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Anita J. Tarzian [34]Anita Tarzian [19]Anita Jeanne Tarzian [1]
  1.  37
    Ethics Consultation in U.S. Hospitals: A National Follow-Up Study.Ellen Fox, Marion Danis, Anita J. Tarzian & Christopher C. Duke - 2022 - American Journal of Bioethics 22 (4):5-18.
    A 1999–2000 national study of U.S. hospitals raised concerns about ethics consultation (EC) practices and catalyzed improvement efforts. To assess how practices have changed since 2000, we administered a 105-item survey to “best informants” in a stratified random sample of 600 U.S. general hospitals. This primary article details the methods for the entire study, then focuses on the 16 items from the prior study. Compared with 2000, the estimated number of case consultations performed annually rose by 94% to 68,000. The (...)
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  2.  37
    Ethics Consultation in U.S. Hospitals: Opinions of Ethics Practitioners.Ellen Fox, Anita J. Tarzian, Marion Danis & Christopher C. Duke - 2022 - American Journal of Bioethics 22 (4):19-30.
    To design effective strategies to improve ethics consultation (EC) practices, it is important to understand the views of ethics practitioners. Previous U.S. studies of ethics practitioners have overrepresented the views of academic bioethicists. To help inform EC improvement efforts, we surveyed a random stratified sample of U.S. hospitals, examining ethics practitioners’ opinions on EC in general, on their own EC service, on strategies to improve EC, and on ASBH practice standards. Respondents across all categories of hospitals had very positive perceptions (...)
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  3.  23
    Ethics Consultation in U.S. Hospitals: New Findings about Consultation Practices.Ellen Fox, Marion Danis, Anita J. Tarzian & Christopher C. Duke - 2022 - AJOB Empirical Bioethics 13 (1):1-9.
    BackgroundWhile previous research has examined various aspects of ethics consultation (EC) in U.S. hospitals, certain EC practices have never been systematically studied.MethodsTo address this gap, we surveyed a random stratified sample of 600 hospitals about aspects of EC that had not been previously explored.ResultsNew findings include: in 26.0% of hospitals, the EC service performs EC for more than one hospital; 72.4% of hospitals performed at least one non-case consultation; in 56% of hospitals, ECs are never requested by patients or families; (...)
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  4.  85
    Health Care Ethics Consultation: An Update on Core Competencies and Emerging Standards from the American Society for Bioethics and Humanities’ Core Competencies Update Task Force.Anita J. Tarzian & Asbh Core Competencies Update Task Force 1 - 2013 - American Journal of Bioethics 13 (2):3-13.
    Ethics consultation has become an integral part of the fabric of U.S. health care delivery. This article summarizes the second edition of the Core Competencies for Health Care Ethics Consultation report of the American Society for Bioethics and Humanities. The core knowledge and skills competencies identified in the first edition of Core Competencies have been adopted by various ethics consultation services and education programs, providing evidence of their endorsement as health care ethics consultation (HCEC) standards. This revised report was prompted (...)
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  5. Disability Rights as a Necessary Framework for Crisis Standards of Care and the Future of Health Care.Laura Guidry-Grimes, Katie Savin, Joseph A. Stramondo, Joel Michael Reynolds, Marina Tsaplina, Teresa Blankmeyer Burke, Angela Ballantyne, Eva Feder Kittay, Devan Stahl, Jackie Leach Scully, Rosemarie Garland-Thomson, Anita Tarzian, Doron Dorfman & Joseph J. Fins - 2020 - Hastings Center Report 50 (3):28-32.
    In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both (...)
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  6.  81
    Quality Attestation for Clinical Ethics Consultants: A Two‐Step Model from the American Society for Bioethics and Humanities.Eric Kodish, Joseph J. Fins, Clarence Braddock, Felicia Cohn, Nancy Neveloff Dubler, Marion Danis, Arthur R. Derse, Robert A. Pearlman, Martin Smith, Anita Tarzian, Stuart Youngner & Mark G. Kuczewski - 2013 - Hastings Center Report 43 (5):26-36.
