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Martin Smith
University of Liverpool
  1.  60
    A Pilot Evaluation of Portfolios for Quality Attestation of Clinical Ethics Consultants.Joseph J. Fins, Eric Kodish, Felicia Cohn, Marion Danis, Arthur R. Derse, Nancy Neveloff Dubler, Barbara Goulden, Mark Kuczewski, Mary Beth Mercer, Robert A. Pearlman, Martin L. Smith, Anita Tarzian & Stuart J. Youngner - 2016 - American Journal of Bioethics 16 (3):15-24.
    Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step (...)
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  2.  46
    A Systematic Review of Activities at a High-Volume Ethics Consultation Service.Courtenay R. Bruce, Martin L. Smith, Sabahat Hizlan & Richard R. Sharp - 2011 - Journal of Clinical Ethics 22 (2):151-164.
    We describe the ethics consultation service (ECS) at the Cleveland Clinic and report on its activities over a 24-month period in which 478 consultations were performed. To our knowledge, this is the largest case series of ethics consultations reported to date. Established more than 25 years ago, the ECS at the Cleveland Clinic is staffed by multiple consultants with advanced training in bioethics. Several of these ethicists work closely with specialized clinical units and research departments, where they participate in multidisciplinary (...)
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  3.  29
    Toward Competency-Based Certification of Clinical Ethics Consultants: A Four-Step Process.Martin L. Smith, Richard R. Sharp, Kathryn Weise & Eric Kodish - 2010 - Journal of Clinical Ethics 21 (1):14-22.
    While consensus exists among many practitioners of ethics consultation about the need for and identification of core competencies and standards, there has been virtually no attempt to determine how these competencies and standards are best taught and assessed. We believe that clinical ethics consultation has reached a state of sufficient maturity that expert practitioners can evaluate those who are new to the field. We will outline several steps that can facilitate the creation of a certification process for clinical ethics consultants, (...)
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  4.  69
    An Embedded Model for Ethics Consultation: Characteristics, Outcomes, and Challenges.Courtenay R. Bruce, Adam Peña, Betsy B. Kusin, Nathan G. Allen, Martin L. Smith & Mary A. Majumder - 2014 - AJOB Empirical Bioethics 5 (3):8-18.
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  5.  9
    Developing and Testing a Checklist to Enhance Quality in Clinical Ethics Consultation.Martin L. Smith, Ruchi Sanghani, Anne Lederman Flamm, Margot M. Eves, Susannah L. Rose & Lauren Sydney Flicker - 2014 - Journal of Clinical Ethics 25 (4):281-290.
    Checklists have been used to improve quality in many industries, including healthcare. The use of checklists, however, has not been extensively evaluated in clinical ethics consultation. This article seeks to fill this gap by exploring the efficacy of using a checklist in ethics consultation, as tested by an empirical investigation of the use of the checklist at a large academic medical system (Cleveland Clinic). The specific aims of this project are as follows: (1) to improve the quality of ethics consultations (...)
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  6.  69
    Practical Guidance for Charting Ethics Consultations.Courtenay R. Bruce, Martin L. Smith, Olubukunola Mary Tawose & Richard R. Sharp - 2014 - HEC Forum 26 (1):79-93.
    It is generally accepted that appropriate documentation of activities and recommendations of ethics consultants in patients’ medical records is critical. Despite this acceptance, the bioethics literature is largely devoid of guidance on key elements of an ethics chart note, the degree of specificity that it should contain, and its stylistic tenor. We aim to provide guidance for a variety of persons engaged in clinical ethics consultation: new and seasoned ethics committee members who are new to ethics consultation, students and trainees (...)
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  7.  10
    Family Members’ Requests to Extend Physiologic Support after Declaration of Brain Death: A Case Series Analysis and Proposed Guidelines for Clinical Management.Patricia A. Mayer, Martin L. Smith & Anne Lederman Flamm - 2014 - Journal of Clinical Ethics 25 (3):222-237.
    We describe and analyze 13 cases handled by our ethics consultation service (ECS) in which families requested continuation of physiological support for loved ones after death by neurological criteria (DNC) had been declared. These ethics consultations took place between 2005 and 2013. Patients’ ages ranged from 14 to 85. Continued mechanical ventilation was the focal intervention sought by all families. The ECS’s advice and recommendations generally promoted “reasonable accommodation” of the requests, balancing compassion for grieving families with other ethical and (...)
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  8.  36
    The goals of ethics consultation: Rejecting the role of "ethics police".Martin L. Smith & Kathryn L. Weise - 2007 - American Journal of Bioethics 7 (2):42 – 44.
