreasing unwanted readmissions near the end of life.

 

Improving Patient and Family Centered Care in Advanced Critical Illness

Principal Investigator: Douglas B. White, MD, MAS

Funding Source:   Support for this project is provided by Stephen Shapiro, UPMC Chief Medical and Scientific Officer

The overall purpose of this research study is to assess health care quality and health outcomes following a Quality Improvement Initiative of a protocolized, team-based intervention to improve patient and family centered care in patients with advanced critical illness (PARTNER).The PARTNER program targets a high-risk population, combines multiple evidence-based practices into a novel team-based intervention, and transforms the healthcare workforce through training existing clinicians in advanced, team-based communication protocols. The specific goals of this project are:
1.To increase the patient-centeredness of end-of-life decisions, and to increase the quality of clinician-family communication.
2.To decrease the psychological burden on family members acting as surrogates.
3.To reduce total health care costs by ensuring that patients who would not choose prolonged intensive treatment instead are offered the use of palliative care and hospice services near the end of life.

 

Developing a Communication and Shared Decision Making Tool to Prepare Family Members in ICUs for the Role of Surrogate Decision Makers

Principal Investigator: Douglas B. White, MD, MAS

Funding Source: NIH/NIA R21-AG050252-01

The purpose of this project is to find ways to  improve the quality of  Surrogate Decision Makers in the ICU by developing and deploying a web based Communication and Decision Support (CDS) tool and a reliable care process to Integrate the tool into routine practice.

 

Communicating with Surrogate Decision Makers About Incapacitated ICU Patients’ Values

Principal Investigator: Leslie P. Scheunemann, MD & Douglas B. White, MD, MAS

Funding Source:   National Heart, Lung, and Blood Institute (NHLBI) - T32HL007820 and National Institutes on Aging (NIA) – F32AG047806-01A1 - pending funding,

One important barrier to patient-centered decision-making for patients with acute respiratory failure is that clinicians do not consistently elicit and incorporate patients’ values when communicating with the patient’s surrogate decision-makers. The goal of this project is to develop three research tools for future interventions to improve this problem: 1. 1) a high-fidelity simulation, which is a laboratory for studying and intervening on how clinicians elicit and incorporate incapacitated patients’ values into life support decisions; 2) consensus from a diverse group of stakeholders about which communication skills for physicians to use to elicit patients’ values and preferences are most important for interventions to target; and 3) a checklist outcome measure to quantify intervention effectiveness.

 

User-centered Design of a New Advance Care Planning Tool for Advanced Lung Disease

Principal Investigator: Jared  Chiarchiaro, MD & Douglas B. White, MD, MAS

Funding Source:  Pulmonary T32 HL007563-26

The goal of this project is to create a web-based, multimedia, interactive advance care planning tool for patients with advanced lung disease and their families that can be further developed to improve patient-related and clinical outcomes.

 

Improving Psychological Distress Among Critical Illness Survivors and Their Informal Caregivers

Principal Investigator: Christopher E. Cox, MD

Funding Source: Patient Centered Outcomes Research Institute (PCORI) - Funding Award 195

The purpose of this randomized trial is to reduce distress and improve quality of life for the ICU survivor-informal caregiver (family) dyad. Dyads will be randomized to receive one of two 6-week, telephone-based interventions: an ICU survivor-specific coping skills training (CST) program or a critical illness educational program. Both programs were developed with patient input and are promising interventions for this high risk group.

 

Improving Decision Making for Patients with Prolonged Mechanical Ventilation

Principal Investigator: Christopher E. Cox

Funding Source:  National Institues of Health - R01 HL109823

This is a multicenter, randomized, controlled trial (RCT) comparing the efficacy of a tablet computer-based decision aid to usual care control in improving the quality of the decision making process for surrogates of incapacitated prolonged mechanical ventilation (PMV) patients, and their ICU physicians and nurses.

 

Current Policy Involvement

Ethics in the Intensive Care Unit: Responding to Requests for Futile or Inappropriate Therapies

These recommendations can be used to help frame local and national policy on responding to requests for futile or inappropriate therapies.

Clinicians are sometimes faced with requests to provide treatments for patients in the intensive care unit (ICU) that they judge to be ill-advised. They often arise due to poor communication regarding prognosis and treatment goals between the treating team and the patient and/or his or her surrogates. Less commonly, such requests may arise because of disagreements between the clinicians, the patient, and/or his or her surrogates about what the goals of care should be in light of a serious medical situation.  Issues related to requests for futile or potentially inappropriate therapies in the ICU were reviewed, terms defined, and recommendations made on how to handle these difficult situations.

 

Would Accommodating Some Conscientious Objections by Physicians Promote Quality in Medical Care?

These recommendations can be used to help frame local and national policy on Conscientious Objections by Physicians.

