57 found
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  1.  20
    Opening the Door: Rethinking “Difficult Conversations” about Living and Dying with Dementia.Mara Buchbinder & Nancy Berlinger - 2024 - Hastings Center Report 54 (S1):22-28.
    This essay looks closely at metaphors and other figures of speech that often feature in how Americans talk about dementia, becoming part of cultural narratives: shared stories that convey ideas and values, and also worries and fears. It uses approaches from literary studies to analyze how cultural narratives about dementia may surface in conversations with family members or health care professionals. This essay also draws on research on a notable social effect of legalizing medical aid in dying: patients may find (...)
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  2.  2
    Are workarounds ethical?: managing moral problems in health care systems.Nancy Berlinger - 2016 - New York: Oxford University Press.
    Should you wash your hands? -- Are workarounds ethical? -- Turfing, bending, and gaming -- Dirty hands and the semiclear conscience -- Problems of humanity -- Ethics without heroics : foreseeing moral problems in complex systems.
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  3.  7
    Brain Death at Fifty: Exploring Consensus, Controversy, and Contexts.Robert D. Truog, Nancy Berlinger, Rachel L. Zacharias & Mildred Z. Solomon - 2018 - Hastings Center Report 48 (S4):2-5.
    This special report is published in commemoration of the fiftieth anniversary of the “Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death,” a landmark document that proposed a new way to define death, with implications that advanced the field of organ transplantation. This remarkable success notwithstanding, the concept has raised lasting questions about what it means to be dead. Is death defined in terms of the biological failure of the organism to (...)
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  4.  11
    Ethical Challenges Experienced by Clinical Ethicists during COVID-19.Connie M. Ulrich, Janet A. Deatrick, Jesse Wool, Liming Huang, Nancy Berlinger & Christine Grady - 2023 - AJOB Empirical Bioethics 14 (1):1-14.
    Background The COVID-19 pandemic continues to disrupt every society as SARs-CoV-2 variants surge among the populations. Health care providers are exhausted, becoming ill themselves, and in some instances have died. Indeed, hospitals are struggling to find staff to care for critically ill patients most in need. Previous work has reported on the unending work-related conditions that hospital staff are laboring under and their subsequent mental and physical health strains. Health care providers need support, but it is not clear where that (...)
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  5.  13
    Moral Stress and Moral Distress: Confronting Challenges in Healthcare Systems under Pressure.Mara Buchbinder, Alyssa Browne, Nancy Berlinger, Tania Jenkins & Liza Buchbinder - forthcoming - American Journal of Bioethics:1-15.
    Stresses on healthcare systems and moral distress among clinicians are urgent, intertwined bioethical problems in contemporary healthcare. Yet conceptualizations of moral distress in bioethical inquiry often overlook a range of routine threats to professional integrity in healthcare work. Using examples from our research on frontline physicians working during the COVID-19 pandemic, this article clarifies conceptual distinctions between moral distress, moral injury, and moral stress and illustrates how these concepts operate together in healthcare work. Drawing from the philosophy of healthcare, we (...)
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  6.  12
    The Ethics of Advocacy for Undocumented Patients.Nancy Berlinger & Rajeev Raghavan - 2013 - Hastings Center Report 43 (1):14-17.
    Approximately 11.2 million undocumented immigrants have settled in the United States. Providing health care to these residents is an everyday concern for the clinicians and health care organizations who serve them. Uncertain how to proceed in the face of severe financial constraints, clinicians may improvise remedies–a strategy that allows our society to avoid confronting the clinical and organizational implications of public policy gaps. There is no simple solution‐no quick fix‐that will work across organizations (in particular, hospitals with emergency departments) in (...)
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  7.  23
    Interdependent Citizens: The Ethics of Care in Pandemic Recovery.Mercer Gary & Nancy Berlinger - 2020 - Hastings Center Report 50 (3):56-58.
