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Joseph J. Fins [118]Joseph Jack Fins [1]
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Joseph Fins
Cornell University
  1.  39
    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.
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  2.  34
    The Effects of Closed-Loop Medical Devices on the Autonomy and Accountability of Persons and Systems.Philipp Kellmeyer, Thomas Cochrane, Oliver Müller, Christine Mitchell, Tonio Ball, Joseph J. Fins & Nikola Biller-Andorno - 2016 - Cambridge Quarterly of Healthcare Ethics 25 (4):623-633.
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  3.  34
    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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  4.  91
    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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  5.  14
    Mosaic Decisionmaking and Reemergent Agency After Severe Brain Injury.Joseph J. Fins - 2018 - Cambridge Quarterly of Healthcare Ethics 27 (1):163-174.
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  6.  86
    Neuroimaging and Disorders of Consciousness: Envisioning an Ethical Research Agenda.Joseph J. Fins, Judy Illes, James L. Bernat, Joy Hirsch, Steven Laureys & Emily Murphy - 2008 - American Journal of Bioethics 8 (9):3 – 12.
    The application of neuroimaging technology to the study of the injured brain has transformed how neuroscientists understand disorders of consciousness, such as the vegetative and minimally conscious states, and deepened our understanding of mechanisms of recovery. This scientific progress, and its potential clinical translation, provides an opportunity for ethical reflection. It was against this scientific backdrop that we convened a conference of leading investigators in neuroimaging, disorders of consciousness and neuroethics. Our goal was to develop an ethical frame to move (...)
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  7.  57
    Clinical Pragmatism: A Method of Moral Problem Solving.Joseph J. Fins, Matthew D. Bacchetta & Franklin G. Miller - 1997 - Kennedy Institute of Ethics Journal 7 (2):129-143.
    : This paper presents a method of moral problem solving in clinical practice that is inspired by the philosophy of John Dewey. This method, called "clinical pragmatism," integrates clinical and ethical decision making. Clinical pragmatism focuses on the interpersonal processes of assessment and consensus formation as well as the ethical analysis of relevant moral considerations. The steps in this method are delineated and then illustrated through a detailed case study. The implications of clinical pragmatism for the use of principles in (...)
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  8.  52
    Beyond Consent in Research.Emily Bell, Eric Racine, Paula Chiasson, Maya Dufourcq-Brana, Laura B. Dunn, Joseph J. Fins, Paul J. Ford, Walter Glannon, Nir Lipsman, Mary Ellen Macdonald, Debra J. H. Mathews & Mary Pat Mcandrews - 2014 - Cambridge Quarterly of Healthcare Ethics 23 (3):361-368.
    Vulnerability is an important criterion to assess the ethical justification of the inclusion of participants in research trials. Currently, vulnerability is often understood as an attribute inherent to a participant by nature of a diagnosed condition. Accordingly, a common ethical concern relates to the participant’s decisionmaking capacity and ability to provide free and informed consent. We propose an expanded view of vulnerability that moves beyond a focus on consent and the intrinsic attributes of participants. We offer specific suggestions for how (...)
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  9.  39
    A Leg to Stand On: Sir William Osler and Wilder Penfield's "Neuroethics".Joseph J. Fins - 2008 - American Journal of Bioethics 8 (1):37 – 46.
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  10.  14
    The Therapeutic “Mis”Conception: An Examination of its Normative Assumptions and a Call for its Revision.Debra J. H. Mathews, Joseph J. Fins & Eric Racine - 2018 - Cambridge Quarterly of Healthcare Ethics 27 (1):154-162.
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  11.  5
    Mosaic Decisionmaking and Severe Brain Injury: Adding Another Piece to the Argument.Joseph J. Fins - 2019 - Cambridge Quarterly of Healthcare Ethics 28 (4):737-743.
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  12.  67
    Rethinking Disorders of Consciousness: New Research and its Implications.Joseph J. Fins - 2005 - Hastings Center Report 35 (2):22-24.
  13.  23
    In the Blink of the Mind's Eye.Joseph J. Fins & Nicholas D. Schiff - 2010 - Hastings Center Report 40 (3):21-23.
  14.  17
    My Time in Medicine.Joseph J. Fins - 2017 - Perspectives in Biology and Medicine 60 (1):19-32.
    Autobiographical essays can be an indulgence. Often self-congratulatory and low on self-reflection, they seldom serve a purpose other than to stoke nostalgia. So when given this opportunity to write about my life in medicine and bioethics, I decided I would take stock, and not simply celebrate whatever accomplishments I might have had. Rather, I would use this opportunity to look for themes that linked the decades together. My hope was that the process might assemble the mosaic that has been my (...)