    We congratulate Fox and her colleagues (2007) for contributing to the published empirical literature on ethics consultation in United States hospitals. Their study demonstrates the continued wide v...
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  9.  30
    Accommodating Religious Beliefs in the ICU: A Narrative Account of a Disputed Death.Martin L. Smith & Anne Lederman Flamm - 2011 - Narrative Inquiry in Bioethics 1 (1):55-64.
    Conflicts of interest. None to report. Despite widespread acceptance in the United States of neurological criteria to determine death, clinicians encounter families who object, often on religious grounds, to the categorization of their loved ones as “brain dead.” The concept of “reasonable accommodation” of objections to brain death, promulgated in both state statutes and the bioethics literature, suggests the possibility of compromise between the family’s deeply held beliefs and the legal, professional and moral values otherwise directing clinicians to withdraw medical (...)
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  10.  47
    Criteria for determining the appropriate method for an ethics consultation.Martin L. Smith, Annette K. Bisanz, Ana J. Kempfer, Barbie Adams, Toya G. Candelari & Roxann K. Blackburn - 2004 - HEC Forum 16 (2):95-113.
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  11.  44
    Religious Insistence on Medical Treatment: Christian Theology and Re‐Imagination.Russell B. Connors & Martin L. Smith - 1996 - Hastings Center Report 26 (4):23-30.
    Families and surrogates sometimes use religious themes to justify their insistence on aggressive end‐of‐life care. Their hope that “God will work a miracle” can halt negotiations with health care professionals and lead to litigation. The possibility of “re‐imagining” religious themes, to broaden their scope and present a wider vision of the Christian tradition, may offer a solution.
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  12.  44
    An assessment of a formal ethics committee consultation process.Janet R. Day, Martin L. Smith, Gerald Erenberg & Robert L. Collins - 1994 - HEC Forum 6 (1):18-30.
  13.  35
    The Gift of Life and the Common Good: The Need for a Communal Approach to Organ Procurement.Paul Lauritzen, Michael McClure, Martin L. Smith & Andrew Trew - 2001 - Hastings Center Report 31 (1):29-35.
    Its critics to the contrary, the “gift of life” metaphor is not to be blamed for the indebtedness and guilt that organ recipients often experience. It is certainly misused, however, both by post‐transplant caregivers, who exploit it to manipulate recipients' behavior, and by the organ procurement system, which has failed to understand that the decision to give the gift of life must be approached communally.
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  14.  46
    “Systematizing” Ethics Consultation Services.Courtenay R. Bruce, Margot M. Eves, Nathan G. Allen, Martin L. Smith, Adam M. Peña, John R. Cheney & Mary A. Majumder - 2015 - HEC Forum 27 (1):35-45.
    While valuable work has been done addressing clinical ethics within established healthcare systems, we anticipate that the projected growth in acquisitions of community hospitals and facilities by large tertiary hospitals will impact the field of clinical ethics and the day-to-day responsibilities of clinical ethicists in ways that have yet to be explored. Toward the goal of providing clinical ethicists guidance on a range of issues that they may encounter in the systematization process, we discuss key considerations and potential challenges in (...)
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  15.  48
    Morally Managing Medical Mistakes.Martin L. Smith & Heidi P. Forster - 2000 - Cambridge Quarterly of Healthcare Ethics 9 (1):38-53.
    Mistakes and errors happen in most spheres of human life and activity, including in medicine. A mistake can be as simple and benign as the collection of an extra and unnecessary urine sample. Or a mistake can cause serious but reversible harm, such as an overdose of insulin in a patient with diabetes, resulting in hypoglycemia, seizures, and coma. Or a mistake can result in serious and permanent damage for the patient, such as the failure to consider epiglottitis in an (...)
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  16.  27
    A Possible Solution, But Not the Last Word.Martin L. Smith - 2009 - Hastings Center Report 39 (6):3-.
  17.  7
    The parameters of ethics consultation.Martin L. Smith - 2012 - In D. Micah Hester & Toby Schonfeld (eds.), Guidance for healthcare ethics committees. Cambridge, UK: Cambridge University Press. pp. 32.
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  18.  50
    All for one, or one for all?Peter C. Adamson, Carmen Paradis & Martin L. Smith - 2007 - Hastings Center Report 37 (4):13-15.
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  19.  26
    A Second Chance.Nancy P. Blumenthal, James D. Mendez, Martin L. Smith & Beth Hyland - 2013 - Hastings Center Report 43 (1):12-13.