    The crisis of Covid‐19 has forced us to notice two things: our human interdependence and American society's tolerance for what Nancy Krieger has called “inequalities embodied in health inequities,” reflected in data on Covid‐19 mortality and geographies. Care is integral to our recovery from this catastrophe and to the development of sustainable public health policies and practices that promote societal resilience and reduce the vulnerabilities of our citizens. Drawing on the insights of Joan Tronto and Eva Feder Kittay, we argue (...)
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  8.  36
    After harm: medical error and the ethics of forgiveness.Nancy Berlinger - 2005 - Baltimore: Johns Hopkins University Press.
    Medical error is a leading problem of health care in the United States. Each year, more patients die as a result of medical mistakes than are killed by motor vehicle accidents, breast cancer, or AIDS. While most government and regulatory efforts are directed toward reducing and preventing errors, the actions that should follow the injury or death of a patient are still hotly debated. According to Nancy Berlinger, conversations on patient safety are missing several important components: religious voices, traditions, and (...)
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  9.  10
    You Can't Always Get (or Give) What You Want: Preferences and Their Limits.Nancy Berlinger - 2018 - Hastings Center Report 48 (3):40-40.
    People who lack decision‐making capacity may be able to communicate preferences, which can and should inform surrogate decision‐making on their behalf. It is unclear whether making a further distinction about “capacity for preferences,” as Jason Wasserman and Mark Navin propose in this issue of the Hastings Center Report, would improve the process of surrogate decision‐making. Anyone who is regularly involved in surrogate decision‐making or who has worked to articulate decision‐making standards and processes can think of cases in which a patient's (...)
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  10.  31
    Avoiding Cheap Grace: Medical Harm, Patient Safety, and the Culture(s) of Forgiveness.Nancy Berlinger - 2003 - Hastings Center Report 33 (6):28-36.
    Too often in a hospital setting, forgiveness is thought to be automatic—given if a physician makes the apology. But this is cheap grace: a forgiveness achieved without the participation of the injured party. We must remember that forgiveness must be given, and devise new practices to see that it can be.
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  11.  14
    Becoming Good Citizens of Aging Societies.Nancy Berlinger & Mildred Z. Solomon - 2018 - Hastings Center Report 48 (S3):2-9.
    The ethical dimensions of an aging society are larger than the experience of chronic illness, the moral concerns of health care professionals, or the allocation of health care resources. What, then, is the role of bioethics in an aging society, beyond calling attention to these problems? Once we’ve agreed that aging is morally important and that population‐level aging across wealthy nations raises ethical concerns that cannot be fixed through transhumanism or other appeals to transcend aging and mortality through technology, what (...)
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  12.  70
    What is Meant by Telling the Truth: Bonhoeffer on the Ethics of Disclosure.Nancy Berlinger - 2003 - Studies in Christian Ethics 16 (2):80-92.
    This article explores Dietrich Bonhoeffer’s writings on truth telling with reference to the problem of medical error in the US, the UK, and other developed nations, with particular attention to physicians’ resistance to disclosing their own mistakes to injured patients and their families. The brief essay ‘What Is Meant by “Telling the Truth”?’ and its historical context — Bonhoeffer’s imprisonment and interrogation in 1943 — is proposed as a text for medical ethicists and others seeking to overcome the barrier of (...)
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  13. Pandemic Flu Planning in the Community: What Can Clinical Ethicists Bring to the Public Health Table?Nancy Berlinger & Jacob Moses - 2008 - Cambridge Quarterly of Healthcare Ethics 17 (4):468-470.
    It is still remarkably difficult for public health officials charged with developing and implementing pandemic influenza preparedness plans at the community levelto obtain clear, concrete, and consistent guidance on how to construct plans that are both ethical and actionable. As of mid-2007, most of the federal and state pandemic plans filed with the Centers for Disease Control and Prevention, describing how public health officials will coordinate public agencies and private entities in the event of an outbreak, failed to include ethical (...)