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  15.  20
    Clinical Pragmatism: Bridging Theory and Practice.Joseph J. Fins, Franklin G. Miller & Matthew D. Bacchetta - 1998 - Kennedy Institute of Ethics Journal 8 (1):37-42.
    : This response to Lynn Jansen's critique of clinical pragmatism concentrates on two themes: (1) contrasting approaches to moral epistemology and (2) the connection between theory and practice in clinical ethics. Particular attention is paid to the status of principles and the role of consensus, with some closing speculations on how Dewey might view the current state of bioethics.
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  16.  27
    Shades of Gray: New Insights Into the Vegetative State.Joseph J. Fins & Nicholas D. Schiff - 2006 - Hastings Center Report 36 (6):8-8.
  17.  42
    The Humanities and the Future of Bioethics Education.Joseph J. Fins - 2010 - Cambridge Quarterly of Healthcare Ethics 19 (4):518-521.
    Let’s face it, the humanities are in trouble. Last year, in The Chronicle of Higher Education, Thomas H. Benton warned prospective graduate students to avoid doctoral studies in the humanities. His rationale: a job market down 40%, the improbability of tenure, the more certain prospect of life as an adjunct, and eventual outright exile from one’s chosen field. Benton, the pen name of William Pannapacker, an associate professor of English at Hope College in Holland, Michigan, pulled no punches. His piece (...)
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  18.  52
    Neuroethics and Neuroimaging: Moving Toward Transparency.Joseph J. Fins - 2008 - American Journal of Bioethics 8 (9):46 – 52.
    Without exaggeration, it could be said that we are entering a golden age of neuroscience. Informed by recent developments in neuroimaging that allow us to peer into the working brain at both a structural and functional level, neuroscientists are beginning to untangle mechanisms of recovery after brain injury and grapple with age-old questions about brain and mind and their correlates neural mechanisms and consciousness. Neuroimaging, coupled with new diagnostic categories and assessment scales are helping us develop a new diagnostic nosology (...)
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  19.  67
    Islam and Informed Consent: Notes From Doha.Pablo Rodríguez Del Pozo & Joseph J. Fins - 2008 - Cambridge Quarterly of Healthcare Ethics 17 (3):273-279.
    Informed consent is a perennial topic in bioethics. It has given the field a place in clinical practice and the law and is often the starting point for introductory instruction in medical ethics. One would think that nearly everything has been said and done on this well-worn topic.
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  20.  19
    Credentialing the Clinical Ethics Consultant: An Academic Medical Center Affirms Professionalism and Practice.Cathleen A. Acres, Kenneth Prager, George E. Hardart & Joseph J. Fins - 2012 - Journal of Clinical Ethics 23 (2):156.
    In response to national trends calling for increasing accountability and an emerging dialogue within bioethics, we describe an effort to credential clinical ethicists at a major academic medical center. This effort is placed within the historical context of prior calls for credentialing and certification and efforts currently underway within organized bioethics to engage this issue. The specific details, and conceptual rationale, behind the New York-Presbyterian Hospital’s graduated credentialing plan are shared as is their evolution and ratification within the context of (...)
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  21.  8
    Off the Charts: Medical Documentation and Selective Redaction in the Age of Transparency.Matthew William McCarthy, Diego Real de Asua, Ezra Gabbay & Joseph J. Fins - 2018 - Perspectives in Biology and Medicine 61 (1):118-129.
    A 47-year-old woman with a history of anxiety disorder is admitted to the hospital for shortness of breath. On the third day of hospitalization, she asks her physician for a copy of all documents pertaining to her care. What expectation should she have for full disclosure? Are there limits on her access to her medical records and do her physician's concerns about professional privilege matter?The virtues of transparency in medicine have been well described. As proponents of transparency, we favor patient (...)
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  22. Clinical Pragmatism and the Care of Brain Damaged Patients: Towards a Palliative Neuroethics for Disorders of Consciousness.Joseph J. Fins - 2006 - In Steven Laureys (ed.), Boundaries of Consciousness. Elsevier.
  23.  18
    Conflicts of Interest in Deep Brain Stimulation Research and the Ethics of Transparency.Joseph J. Fins & Nicholas D. Schiff - 2010 - Journal of Clinical Ethics 21 (2):125-132.
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  24.  27
    Engineering Medical Decisions.Meredith Stark & Joseph J. Fins - 2013 - Cambridge Quarterly of Healthcare Ethics 22 (4):373-381.
