Cynda Hylton Rushton, PhD, RN

Anne and George L. Bunting Professor of Clinical Ethics


1809 Ashland Avenue
Deering Hall
Baltimore, MD 21205
  • Anne and George L. Bunting Professor of Clinical Ethics
    Berman Institute of Bioethics
    Johns Hopkins School of Nursing
  • Professor
    Dept. of Pediatrics, Johns Hopkins School of Medicine

Dr. Cynda Hylton Rushton, an international leader in bioethics and nursing, is the Anne and George L. Bunting Professor of Clinical Ethics at the Johns Hopkins Berman Institute of Bioethics and the School of Nursing, and co-chairs the Johns Hopkins Hospital’s Ethics Committee and Consultation Service.

A founding member of the Berman Institute, she co-led the first National Nursing Ethics Summit that produced a Blueprint for 21st Century Nursing Ethics. In 2016, she co-led a national collaborative State of the Science Initiative: Transforming Moral Distress into Moral Resilience in Nursing and co-chaired the American Nurses Association professional issues panel that created A Call to Action: Exploring Moral Resilience Toward a Culture of Ethical Practice. She was a member of the National Academies of Medicine, Science and Engineering Committee that produced the report: Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-being. She was a member of the American Nurses Association Center for Ethics & Human Rights Ethics Advisory Board and American Nurses Foundation Well-Being Initiative Advisory Board.

Dr. Rushton is the chief synergy strategist for Maryland’s R3 Resilient Nurses Initiative, a statewide initiative to build resilience and ethical practice in nursing students and novice nurses.  She is co-creator of the Mindful Ethical Practice and Resilience Academy (MEPRA). She serves on the Nursing Advisory Board for Corporate Counseling Associates. Dr. Rushton is a Hastings Center Fellow, Past-Chair of the Hastings Center Fellows Council, and Trustee Emeritus and a Fellow of the American Academy of Nursing. The recipient of many awards, she received the Marguerite Rodgers Kinney Distinguished Career Award and the Distinguished Researcher award from American Association of Critical Care Nurses. She is the editor and author of Moral Resilience: Transforming Moral Suffering in Healthcare and co-creator of the Rushton Moral Resilience Scale (RMRS).

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Dr. Rushton’s seminal work on nurse suffering and moral distress was selected for inclusion in the U.S. Nursing Ethics History project chronicling the evolution of nursing ethics in the United States. As part of her RWJ Fellowship, she also tested an intervention to reduce moral distress and burnout by cultivating resilience in nurses working in critical care, oncology and neonatal/pediatrics.  Dr. Rushton is currently designing, implementing and evaluating the Mindful Ethical Practice and Resilience Academy (MEPRA) to build moral resilience in novice nurses.  Her forthcoming book, Moral Resilience: Transforming Moral Suffering in Health Care, to be published by Oxford University Press aims to transform current approaches for addressing moral distress by focusing on innovative methods to cultivate moral resilience and designing a culture in health care that supports ethical practice.

Dr. Rushton is also an internationally recognized expert in ethics and palliative and end-of-life care. In 2001, she received the American Association of Critical-Care Nurses Pioneering Spirit Award for her work in advancing palliative care across the life-span.  Dr. Rushton was appointed by Maryland’s governor as the first chair of the State Council on Quality Care at the End-of-Life and served from 2002-2008. She has provided leadership to a variety of national projects focusing on palliative and end-of-life care, including the National Nursing Academy on Palliative and End-of-Life Care Open Society Institute (PDIA), an innovative, experiential interdisciplinary communication training model (HRSA), the Initiative for Pediatric Palliative Care (IPPC) a research, education and quality improvement project, the End of Life Nursing Education Consortium (ELNEC) and the Upaya Institute’s Being With Dying Professional training program.  Dr. Rushton served as a member of the Institute of Medicine’s Committee on Increasing Organ Donation and as a consultant to the IOM’s project “When Children Die.” She also served on the board of directors of the Coalition to Transform Advanced Care (CTAC). She led (with Dr. Gail Geller) an international collaboration to improve the lives of children affected by life-threatening neuromuscular diseases and a related project, focusing on the ethical issues faced by neuromuscular clinicians.