    Clinical ethics consultation is largely outside the scope of regulation and oversight, despite its importance. For decades, the bioethics community has been unable to reach a consensus on whether there should be accountability in this work, as there is for other clinical activities that influence the care of patients. The American Society for Bioethics and Humanities, the primary society of bioethicists and scholars in the medical humanities and the organizational home for individuals who perform CEC in the United States, has (...)
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  7.  60
    A Code of Ethics for Health Care Ethics Consultants: Journey to the Present and Implications for the Field.Anita J. Tarzian, Lucia D. Wocial & the Asbh Clinical Ethics Consultation Affairs Committee - 2015 - American Journal of Bioethics 15 (5):38-51.
    For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, the American Society (...)
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  8.  75
    A Pilot Evaluation of Portfolios for Quality Attestation of Clinical Ethics Consultants.Joseph J. Fins, Eric Kodish, Felicia Cohn, Marion Danis, Arthur R. Derse, Nancy Neveloff Dubler, Barbara Goulden, Mark Kuczewski, Mary Beth Mercer, Robert A. Pearlman, Martin L. Smith, Anita Tarzian & Stuart J. Youngner - 2016 - American Journal of Bioethics 16 (3):15-24.
    Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step (...)
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  9.  33
    Patient and Family Descriptions of Ethical Concerns.Hae Lin Cho, Christine Grady, Anita Tarzian, Gail Povar, Jed Mangal & Marion Danis - 2020 - American Journal of Bioethics 20 (6):52-64.
    Ethically challenging situations routinely arise in the course of illness and healthcare. However, very few studies have surveyed patients and family members about their experiences with ethically challenging situations. To address this gap in the literature, we surveyed patients and family members at three hospitals. We conducted a content analysis of their responses to open-ended questions about their most memorable experience with an ethical concern for them or their family member. Participants described 219 unique ethical experiences that spanned many of (...)
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  10.  13
    Ethics Consultation in U.S. Hospitals: Adherence to National Practice Standards.Anita Tarzian, Ellen Fox, Marion Danis & Christopher C. Duke - 2022 - AJOB Empirical Bioethics 13 (1):10-21.
    BackgroundAdherence to widely accepted practice standards is a frequently used measure of healthcare quality. In the U.S., the most widely recognized authoritative source of practice standards for ethics consultation (EC) is the second edition of the American Society for Bioethics and Humanities’ Core Competencies for Healthcare Ethics Consultation report.MethodsTo determine the extent to which EC practices in U.S. hospitals adhere to these practice standards, we developed and analyzed 12 evaluative measures from a national survey.ResultsOnly three of the 12 standards achieved (...)
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  11.  20
    Health care ethics programs in U.S. Hospitals: results from a National Survey.Christopher C. Duke, Anita Tarzian, Ellen Fox & Marion Danis - 2021 - BMC Medical Ethics 22 (1):1-14.
    BackgroundAs hospitals have grown more complex, the ethical concerns they confront have grown correspondingly complicated. Many hospitals have consequently developed health care ethics programs (HCEPs) that include far more than ethics consultation services alone. Yet systematic research on these programs is lacking.MethodsBased on a national, cross-sectional survey of a stratified sample of 600 US hospitals, we report on the prevalence, scope, activities, staffing, workload, financial compensation, and greatest challenges facing HCEPs.ResultsAmong 372 hospitals whose informants responded to an online survey, 97% (...)
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  12.  59
    The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain.Diane E. Hoffmann & Anita J. Tarzian - 2001 - Journal of Law, Medicine and Ethics 28 (s4):13-27.
  13.  25
    The Girl Who Cried Pain: A Bias against Women in the Treatment of Pain.Diane E. Hoffmann & Anita J. Tarzian - 2001 - Journal of Law, Medicine and Ethics 28 (4_suppl):13-27.
