Center for Medical Ethics and Health Policy

Scholarship to Research


The center's clinical ethics personnel engage in scholarship focusing on the practice of clinical ethics consultation as well as on the challenging theoretical questions that arise in the clinical context. Our team writes on best practices for clinical ethics consultation services using empirical and conceptual approaches with the hope that our work can contribute to the evolution of our young field. We also seek to develop robust ethical analyses of novel or controversial issues for which ethical consensus is lacking. Please see below for some recent examples of our team's scholarship.


Clinical Ethics Consultation Practices


Adam Omelianchuk (2023) Can People Work Together to Create a Self-Administered Act? No. Should They Work Together to Repeal the End of Life Option Act? Yes Am J Bioeth. 2023.

Omelianchuk A. Protecting Life and Ensuring Death-Confounding the Dead Donor Rule. Am J Bioeth. 2023.

Rezaei, S., Childress, A., Kaul, B., Rosales, K. M., Newell, A., & Rose, S. Using Visual Arts Education and Reflective Practice to Increase Empathy and Perspective Taking in Medical Students. MedEdPORTAL : the journal of teaching and learning resources, 19, 11346.

Childress, A., & Lou, M. Illness Narratives in Popular Music: An Untapped Resource for Medical Education. The Journal of medical humanities, 44(4), 533–552. 2023.

Nash, W., Erondu, M., & Childress, A.Expanding Narrative Medicine through the Collaborative Construction and Compelling Performance of Stories. The Journal of medical humanities, 2023.

Cavanagh, C. E., Rosman, L., Chui, P., Minges, K., Desai, N. R., Goodlin, S., Fedson, S., Spertus, J. A., Gluckman, T. J., Song, Y., Zheng, L., Turchin, A., Doros, G., Lee, J. J., & Burg, M. M. Advance Care Planning and End-of-Life Education in Heart Failure: Insights From the NCDR PINNACLE Registry. Circulation. Cardiovascular quality and outcomes, 16(1), e008989. 2023.

Bibler, T. M., & Zainab, A. (2023). Withdrawing extra corporeal membrane oxygenation (ECMO) against a family's wishes: Three permissible scenarios. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 42(7), 849–852. 2023.

Ness, T. E., Tabb, Z. J., Malek, J., & Placencia, F. X. Uninformed Origins: Should We Be Advising Parents on the Source of Medicines and Therapies?. Health care analysis : HCA : journal of health philosophy and policy, 31(3-4), 186–195. 2023.

Kaplan, H. The Tincture of the Doctor's Time. Narrative Inquiry in Bioethics 13(1), 12-14. doi:10.1353/nib.2023.0005. 2023.

Omelianchuk, A., Magnus, D. Arguments Opposing Continuation of Organ Support When Families Object to Declaration of Death by Neurological Criteria. In: Lewis, A., Bernat, J.L. (eds) Death Determination by Neurologic Criteria. Advances in Neuroethics. Springer, Cham. 2022

Malek J. A Call for Evidence-Based Clinical Ethics ConsultationAm J Bioeth. 2022;22(4):40-42. doi:10.1080/15265161.2022.2044566.

Horner C. The Existential Crisis of Clinical Ethics ConsultantsAm J Bioeth. 2022;22(4):64-65. doi:10.1080/15265161.2022.2044560

Childress A. Assistant Coach, Advice Columnist, or Seasoned Diplomat: Distinguishing Between Formal, Informal, and “FYI” Ethics ConsultationsAm J Bioeth. 2022;22(4):45-47. doi:10.1080/15265161.2022.2044559.

Robertson-Preidler J. Measuring Value with VolumeAm J Bioeth. 2022;22(4):76-78. doi:10.1080/15265161.2022.2044557

Bibler TM, Nelson RH, Moore B, Malek J, Majumder MA. Building Effective Mentoring Relationships During Clinical Ethics Fellowships: Pedagogy, Programs, and People. [published online ahead of print, 2022 Feb 26]. HEC Forum. 2022;10.1007/s10730-022-09473-z. doi:10.1007/s10730-022-09473-z.

Bibler TM. Responding Well to Spiritual Worldviews: A Taxonomy for Clinical Ethicists. [published online ahead of print, 2022 Jan 7]. HEC Forum. 2022;10.1007/s10730-021-09468-2. doi:10.1007/s10730-021-09468-2

Horner C. Bridging the Divide between a Patient's Blog and the Staff's Privacy. Am J Bioeth. 2021.