In 2008 and 2014, Dr. Rushton was honored as one of Maryland’s Top 100 Women.  She is also an American Academy of Nursing’s Edge Runner and in 2014 received the Milestone Award for Bioethics Leadership from the Centre for Health Care Ethics at Lakehead University. Dr. Rushton is a Fellow of the Hastings Center and the American Academy of Nursing.

Dr. Rushton received her Master’s of Science in Nursing, with specialization as a pediatric clinical nurse specialist, from the Medical University of South Carolina. She completed her undergraduate degree in nursing at the University of Kentucky and received a doctorate in nursing at the Catholic University of America, with a concentration in bioethics. Dr. Rushton is the recipient of three post-doctoral fellowships: a Robert Wood Johnson Nurse Executive Fellowship (2006-2009), a Kornfeld Fellowship in end-of-life, ethics and palliative care (2000), and a Mind and Life Institute Fellowship in Contemplative Science (2013-2014).

Research Interests

  • Moral distress and suffering of clinicians
  • The development of moral resilience
  • Designing a culture of ethical practice
  • Conceptual foundations of integrity, respect, trust and compassion


  • PhD, Catholic University of America
  • MSN, Medical University of South Carolina
  • BSN, University of Kentucky

Recent Publications

  1. Rushton, C. Swoboda, S., Reimer, T, Boyce, D., Hansen, G. (2023) The Mindful Ethical Practice & Resilience Academy (MEPRA): Sustainability of Impact. American Journal of Critical Care. 32(3):184-194. doi: 10.4037/ajcc2023236. PMID: 37121900.
  2. Rushton, C. (2023) Do I still belong? American Nurse Journal. 18(3),48.
  3. ⌘Mubarak, E., Kaur, S., Hughes, M., Rushton, C., Ali, J. (2023) Emerging experiences with virtual ethics consultation: Case Studies from the United States and Malaysia. Journal of Clinical Ethics.34(1),51-57.
  4. Bergman, A.,Rushton, C. (2023) Overcoming stigma: Asking for and receiving mental health support. AACN Advanced Critical Care.
  5. *⌘Holtz, H. K., Weissinger, G. M., Swavely, D., Lynn, L., Yoder, A., Cotton, B., Adil, T., Alderfer, M., Romig, B., Neils, K., & Rushton, C. H. (2022). The Long Tail of COVID-19: Implications for the Future of Emergency Nursing. Journal of emergency nursing, S0099-1767(22)00282-3. Advance online publication.
  6. ⌘Klepper, M., Clark, K. D., Bosse, J. D., Kerbyson, M., Roy, E., & Rushton, C. H. (2022). State-level anti-transgender policies in conflict with core principles of nursing: An educator call to action. Nurse education today119, 105608.
  7. McGeehan, C., Rushton, C. (2022) Ethical Challenges and Implications of deactivating mechanical circulatory support for patients with Preserved Cognitive Function. AACN Advanced Critical Care, 33(3), pp. 289-296
  8. *⌘Veenema, TG., Meyer, D, Rushton,C., Bruns,, R. Watson,M.,  Schneider-Firestone,, S. Wiseman., R.  (2022)The COVID-19 Nursing Workforce Crisis: Implications for National Health Security Health Security, 20(3), .264-269.
  9. *⌘Rushton, C., Nelson, K. Antonsdottir, I., Hanson, G., Boyce, D. (2022) Perceived organizational effectiveness, moral injury, and moral resilience among nurses during the COVID-19 pandemic: Secondary analysis. Nursing Management, 53(7)12-22.
  10. *⌘ D. Weissinger, G., Holtz. H, Aldi, T. Alderfer, M.,Lynn, L., Rushton, C. (2022) The Impact of Traumatic Stress, Resilience, and Threats to Core Values on Nurses during a Pandemic. Journal of Nursing Administration. 52(10). 525-535. doi:10.1097/NNA.0000000000001194