  14.  13
    Ethics Consultation in United States Hospitals: Assessment of Training Needs.Christopher C. Duke, Marion Danis, Anita J. Tarzian & Ellen Fox - 2021 - Journal of Clinical Ethics 32 (3):247-255.
    BackgroundTo help inform the development of more accessible, acceptable, and effective ethics consultation (EC) training programs, we conducted an EC training needs assessment, exploring ethics practitioners’ opinions on: the relative importance of various EC practitioner competencies; the potential market for EC training (that is, how many individuals would benefit and how much individuals and hospitals would be willing to pay); and the preferred content, format, and characteristics of EC training.MethodsAs part of a multipart study, we surveyed “best informants” who self-identified (...)
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  15.  42
    Are Ethics Committee Members Competent to Consult?Diane Hoffmann, Anita Tarzian & J. Anne O'Neil - 2000 - Journal of Law, Medicine and Ethics 28 (1):30-40.
    A significant amount of discussion in the bioethics community has been devoted to the question of whether individuals performing ethics consultations in healthcare institutions have any special expertise. In addition, articles in the lay press have questioned the “added value” that bioethicists bring to ethical dilemmas. Those at the forefront of the bioethics community have argued repeatedly that those doing ethics consults cannot simply be well-intentioned individuals, that some training in bioethics, group process, and facilitation is necessary to competently execute (...)
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  16.  31
    Are Ethics Committee Members Competent to Consult?Diane Hoffmann, Anita Tarzian & J. Anne O'Neil - 2000 - Journal of Law, Medicine and Ethics 28 (1):30-40.
    A significant amount of discussion in the bioethics community has been devoted to the question of whether individuals performing ethics consultations in healthcare institutions have any special expertise. In addition, articles in the lay press have questioned the “added value” that bioethicists bring to ethical dilemmas. Those at the forefront of the bioethics community have argued repeatedly that those doing ethics consults cannot simply be well-intentioned individuals, that some training in bioethics, group process, and facilitation is necessary to competently execute (...)
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  17.  20
    The Girl Who Cried Pain: A Bias against Women in the Treatment of Pain.Diane E. Hoffmann & Anita J. Tarzian - 2001 - Journal of Law, Medicine and Ethics 29 (1):13-27.
    To the woman, God said, “I will greatly multiply your pain in child bearing; in pain you shall bring forth children, yet your desire shall be for your husband, and he shall rule over you.”Genesis 3:16There is now a well-established body of literature documenting the pervasive inadequate treatment of pain in this country. There have also been allegations, and some data, supporting the notion that women are more likely than men to be undertreated or inappropriately diagnosed and treated for their (...)
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  18.  64
    Credentials for clinical ethics consultation – are we there yet?Anita J. Tarzian - 2009 - HEC Forum 21 (3):241-248.
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  19.  31
    What Is the Minimal Competency for a Clinical Ethics Consult Simulation? Setting a Standard for Use of the Assessing Clinical Ethics Skills (ACES) Tool.Katherine Wasson, William H. Adams, Kenneth Berkowitz, Marion Danis, Arthur R. Derse, Mark G. Kuczewski, Michael McCarthy, Kayhan Parsi & Anita J. Tarzian - 2019 - AJOB Empirical Bioethics 10 (3):164-172.
    Background: The field of clinical ethics is examining ways of determining competency. The Assessing Clinical Ethics Skills (ACES) tool offers a new approach that identifies a range of skills necessary in the conduct of clinical ethics consultation and provides a consistent framework for evaluating these skills. Through a training website, users learn to apply the ACES tool to clinical ethics consultants (CECs) in simulated ethics consultation videos. The aim is to recognize competent and incompetent clinical ethics consultation skills by watching (...)
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  20.  43
    Achieving the Right Balance in Oversight of Physician Opioid Prescribing for Pain: The Role of State Medical Boards.Diane E. Hoffmann & Anita J. Tarzian - 2003 - Journal of Law, Medicine and Ethics 31 (1):21-40.
