Clinical ethics addresses the complex set of issues associated with clinical practice. The Berman Institute approaches clinical ethics in three core areas: education, research/scholarship, service/policy.
The Berman Institute leads efforts to create substantive educational experiences in clinical ethics for medical students, nursing students, residents, and other clinicians.
Medical Students: Berman Institute faculty members lead parts of the Johns Hopkins School of Medicine curriculum, which integrate themes of Ethics and Professionalism, Communication, and Cultural Competence throughout the four-year medical school curriculum. Included are Selectives and Workshops within preclinical courses, small group sessions that introduce case-based analysis and medical/legal issues when students are transitioning from the classroom to clinical settings, and experiential learning of specific topics within clinical rotations. The Healer’s Art course for first year medical students includes a curriculum to help medical students identify, strengthen and cultivate the human dimensions of the practice of medicine. Berman faculty also direct a first year medical student Scholarly Concentrations course and offer a concentration in Ethics and the Art of Medicine.
Nursing Students: All Masters of Nursing students take a core course focused on the philosophical, theoretical and ethical aspects of advance practice nursing. This course provides students with a foundation of ethical practice in nursing, a survey of key ethical issues in clinical practice and builds foundational elements of ethical competence. The new Masters Entry Program will incorporate this core course as well as integrating ethics content throughout the entire curriculum including new seminars focusing on key clinical ethics topics.
Interns, Residents and Fellows: Berman Institute faculty members are actively involved in ethics education for trainees in the Departments of Medicine at Johns Hopkins Hospital (JHH) and Johns Hopkins Bayview Medical Center (JHBMC), Pediatrics, Surgery, Obstetrics and Gynecology, Neurology, Neurosurgery, Ophthalmology and Child and Adolescent Psychiatry. These efforts reach approximately 60% of all residents at Johns Hopkins. The Berman Institute also helps train fellows with interests in clinical ethics through its Hecht-Levi Fellowship Program and the Starkey Fellowship.
Clinicians: The JHBMC monthly Ethics for Lunch conference series attracts 60-70 attendees to each session from the entire hospital community: physicians, medical students, nurses, social workers, chaplains, etc. to participate in discussion about an important clinical ethics issue. This model will soon be expanded to the JHH. Berman Institute faculty members also lead ethics rounds on selected clinical units.
Bioethics Intensives: The Berman Institute offers courses in bioethics each June through the Berman Institute Bioethics Intensives (BI2) program. BI2 courses provide an engaging, non-degree learning opportunity to anyone interested in exploring bioethics in an interactive short-course format. The courses focus on both theoretical and applied aspects of bioethics, including clinical ethics, so that they are of practical value to medical, legal, and policy professionals; researchers; scholars; students and others.
The Berman Institute produces ground-breaking work on concepts in clinical ethics such as respect, dignity, trust and compassion, as well as on specific issues including palliative care across the lifespan, moral distress and clinician suffering, obligations to treat patients with Ebola and clinician-patient communication. Berman Institute faculty members also conduct collaborative empirical research on ethical issues related to clinical practice. The following is a selection of some of the areas of active empirical research:
- Ensuring respect and dignity in the intensive care unit
- Ethical issues in everyday clinical practice
- Palliative and end of life care
- Ethics in accountable care organizations
- Spirituality and religious beliefs
- Treatment of patients with sickle cell disease and HIV/AIDS
- Decision making among youth with neuromuscular diseases, sickle cell disease
- Moral distress and clinician suffering
- Breast cancer survivorship
- Surrogate and shared decision-making
- Chemotherapy drug shortages in childhood cancer
- Ethical issues involving persons with dementia
- Ethical issues in genetic testing
- Ethical issues and cultural diversity
- Clinical ethics education
Berman Institute faculty members lead the Ethics Committees and Consultation Services at JHH and JHBMC and assist with these services in other Johns Hopkins Health System and Affiliate entities. They also serve in related leadership positions in key Hospital, Health System and University Committees and task forces. Berman Institute faculty play a critical role in the Johns Hopkins Institutional Review Board (IRB) system, by serving as members of all six School of Medicine and both School of Public Health IRBs, with two faculty members in leadership positions on their respective IRBs. Faculty members also serve on key committees and initiatives in their respective Schools of Nursing, Medicine, and Public Health as well as national and international leadership in organizations and initiatives addressing key areas of clinical ethics.
Berman Institute faculty member are involved with national policy initiatives regarding clinical ethics. These include developing standards for clinical ethics consultation, standards for education and training in professionalism, and ethical practice for nurses.
Faculty in Clinical Ethics:
- Mary Catherine Beach, MD, MPH
- Zackary Berger, MD, PhD
- Betty Black, PhD
- Renee Boss, MD
- Joseph Carrese, MD, MPH
- Matthew DeCamp, MD, PhD
- Daniel Finkelstein, MD
- Thomas Finucane, MD
- Gail Geller, ScD, MHS
- Carlton Haywood, Jr, PhD, MA
- Leslie Meltzer Henry, JD, MSc
- Mark Hughes, MD, MA
- Margaret Moon, MD, MPH
- Marie Nolan, PhD, MPH, RN, FAAN
- Cynda Rushton, PhD, RN, FAAN
- Jeremy Sugarman, MD, MPH, MA
- Peter Terry, MD
- Yoram Unguru, MD, MS, MA
- Nursing Ethics in the 21st Century: A Blueprint
- Phases – Pregnancy And Hiv/Aids: Seeking Equitable Study
- Center for Bridging Genomics, Infectious Disease, and Society (BRIDGES)
- Vision Of Hope: Integration Of Palliative Care In Chronic Pediatric Disease
- Community Values And The Allocation Of Scarce Medical Resources In Disasters – A Public Engagement Project
- Ethical Challenges in Short-Term Global Health Training
- The Chemotherapy Shortage: Ethical Challenges Facing Pediatric Oncology – Working Group Briefing Website
- User’s Guide to Integrating Patient-Reported Outcomes in Electronic Health Records (PDF)