  11. Rushton, C. Boston-Leary, K. (2022) Nurses suffering in silence: Addressing stigma of mental health in nursing and healthcare. Nursing Management. 53(8):7-11. doi:10.1097/01.NUMA.0000853148.17873.77
  12. * Nelson, K., Hansen, G., Boyce, D., Ley, C., Swavely, D., Reina, M., Rushton, C. (2022) Organizational Impact on Health Care Workers’ Moral Injury During COVID-19: A Mixed-Methods Analysis. Journal of Nursing Administration. 52(1).57-66
  13. Hughes, M. T., & Rushton, C. H. (2022). Ethics and Well-Being: The Health Professions and the COVID-19 Pandemic. Academic Medicine:Journal of the Association of American Medical Colleges97(3S), S98–S103.
  14. Schlak, A.E., Rosa. W.E., Rushton, C.H., Poghosyan, L., Root, M.C, McHugh, M.D. (2022). An expanded institutional and national-level blueprint to address nurse burnout and moral suffering. Nursing Management, 53(1), 1. doi: 10.1097/01.NUMA.0000816956.46367.71
  15. Rushton, C. (2022) Harnessing our anger in constructive ways. American Nurse Journal. P.55.
  16. Rushton CH, Wood LJ, Grimley K, Mansfield J, Jacobs B, Wolf JA. Rebuilding a foundation of trust (2021) A call to action in creating a safe environment for everyone. Patient Experience Journal. 8(3):5-12. doi: 10.35680/2372-0247.1651.
  17. Brenner, M.J., Boothman, R.C,.,Rushton, C.H. Bradford, C. R., Hickson, G.B. (2021) Honesty and Transparency, Indispensable to the Clinical Mission– Part I: How Tiered Professionalism Interventions Support Teamwork and Prevent Adverse Events. Otolaryngologic Clinics of North America. 55(1) 43-61.
  18. Brenner, M., Hickson, G.B. Boothman, R. C., Rushton, C.H. Bradford, C. R.(2021) Honest and Transparency, Indispensable to the Clinical Mission – Part II: How Communication-and-Resolution Programs Promote Patient Safety and Trust. Otolaryngologic Clinics of North America. 55(1), 63-82.
  19. Brenner, M., Hickson, G.B. Boothman, R.C., Rushton, C.H. Bradford, C. R.(2021). Honesty and Transparency, Indispensable to the Clinical Mission – Part III:How Leaders Can Prevent Burnout, Foster Wellness and Recovery, and Instill Resilience. Otolaryngologic Clinics of North America. 55(1), 83-103.
  20. * Spilg, E., Rushton, C. Phillips, J., Kendzerska, T., Saad, M.,Gifford, W., Gautam, M.,  Bhatla, R., Edwards, J.,Quilty, L., Leveille, C,  Robillar d , R. (2022)  The new frontline: Exploring the links between moral distress, moral resilience, and mental health in healthcare workers during the COVID-19 pandemic, BMC Psychiatry. 2022) 22(19), 1-12.
  21. *⌘Koirala, B., Davidson, P. M., & Rushton, C. H. (2022). Ethics in nursing: Progress on national nursing ethics summit. Nursing outlook70(1), 154–165.
  22. *⌘ Rushton, C. H., Thomas, T., Antonsdottir, I., Nelson, K, Boyce, D., Vioral, A., Swavley, D., Ley, C., Hanson, G. (2021) Moral Injury, Ethical Concerns and Moral Resilience in Health Care Workers during COVID-19 Pandemic, Journal of Palliative Medicine, 25(5), 712-719
  23. Nelson, K. E., & Rushton, C. H. (2021). Working While Ill During COVID-19: Ethics, Guilt, and Moral Community. AACN advanced critical care32(3), 356–361.
  24. ⌘Hughes, V., Cologer, S., Swoboda, S., & Rushton, C. (2021).  Strengthening Internal Resources to Promote Resilience Among Prelicensure Nursing Students. Journal of Professional Nursing. 37(4), 777-783.