Moral pluralism is a valuable aspect of a free society but sometimes creates conflicts in medical care when individual physicians object to providing certain legal but morally controversial services, such as abortion, physician-assisted suicide (where it is legal), and palliative sedation to unconsciousness. The notion that protecting physicians' consciences benefits physicians at the expense of patients has created an overly simplistic dialogue about conscience in medicine. Viewing the issue from a societal perspective and conceptualizing medical quality as a public good allow a more robust understanding of the relationship between CBR and quality medical care. Policies that allow some CBRs while also ensuring patients' access to the requested services may yield better overall medical quality by fostering a diverse workforce that possesses integrity, sensitivity to patients' needs, and respect for diversity. This analysis is necessary for a genuine public discussion about how to handle moral pluralism among patients and physicians. The societal perspective should be incorporated into efforts to develop a comprehensive framework for when CBRs should and should not be accommodated.

 

Research Seminar on Ethics and Decision Making

Our Research Seminar on Ethics and Decision Making is held bi-weekly throughout the academic calendar year.  Guest presenters share their research on an array of topics which include decision sciences, bioethics, and health service research.

When: Every other Friday, 10 to 11 a.m.

Where: Conference Room 615 Scaife Hall, University of Pittsburgh Department of Critical Care Medicine

 

Research Seminar Calendar*

*Updates coming soon

2017-2018 Date

Speaker

Talk Title

September 29, 2017

​Deepika Mohan

Designing an RCT to test the efficacy of two behavioral interventions at recalibrating physician heuristics in trauma triage

October 13, 2017

Shreyus S. Kulkarni​

Quantifying and Assessing Determinants of Surgeon Decision-Making Variability in Emergency General Surgery

Octopber 27, 2017

Jennifer Seaman

Pilot testing a nurse-led intervention to ensure timely interdisciplinary family meetings in the ICU: Selection of feasibility and acceptability outcome measures

November 10, 2017

Barry Dewitt​

You’re outta here: Exclusion criteria for health preference studies

November 24, 2017

Cancelled-Holiday

 

December 8, 2017

Open​  

December 22, 2017

Cancelled-Holiday

 

January 17, 2018 (this is a Wednesday) 

Corita Grudzen

The Palliation of Emergency Medicine

January 26, 2018

Jennifer Ervin

Defining and understanding Teamwork in the ICU

February 9, 2018

Tamar Krishnamurti

Developing and evaluating targeted informed consent for clinical trials

February 23, 2018

Cancelled

 

March 09, 2018

Cancelled-Holiday

 

March 20, 2018

Fazal Khan, MD, JD

Note: this is a Tuesday

“A.I. in the Clinic: Barriers, Opportunities, and Pittfalls”

April 6, 2018

Cancelled

    

April 20, 2018

Douglas White

A Randomized Trial of a Family Support Intervention Delivered by the Interprofessional Team in ICUs

May 4, 2018

Taylor Lincoln

The Effect of Family Meetings on Surrogates’ Trust in the ICU Physician

May 18, 2018

           Cancelled-ATS

 

June 1, 2018

Holly Witteman

 Designing and Testing Tools for Patient and Family   Decision Support

 

                            

 

Selected Program Publications

View Douglas B. White's Publications on PubMed

 

Empirical Work

 

Normative and Policy Work

 

Around the Program

Program on Ethics & Decision Making vs. Health Policy & Management Program Kickball Game 7-15-2016

          Fun Balloon Slingshot at Team Picnic          Team Meeting

 

 

 

 

 

 

 

Enjoying the view-Mount Major, Alton NH, July 2013

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Supporting Ethics and Decision Making Research

Donations to the Program on Ethics and Decision Making at the University of Pittsburgh support important research and training of new physician researchers.

To donate:

  • Print Donor Card and return it with your donation to the Department of Critical Care Medicine, University of Pittsburgh

Every donation is tax deductible to the full extent of the law.

All contributions will support the Program’s vision, mission and activities. For more information on specific funding options for this research program, please contact:

Douglas B. White
Department of Critical Care Medicine
University of Pittsburgh
3550 Terrace Street Scaife Hall, Room 608
Pittsburgh, PA 15261
Phone: 412-864-3757

whitedb@upmc.edu

Your contributions are important to furthering the work of the Program on Ethics and Decision Making in Critical Illness, the critical care profession, and the delivery of quality patient care.

Thank you!

 

Contact

Douglas B. White, MD, MAS

UPMC Endowed Chair for Ethics in Critical Care Medicine
Professor of Critical Care Medicine
Director, Program on Ethics and Decision Making in Critical Illness
University of Pittsburgh Medical Center

Email: whitedb@upmc.edu

Phone: 412-864-3757
Fax: 412-647-8060


Mailing address:

University of Pittsburgh Medical Center
Department of Critical Care Medicine
3550 Terrace St. Scaife Hall, Room 608
HPU010604
Pittsburgh, PA 15261