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Trevor M. Bibler [8]Trevor Bibler [7]
  1.  22
    From Bridge to Destination? Ethical Considerations Related to Withdrawal of ECMO Support over the Objections of Capacitated Patients.Andrew Childress, Trevor Bibler, Bryanna Moore, Ryan H. Nelson, Joelle Robertson-Preidler, Olivia Schuman & Janet Malek - 2022 - American Journal of Bioethics 23 (6):5-17.
    Extracorporeal membrane oxygenation (ECMO) is typically viewed as a time-limited intervention—a bridge to recovery or transplant—not a destination therapy. However, some patients with decision-making capacity request continued ECMO support despite a poor prognosis for recovery and lack of viability as a transplant candidate. In response, critical care teams have asked for guidance regarding the ethical permissibility of unilateral withdrawal over the objections of a capacitated patient. In this article, we evaluate several ethical arguments that have been made in favor of (...)
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  2. COVID-19 vaccination status should not be used in triage tie-breaking.Olivia Schuman, Joelle Robertson-Preidler & Trevor M. Bibler - 2022 - Journal of Medical Ethics 48 (10):1-3.
    This article discusses the triage response to the COVID-19 delta variant surge of 2021. One issue that distinguishes the delta wave from earlier surges is that by the time it became the predominant strain in the USA in July 2021, safe and effective vaccines against COVID-19 had been available for all US adults for several months. We consider whether healthcare professionals and triage committees would have been justified in prioritising patients with COVID-19 who are vaccinated above those who are unvaccinated (...)
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  3.  40
    Response to Open Peer Commentaries on “Responding to Those Who Hope for a Miracle: Practices for Clinical Bioethicists”.Trevor M. Bibler, Myrick C. Shinall & Devan Stahl - 2018 - American Journal of Bioethics 18 (5):W1-W5.
    Significant challenges arise for clinical care teams when a patient or surrogate decision-maker hopes a miracle will occur. This article answers the question, “How should clinical bioethicists respond when a medical decision-maker uses the hope for a miracle to orient her medical decisions?” We argue the ethicist must first understand the complexity of the miracle-invocation. To this end, we provide a taxonomy of miracle-invocations that assist the ethicist in analyzing the invocator's conceptions of God, community, and self. After the ethicist (...)
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  4.  20
    Remaining ambiguities surrounding theological negotiation and spiritual care: reply to Greenblum and Hubbard.Trevor Bibler - 2019 - Journal of Medical Ethics 45 (11):711-712.
    Readers have much to consider when evaluating Greenblum and Hubbard’s conclusion that ‘physicians have no business doing theology’.1 The two central arguments the authors offer are fairly convincing within the confines they set for themselves, the provisos they stipulate and their notions of ‘privacy’ and ‘public reason’. However, I would ask readers to consider two questions, the answers to which I believe the authors leave opaque. First, what is theological negotiation? Second, what makes chaplains the singular group of healthcare professionals (...)
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  5.  34
    We don’t need unilateral DNRs: taking informed non-dissent one step further.Diego Real de Asúa, Katarina Lee, Peter Koch, Inmaculada de Melo-Martín & Trevor Bibler - 2019 - Journal of Medical Ethics 45 (5):314-317.
    Although shared decision-making is a standard in medical care, unilateral decisions through process-based conflict resolution policies have been defended in certain cases. In patients who do not stand to receive proportional clinical benefits, the harms involved in interventions such as cardiopulmonary resuscitation seem to run contrary to the principle of non-maleficence, and provision of such interventions may cause clinicians significant moral distress. However, because the application of these policies involves taking choices out of the domain of shared decision-making, they face (...)
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  6.  14
    Not There Yet: Evaluating Clinical Ethics Consultation in an Accountability Culture.Courtenay R. Bruce & Trevor M. Bibler - 2016 - American Journal of Bioethics 16 (3):46-48.
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  7.  16
    Ethical Challenges in Advance Care Planning During the COVID-19 Pandemic.Anveet S. Janwadkar & Trevor M. Bibler - 2020 - American Journal of Bioethics 20 (7):202-204.
    Volume 20, Issue 7, July 2020, Page 202-204.
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  8.  11
    I am not interested in talking with you.Adam Peña & Trevor Bibler - 2016 - Hastings Center Report 46 (4):7-9.
    Mr. M is an eighty-five-year-old who presented to the hospital with congestive heart failure exacerbation, pneumonia, altered mental status, and sepsis. A physician determines that he lacks capacity, and the team in the intensive care unit looks to the patient's daughter, Celia, as his surrogate decision-maker because she is named as an agent in his medical power of attorney form. While in the ICU, Mr. M suffers acute respiratory distress secondary to pneumonia and thus requires intubation. Celia accepts several life-sustaining (...)