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  14.  9
    Centering Home Care in Bioethics Scholarship, Education, and Practice.Mercer Gary & Nancy Berlinger - 2023 - Hastings Center Report 53 (3):34-36.
    This commentary responds to “Home Care in America: The Urgent Challenge of Putting Ethical Care into Practice,” by Coleman Solis and colleagues, in the May‐June 2023 issue of the Hastings Center Report. More specifically, we respond to the authors’ call for “inquiry into the nature, value, and practice” of home care. We argue that the most urgently needed normative reset for thinking about care work is the replacement of dominant individualistic thinking with systemic thinking. Deepening a focus on the social, (...)
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  15. Case Study: Who Is Responsible?Carol Bayley & Nancy Berlinger - forthcoming - Hastings Center Report.
     
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  16.  35
    Who Is Responsible?Carol Bayley & Nancy Berlinger - 2006 - Hastings Center Report 36 (3):11-12.
  17.  3
    Almost Over: Aging, Dying, Dead by F.M. Kamm.Nancy Berlinger - 2022 - Kennedy Institute of Ethics Journal 32 (3):1-2.
    "I begin to discern the profile of my death." This sentence from Marguerite Yourcenar's novel Memoirs of Hadrian has stuck with me over the decades. In checking the quote, I learned that this sentence from an early draft caught the novelist's attention, and encouraged her to write the book from perspective of the dying Roman emperor. Something of this magic – finding, in one's earlier thoughts, a key that unlocks a story – is at work in F.M. Kamm's Almost Over, (...)
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  18. At the Center.Nancy Berlinger - forthcoming - Hastings Center Report.
     
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  19.  11
    Choice Architecture.Nancy Berlinger - 2019 - Hastings Center Report 49 (3).
    Abstract“Choices” about nonmedical aging‐related matters, such as housing, are weirdly extreme in the long last stage of life in America. In my experiences accompanying my parents to consultations with physicians, elder‐care lawyers, and social service providers, a middle‐class older adult's presumed choices are the high‐end assisted living facility—or the Medicaid spend‐down. Nothing in between. Experts in aging and housing are calling attention to this “forgotten middle”—the millions of older Americans like my mother, people who are neither rich nor poor and (...)
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  20.  6
    Cueing “The Conversation”.Nancy Berlinger - 2013 - Hastings Center Report 43 (4):29-30.
    In “Avoiding a ‘Death Panel Redux,” Nicole M. Piemonte describes how she tried to fire palliative care after first refusing to let it—and any mention of death, from any source—into her dying mother's room. One way to read this is as a familiar human story about the profound difficulty of facing death, a story that, too often, is reduced to the word “denial.” But Piemonte and Hermer suggest that there is another way to read this story, in terms of the (...)
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  21.  29
    Difficult Doctors and Rational Fears.Nancy Berlinger - 2010 - Hastings Center Report 40 (4):25-29.
    Should the doing of bioethics require the reading of novels? No, unless we believe that fiction trumps nonfiction as a means of exploring complex issues in medicine and the life sciences, and also that writers of novels have a lock on the arts-and-humanities department of the moral imagination. And it’s hard to get science right—convincing, not distracting—in a literary novel, even as plot-driven genre fiction may rely on biotechnological twists. So, let’s narrow our scope to the care of the sick, (...)
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  22.  26
    Define "Effective": The Curious Case of Chronic Cancer.Nancy Berlinger & Anne Lederman Flamm - 2009 - Hastings Center Report 39 (6):17-20.
  23.  5
    Et in Arcadia ego.Nancy Berlinger - 2014 - Hastings Center Report 44 (1):inside front cover-inside front.
    Two years ago, I was on a boat in the middle of the river that runs through Brisbane, Australia, with Sarah Winch, a medical ethicist at the University of Queensland. We were talking about the intersection of our professional work and our personal experiences of caregiving. Sarah's husband, Lincoln, had died at the age of forty‐eight, four months after a late‐stage diagnosis of kidney cancer. My friend Julia was the same age when she died, on November 18, 2010, after living (...)