  25. ⌘Ehmann, M. R., Zink, E. K., Levin, A. B., Suarez, J. I., Belcher, H., Daugherty Biddison, E. L., Doberman, D. J., D’Souza, K., Fine, D. M., Garibaldi, B. T., Gehrie, E. A., Golden, S. H., Gurses, A. P., Hill, P. M., Hughes, M. T., Kahn, J. P., Koch, C. G., Marx, J. J., Meisenberg, B. R., Natterman, J., … Kachalia, A. (2021). Operational Recommendations for Scarce Resource Allocation in a Public Health Crisis. Chest159(3), 1076–1083.
  26. Rushton C. H. (2021). Preserving Integrity and Staying Power as a Nurse in a Pandemic. The American Journal of Nursing121(3), 68–69.
  27. *⌘Thomas, T. A., Davis, F. D., Kumar, S., Thammasitboon, S., & Rushton, C. H. (2021). COVID-19 and Moral Distress: A Pediatric Critical Care Survey. American journal of critical care: e1–e19. Advance online publication.
  28. *⌘Antonsdottir, I., Rushton, C. H., Nelson, K. E., Heinze, K. E., Swoboda, S. M., & Hanson, G. C. (2021). Burnout and moral resilience in interdisciplinary healthcare professionals.Journal of Clinical Nursing. 00, 1-13.
  29. ⌘Rosa, W.E.,Buck, H.G., Squires, A.P., Kozachik, S.L., Abu-Saad Huijer, H., Bakitas, M., McGowan Boit, J., Bradley, P.K., Cacchione, P.Z., Chan, G., Crisp, N., Dahlin, C., Daoust, P., Davidson, P.M., Davis, S., Doumit, M.A.A., Fink, R.M., Herr, K.A., Hinds, P.S., Hughes, T.L., Karanja, V., Kenny, D.J., King, C.R., Klopper, H.C., Knebel, A.R., Kurth, A.E., Madigan, E.A., Malloy, P., Matzo, M., Mazanec, P., Meghani, S.H., Monroe, T.B., Moreland, P.J., Paice, J.A., Phillips, J.C., Rushton, C.H., Shamian, J., Shattell, M., Snethen, J., Ulrich, C.M., Wholihan, D., Wocial, L.D., & Ferrell, B.R. (in press). American Academy of Nursing Expert Panel consensus statement on nursing’s roles in ensuring universal palliative care access. Nursing Outlook.
  30. ⌘Rosa, W.E.,Buck, H.G., Squires, A.P., Kozachik, S.L., Abu-Saad Huijer, H., Bakitas, M., McGowan Boit, J., Bradley, P.K., Cacchione, P.Z., Chan, G., Crisp, N., Dahlin, C., Daoust, P., Davidson, P.M., Davis, S., Doumit, M.A.A., Fink, R.M., Herr, K.A., Hinds, P.S., Hughes, T.L., Karanja, V., Kenny, D.J., King, C.R., Klopper, H.C., Knebel, A.R., Kurth, A.E., Madigan, E.A., Malloy, P., Matzo, M., Mazanec, P., Meghani, S.H., Monroe, T.B., Moreland, P.J., Paice, J.A., Phillips, J.C., Rushton, C.H., Shamian, J., Shattell, M., Snethen, J., Ulrich, C.M., Wholihan, D., Wocial, L.D., & Ferrell, B.R. (in press). International consensus-based policy recommendations to advance universal palliative care access from the American Academy of Nursing Expert Panels. Nursing Outlook.
  31. Madara, J., S. Miyamoto, J. E. Farley, M. Gong, M. Gorham, H. Humphrey, M. Irons, A. Mehrotra, J. Resneck Jr., C. Rushton, and T. Shanafelt. (2021). Clinicians and Professional Societies COVID-19 Impact Assessment: Lessons Learned and Compelling Needs. NAM Perspectives.Discussion Paper, National Academy of Medicine, Washington, DC.
  32. * Miles, A., Rushton, C., Wise, B., Moore, A., Boss, R. (2021) Pediatric chronic critical illness, prolonged ICU admissions and clinician distress. Journal of Pediatric Intensive Care. 10.1055/s-0041-1724098.
  33. ⌘Braxton, J., Busse, E., Rushton, C. (2021) Mapping the terrain of moral suffering. Perspectives in Biology and Medicine, 64 (2), 235-245.
  34. *⌘Rushton, C. Swoboda, S., Reller, N. Skrupski, K., Prizzi, M., Young, P., Hanson, G. (2021) Mindful Ethical Practice and Resilience Academy: Equipping Nurses to Address Ethical Challenges, American Journal of Critical Care. 30(1), e1-e11.
  35. Rushton, C. Turner, K., Brock, R., Braxton, J. (2021) The invisible moral wounds of the pandemic: Are we experiencing moral injury? AACN Advanced Critical Care.35(1), 119-125.
