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19The effect of COVID-19 on vulnerable populations in the US and UK: an international scoping reviewEthic@: An International Journal for Moral Philosophy 22 (1). 2023.Context: Comparing the Covid-19 related experiences of vulnerable groups can help to improve public health.?The United States and the United Kingdom are both characterized by underfunded public health in the context of racist systems. We reviewed differences in Covid-19 outcomes between groups in the US and UK and compared intergroup differences between the two countries. Methods: The scoping review analyzed articles published in English during the Covid-19 pandemic focusing on the US or the UK.…Read more
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202When We Collide. Rebecca J. Epstein-Levi, 2023. Bloomington, University of Indiana Press. xii + 257 pp, $34 (pb and e-book), $75 (hb). (review)Journal of Applied Philosophy (1): 174-176. 2023.
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23An ethical approach to shared decision-making for adolescents with terminal illnessClinical Ethics 18 (2): 264-270. 2023.Shared decision-making is a well-recognized model to guide decision-making in medical care. However, the shared decision-making concept can become exceedingly complex in adolescent patients with varying degrees of autonomy who have most of their medical decisions made by their parents or legal guardians. The complexity increases further in ethically difficult situations such as terminal illness. In contrast to the typical patient-physician dyad, shared decision-making in adolescents requires a d…Read more
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246"Do I Have to Be Tested?": Understanding Reluctance to Be Screened for COVID-19American Journal of Public Health 110 (12). 2020.
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381Long COVID and Health Inequities: The Role of Primary CareMilbank Quarterly 99 (2): 519-541. 2021.An estimated 700,000 people in the United States have "long COVID," that is, symptoms of COVID-19 persisting beyond three weeks. COVID-19 and its long-term sequelae are strongly influenced by social determinants such as poverty and by structural inequalities such as racism and discrimination. Primary care providers are in a unique position to provide and coordinate care for vulnerable patients with long COVID. Policy measures should include strengthening primary care, optimizing data quality, an…Read more
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16Healthcare Professionals’ Experience, Training, and Knowledge Regarding Immigration-Related Law Enforcement in Healthcare Facilities: An Online SurveyJournal of Law, Medicine and Ethics 49 (1): 50-58. 2021.U.S. immigration policies and enforcement can make immigrants fearful of accessing healthcare. Although current immigration policies restrict enforcement in “sensitive locations” including healthcare facilities, there are reports of enforcement actions in such settings.
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31The need for empathetic healthcare systemsJournal of Medical Ethics 47 (12). 2021.Medicine is not merely a job that requires technical expertise, but a profession concerned with making the best decisions and recommendations with reference to, and in consultation with, the patient. This means that the skill set required for healthcare professionals in order to provide good care is a combination of scientific knowledge, technical aptitude, and affective qualities or virtues such as compassion and empathy.
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361Metrics of Patient, Public, Consumer, and Community Engagement in Healthcare Systems: How Should We Define Engagement, What Are We Measuring, and Does It Matter for Patient Care? Comment on "Metrics and Evaluation Tools for Patient Engagement in Healthcare Organization- and System-Level Decision-Making: A Systematic Review". (review)International Journal of Health Policy and Management 8 49-50. 2018.In a rigorous systematic review, Dukhanin and colleagues categorize metrics and evaluative tools of the engagement of patient, public, consumer, and community in decision-making in healthcare institutions and systems. The review itself is ably done and the categorizations lead to a useful understanding of the necessary elements of engagement, and a suite of measures relevant to implementing engagement in systems. Nevertheless, the question remains whether the engagement of patient representative…Read more
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540Are Children Allowed? A Survey of Childcare and Family Policies at Academic Medical Conferences.Academic Emergency Medicine 3 (26): 339-341. 2019.
