(2020). The Meaning of Care and Ethics to Mitigate the Harshness of Triage in Second-Wave Scenario Planning During the COVID-19 Pandemic. The American Journal of Bioethics. Ahead of Print.

Abstract Ethics consultants and critical care clinicians reflect on Seattle’s early experience as the United States’ first epicenter of COVID-19. We discuss ethically salient issues confronted at UW Medicine’s hospitals and provide lessons for other health care institutions that may soon face what we have faced.

Abstract The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing policies for pandemics differ by institution, health system, and applicable law. Most seem to agree that a patient’s ability to benefit from treatment and to survive are first-order considerations

Abstract The COVID-19 pandemic is a global contagion of unprecedented proportions and health, economic, and social consequences. As with many health problems, its impact is uneven. This article argues the COVID-19 pandemic is a global health injustice due to moral failures of national governments and international organizations to prepare for, prevent and control it. Global and national health communities

Abstract New York City hospitals expanded resources to an unprecedented extent in response to the COVID pandemic. Thousands of beds, ICU beds, staff members, and ventilators were rapidly incorporated into hospital systems. Nonetheless, this historic public health disaster still created scarcities and the need for formal crisis standards of care. These were not available to NY clinicians because of

(2020). Brain Death Testing: Time for National Uniformity. The American Journal of Bioethics: Vol. 20, No. 6, pp. 1-3.

The past decade has witnessed escalating legal and ethical challenges to the diagnosis of death by neurologic criteria (DNC). The legal tactic of demanding consent for the apnea test, if successful, can halt the DNC. However, US law is currently unsettled and inconsistent in this matter. Consent has been required in several trial cases in Montana and Kansas but not in Virginia and Nevada. In this paper

(2020). Beyond the Apnea Test: An Argument to Broaden the Requirement for Consent to the Entire Brain Death Evaluation. The American Journal of Bioethics: Vol. 20, No. 6, pp. 17-19.

(2020). The Case Against Solicitation of Consent for Apnea Testing. The American Journal of Bioethics: Vol. 20, No. 6, pp. 20-22.

(2020). Apnea Testing is Medical Treatment Requiring Informed Consent. The American Journal of Bioethics: Vol. 20, No. 6, pp. 22-24.

(2020). Informed Consent Should Not Be Required for Apnea Testing and Arguing It Should Misses the Point. The American Journal of Bioethics: Vol. 20, No. 6, pp. 25-27.

(2020). Requiring Consent for Brain-Death Testing: A Perilous Proposal. The American Journal of Bioethics: Vol. 20, No. 6, pp. 28-30.

(2020). Shared Decision-Making in the Determination of Death by Neurologic Criteria. The American Journal of Bioethics: Vol. 20, No. 6, pp. 30-32.

(2020). Restoring Trust and Requiring Consent in Death by Neurological Criteria. The American Journal of Bioethics: Vol. 20, No. 6, pp. 33-35.

(2020). Can’t Hit Pause? On the Constitutive Elements of Responsible Ventilator Management & the Apnea Test. The American Journal of Bioethics: Vol. 20, No. 6, pp. 35-37.

(2020). Determining Death and the Scope of Medical Obligations. The American Journal of Bioethics: Vol. 20, No. 6, pp. 37-39.

(2020). Schrödinger’s Cat and the Ethically Untenable Act of Not Looking. The American Journal of Bioethics: Vol. 20, No. 6, pp. 40-42.

(2020). The Apnea Test: Requiring Consent for a Test That is a Self-Fulfilling Prophecy, Not Fit for Purpose, and Always Confounded? The American Journal of Bioethics: Vol. 20, No. 6, pp. 42-44.

(2020). Death Determination and Clinicians’ Epistemic Authority. The American Journal of Bioethics: Vol. 20, No. 6, pp. 44-47.

(2020). Accommodating Apnea Testing Not Death Determination Refusal. The American Journal of Bioethics: Vol. 20, No. 6, pp. 47-49.

