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Stuart Youngner
Case Western Reserve University
  1.  59
    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.  85
    Propranolol and the prevention of post-traumatic stress disorder: Is it wrong to erase the “sting” of bad memories?Michael Henry, Jennifer R. Fishman & Stuart J. Youngner - 2007 - American Journal of Bioethics 7 (9):12 – 20.
    The National Institute of Mental Health (Bethesda, MD) reports that approximately 5.2 million Americans experience post-traumatic stress disorder (PTSD) each year. PTSD can be severely debilitating and diminish quality of life for patients and those who care for them. Studies have indicated that propranolol, a beta-blocker, reduces consolidation of emotional memory. When administered immediately after a psychic trauma, it is efficacious as a prophylactic for PTSD. Use of such memory-altering drugs raises important ethical concerns, including some futuristic dystopias put forth (...)
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  3.  77
    Death and organ procurement: Public beliefs and attitudes.Laura A. Siminoff, Christopher Burant & Stuart J. Youngner - 2004 - Kennedy Institute of Ethics Journal 14 (3):217-234.
    : Although "brain death" and the dead donor rule—i.e., patients must not be killed by organ retrieval—have been clinically and legally accepted in the U.S. as prerequisites to organ removal, there is little data about public attitudes and beliefs concerning these matters. To examine the public attitudes and beliefs about the determination of death and its relationship to organ transplantation, 1351 Ohio residents ≥18 years were randomly selected and surveyed using random digit dialing (RDD) sample frames. The RDD telephone survey (...)
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  4.  59
    The Dead Donor Rule: Should We Stretch It, Bend It, or Abandon It?Robert M. Arnold & Stuart J. Youngner - 1993 - Kennedy Institute of Ethics Journal 3 (2):263-278.
    The dead donor rule—that persons must be dead before their organs are taken—is a central part of the moral framework underlying organ procurement. Efforts to increase the pool of transplantable organs have been forced either to redefine death (e.g., anencephaly) or take advantage of ambiguities in the current definition of death (e.g., the Pittsburgh protocol). Society's growing acceptance of circumstances in which health care professionals can hasten a patient's death also may weaken the symbolic importance of the dead donor rule. (...)
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  5.  53
    Ethics consultation: from theory to practice.Mark P. Aulisio, Robert M. Arnold & Stuart J. Youngner (eds.) - 2003 - Baltimore: Johns Hopkins University Press.
    In the clinical setting, questions of medical ethics raise a host of perplexing problems, often complicated by conflicting perspectives and the need to make immediate decisions. In this volume, bioethicists and physicians provide a nuanced, in-depth approach to the difficult issues involved in bioethics consultation. Addressing the needs of researchers, clinicians, and other health professionals on the front lines of bioethics practice, the contributors focus primarily on practical concerns -- whether ethics consultation is best done by individuals, teams, or committees (...)
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  6.  65
    For Experts Only? Access to Hospital Ethics Committees.George J. Agich & Stuart J. Youngner - 1991 - Hastings Center Report 21 (5):17-24.
    How closely involved with hospital ethics committees should patients and their families become? Should they routinely have access to committees, or be empowered to initiate consultations? To what extent should they be informed of the content or outcome of committee deliberations? Seeing ethics committees as the locus of competing responsibilities allows us to respond to the questions posed by a patient rights model and to acknowledge more fully the complex moral dynamics of clinical medicine.
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  7.  89
    Philosophical debates about the definition of death: Who cares?Stuart J. Youngner & Robert M. Arnold - 2001 - Journal of Medicine and Philosophy 26 (5):527 – 537.
    Since the Harvard Committees bold and highly successful attempt to redefine death in 1968 (Harvard Ad Hoc committee, 1968), multiple controversies have arisen. Stimulated by several factors, including the inherent conceptual weakness of the Harvard Committees proposal, accumulated clinical experience, and the incessant push to expand the pool of potential organ donors, the lively debate about the definition of death has, for the most part, been confined to a relatively small group of academics who have created a large body of (...)
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  8.  25
    The Definition of Death: Contemporary Controversies.Karen G. Gervais, Stuart J. Youngner, Robert M. Arnold & Renie Shapiro - 2000 - Hastings Center Report 30 (5):45.
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  9.  23
    Casting Light and Doubt on Uncontrolled DCDD Protocols.David Rodríguez-Arias, Iván Ortega-Deballon, Maxwell J. Smith & Stuart J. Youngner - 2013 - Hastings Center Report 43 (1):27-30.
    The ever‐increasing demand for organs led Spain, France, and other European countries to promote uncontrolled donation after circulatory determination of death (uDCDD). For the same reason, New York City has recently developed its own uDCDD protocol, which differs from European programs in some key ways. The New York protocol incorporates a series of technical and management improvements that address some practical problems identified in response to European uDCDD protocols. However, the more fundamental issue of whether uDCDD donors are dead when (...)