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  24.  40
    Elizabeth Mitchell Armstrong is asso.Nancy Berlinger, Pauline W. Chen, Rebecca Dresser, Nancy Neveloff Dubler, Anne Lederman Flamm, Susan Gilbert, Mark A. Hall & Lisa H. Harris - forthcoming - Hastings Center Report.
  25.  19
    Franklin G. Miller works in the De.Nancy Berlinger & Wendy Cadge - forthcoming - Hastings Center Report.
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  26. From Julius Varwig to Julie Dupree: Professionalizing Hospital Chaplains.Nancy Berlinger - forthcoming - Bioethics Forum.
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  27.  23
    Field notes.Nancy Berlinger - 2007 - Hastings Center Report 37 (4):46-47.
    Out of the shadows. One of the interesting things about starting a new research project is its uncertainty. You’re not yet sure what you think about the issues you’re about to explore. I was reminded of this recently when, with colleagues here at the Center, I started work on a project on undocumented patients in the U.S. health care system—or rather, in the different systems that make up this fragmented system. There are more than eleven million undocumented residents of the (...)
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  28.  31
    Field notes.Nancy Berlinger - 2008 - Hastings Center Report 38 (2):46-47.
    Out of the shadows. One of the interesting things about starting a new research project is its uncertainty. You’re not yet sure what you think about the issues you’re about to explore. I was reminded of this recently when, with colleagues here at the Center, I started work on a project on undocumented patients in the U.S. health care system—or rather, in the different systems that make up this fragmented system. There are more than eleven million undocumented residents of the (...)
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  29.  6
    Field Notes.Nancy Berlinger - 2007 - Hastings Center Report 37 (4):2-2.
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  30.  12
    Field Notes.Nancy Berlinger - 2008 - Hastings Center Report 38 (2):2-2.
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  31.  6
    Field Notes.Nancy Berlinger - 2009 - Hastings Center Report 39 (6):2.
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  32.  19
    Grace.Nancy Berlinger - forthcoming - Hastings Center Report.
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  33.  6
    “Getting Creative”: From Workarounds to Sustainable Solutions for Immigrant Health Care.Nancy Berlinger - 2019 - Journal of Law, Medicine and Ethics 47 (3):409-411.
  34.  18
    Helping People Out.Nancy Berlinger - 2009 - Hastings Center Report 39 (1):3-3.
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  35.  21
    "Just Act Normally": How Culture Gives Birth to Policy.Nancy Berlinger - 2006 - Hastings Center Report 36 (4):C2-C2.
  36.  6
    Listening to Aslan®.Nancy Berlinger - 2003 - Hastings Center Report 33 (2):17-18.
  37.  5
    Martin Luther at the bedside.Nancy Berlinger - 2007 - Hastings Center Report 37 (2):3-3.
  38.  6
    No patient left behind: Administration announces pay for performance plan.Nancy Berlinger - 2003 - Hastings Center Report 33 (5):8-9.
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  39. Perspective: Helping People Out.Nancy Berlinger - forthcoming - Hastings Center Report.
     
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  40.  32
    Spirituality and medicine: Idiot-proofing the discourse.Nancy Berlinger - 2004 - Journal of Medicine and Philosophy 29 (6):681 – 695.
    The field of spirituality and medicine has seen explosive growth in recent years, due in part to significant private support for the development of curricula in more than half of all U.S. medical schools, and for related residency training programs and research centers. While there is no single definition of " spirituality " in use across these initiatives, this article examines the definitions and learning objectives relevant to spirituality that are addressed in a 1999 report of the Medical School Objectives (...)
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  41. The Five People You Meet in a Pandemic—and What They Need from You Today.Nancy Berlinger & Jacob Moses - forthcoming - Hastings Center Report.
     
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  42.  24
    The Nature of Chaplaincy and the Goals of QI: Patient-Centered Care as Professional Responsibility.Nancy Berlinger - 2008 - Hastings Center Report 38 (6):30-33.
