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  1.  26
    After the DNR: Surrogates Who Persist in Requesting Cardiopulmonary Resuscitation.Ellen M. Robinson, Wendy Cadge, Angelika A. Zollfrank, M. Cornelia Cremens & Andrew M. Courtwright - 2017 - Hastings Center Report 47 (1):10-19.
    Some health care organizations allow physicians to withhold cardiopulmonary resuscitation from a patient, despite patient or surrogate requests that it be provided, when they believe it will be more harmful than beneficial. Such cases usually involve patients with terminal diagnoses whose medical teams argue that aggressive treatments are medically inappropriate or likely to be harmful. Although there is state-to-state variability and a considerable judicial gray area about the conditions and mechanisms for refusals to perform CPR, medical teams typically follow a (...)
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  2.  19
    Enhancing Moral Agency: Clinical Ethics Residency for Nurses.Ellen M. Robinson, Susan M. Lee, Angelika Zollfrank, Martha Jurchak, Debra Frost & Pamela Grace - 2014 - Hastings Center Report 44 (5):12-20.
    One antidote to moral distress is stronger moral agency—that is, an enhanced ability to act to bring about change. The Clinical Ethics Residency for Nurses, an educational program developed and run in two large northeastern academic medical centers with funding from the Health Resources and Services Administration, intended to strengthen nurses’ moral agency. Drawing on Improving Competencies in Clinical Ethics Consultation: An Education Guide, by the American Society for Bioethics and Humanities, and on the goals of the nursing profession, CERN (...)
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  3.  6
    Operationalizing the role of the nurse ethicist: More than a job.Georgina Morley, Ellen M. Robinson & Lucia D. Wocial - 2023 - Nursing Ethics 30 (5):688-700.
    The idea of a role in nursing that includes expertise in ethics has been around for more than 30 years. Whether or not one subscribes to the idea that nursing ethics is separate and distinct from bioethics, nursing practice has much to contribute to the ethical practice of healthcare, and with the strong grounding in ethics and aspiration for social justice considerations in nursing, there is no wonder that the specific role of the nurse ethicist has emerged. Nurse ethicists, expert (...)
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  4.  6
    The Work of ASBH’s Clinical Ethics Consultation Affairs Committee: Development Processes Behind Our Educational Materials.George E. Hardart, Katherine Wasson, Ellen M. Robinson, Aviva Katz, Deborah L. Kasman, Liza-Marie Johnson, Barrie J. Huberman, Anne Cordes, Barbara L. Chanko, Jane Jankowski & Courtenay R. Bruce - 2018 - Journal of Clinical Ethics 29 (2):150-157.
    The authors of this article are previous or current members of the Clinical Ethics Consultation Affairs (CECA) Committee, a standing committee of the American Society for Bioethics and Humanities (ASBH). The committee is composed of seasoned healthcare ethics consultants (HCECs), and it is charged with developing and disseminating education materials for HCECs and ethics committees. The purpose of this article is to describe the educational research and development processes behind our teaching materials, which culminated in a case studies book called (...)
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  5.  12
    The Role of a Hospital Ethics Consultation Service in Decision-Making for Unrepresented Patients.Andrew M. Courtwright, Joshua Abrams & Ellen M. Robinson - 2017 - Journal of Bioethical Inquiry 14 (2):241-250.
    Despite increased calls for hospital ethics committees to serve as default decision-makers about life-sustaining treatment for unrepresented patients who lack decision-making capacity or a surrogate decision-maker and whose wishes regarding medical care are not known, little is known about how committees currently function in these cases. This was a retrospective cohort study of all ethics committee consultations involving decision-making about LST for unrepresented patients at a large academic hospital from 2007 to 2013. There were 310 ethics committee consultations, twenty-five of (...)
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  6.  5
    Declining to Provide or Continue Requested Life-Sustaining Treatment: Experience With a Hospital Resolving Conflict Policy.Emily B. Rubin, Ellen M. Robinson, M. Cornelia Cremens, Thomas H. McCoy & Andrew M. Courtwright - 2023 - Journal of Bioethical Inquiry 20 (3):457-466.
    In 2015, the major critical care societies issued guidelines outlining a procedural approach to resolving intractable conflict between healthcare professionals and surrogates over life-sustaining treatments (LST). We report our experience with a resolving conflict procedure. This was a retrospective, single-centre cohort study of ethics consultations involving intractable conflict over LST. The resolving conflict process was initiated eleven times for ten patients over 2,015 ethics consultations from 2000 to 2020. In all cases, the ethics committee recommended withdrawal of the contested LST. (...)
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  7.  23
    The role of religious beliefs in ethics committee consultations for conflict over life-sustaining treatment.Julia I. Bandini, Andrew Courtwright, Angelika A. Zollfrank, Ellen M. Robinson & Wendy Cadge - 2017 - Journal of Medical Ethics 43 (6):353-358.
    Previous research has suggested that individuals who identify as being more religious request more aggressive medical treatment at end of life. These requests may generate disagreement over life-sustaining treatment (LST). Outside of anecdotal observation, however, the actual role of religion in conflict over LST has been underexplored. Because ethics committees are often consulted to help mediate these conflicts, the ethics consultation experience provides a unique context in which to investigate this question. The purpose of this paper was to examine the (...)
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  8.  12
    Ethics Consultation for Adult Solid Organ Transplantation Candidates and Recipients: A Single Centre Experience.Andrew M. Courtwright, Kim S. Erler, Julia I. Bandini, Mary Zwirner, M. Cornelia Cremens, Thomas H. McCoy, Ellen M. Robinson & Emily Rubin - 2021 - Journal of Bioethical Inquiry 18 (2):291-303.