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  10. Physician-Assisted Death in Perspective: Assessing the Dutch Experience.Stuart J. Youngner & Gerrit K. Kimsma (eds.) - 2012 - Cambridge University Press.
    This book is the first comprehensive report and analysis of the Dutch euthanasia experience over the last three decades. In contrast to most books about euthanasia, which are written by authors from countries where the practice is illegal and therefore practised only secretly, this book analyzes empirical data and real-life clinical behavior. Its essays were written by the leading Dutch scholars and clinicians who shaped euthanasia policy and who have studied, evaluated and helped regulate it. Some of them have themselves (...)
     
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  11.  33
    Do Formal Advance Directives Affect Resuscitation Decisions and the Use of Resources for Seriously Ill Patients?Joan M. Teno, Joanne Lynn, Russell S. Phillips, Donald Murphy, Stuart J. Youngner, Paul Bellamy, Alfred F. Connors Jr, Norman A. Desbiens, William Fulkerson & William A. Knaus - 1994 - Journal of Clinical Ethics 5 (1):23-30.
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  12.  15
    Who Will Watch the Watchers?Stuart J. Youngner & Robert Arnold - 2002 - Hastings Center Report 32 (3):21-22.
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  13.  95
    Intrinsic Conflicts of Interest in Clinical Research: A Need for Disclosure.Sharmon Sollitto, Sharona Hoffman, Maxwell J. Mehlman, Robert J. Lederman, Stuart J. Youngner & Michael M. Lederman - 2003 - Kennedy Institute of Ethics Journal 13 (2):83-91.
    : Protection of human subjects from investigators' conflicts of interest is critical to the integrity of clinical investigation. Personal financial conflicts of interest are addressed by university policies, professional society guidelines, publication standards, and government regulation, but "intrinsic conflicts of interest"—conflicts of interest inherent in all clinical research—have received relatively less attention. Such conflicts arise in all clinical research endeavors as a result of the tension among professionals' responsibilities to their research and to their patients and both academic and financial (...)
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  14.  23
    When Is "Dead"?Stuart J. Youngner, Robert M. Arnold & Michael A. DeVita - 1999 - Hastings Center Report 29 (6):14.
    One way of increasing the supply of vital organs without violating the dead donor rule is to declare death on cardiopulmonary criteria after withdrawing life support. The question then is how quickly death may be declared.
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  15. Should individuals choose their definition of death?Alberto Molina, David Rodriguez-Arias & Stuart J. Youngner - 2008 - Journal of Medical Ethics 34 (9):688-689.
    Alireza Bagheri supports a policy on organ procurement where individuals could choose their own definition of death between two or more socially accepted alternatives. First, we claim that such a policy, without any criterion to distinguish accepted from acceptable definitions, easily leads to the slippery slope that Bagheri tries to avoid. Second, we suggest that a public discussion about the circumstances under which the dead donor rule could be violated is more productive of social trust than constantly moving the line (...)
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  16.  21
    Original Articles.Stuart J. Youngner, Robert M. Arnold & Michael A. Devita - 1999 - Hastings Center Report 29 (6):14-21.
    One way of increasing the supply of vital organs without violating the dead donor rule is to declare death on cardiopulmonary criteria after withdrawing life support. The question then is how quickly death may be declared.
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  17.  26
    Patients?Attitudes Toward Hospital Ethics Committees.Stuart J. Youngner, Claudia Coulton, Barbara W. Juknialis & David L. Jackson - 1984 - Journal of Law, Medicine and Ethics 12 (1):21-25.
  18.  33
    When slippery slope arguments miss the mark: a lesson from one against physician-assisted death.Eric Blackstone & Stuart J. Youngner - 2018 - Journal of Medical Ethics 44 (10):657-660.
    In 1989, Susan Wolf convincingly warned of a troublesome consequence that should discourage any movement in American society towards physician-assisted death—a legal backlash against the gains made for limiting life-sustaining treatment. The authors demonstrate that this dire consequence did not come to pass. As physician-assisted suicide gains a foothold in USA and elsewhere, many other slippery slope arguments are being put forward. Although many of these speculations should be taken seriously, they do not justify halting the new practice. Instead, our (...)
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  19.  15
    School DNAR in the Real World.Stuart J. Youngner - 2005 - American Journal of Bioethics 5 (1):66-67.
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  20.  4
    Physicians’ Quantitative Assessments of Medical Futility.William J. Winslade, Henry S. Perkins, Stuart J. Youngner, Jeffrey W. Swanson & S. Van McCrary - 1994 - Journal of Clinical Ethics 5 (2):100-105.