    Mr. F. is a fifty‐year‐old father of two school‐aged daughters. Six years ago, he received a double lung transplant because he was suffering from interstitial lung disease, a fatal illness that causes suffocation by progressive scarring of the lungs. He is now experiencing chronic rejection of the transplant and is being considered to receive another. Without it, he is expected to survive only a year and a half. With it, his prognosis will improve, but the numbers are still not good. (...)
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  20.  33
    Bad Words.Courtenay R. Bruce, Martin L. Smith, Adam M. Peña & Mary A. Majumder - 2014 - Hastings Center Report 44 (2):13-14.
    The clinical ethicist met with Ms. H to clarify what information she wants and does not want to know. First, she wants to receive any treatment that could prolong her life, regardless of how the treatment affects her ability to engage in activities of daily living. Second, she wants to be included in the decision‐making process as much as possible, as long as clinicians use only “positive” language. Ms. H considers the words “dying,” “chemotherapy,” “radiation,” and “cancer” to be “bad (...)
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  21. Go in Peace: The Art of Hearing Confessions.Julia Gatta & Martin L. Smith - 2012
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  22.  13
    All for One, or One for All?Carmen Paradis & Martin L. Smith - 2007 - Hastings Center Report 37 (4):13-15.
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  23.  22
    Transplant Ethics: Let’s Begin the Conversation Anew: A Critical Look at One Institute’s Experience with Transplant Related Ethical Issues.David Shafran, Martin L. Smith, Barbara J. Daly & David Goldfarb - 2016 - HEC Forum 28 (2):141-152.
    Standardizing consultation processes is increasingly important as clinical ethics consultation becomes more utilized in and vital to medical practice. Solid organ transplant represents a relatively nascent field replete with complex ethical issues that, while explored, have not been systematically classified. In this paper, we offer a proposed taxonomy that divides issues of resource allocation from viable solutions to the issue of organ shortage in transplant and then further distinguishes between policy and bedside level issues. We then identify all transplant related (...)
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  24.  9
    Commentary.Martin L. Smith - 2009 - Hastings Center Report 39 (1):12-13.
  25.  23
    Chaplaincy and Clinical Ethics: A Common Set of Questions.Martin L. Smith - 2008 - Hastings Center Report 38 (6):28-29.
  26.  14
    Chaplains and Confidentiality.Martin L. Smith & Jon Overvold - 2009 - Hastings Center Report 39 (1):12-13.
  27.  21
    Confidentiality in the Age of AIDS: A Case Study in Clinical Ethics.Martin L. Smith & Kevin P. Martin - 1993 - Journal of Clinical Ethics 4 (3):236-241.
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  28.  11
    Desperately Seeking a Surrogate—For a Patient Lacking Decision–Making Capacity.Martin L. Smith & Catherine L. Luck - 2014 - Narrative Inquiry in Bioethics 4 (2):161-169.
    Our hospital’s policy and procedures for “Patients Without Surrogates” provides for gradated safeguards for managing patients’ treatment and care when they lack decision–making capacity, have no advance directives, and no surrogate decision makers are available. The safeguards increase as clinical decisions become more significant and have greater consequences for the patient. The policy also directs social workers to engage in “rigorous efforts” to search for surrogates who can potentially provide substituted judgments for such patients. We describe and illustrate the policy, (...)
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  29.  32
    Guidelines for patient refusal of life-sustaining treatment.Martin L. Smith, Kathleen Lawry, Loretta Planavsky, Holly A. Segel, Linda Solar & Doug Burleigh - 1994 - HEC Forum 6 (1):64-68.
  30. Mission, vision, goals : defining the parameters of ethics consultation.Martin L. Smith - 2012 - In D. Micah Hester & Toby Schonfeld (eds.), Guidance for healthcare ethics committees. Cambridge, UK: Cambridge University Press.
     
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  31.  10
    On being an authentic scientist.Martin L. Smith - 1991 - IRB: Ethics & Human Research 14 (2):1-4.
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  32.  17
    Should possible disparities and distrust trump do-no-harm?Martin L. Smith - 2006 - American Journal of Bioethics 6 (5):28 – 30.
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  33.  20
    Re-Imagination Lacks Compassion.Charles W. Taylor, Martin L. Smith & Russell B. Connors - 1997 - Hastings Center Report 27 (4):4.
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  34.  54
    Physical restraint elimination in the acute care setting: Ethical considerations. [REVIEW]Jacquelyn Slomka, George J. Agich, Susan J. Stagno & Martin L. Smith - 1998 - HEC Forum 10 (3-4):244-262.
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