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  43.  25
    When Policy Produces Moral Distress: Reclaiming Conscience.Nancy Berlinger - 2016 - Hastings Center Report 46 (2):32-34.
    For too long, bioethics has followed law in reducing “conscience” to “conscientious objection,” in other words, to laws and policies permitting and protecting refusal. In “Reframing Conscientious Care: Providing Abortion Care When Law and Conscience Collide,” Mara Buchbinder and colleagues draw our attention to one dimension of the problem of reducing conscience to refusal to provide certain forms of medical care: what about the conscience problems experienced by the professionals who are attempting to provide safe, effective health care that includes (...)
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  44.  8
    Writing Wrongs: On Narratives of Moral Distress.Nancy Berlinger - 2013 - Narrative Inquiry in Bioethics 3 (2):131-137.
    The perception that one is being forced to do wrong, or being prevented from doing the right thing, is often described in the most brutal terms, as a situation that feels like participating in the torture of another human being. The emotional force of the experience of moral distress, and the perception that one is powerless to do anything to change the situation producing moral distress, can make it hard to look at these experiences critically, and to imagine a different (...)
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  45.  51
    Values Engineering: The Ethics of Design in Community Health Centers.Benjamin Boltind & Nancy Berlinger - 2011 - Hastings Center Report 41 (1):27-28.
    Architecture, like ethics, concerns actual rather than ideal choices. William James's remarks on ethics, at a meeting of the Yale Philosophical Club in 1890, could apply equally well to the built environment:The actual possible in this world is vastly narrower than all that is demanded; and there is always a pinch between the ideal and the actual which can only be got through by leaving part of the ideal behind. There is hardly a good which we can imagine except as (...)
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  46.  7
    Protecting Practitioners in Stressed Systems: Translational Bioethics and the COVID-19 Pandemic.Mara Buchbinder, Nancy Berlinger & Tania M. Jenkins - 2022 - Perspectives in Biology and Medicine 65 (4):637-645.
    ABSTRACT:COVID-19 revealed health-care systems in crisis. Intersecting crises of stress, overwork, and poor working conditions have led to workforce strain, under-staffing, and high rates of job turnover. Bioethics researchers have responded to these conditions by investigating the ethical challenges of pandemic response for individuals, institutions, and health systems. This essay draws on pandemic findings to explore how empirical bioethics can inform post-pandemic translational bioethics. Borrowing from the concept of translational science in medicine, this essay proposes that translational bioethics should communicate (...)
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  47. Medical Encounter.Gail Coover, Dale Guenter, Elizabeth Clark, Janet Hortin, Joseph F. O’Donnell, Michael W. Rabow, Rachel N. Remen, Aanand D. Naik, Krista Hirschmann & Nancy Berlinger - 2007 - Complexity 21 (1).
     
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  48.  14
    Moral Progress in the Public Safety Net: Access for Transgender and LGB Patients.Stephan Davis & Nancy Berlinger - 2014 - Hastings Center Report 44 (s4):45-47.
    As a population, people who self‐identify as lesbian, gay, bisexual, or transgender face significant risks to health and difficulty in obtaining medical and behavioral health care, relative to the general public. These issues are especially challenging in safety‐net health care institutions, which serve a range of vulnerable populations with limited access, limited options, and significant health disparities. Safety‐net hospitals, particularly public hospitals with fewer resources than academic medical centers and other nonprofit hospitals that also serve as safety nets, are under (...)
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  49.  8
    Not Wanting to Lose the Dignity of Risk: On Living Alone with Dementia.Kate de Medeiros, Nancy Berlinger & Laura Girling - 2022 - Perspectives in Biology and Medicine 65 (2):274-282.
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  50.  24
    Lost in Translation: The Chaplain's Role in Health Care.Raymond de Vries, Nancy Berlinger & Wendy Cadge - 2008 - Hastings Center Report 38 (6):23-27.
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