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  21.  12
    Do‐Not‐Resuscitate Orders: No Longer Secret But Still a Problem.Stuart J. Youngner - 1987 - Hastings Center Report 17 (1):24-33.
    Over the past decade, public discussion has focused on the ethics of issuing Do‐Not‐Resuscitate Orders, and the failure of many hospitals to acknowledge their actions openly. Recent efforts on the part of some hospitals to establish formal DNR guidelines that are prudent, fair, and humane, are a helpful beginning, though they cannot account for all the vagaries of illness and human communication. But concerns about DNR should not divert us from looking closely and rigorously at other, more common treatment/nontreatment decisions (...)
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  22.  52
    Some Must Die.Stuart J. Youngner - 2003 - Zygon 38 (3):705-724.
    The transplantation and procurement of human organs has become almost routine in American society. Yet, organ transplantation raises difficult ethical and psychosocial issues in the context of “controlled” death, including the blurring of boundaries between life and death, self and other, healing and harming, and killing and letting die. These issues are explored in the context of the actual experiences of organ donors and recipients, brain death, the introduction of non‐heartbeating donor protocols, and the increasing reliance on living donors. The (...)
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  23.  33
    Poverty: Not a Justification for Banning Physician‐Assisted Death.Lindsey M. Freeman, Susannah L. Rose & Stuart J. Youngner - 2018 - Hastings Center Report 48 (6):38-46.
    Many critics of the legalization of physician‐assisted death oppose it in part because they fear it will further disadvantage those who are already economically disadvantaged. This argument points to a serious problem of how economic considerations can influence medical decisions, but in the context of PAD, the concern is not borne out. We will provide empirical evidence suggesting that concerns about money influence medical decisions throughout the full course of illness, but at the end of life, financial pressure is much (...)
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  24.  44
    Back to the Future: Obtaining Organs from Non-Heart-Beating Cadavers.Robert M. Arnold & Stuart J. Youngner - 1993 - Kennedy Institute of Ethics Journal 3 (2):103-111.
    In lieu of an abstract, here is a brief excerpt of the content:Back to the Future:Obtaining Organs from Non-Heart-Beating CadaversRobert M. Arnold (bio) and Stuart J. Youngner (bio)Organ Transplantation requires viable donor organs. This simple fact has become the Achilles' heel of transplantation programs. Progress in immunology and transplant surgery has outstripped the supply of available organs. Between 1988 and 1991, for example, the number of transplant candidates on waiting lists increased by about 55 percent, while the number of donors (...)
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  25.  32
    Should Psychiatrists Serve as Gatekeepers for Physician‐Assisted Suicide?Mark D. Sullivan, Stuart J. Youngner & Linda Ganzini - 1998 - Hastings Center Report 28 (4):24-31.
    Mandating psychiatric evaluation for patients who request physician‐assisted suicide may not offer the clearcut protection from possible coercion or other abuse that proponents assert. Competence itself is a complex concept and determinations of decisionmaking capacity are not straightforward, nor is the relationship between mental illness and decisionmaking capacity in dying patients clearly understood. And casting psychiatrists as gatekeepers in end‐of‐life decisions poses risks to the profession itself.
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  26.  29
    Response to Open Commentaries for "Propranolol and the Prevention of Post-Traumatic Stress Disorder: Is It Wrong to Erase the 'Sting' of Bad Memories?".Michael Henry, Jennifer R. Fishman & Stuart J. Youngner - 2007 - American Journal of Bioethics 7 (9):1-3.
    The National Institute of Mental Health reports that approximately 5.2 million Americans experience post-traumatic stress disorder each year. PTSD can be severely debilitating and diminish quality of life for patients and those who care for them. Studies have indicated that propranolol, a beta-blocker, reduces consolidation of emotional memory. When administered immediately after a psychic trauma, it is efficacious as a prophylactic for PTSD. Use of such memory-altering drugs raises important ethical concerns, including some futuristic dystopias put forth by the President's (...)
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  27.  18
    Patient‐Satisfaction Surveys on a Scale of 0 to 10: Improving Health Care, or Leading It Astray?.Alexandra Junewicz & Stuart J. Youngner - 2015 - Hastings Center Report 45 (3):43-51.
    The current institutional focus on patient satisfaction and on surveys designed to assess this could eventually compromise the quality of health care while simultaneously raising its cost. We begin this paper with an overview of the concept of patient satisfaction, which remains poorly and variously defined. Next, we trace the evolution of patient‐satisfaction surveys, including both their useful and problematic aspects. We then describe the effects of these surveys, the most troubling of which may be their influence on the behavior (...)
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  28.  16
    A Physician/Ethicist Responds: A Student's Rights Are Not So Simple.Stuart J. Youngner - 1992 - Kennedy Institute of Ethics Journal 2 (1):13-18.