(2020). Informed Consent for Apnea Testing: Meeting the Standard of Care. The American Journal of Bioethics: Vol. 20, No. 6, pp. 49-51.

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

(2020). Taking Family-Centered Care Seriously. The American Journal of Bioethics: Vol. 20, No. 6, pp. 65-67.

(2020). The Moral Distress of Patients and Families. The American Journal of Bioethics: Vol. 20, No. 6, pp. 68-70.

(2020). How to Support Patient and Family in Dealing with Ethical Issues? The Relevance of Moral Case Deliberation. The American Journal of Bioethics: Vol. 20, No. 6, pp. 70-72.

(2020). Myopia in Reportability of Ethical Concerns in Healthcare Ethics Consultation. The American Journal of Bioethics: Vol. 20, No. 6, pp. 73-75.

(2020). Gaps in Ethics Consultation Support for Patients and Families and Practical Guidance for Future Research or Quality Work Involving These Stakeholders. The American Journal of Bioethics: Vol. 20, No. 6, pp. 75-77.

(2020). The Genetic Family as Patient? The American Journal of Bioethics: Vol. 20, No. 6, pp. 77-80.

(2020). Who Cares About Care? Family Members as Moral Actors in Treatment Decision Making. The American Journal of Bioethics: Vol. 20, No. 6, pp. 80-82.

(2020). Engaging Patients and Families in the Ethics of Involuntary Psychiatric Care. The American Journal of Bioethics: Vol. 20, No. 6, pp. 82-84.

(2020). Response to Open Peer Commentaries “Rethinking the Ethical, Legal, and Clinical Foundations of Informed Consent and Shared Decision-Making for Brain Death Determination”. The American Journal of Bioethics: Vol. 20, No. 6, pp. W1-W5.

(2020). Broadening the Scope of Health Care Ethics Consultation: A Response to Open Peer Commentaries on Patient and Family Description of Ethical Concerns. The American Journal of Bioethics: Vol. 20, No. 6, pp. W6-W8.

(2020). COVID-19 and Financial Vulnerability: What Health Care Organizations and Society Owe Each Other. The American Journal of Bioethics. Ahead of Print.

Although unprecedented in scope and beyond all our life experiences, sweeping social distancing measures are not without historical precedent. Historically, racism, stigma, and discrimination resulted in grossly inequitable application of disease containment measures. But history also provides examples in which broad measures enjoyed remarkable public support. When it comes to COVID-19, blame and division

(2020). The Value and Ethics of Using Technology to Contain the COVID-19 Epidemic. The American Journal of Bioethics. Ahead of Print.

During public health crises including the COVID-19 pandemic, resource scarcity and contagion risks may require health systems to shift-to some degree-from a usual clinical ethic, focused on the well-being of individual patients, to a public health ethic, focused on population health. Many triage policies exist that fall under the legal protections afforded by "crisis standards of care," but they have

(2020). Ethical and Sensible Dissemination of Information During the COVID-19 Pandemic. The American Journal of Bioethics. Ahead of Print.

(2020). Rural and Remote Communities: Unique Ethical Issues in the COVID-19 Pandemic. The American Journal of Bioethics. Ahead of Print.

(2020). Potential Implications of Testing an Experimental mRNA-Based Vaccine During an Emerging Infectious Disease Pandemic. The American Journal of Bioethics. Ahead of Print.

(2020). Prioritizing Frontline Workers during the COVID-19 Pandemic. The American Journal of Bioethics. Ahead of Print.

In a crisis, societal needs take precedence over a patient's best interests. Triage guidelines, however, differ on whether limited resources should focus on maximizing lives or life-years. Choosing between these two approaches has implications for neonatology. Neonatal units have ventilators, some adaptable for adults. This raises the question of whether, in crisis conditions, guidelines for treating

(2020). COVID-19: Act First, Think Later. The American Journal of Bioethics. Ahead of Print.

(2020). Medically Vulnerable Clinicians and Unnecessary Risk During the COVID-19 Pandemic. The American Journal of Bioethics. Ahead of Print.