    Systematic study of the intersection of ethics consultation services and solid organ transplants and recipients can identify and illustrate ethical issues that arise in the clinical care of these patients, including challenges beyond resource allocation. This was a single-centre, retrospective cohort study of all adult ethics consultations between January 1, 2007, and December 31, 2017, at a large academic medical centre in the north-eastern United States. Of the 880 ethics consultations, sixty (6.8 per cent ) involved solid organ transplant, thirty-nine (...)
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  9.  40
    Ethics committee consultation due to conflict over life-sustaining treatment: A sociodemographic investigation.Andrew M. Courtwright, Frederic Romain, Ellen M. Robinson & Eric L. Krakauer - 2016 - AJOB Empirical Bioethics 7 (4):220-226.
    Background: The bioethics literature contains speculation but little data about sociodemographic differences between patients for whom ethics committees (EC) are consulted for conflict about life-sustaining treatment (LST) and the broader hospital population that these committees serve. To provide an empirical context for this discussion, we examined differences in five sociodemographic factors between patients for whom an EC was consulted for conflict over LST and the general inpatient population, hypothesizing that nonwhite patients were most likely to be disproportionately represented. Methods: This (...)
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  10.  9
    Experience with a Revised Hospital Policy on Not Offering Cardiopulmonary Resuscitation.Andrew M. Courtwright, Emily Rubin, Kimberly S. Erler, Julia I. Bandini, Mary Zwirner, M. Cornelia Cremens, Thomas H. McCoy & Ellen M. Robinson - 2020 - HEC Forum 34 (1):73-88.
    Critical care society guidelines recommend that ethics committees mediate intractable conflict over potentially inappropriate treatment, including Do Not Resuscitate status. There are, however, limited data on cases and circumstances in which ethics consultants recommend not offering cardiopulmonary resuscitation despite patient or surrogate requests and whether physicians follow these recommendations. This was a retrospective cohort of all adult patients at a large academic medical center for whom an ethics consult was requested for disagreement over DNR status. Patient demographic predictors of ethics (...)
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  11.  11
    An Ethical Framework for the Care of Patients with Prolonged Hospitalization Following Lung Transplantation.Andrew M. Courtwright, Emily Rubin, Ellen M. Robinson, Souheil El-Chemaly, Daniela Lamas, Joshua M. Diamond & Hilary J. Goldberg - 2019 - HEC Forum 31 (1):49-62.
    The lung allocation score system in the United States and several European countries gives more weight to risk of death without transplantation than to survival following transplantation. As a result, centers transplant sicker patients, leading to increased length of initial hospitalization. The care of patients who have accumulated functional deficits or additional organ dysfunction during their prolonged stay can be ethically complex. Disagreement occurs between the transplant team, patients and families, and non-transplant health care professionals over the burdens of ongoing (...)
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  12.  9
    Clinical Ethics Consultation During the First COVID-19 Pandemic Surge at an Academic Medical Center: A Mixed Methods Analysis.Kimberly S. Erler, Ellen M. Robinson, Julia I. Bandini, Eva V. Regel, Mary Zwirner, Cornelia Cremens, Thomas H. McCoy, Fred Romain & Andrew Courtwright - 2023 - HEC Forum 35 (4):371-388.
    While a significant literature has appeared discussing theoretical ethical concerns regarding COVID-19, particularly regarding resource prioritization, as well as a number of personal reflections on providing patient care during the early stages of the pandemic, systematic analysis of the actual ethical issues involving patient care during this time is limited. This single-center retrospective cohort mixed methods study of ethics consultations during the first surge of the COVID 19 pandemic in Massachusetts between March 15, 2020 through June 15, 2020 aim to (...)
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  13.  10
    Making Treatment Choices From “Dark Places”: A Role for Ethics Consultation.Gail Leslie, Ellen M. Robinson, Mary Zwirner, John J. Purcell & Cornelia Cremens - 2015 - American Journal of Bioethics 15 (7):72-74.
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  14.  3
    Mrs. T’s Story: An Interview.Ellen M. Robinson, Lauren Kattany & Rebecca Horr - 2003 - Journal of Clinical Ethics 14 (3):190-193.
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  15.  3
    Structure, Operation, and Experience of Clinical Ethics Consultation 2007-2013: A Report from the Massachusetts General Hospital Optimum Care Committee. [REVIEW]Andrew M. Courtwright, Eric L. Krakauer, M. Cornelia Cremens, Alexandra Cist, Julia Bandini, Sharon Brackett, Kimberly Erler, Wendy Cadge & Ellen M. Robinson - 2017 - Journal of Clinical Ethics 28 (2):137-152.
    We describe the structure, operation, and experience of the Massachusetts General Hospital ethics committee, formally called the Edwin H. Cassem Optimum Care Committee, from January 2007 through December 2013. Founded in 1974 as one of the nation’s first hospital ethics committees, this committee has primarily focused on the optimum use of life-sustaining treatments. We outline specific sociodemographic and clinical characteristics of consult patients during this period, demographic differences between the adult inpatient population and patients for whom the ethics committee was (...)
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  16.  22
    The Changing Composition of a Hospital Ethics Committee: A Tertiary Care Center’s Experience. [REVIEW]Andrew Courtwright, Sharon Brackett, Alexandra Cist, M. Cornelia Cremens, Eric L. Krakauer & Ellen M. Robinson - 2014 - HEC Forum 26 (1):59-68.
    A growing body of research has demonstrated significant heterogeneity of hospital ethics committee (HEC) size, membership and training requirements, length of appointment, institutional support, clinical and policy roles, and predictors of self identified success. Because these studies have focused on HECs at a single point in time, however, little is known about how the composition of HECs changes over time and what impact these changes have on committee utilization. The current study presents 20 years of data on the evolution of (...)
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