  25.  6
    Pandemics, Protocols, and the Plague of Athens: Insights From Thucydides.Joseph J. Fins - 2020 - Hastings Center Report 50 (3):50-53.
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  26.  69
    Late Recovery From the Minimally Conscious State: Ethical and Policy Implications.Joseph J. Fins, Nicholas D. Schiff & Kathleen M. Foley - 2007 - Neurology 68 (4):304-307.
  27.  7
    Rethinking Disorders of Consciousness: New Research and Its Implications.Joseph J. Fins - 2005 - Hastings Center Report 35 (2):22.
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  28.  33
    The Patient's Work.Leonard C. Groopman, Franklin G. Miller & Joseph J. Fins - 2007 - Cambridge Quarterly of Healthcare Ethics 16 (1):44-52.
    In The Healer's Power, Howard Brody placed the concept of power at the heart of medicine's moral discourse. Struck by the absence of “power” in the prevailing vocabulary of medical ethics, yet aware of peripheral allusions to power in the writings of some medical ethicists, he intuited the importance of power from the silence surrounding it. He formulated the problem of the healer's power and its responsible use as “the central ethical problem in medicine.” Through the prism of power he (...)
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  29.  17
    Whither the “Improvement Standard”? Coverage for Severe Brain Injury After Jimmo V. Sebelius.Joseph J. Fins, Megan S. Wright, Claudia Kraft, Alix Rogers, Marina B. Romani, Samantha Godwin & Michael R. Ulrich - 2016 - Journal of Law, Medicine and Ethics 44 (1):182-193.
    As improvements in neuroscience have enabled a better understanding of disorders of consciousness as well as methods to treat them, a hurdle that has become all too prevalent is the denial of coverage for treatment and rehabilitation services. In 2011, a settlement emerged from a Vermont District Court case, Jimmo v. Sebelius, which was brought to stop the use of an “improvement standard” that required tangible progress over an identifiable period of time for Medicare coverage of services. While the use (...)
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  30.  19
    “Humanities Are the Hormones:” Osler, Penfield and “Neuroethics” Revisited.Joseph J. Fins - 2008 - American Journal of Bioethics 8 (1):5-8.
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  31.  60
    Neurological Diagnosis is More Than a State of Mind: Diagnostic Clarity and Impaired Consciousness.Joseph J. Fins & F. Plum - 2004 - Archives of Neurology 61 (9):1354-1355.
  32.  10
    Family Portrait.Joseph J. Fins - 2018 - Narrative Inquiry in Bioethics 8 (1):4-6.
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  33.  8
    Pragmatic Convergence and the Epistemology of an Adolescent Neuroethics.Joseph J. Fins & Judy Illes - 2018 - Cambridge Quarterly of Healthcare Ethics 27 (4):554-557.
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  34.  10
    Inching Toward Health Decision Exceptionalism.Meredith Stark & Joseph J. Fins - 2013 - American Journal of Bioethics 13 (5):18-19.
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  35.  25
    Reinvigorating Ethics Consultations: An Impetus From the “Quality” Debate. [REVIEW]Elizabeth G. Nilson & Joseph J. Fins - 2006 - HEC Forum 18 (4):298-304.
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  36.  40
    In Praise of the Humanities in Academic Medicine.Joseph J. Fins, Barbara Pohl & David J. Doukas - 2013 - Cambridge Quarterly of Healthcare Ethics 22 (4):355-364.
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  37.  25
    The Ethical Imperative to Think About Thinking.Meredith Stark & Joseph J. Fins - 2014 - Cambridge Quarterly of Healthcare Ethics 23 (4):386-396.
    While the medical ethics literature has well explored the harm to patients, families, and the integrity of the profession in failing to disclose medical errors once they occur, less often addressed are the moral and professional obligations to take all available steps to prevent errors and harm in the first instance. As an expanding body of scholarship further elucidates the causes of medical error, including the considerable extent to which medical errors, particularly in diagnostics, may be attributable to cognitive sources, (...)
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  38.  44
    Lessons From the Injured Brain: A Bioethicist in the Vineyards of Neuroscience.Joseph J. Fins - 2009 - Cambridge Quarterly of Healthcare Ethics 18 (1):7.
    I would like to share some reflections on how bioethics fosters dialogue between the sciences and humanities by talking a bit about my work as a physician-ethicist collaborating with neuroscientists studying severe brain injury and mechanisms of recovery. If I am successful in this Pilgrim's Progress, I hope I will convince you that the injured brain can teach us much about ourselves. It is not something I was prepared to believe as a medical student, when I was more certain of (...)
