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Clinical Ethics

Impacting and enhancing ethics in practice

The Department of Bioethics has a particular interest in research activities that have the potential to impact and enhance ethics in practice. This includes thinking and writing about challenging issues and questions of relevance to clinical ethics practice at or near the health care frontline.

Fairness

One focus of this is the academic exploration of the ethics dimensions of complex health care practices such as novel end-of-life practices by Dr. Jeff Kirby. With this objective in mind, a ‘domains of ethics analysis’ approach has been developed to support, deepen and legitimize such analyses.

Other scholarly clinical ethics emphases for the department are the ethics of organ donation/transplantation, and enhancement of fairness in the development and implementation of pandemic/all-hazards critical care triage protocols.

Hope

Dr. Christy Simpson has been exploring and writing thoughtfully about the role of hope in health care including the topics of addressing how health care providers can or should respond in moral ways to the emotions of others (patients, families, staff, etc.), and the development and use of a conceptual framework to critique and constructively reformulate existing notions of ‘false hope’.

Responsibility

Dr. Marika Warren has emerging research interests in disability and bioethics, responsibility and health, and addressing uncertainty in the health care context.

Pediatric Ethics

Another historic and current research focus is pediatric ethics. In her role as a pediatrician/ethicist, Dr. Nuala Kenny focused on issues of decision-making with children and adolescents, among other relevant practice issues. Drs. Christy Simpson and Conrad Fernandez share this interest, and are engaged in related research projects.

Selected publications

Kirby J. 2012. Ethics-informed Pragmatic Conditions for Donation After Cardiocirculatory Death. Journal of Clinical Ethics (In Press ).

Kirby J. 2011. Ethically Preferable Practice: ‘No’; An Alternative Head-to-head
Analytical Approach: ‘Maybe’
. American Journal of Bioethics 11,6: 57-9 (a comparison and contrast analysis of palliative sedation and physician-assisted suicide).

Simpson C. 2010. Considering Hope in the Context of Palliative Care in the ICU. In End of Life Care in the ICU: From advanced disease to bereavement. Eds. Graeme Rocker, Kathleen Puntilo, Elie Azoulay and Judith E. Nelson. Oxford: Oxford University Press: 146-49.

Kirby J. 2010. Assessing the Ethics of Complex Health Care Practices: Would a
‘domains of ethics analysis’ approach help?
HEC Forum 22,2: 133-43.

Kirby J. 2009. Organ Donation: Who Should Decide? – A Canadian Perspective.
Journal of Bioethical Inquiry 6: 123-8.

Benedict J, Simpson C, Fernandez C. 2006. Validity and Consequences of Informed Consent in Pediatric Bone Marrow Transplantation: The parental experience. Pediatric Blood & Cancer 49: 846-51.

Davison S, Simpson C. 2006. Reconceptualizing Hope in the Context of Advance Care Planning from the Perspective of Patients with End Stage Renal Disease. BMJ.

Simpson C. 2004. When Hope Makes Us Vulnerable: A discussion of patient-health care provider interactions in the context of hope. Bioethics 18,5: 428-47.

Harrison C, Kenny N, Sidarous M, Rowell M. 1997. Bioethics for clinicians: 9. Involving children in medical decisions. CMAJ 156:825-8.