  36. *⌘ Heinze, K. E., Hanson, G., Holtz, H., Swoboda, S. M., & Rushton, C. H. (2021). Measuring Health Care Interprofessionals’ Moral Resilience: Validation of the Rushton Moral Resilience Scale. Journal of palliative medicine24(6), 865–872.
  37. *⌘Robillard, R., Saad, M., Edwards, J., Solomonova, E., Pennestri, M. H., Daros, A., Veissière, S., Quilty, L., Dion, K., Nixon, A., Phillips, J., Bhatla, R., Spilg, E., Godbout, R., Yazji, B., Rushton, C., Gifford, W. A., Gautam, M., Boafo, A., Swartz, R., … Kendzerska, T. (2020). Social, financial and psychological stress during an emerging pandemic: observations from a population survey in the acute phase of COVID-19. BMJ open10(12), e043805.
  38. ⌘ Galiatsatos, P., Kachalia, A., Belcher, H., Hughes, M. T., Kahn, J., Rushton, C. H., Suarez, J. I., Biddison, L. D., & Golden, S. H. (2020). Health equity and distributive justice considerations in critical care resource allocation. The Lancet. Respiratory medicine8(8), 758–760.
  39. ⌘Pandian, V., Morris, L. L., Brodsky, M. B., Lynch, J., Walsh, B., Rushton, C., Phillips, J., Rahman, A., DeRose, T., Lambe, L., Lami, L., Man Wu, S. P., Garza, F. P., Maiani, S., Zavalis, A., Okusanya, K. A., Palmieri, P. A., McGrath, B. A., Pelosi, P., Sole, M. L., Davidson, P., & Brenner, M. J. (2020). Critical Care Guidance for Tracheostomy Care During the COVID-19 Pandemic: A Global, Multidisciplinary Approach. Am J Crit Care, e1-e12.
  40. Rushton, C., Reller, N., Swoboda, S. (2020) Applying E-PAUSE to Ethical Challenges in a Pandemic. AACN Advanced Critical Care.31(3) 334-339.
  41. *⌘ Feeg, V. D., Mancino, D. J., Rushton, C. H., Waligora Mendez, K. J., & Baierlein, J. (2021). Ethical Dilemmas for Nursing Students and Faculty: In Their Own Voices. Nursing education perspectives42(1), 29–35.
  42. ⌘Rushton, C. & Thompson, L. (2020) Moral outrage: Promise or peril. Nursing Outlook. 68(5), P536-538. DOI:
  43. ⌘Ulrich, C., Rushton, C., Grady, C. (2020) Nurses confronting the Coronavirus: Challenges met and lessons learned to date. Nursing Outlook. doi:
  44. Rushton, C. Doerries ,B, Greene J, Geller G.(2020)  In the tragedy of this pandemic, dramatic interventions can heal moral suffering. Lancet, S0140-6736(20)31641-X
  45. Gujral, H. Rushton, C., Rosa, W. (2020) Action Steps Toward a Culture of Moral Resilience in the Face of COVID-19. J Psychosoc Nurs Ment Health Serv. 58(7):2-4. PMID: 32602927, DOI: 3928/02793695-20200617-01
  46. ⌘Rosa, W.E, Schlak, A. E., Rushton, C. (2020) A blueprint for leadership during COVID-19: Minimizing burnout and moral distress among the nursing workforce, Nursing Management, ahead of print
  47. Pappas, S. & Rushton, C. (2020) Leading the Way to Professional Well-Being, American Nurse Journal, 15(2), 28-31.
  48. Rushton, C. & Pappas, S. (2020) System recommendations to address burnout and support clinician well-being: Implications for critical care nurses. AACN’s Advanced Critical Care.31(2), 141-145.
  49. Rushton, C. H. &Turner, K, (2020) Suspending our agenda when confronting ethical challenges. AACN’s Advanced Critical 31(1):98-105. doi: 10.4037/aacnacc2020569.
  50. Hughes, V., Delva, S., Nkimbeng, M., Spaulding, E., Turkson-Ocran, R. A., Cudjoe, J., Ford, A., Rushton, C., D’Aoust, R., & Han, H. R. (2020). Not missing the opportunity: Strategies to promote cultural humility among future nursing faculty. Journal of Professional Nursing, 36(1), 28–33.