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  39.  4
    Mediative Fluency and Futility Disputes.Samantha F. Knowlton & Joseph J. Fins - 2018 - Perspectives in Biology and Medicine 60 (3):373-382.
    It is generally agreed that physicians should not provide futile interventions, for the obvious reason that an intervention without utility causes harm without benefit. However, despite efforts to standardize a definition, there is a lack of universal consensus as to what constitutes “futility.” Two recent policy statements object to the terminology of futility based on the lack of a universal definition. Schneiderman, Jecker, and Jonsen object to the proposed alternative terminology of “inappropriate.” These differing opinions about the most apt terminology (...)
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  40.  36
    The Self, Social Media, and Social Construction.Meredith Stark & Joseph J. Fins - 2012 - American Journal of Bioethics 12 (10):38-39.
    The American Journal of Bioethics, Volume 12, Issue 10, Page 38-39, October 2012.
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  41.  49
    Commercialism in the Clinic: Finding Balance in Medical Professionalism.Joseph J. Fins - 2007 - Cambridge Quarterly of Healthcare Ethics 16 (4):425.
    There is a palpable malaise in American medicine as clinical practice veers off its moorings, swept along by a new commercialism that is displacing medical professionalism and its attendant moral obligations. Although the sociology of this phenomenon is complex and multifactorial, I argue that this move toward medical commercialism was accelerated by the abortive efforts of the Clinton Administration's Health Security Act. Through an analysis of performative speech I show that, although the Clinton plan drew on many strands of speech (...)
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  42.  23
    The Economics of Clinical Ethics Programs: A Quantitative Justification.Matthew D. Bacchetta & Joseph J. Fins - 1997 - Cambridge Quarterly of Healthcare Ethics 6 (4):451-.
    The restructuring of the healthcare marketplace has exerted pressure directly and indirectly on clinical ethics programs. The fiscal orientation and emphasis on efficiency, outcome measures, and cost control have made it increasingly difficult to communicate arguments in support of the existence or growth of ethics programs. In the current marketplace, arguments that rely on the claim that ethics programs protect patient rights or assist in the professional formation of practitioners often result in minimal levels of funding and preclude program growth. (...)
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  43.  9
    Guardianship and Clinical Research Participation: The Case of Wards with Disorders of Consciousness.Megan S. Wright, Michael R. Ulrich & Joseph J. Fins - 2017 - Kennedy Institute of Ethics Journal 27 (1):43-70.
    Incapacitated adults with a legally appointed guardian or conservator may be recruited for or involved with medical, behavioral, or social science research. Much of the research in which such persons participate is aimed at evaluating medical interventions for them, or contributing to general knowledge about disorders from which they may suffer. In this paper we will consider how the appointment of guardians for patients with disorders of consciousness —severe brain injuries that affect a patient’s level of arousal and ability to (...)
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  44.  17
    The Orwellian Threat to Emerging Neurodiagnostic Technologies.Joseph J. Fins - 2005 - American Journal of Bioethics 5 (2):56-58.
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  45.  14
    What's Wrong with Evidence‐Based Medicine?Joseph J. Fins - 2016 - Hastings Center Report 46 (1):inside back cover-inside back co.
    Medicine in the last decades of the twentieth century was ripe for a data sweep that would bring systematic analysis to treatment strategies that seemingly had stood the test of time but were actually unvalidated. Coalescing under the banner of evidence-based medicine, this process has helped to standardize care, minimize error, and promote patient safety. But with this advancement, something of the art of medicine has been lost.
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  46.  18
    Border Zones of Consciousness: Another Immigration Debate?Joseph J. Fins - 2007 - American Journal of Bioethics 7 (1):51-54.
  47.  25
    Ideology and Microbiology: Ebola, Science, and Deliberative Democracy.Joseph J. Fins - 2015 - American Journal of Bioethics 15 (4):1-3.
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  48.  1
    Decisional Humility and the Marginally Represented Patient.Barrie J. Huberman & Joseph J. Fins - 2020 - American Journal of Bioethics 20 (2):51-53.
    Volume 20, Issue 2, February 2020, Page 51-53.
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  49.  22
    Web of Care: How Will the Electronic Medical Record Change Medicine?Joseph J. Fins - 2008 - Hastings Center Report 38 (5):pp. 36-38.
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  50.  15
    Toward an Agile Defense of Patient Health Care Decisions.Meredith Stark & Joseph J. Fins - 2014 - American Journal of Bioethics 14 (3):44-46.
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