Childress A, Lee SW, Matsler JS, Farroni JS. (2020) Clarifying and Expanding the Role of Narrative in Ethics Consultation. J Clin Ethics.

Malek, J and C Horner. “The Top 10 Issues Facing the Field of Clinical Ethics in 2020: Reflections on the Evolving Clinical Ethics UnConference.” Journal of Clinical Ethics; 2020. Refereed.

Horner, C, A Childress, S Fantus, and J Malek. “What the HEC-C? An Analysis of the Healthcare Ethics Consultant-Certified Program: One Year In.” Target Article in the American Journal of Bioethics; 2020. Refereed.

Bibler T., Stahl D., Fantus S., Lion A., Brothers K.B., “A Process-Based Approach to Responding to Parents or Guardians Who Hope for a Miracle.” Pedatrics; 2020.

Malek J, Bibler TM, Childress A, Crist J, Fedson S, Horner C, Moore B, Nelson R, "Critical Conversations: Say This, Not That.” CHEST; 2020.

Stephens, AL, CR Bruce, A Childress, J Malek. Why Families Get Angry: Practical Strategies for Clinical Ethics Consultants to Rebuild Trust Between Angry Families and Clinicians in the Critical Care Environment. HEC Forum; 2019.

Malek, J. The Appropriate Role of a Clinical Ethics Consultant's Religious Worldview in Consultative Work: Nearly None. HEC Forum; 2018.

Bruce CR, Majumder MA, Stephens A, Malek J, McGuire AM. Cultivating
administrative support for a clinical ethics consultation service. Journal of Clinical Ethics; 2016.

Bruce CR, Bibler TM, Pena AM. Kusin B. A qualitative exploration of a clinical ethicist's role and contributions during family meetings. HEC Forum; 2016.

Bruce CR, Majumder MA, Bibler TM, McCullough LB, Blumenthal-Barby JS, Allen NA, Pena A. McGuire AM. A Practical Guide to Developing and Sustaining a Clinical Ethics Consultation Service. 2015.


Normative Clinical Ethics Analysis


Bobier, C., Rodger, D., Hurst, D. J., & Omelianchuk, A. In defense of xenotransplantation research: Because of, not in spite of, animal welfare concerns. Xenotransplantation, 30(1), e12791. 2023.

Adam Omelianchuk PhD (2023) Creating human nature: the political challenges of genetic engineering, The New Bioethics. 2023.

Zaidi, D., Kirkpatrick, J. N., Fedson, S. E., & Hull, S. C. (2023). Deactivation of Left Ventricular Assist Devices at the End of Life: Narrative Review and Ethical Framework. JACC. Heart failure, 11(11), 1481–1490. 2023.

Fedson S. Will Knowing More Translate Into More Organs?. JACC. Heart failure, 11(5), 612–613. 2023.

Bhardwaj, A., Fedson, S., Munagala, M., Pinney, S., Rajapreyar, I., & Mancini, D. Pregnancy in Patients With Advanced Heart Failure: Impact of Overturn of Roe v Wade Ruling. JACC. Heart failure, 11(3), 362–364. 2023.

Dougherty, R. J., & Fins, J. J. Toward a Social Bioethics Through Interpretivism: A Framework for Healthcare Ethics. Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees, 1–11. Advance online publication. 2023.

Kaplan, H., Robinson, M., & Grouls, A. Voices behind bars: Ethical, legal, and practical considerations for surrogates who are incarcerated. Annals of Internal Medicine, 176(9), 1261–1263. 2023.

Kaplan, H., Guidry-Grimes, L., Crutchfield, P., Hulkower, A., Horner, C., Burke, J. E., & Fedson, S. An Open Discussion of the Impact of OpenNotes on Clinical Ethics: A Justification for Harm-Based Exclusions from Clinical Ethics Documentation. The Journal of clinical ethics, 33(4), 303–313. 2022.

Kolbe, Laura Kolbe, Nelson, Ryan H. Joelle Robertson-Preidler, Joelle,  Schuman, Olivia, Melo-Martín,  Inmaculada de. Is a video worth a thousand words AMA J Ethics. 2022;24(7):E549-555. doi: 10.1001/amajethics.2022.549.