    State medical boards are beginning to take a more balanced approach to monitoring and disciplining for prescribing of pain medications, according to this survey of state medical boards across the country. Overall, respondents indicated that they are becoming more educated and more sophisticated in their approach to complaints of opioid overprescribing. In addition, their responses reflect a heightened awareness of the appropriateness of treating chronic pain with controlled substances.Yet, despite these inroads, boards generally demonstrate a continued tolerance of pain undertreatment, (...)
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  21.  31
    Achieving the Right Balance in Oversight of Physician Opioid Prescribing for Pain: The Role of State Medical Boards.Diane E. Hoffmann & Anita J. Tarzian - 2003 - Journal of Law, Medicine and Ethics 31 (1):21-40.
    Uncertainty regarding potential disciplinary action may give physicians pause when considering whether to accept a chronic pain patient or how to treat a patient who may require long-term or high doses of opioids. Surveys have shown that physicians fear potential disciplinary acrion for prescribing controlled substances and that physicians will, in some cases, inadequately prescribe opioids due to fear of regulatory scrutiny. Prescribing opioids for long-term pain management, particularly noncancer pain management, has been controversial; and boards have investigated and, in (...)
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  22.  60
    Getting Real: The Maryland Healthcare Ethics Committee Network’s COVID-19 Working Group Debriefs Lessons Learned.Norton Elson, Howard Gwon, Diane E. Hoffmann, Adam M. Kelmenson, Ahmed Khan, Joanne F. Kraus, Casmir C. Onyegwara, Gail Povar, Fatima Sheikh & Anita J. Tarzian - 2021 - HEC Forum 33 (1):91-107.
    Responding to a major pandemic and planning for allocation of scarce resources under crisis standards of care requires coordination and cooperation across federal, state and local governments in tandem with the larger societal infrastructure. Maryland remains one of the few states with no state-endorsed ASR plan, despite having a plan published in 2017 that was informed by public forums across the state. In this article, we review strengths and weaknesses of Maryland’s response to COVID-19 and the role of the Maryland (...)
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  23.  14
    Vaginal Microbiota Transplantation: The Next Frontier.Kevin DeLong, Fareeha Zulfiqar, Diane E. Hoffmann, Anita J. Tarzian & Laura M. Ensign - 2019 - Journal of Law, Medicine and Ethics 47 (4):555-567.
    The success of fecal microbiota transplantation as a treatment for Clostrioides difficile infection has stirred excitement about the potential for microbiota transplantation as a therapy for a wide range of diseases and conditions. In this article, we discuss vaginal microbiota transplantation as “the next frontier” in microbiota transplantation and identify the medical, regulatory, and ethical challenges related to this nascent field. We further discuss what we anticipate will be the first context for testing VMT in clinical trials, prevention of the (...)
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  24.  15
    Responding to a Nurse’s Perceived Moral Distress Prompting an Ethics Consultation Request.Anita Tarzian - 2024 - American Journal of Bioethics 24 (1):129-131.
    In 2017, Jameton reflected on the conceptual evolution of “moral distress” in the near-forty years since he coined the term in his book: Nursing Practice, The Ethical Issues. Jameton based the book...
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  25. The role of healthcare ethics committee networks in shaping healthcare policy and practices.Anita J. Tarzian, Diane E. Hoffmann, Rose Mary Volbrecht & Judy L. Meyers - 2006 - HEC Forum 18 (1):85-94.
    As national and state health care policy -making becomes contentious and complex, there is a need for a forum to debate and explore public concerns and values in health care, give voice to local citizens, to facilitate consensus among various stakeholders, and provide feedback and direction to health care institutions and policy makers. This paper explores the role that regional health care ethics committees can play and provides two contrasting examples of Networks involved in facilitation of public input into and (...)
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  26.  39
    Disability and slippery slopes.Anita J. Tarzian - 2007 - Hastings Center Report 37 (5):3-3.