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11Making Sense of Medicine: Bridging the Gap between Doctor Guidelines and Patient PreferencesRowman & Littlefield. 2016.The more we know about medicine, the more we realize that many health questions have no one true answer. Realizing this, and thinking carefully about how medicine asks patients to treat their conditions, leads us to some questions. How reliable are the guidelines that might form the basis of doctors’ advice? Is it wrong, after all, to base an approach to medicine on patients’ preferences? And, given that there is often a distance between the treatment a doctor advises and what a patient would li…Read more
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289The Medical Cosmology of Halakha: The Expert, the Physician, and the Sick Person on Shabbat in the Shulchan AruchStudies in Judaism, Humanities, and the Social Sciences 1 (2). 2018.One of the best-known principles of halakha is that Shabbat is violated to save a life. Who does this saving and how do we know that a life is in danger? What categories of illness violate Shabbat and who decides? A historical-sociological analysis of the roles played by Jew, non-Jew, and physician according to the approach of “medical cosmology” can help us understand the differences in the approach of the Shulchan Aruch compared to later decisors (e.g., the Mishnah Berurah). Such differences i…Read more
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481Patient Autonomy in Talmudic Context: The Patient’s ‘‘I Must Eat’’ on Yom Kippur in the Light of Contemporary BioethicsJournal of Religion and Health 5 (5): 5. 2016.In contemporary bioethics, the autonomy of the patient has assumed considerable importance. Progressing from a more limited notion of informed consent, shared decision making calls upon patients to voice the desires and preferences of their authentic self, engaging in choice among alternatives as a way to exercise deeply held values. One influential opinion in Jewish bioethics holds that Jewish law, in contradistinction to secular bioethics, limits the patient's exercise of autonomy only in thos…Read more
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1049Patient centred diagnosis: sharing diagnostic decisions with patients in clinical practice.British Medical Journal 359. 2017.Patient centred diagnosis is best practised through shared decision making; an iterative dialogue between doctor and patient, whichrespects a patient’s needs, values, preferences, and circumstances. Shared decision making for diagnostic situations differs fundamentally from that for treatment decisions. This has important implications when considering its practical application. The nature of dialogue should be tailored to the specific diagnostic decision; scenarios with higher stakes or uncertai…Read more
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496Clinical care and complicity with tortureBritish Medical Journal 360. 2018.The UN Convention against Torture defines torture as “any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person” by someone acting in an official capacity for purposes such as obtaining a confession or punishing or intimidating that person.1 It is unethical for healthcare professionals to participate in torture, including any use of medical knowledge or skill to facilitate torture or allow it to continue, or to be present during torture.2-7 Yet…Read more
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563Prior Authorization as a Potential Support of Patient-Centered Care.Patient 4 (11): 371-375. 2018.We discuss the role of prior authorization (PA) in supporting patient-centered care (PCC) by directing health system resources and thus the ability to better meet the needs of individual patients. We begin with an account of PCC as a standard that should be aimed for in patient care. In order to achieve widespread PCC, appropriate resource management is essential in a healthcare system. This brings us to PA, and we present an idealized view of PA in order to argue how at its best, it can contrib…Read more
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26Influences on Primary Care Provider Imaging for a Hypothetical Patient with Low Back Pain.Southern Journal of Medicine 12 (111): 758-762. 2018.OBJECTIVE: How outside factors affect physician decision making remains an open question of vital importance. We sought to investigate the importance of various influences on physician decision making when clinical guidelines differ from patient preference. METHODS: An online survey asking 469 primary care providers (PCPs) across four practice sites whether they would order magnetic resonance imaging for a patient with uncomplicated back pain. Participants were randomized to one of four scenario…Read more
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Talking To Your DoctorRowman and Littlefield. 2015.The last time you went to your doctor, you might have emerged feeling dissatisfied and disoriented. Nothing was clear after you left the office, and you don’t know whether it’s your fault or the doctor’s. While patients need to take control of the visit and set their agenda, the latest research shows that doctors and patients need to connect on a more emotional level as well. In Talking to Your Doctor, readers will learn to: •Talk to your doctor—and get your doctor to talk to you • Remake the re…Read more
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26Bayesian and frequentist models: legitimate choices for different purposes of clinical researchJournal of Evaluation in Clinical Practice 16 (6): 1045-1047. 2010.
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41Understanding Communication to Repair Difficult Patient–Doctor Relationships from WithinAmerican Journal of Bioethics 12 (5): 15-16. 2012.The American Journal of Bioethics, Volume 12, Issue 5, Page 15-16, May 2012
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88Jonathan D. Moreno and Sam Berger (eds.), Progress in bioethics: science, policy, and politics, Foreword by Harold ShapiroTheoretical Medicine and Bioethics 32 (3): 211-215. 2011.
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27Reason for Hospital Admission: A Pilot Study Comparing Patient Statements with Chart ReportsNarrative Inquiry in Bioethics 3 (1): 67-79. 2013.Providers and patients bring different understandings of health and disease to their encounters in the hospital setting. The literature to date only infrequently addresses patient and provider concordance on the reported reason for hospitalization, that is, whether they express this reason in similar ways. An agreement or common ground between such understandings can serve as a basis for future communication regarding an illness and its treatment. We interviewed a convenience sample of patients …Read more
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1991Communication behaviors and patient autonomy in hospital care: A qualitative study.Patient Education and Counseling 2017. 2017.BACKGROUND: Little is known about how hospitalized patients share decisions with physicians. METHODS: We conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. A research assistant (RA) approached newly hospitalized patients and their physicians before morning rounds and obtained consent. The RA audio recorded morning rounds, and then separately interviewed both patient and physician. Coding was done usin…Read more
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18Review of Peter Ubel, Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together (review)American Journal of Bioethics 13 (4). 2013.(2013). Review of Peter Ubel, Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together. The American Journal of Bioethics: Vol. 13, No. 4, pp. 53-54. doi: 10.1080/15265161.2013.768866
Baltimore, Maryland, United States of America
Areas of Specialization
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Applied Ethics |
Medical Ethics |
Health and Illness |
Philosophy of Medicine, Misc |
Institutional Accounts of Racism |
Jewish Ethics |