Snapshot of Clinical Ethics Work

I received training in clinical ethics by participating in several seminars and practica:

• Summer Seminar in Health Care Ethics, Univ. of Washington School of Medicine (2015)
• Bioethics Consultation Skills Course, Montefiore-Einstein Center for Bioethics (2015)
• Clinical Ethics Immersion, MedStar Washington Hospital Center (2015)
• Clinical Practicum, Center for Clinical Bioethics at Georgetown University (2012)

Since 2015, I have contributed to clinical ethics consultation, hospital committees and subcommittees (including substantial policy work), clinical education, and QI/QA projects and data collection at several hospitals. From 2015-2017, I was a clinical ethicist at MedStar Washington Hospital Center in Washington, DC, and I participated on the ethics committee of Children's National Medical Center. In 2017, I moved to Little Rock, AR, and I now serve the University of Arkansas for Medical Sciences Health system and Arkansas Children's. I am often asked about what I do as a clinical ethicist, so the below sections give a snapshot of what this work is like. 

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Clinical Ethics Consultation

In my role as a clinical ethics consultant, my aim is to address ethical uncertainty and concerns that arise in patient care. My experiences include:

• Serving as the lead on-call ethicist or back-up ethicist, responding to pages from healthcare professionals, family, and patients. As of 2020, I have been the lead ethicist on over 150 full consultation on an individual consultant model, and I have assisted with over 100 additional cases.
• ​Rounding on different services and attending multidisciplinary meetings, such as those for psychiatry, medical ICU, neonatal ICU, complex case management, palliative care, pediatric hematology/oncology, cardiovascular ICU, high risk OB, and intermediary care

Committees, Policy Work, and Climate

I work collaboratively with clinicians and healthcare leadership on diverse issues aimed at promoting ethical care and climate in the institution. I have served in various capacities at my different institutions, such as being a contributing member of the following:

• Ethics committees
  • Policy, consultation, and education subcommittees 
• Medical Center Policy Review Committee
• Healthcare Equality Index Committee 
• Schwartz Rounds Advisory Committee
• Psychiatry & Bioethics Case Conference 
• Mortality Review Committee
• Patient- and Family-Centered Care ICU Committee

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Education and Training

I provide formal and informal ethics education to residents, fellows, attending physicians, nurses, social workers, case managers, and others. Some of the ethics teaching I've done over the years include those for the following:

• Psychiatry residency program
• Nurse residency program
• Nurse orientation
• SICU Ethics Education Rounds
• Learn on Demand module available to all faculty and staff for CE: "The Challenge of Non-Adherence"
• Patient Rights and Responsibilities online module
• Initiative for Pediatric Palliative Care Conference
• Neonatal section meetings
• Moral distress workshops for respiratory therapists
• Moral distress discussions for MICU and SICU residents
• Resident case conferences
• Training on LGBTQ+ patient care for nurses
• Training others on clinical ethics consultation
• Breast cancer fellow didactics
• Mentoring interns in ethics

Data Collection

Data from the clinical ethics consultation service can be valuable for several purposes, including peer review, QI/QA, and keeping track of trends. This can help the service understand repeated ethical issues and where they arise, as well as the extent of the service's outreach. My role has included:

• Creating data collection system at multiple hospitals, incorporating information from intake forms and the electronic medical record
• Reporting key data trends to the ethics committees and consultation subcommittees
• Conducting an ethics needs assessment in neonatal ICUs, including sources of moral distress

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