  29.  23
    Case Studies: Family Wishes and Patient Autonomy.Stuart J. Youngner, David L. Jackson & William Ruddick - 1980 - Hastings Center Report 10 (5):21.
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  30.  16
    Family Wishes And Patient Autonomy: Commentary.Stuart J. Youngner & David L. Jackson - 1980 - Hastings Center Report 10 (5):21-22.
  31.  12
    Moving the Conversation Forward.Mark P. Aulisio, Robert M. Arnold & Stuart J. Youngner - 1999 - Journal of Clinical Ethics 10 (1):49-56.
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  32.  26
    Ethics Without Borders? Why The United States Needs an International Dialogue on Living Organ Donation.M. Aulisio, Nicole M. Deming, Donna L. Luebke, Miriam Weiss, Rachel Phetteplace & Stuart J. Youngner - 2014 - In Akira Akabayashi (ed.), The Future of Bioethics: International Dialogues. Oxford University Press.
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  33.  14
    The Authors Reply.Alexandra Junewicz & Stuart J. Youngner - 2015 - Hastings Center Report 45 (6):4-5.
    A response to “CAHPS Surveys: Valid and Valuable Measures of Patient Experience,” byWilliam G. Lehrman and Mark W. Friedberg, and to “Courage, Context, and Contemporary Health Care,” by Jeffrey T. Berger.
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  34. The Future of Psychiatry.Mary C. Rawlinson & Stuart J. Youngner - 1990 - Journal of Medicine and Philosophy 15 (1):1-119.
     
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  35. Organizational ethics: promises and pitfalls.Paul M. Schyve, Linda L. Emanuel, William Winslade & Stuart J. Youngner - 2003 - In Mark P. Aulisio, Robert M. Arnold & Stuart J. Youngner (eds.), Ethics Consultation: From Theory to Practice. Johns Hopkins University Press.
     
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  36.  20
    A Model System Works: Looking Deeper than Suicide.Stuart J. Youngner - 1993 - Journal of Clinical Ethics 4 (4):332-333.
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  37.  9
    Clinical Ethics Consultation: Attention to Cultural and Historic Context.Stuart J. Youngner & Susan E. Watson - 2008 - Arbor 184 (730).
  38.  9
    Commentary on" Is Mr. Spock Mentally Competent?".Stuart J. Youngner - 1998 - Philosophy, Psychiatry, and Psychology 5 (1):89-92.
  39.  15
    Drawing the Line in Brain Death.Stuart J. Youngner - 1987 - Hastings Center Report 17 (4):43-44.
  40.  53
    To the Editor.Stuart J. Youngner - 2012 - Hastings Center Report 40 (3):7-8.
  41.  27
    Introduction.Stuart J. Youngner, Laura A. Siminoff & Renie Schapiro - 2004 - Kennedy Institute of Ethics Journal 14 (3):211-215.
    In lieu of an abstract, here is a brief excerpt of the content:IntroductionStuart J. Youngner (bio), Laura A. Siminoff (bio), and Renie Schapiro (bio)This issue of the Kennedy Institute of Ethics Journal (KIEJ) centers on a piece of empirical research. The motivation behind the study of Laura Siminoff, Christopher Burant, and Stuart Youngner (2004) was to find out more about what the general public understands and believes about when a person is dead. More specifically, the study tried to determine how (...)
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  42.  39
    Resolving problems at the intensive care unit/oncology unit interface.Stuart J. Youngner, Martha Allen, Hugo Montenegro, Jill Hreha & Hillard Lazarus - 1988 - Perspectives in Biology and Medicine 31 (2):299.
  43.  26
    Response to Open Peer Commentaries on “The Texas Advanced Directive Law: Unfinished Business”.Stuart J. Youngner & Michael Kapattos - 2015 - American Journal of Bioethics 15 (9):6-7.
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  44.  30
    Talking about death is not the same as communicating about death.Stuart J. Youngner - 2015 - Journal of Medical Ethics 41 (4):303-303.
  45.  10
    The Psychological and Moral Consequences of Participating in Human Fetal-Tissue Research.Stuart J. Youngner - 1993 - Journal of Clinical Ethics 4 (4):356-358.
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  46.  26
    The stakes are not very high in this game.Stuart J. Youngner - 2007 - American Journal of Bioethics 7 (4):42 – 43.
  47.  7
    To the Editor.Stuart J. Youngner - 2010 - Hastings Center Report 40 (3):7-8.
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  48.  35
    Task Force on Standards for Ethics Consultation: Response to “Ethics Consultation: The Least Dangerous Profession?”. [REVIEW]Robert Arnold & Stuart J. Youngner - 1996 - Cambridge Quarterly of Healthcare Ethics 5 (2):284.