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  27.  15
    Dialysis Refusal: Discerning the Credibility of a Prior Verbal Directive.Anita Tarzian - 2023 - American Journal of Bioethics 23 (8):88-89.
    Sean Morrison, the Senior Associate Editor of the Journal of Palliative Medicine, recently depicted advance directives (ADs) and advance care planning (ACP) as “clear, simple, and wrong” (Morrison...
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  28.  17
    Last Rites.Anita J. Tarzian & Carol Mackenzie Jackson - 1995 - Hastings Center Report 25 (6):3-3.
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  29.  36
    The role and legal status of health care ethics committees in the United States.Diane Hoffmann & Anita Tarzian - forthcoming - Legal Perspectives in Bioethics: Annals of Bioethics Series, Ana S. Iltis, Sandra H. Johnson, Barbara A. Hinze, Eds.
  30.  15
    Trauma-Informed Ethics Consultation in the ICU: Exploring Best Practices in a Case Involving a Self-Inflicted Gunshot Wound.Anita J. Tarzian - 2023 - American Journal of Bioethics 23 (1):96-97.
    Responding to the impact of prior trauma on mental and physical health and disease/injury recovery is decades-old. In the 1970s, healthcare providers and researchers expanded our understanding of h...
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  31.  15
    Tertiary Healthcare Ethics Consultation: Enhancing Access to Expertise.Cynthia M. A. Geppert, Kenneth A. Berkowitz & Anita J. Tarzian - 2022 - Journal of Clinical Ethics 33 (4):314-322.
    Tertiary healthcare ethics (HCE) consultation occurs when an HCE consultant at a healthcare facility requests guidance from one or more senior HCE consultants who are not members of that facility’s HCE consultation service. Tertiary HCE consultants provide advanced HCE guidance and/or mentoring to facility (secondary) HCE consultants, mirroring healthcare consultation in clinical practice. In this article, we describe advantages and challenges of providing tertiary HCE consultation through a hub-and-spoke model administered by a national integrated HCE service.
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  32.  13
    COVID-19 Ethics Debrief: Pearls and Pitfalls of a Hub and Spoke Model.Anita J. Tarzian, Toby Schonfeld, Kenneth A. Berkowitz & Cynthia M. A. Geppert - 2022 - Journal of Clinical Ethics 33 (1):63-68.
    A hub and spoke model offers an effective and efficient approach to providing informed guidance to those who need it. The National Center for Ethics in Health Care (NCEHC) at the Veterans Health Administration, Department of Veterans Affairs, is the largest known hub and spoke healthcare ethics delivery model. In this article, we describe ways NCEHC’s hub and spoke configuration succeeded during the COVID- 19 pandemic, as well as limitations of the model and possible improvements to inform adoption at other (...)
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  33.  30
    Dying in America - An Examination of Policies that Deter Adequate End-of-life Care in Nursing Homes.Diane E. Hoffmann & Anita J. Tarzian - 2005 - Journal of Law, Medicine and Ethics 33 (2):294-309.
    The quality of end-of-life care in this country is often poor. There is abundant literature indicating that dying individuals do not receive adequate pain medication or palliative care, are tethered to machines and tubes in a way that challenges their dignity and autonomy, and are not helped to deal with the emotional grief and psychological angst that may accompany the dying process. While this is true for individuals in many settings, it seems to be especially true for individuals in nursing (...)
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  34.  19
    Dying in America — An Examination of Policies That Deter Adequate End-of-life Care in Nursing Homes.Diane E. Hoffmann & Anita J. Tarzian - 2005 - Journal of Law, Medicine and Ethics 33 (2):294-309.
    The quality of end-of-life care in this country is often poor. There is abundant literature indicating that dying individuals do not receive adequate pain medication or palliative care, are tethered to machines and tubes in a way that challenges their dignity and autonomy, and are not helped to deal with the emotional grief and psychological angst that may accompany the dying process. While this is true for individuals in many settings, it seems to be especially true for individuals in nursing (...)