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  9.  17
    A Risky Recommendation.Trevor Bibler & Courtenay R. Bruce - 2015 - American Journal of Bioethics 15 (1):70-72.
  10.  8
    Between Crisis and Convention: How Should We Address Contingency?Trevor Bibler - 2020 - Hastings Center Report 50 (5):17-19.
    The Covid‐19 pandemic has brought about renewed conversation about equality and equity in the distribution of medical resources. Much of the recent conversation has focused on creating and implementing policies in times of crisis when resources are exhausted. Depending on how the pandemic develops, some communities may implement crisis measures, but many health care facilities are currently experiencing shortages of staff and materials even if the facilities have not implemented crisis standards. There is a need for shared conversation about equality (...)
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  11.  17
    Building Effective Mentoring Relationships During Clinical Ethics Fellowships: Pedagogy, Programs, and People.Trevor M. Bibler, Ryan H. Nelson, Bryanna Moore, Janet Malek & Mary A. Majumder - 2024 - HEC Forum 36 (1):1-29.
    How should clinical ethicists be trained? Scholars have stated that clinical ethics fellowships create well-trained, competent ethicists. While this appears intuitive, few features of fellowship programs have been publicly discussed, let alone debated. In this paper, we examine how fellowships can foster effective mentoring relationships. These relationships provide the foundation for the fellow’s transition from novice to competent professional. In this essay, we begin by discussing our pedagogical commitments. Next, we describe the structures our program has created to assist our (...)
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  12.  10
    Consultations across Languages.Trevor Bibler, Adam Peña & Courtenay R. Bruce - 2015 - Hastings Center Report 45 (3):13-14.
    Lei, a twenty‐seven‐year‐old Mandarin speaker, visits the United States seeking curative treatments for his acute myeloid leukemia. His mother, Hua, has traveled with him. Neither she nor Lei speak English, and the hospital does not have an onsite professional Mandarin‐speaking interpreter. Using a professional interpreter over the phone, Lei's oncologist, Dr. Branson, attempts to initiate a face‐to‐face goals‐of‐care conversation with Hua as the surrogate decision‐maker. Dr. Branson explains that Lei has “only weeks to months to live” and recommends initiating comfort‐care‐only (...)
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  13.  14
    Do we have to replace the balloon pump when it fails?Trevor M. Bibler, Jamie M. Crist, Janet Malek & Andrew M. Childress - 2020 - Hastings Center Report 50 (1):10-13.
    Mrs. Duong had coronary artery disease, ischemic cardiomyopathy, and mildly altered mental status when her case was presented before an advanced heart therapy medical review board. She was accepted for left ventricular assist device placement pending additional insight into her cognitive state. Before the LVAD could be implanted, however, Mrs. Duong went into cardiogenic shock, and her heart failure team placed an intra‐aortic balloon pump in her subclavian artery. Within two weeks, Mrs. Duong became IABP dependent and deconditioned. The attending (...)
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  14.  14
    Responding Well to Spiritual Worldviews: A Taxonomy for Clinical Ethicists.Trevor M. Bibler - 2023 - HEC Forum 35 (4):309-323.
    Every clinical ethics consultant, no matter their own spirituality, will meet patients, families, and healthcare professionals whose spiritualities anchor their moral worldviews. How might ethicists respond to those who rely on spirituality when making medical decisions? And further, should ethicists incorporate their own spiritual commitments into their clinical analyses and recommendations? These questions prompt reflection on foundational issues in the philosophy of medicine, political and moral theory, and methods of proper clinical ethics consultation. Rather than attempting to offer definitive answers (...)
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  15.  30
    A Qualitative Exploration of a Clinical Ethicist’s Role and Contributions During Family Meetings.Courtenay R. Bruce, Trevor M. Bibler, Adam M. Pena & Betsy Kusin - 2016 - HEC Forum 28 (4):283-299.
    Despite the interpersonal nature of family meetings and the frequency in which they occur, the clinical ethics literature is devoid of any rich descriptions of what clinical ethicists should actually be doing during family meetings. Here, we propose a framework for describing and understanding “transitioning” facilitation skills based on a retrospective review of our internal documentation of 100 consecutive cases wherein a clinical ethicist facilitated at least one family meeting. The internal documents were analyzed using qualitative methodologies, i.e., “codes”, to (...)
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