Alden March Bioethics Institute Research

Organ Donation and Transplantation
Research in the area of organ donation and transplantation has primarily been based on two  3-year HRSA-funded grant projects designed to analyze the effect of a hospital-based family support intervention on organ donation consent rates and on the experiences of next of kin during the decision–making process. The program, which was implemented in several geographic regions of the country, entailed support provided by mothers of donors who were trained with the use of simulation in collaboration with local organ procurement organizations. Drawing on their own experiences as bereaved parents, the mothers offered consolation, information, patience and understanding to families facing the death of a loved one. The project was directed by Liva H. Jacoby, Ph.D. 

Informed Consent
Drs. Liva Jacoby, Wayne Shelton and John Balint collaborated on a longitudinal study examining the ethical basis for informed consent among patients preparing for bone marrow transplants.

AMBI faculty conducted two surveys regarding public attitudes toward emergency medical research with exception from informed consent. This research which was related to public disclosure about the PolyHeme trial, entailed one survey undertaken with a random sample of community dwellers and another with patients and families in an emergency department.

Preventive Ethics: Family Support Study in the Surgical ICU
Research based on insights gained from many years of ethics consultations in the ICU led to the implementation of a research project in 2006 that introduced a new role in the ICU: the Family Support Coordinator (FSC). The purpose of this new role was to help the ICU team coordinate the care of the most at-risk families, based on the medical severity of the patient. Research to determine the impact of this role was conducted over 2 ½ years using a pre- and post- study design The results show that the FSC had a significant impact on a wide range of family satisfaction issues, and decreased length of stay and cost of care. This research was directed by Dr. Shelton, who has continued to refine the intervention for further research.

Ethics Review Study
Currently, a small study is being conducted in the Medical ICU focusing on those patients that stay beyond 6 days, and for whom there is no plan for discharge. These cases—which often do not receive focused attention—constitute the highest risk for ethical conflicts and extended lengths of stay.

The study was initiated to examine the impact of a brief ethics intervention using a pre- and post- research design. The intervention is being provided as a proactive measure to determine if a critical ethical assessment in each case can identify issues in advance. The research question based on which data is being collected is: Can such an intervention help reduce and possibly preclude conflict down the road, and reduce length of stay? We are also looking at the impact of this intervention on the caregivers, including physicians and nurses, to determine if they find this service helpful to their work. This study is directed by Dr. Shelton.

Palliative Care Education
Research on palliative care education is based on a required one-week rotation for third year medical students at a local hospice program. Qualitative analysis has been undertaken of students’ essays describing their learning experiences. Considered an essential component of medical education, bedside experiences in palliative care have provided students with important clinical and communication skills, as well as personal and professional development.

Reproductive Ethics and Technologies
Research on reproductive ethics and technologies has been based, in part, on a NIH Oncofertility Pilot Grant and has encompassed a broad range of topics including embryo and parthenote research, motivations for ovarian transplantations during the last century, legal classification of ovarian tissue used in transplantation, gendered responses of cancer patients to potential infertility, legal mandates for insurance coverage of fertility preservation treatments. This research has been spearheaded by Lisa Campo-Engelstein PhD. Given the interdisciplinary nature of this research, collaborators have come from a variety of disciplines such as philosophy, political science, history, law, medicine, and biology.