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  35.  26
    Alone and Saying No.Jeffrey Spike & Anita J. Tarzian - 2016 - American Journal of Bioethics 16 (2):76-77.
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  36.  30
    Comfort Care Request for Preterm Infant.Jeffrey P. Spike & Anita J. Tarzian - 2017 - American Journal of Bioethics 17 (1):82-83.
  37.  27
    Parental Neglect or Appropriate End-of-Life Care?Jeffrey Spike & Anita J. Tarzian - 2016 - American Journal of Bioethics 16 (2):68-69.
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  38.  16
    A Call to Justice in Serving Hospitalized Prisoners.Anita Tarzian - 2019 - American Journal of Bioethics 19 (7):56-57.
    Volume 19, Issue 7, July 2019, Page 56-57.
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  39.  8
    Do You Follow Me? Limits to Posting on PICU Patient’s Blog.Anita Tarzian - 2021 - American Journal of Bioethics 21 (7):71-72.
    One can find numerous examples of how health care providers have breached the Health Insurance Portability and Accountability Act by posting video recordings, photos, or identifying...
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  40.  2
    Emergency Department Boarding of a Teen Requiring Complex Care: How Should an Ethics Consultant Respond?Anita Tarzian - 2024 - American Journal of Bioethics 24 (7):132-134.
    In 1979, the U.S. Surgeon General published the first “Healthy People” report, launching subsequent initiatives in ten-year intervals to improve the nation’s health by focusing on preventive care a...
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  41.  20
    Foregoing Spoon Feeding in End-Stage Dementia.Anita Tarzian - 2019 - American Journal of Bioethics 19 (1):88-89.
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  42.  18
    Is There a Duty to Warn Parents of a Cancer-Causing Genetic Mutation?Anita J. Tarzian - 2018 - American Journal of Bioethics 18 (7):73-74.
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  43.  27
    Preemptive C-Section Refusal Based on Religious Beliefs.Anita J. Tarzian & Jeffrey P. Spike - 2017 - American Journal of Bioethics 17 (1):92-93.
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  44.  16
    Relational Autonomy in an Era of Limited Visitation: What’s a Son, Mother, and Medical Team to Do?Anita Tarzian - 2021 - American Journal of Bioethics 21 (1):78-79.
    Since Spring of 2020, health care facilities across the globe have accommodated to the stark reality of altered standards of care during the COVID-19 pandemic by drastically limiting family visitat...
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  45.  13
    Re-envisioning “Doing Everything” for an Infant with Trisomy 18.Anita Tarzian - 2020 - American Journal of Bioethics 20 (1):62-63.
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  46.  22
    Repeat Valve Replacement in a Person With Substance Use Disorder: What Does Justice Dictate?Anita J. Tarzian - 2018 - American Journal of Bioethics 18 (1):74-75.
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  47.  17
    Surprise Billing in the Emergency Department: What’s a Clinical Ethics Consultant to Do?Anita Tarzian - 2020 - American Journal of Bioethics 20 (8):110-111.
    Volume 20, Issue 8, August 2020, Page 110-111.
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  48.  16
    Unanswered Questions About Clinical Ethics Expertise.Anita Tarzian & Ellen Fox - 2019 - American Journal of Bioethics 19 (11):91-94.
    Volume 19, Issue 11, November 2019, Page 91-94.
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  49.  10
    Who’s Abandoning Whom? The Role of Ethics Consultation for Unaccompanied Emergency Department Patients with Dementia.Anita J. Tarzian - 2022 - American Journal of Bioethics 22 (7):84-85.
    The COVID-19 pandemic has triggered much-needed reflection on family caregiver burden. This is unsurprising, given U.S. dependence on acute health care delivery and long-standing t...
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  50.  26
    Withdrawing Life Support in Pregnancy: State Laws and Implications for Ethics.Anita J. Tarzian - 2017 - American Journal of Bioethics 17 (7):75-76.
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