Childress A, Bibler T, Moore B, et al. From Bridge to Destination? Ethical Considerations Related to Withdrawal of ECMO Support over the Objections of Capacitated Patients. [published online ahead of print, 2022 May 26]. Am J Bioeth. 2022;1-13. doi:10.1080/15265161.2022.2075959

Schuman O, Robertson-Preidler J, Bibler TM. COVID-19 vaccination status should not be used in triage tie-breaking. [published online ahead of print, 2022 Jan 6]. J Med Ethics. 2022;medethics-2021-107836. doi:10.1136/medethics-2021-107836

Bibler TM, Nelson RH, Schuman O, Miller SM. Caring for Unvaccinated Patients in the ICU: Beyond Frustration, Toward Beneficial RelationshipsCrit Care Explor. 2021;3(12):e0581. Published 2021 Dec 2. doi:10.1097/CCE.0000000000000581

Moore B, Nelson RH, Meredyth N, Pandya N. Consistently Inconsistent: Does Inconsistency Really Indicate Incapacity? [published online ahead of print, 2021 Oct 6]. HEC Forum. 2021;10.1007/s10730-021-09462-8.

Bibler TM, Suen A. Determination of Brain Death. JAMA. 2021.

Bryant BE, Adler AC, Mann DG, Malek J. "You can't make me!" Managing adolescent dissent to anesthesia. Paediatr Anaesth. 2021.

Moore B, Nelson RH, Ubel PA, Blumenthal-Barby J. Two Minds, One Patient: Clearing up Confusion About "Ambivalence". Am J Bioeth. 2021.

Horner C, Garvis D. Ethical Analysis and Beyond! How Christian Anthropology and the Concept of Dignity Can Also Address Moral Distress in End-of-Life Care. Am J Bioeth. 2020

Bibler, T. Between Crisis and Convention: How Should We Address Contingency? The Hastings Center Report; 2020.

Bibler T., Malek, J., Childress, A., Crist, J. “Do we have to replace the balloon pump when it fails?” Hastings Center Report; 2020.

Moore, B. Dying during Covid‐19. Hastings Center Report; 2020.

Moore, B., Hempton, C. and Kendal, E. Victoria’s Voluntary Assisted Dying Act: Navigating the Section 8 ‘gag clause’. The Medical Journal of Australia; 2020.

Nelson, R.,Francis, L. “Intellectual Disability and Justice in a Pandemic", Kennedy Institute of Ethics Journal, 2020.

Bibler, T. Choosing Between Practicing Good Medicine and Following the Law in Texas. American Journal of Respiratory and Critical Care Medicine, 2019.

Real de Asua, D.., Lee K., Koch P., de Melo-Martin, I.,Bibler, T. We don't need unilateral DNRs: Taking informed non-dissent one step further. Journal of Medical Ethics, 2019.

Bibler, T., Miller SM. What if she was your mother?: Toward better responses. Journal of Critical Care; 2019.

Bruce CR, Bibler T, Childress A, Fedson S. Legislating Medicine: The Need for Evidence, Argument, and Alliance. Critical Care Medicine; 2018.

Childress, A. M., and C. R. Thomas. Navigating the Perfect Storm: Ethical Guidance for Conducting Research Involving Participants with Multiple Vulnerabilities. Kennedy Institute Ethics; 2018.

Shinall M., Stahl D., Bibler, T. Addressing a Patient's Hope for a Miracle. Journal of Pain and Symptom Management; 2018.

Bibler, T., Galbraith KR., Brothers, KB. Ethics and Pediatric Brain Death: Recent Controversy and Practical Suggestions. Journal of Pediatric Intensive Care; 2017.

Malek J. Maternal Decision-making During Pregnancy: Parental Obligations and Cultural Differences. Best Practice and Research: Clinical Obstetrics Gynecology; 2017.

Koch, P, Lazaridis, C. What does it mean for a critically ill patient to fare well? Intensive Care Medicine; 2017.

Malek, J. 2016. Responding to Refusal of Recommended Cesarean Section: Promoting Good Parenting. Seminars in Perinatology; 2016.

Bruce CR, Bibler TM, Childress A, Stephens A, Pena A, Allen N. Navigating ethical conflicts between advance directives and surrogate decision makers' interpretations of patient wishes. CHEST. 2016.


Research Overview


Clinical ethics faculty are engaged in ground-breaking research in the areas of Clinical Ethics Research and Medical Decision Making and Ethics. The center’s research efforts involve active partnerships with various government and private institutions, including the National Institutes for Health, the Houston Methodist Hospital and the Houston Methodist Research Institute, and the Patient Centered Outcomes Research Institute.