Research Area: Clinical Ethics

Zackary Berger, MD, PhD

Dr. Berger is Associate Professor in the Johns Hopkins Division of General Internal Medicine and Core Faculty at the Johns Hopkins Berman Institute of Bioethics, with joint appointment in the Johns Hopkins Bloomberg School of Public Health. With an active practice in primary care internal medicine at Johns Hopkins, Dr. Berger focuses his clinical, educational, and research work, as well as his widely read publications for the lay public, on the ways in which shared decision making in the doctor-patient encounter might be in conflict with medical evidence and the political, social, and psychological realities of the patient.

Dr. Berger teaches residents in their internal medicine clinic and medical students on the wards at Johns Hopkins Hospital, and is part of a Berman faculty team which teaches bioethics to residents in a number of Johns Hopkins specialty programs. He is also staff physician at the Esperanza Clinic Health Center, a free clinic serving undocumented Spanish-speaking immigrants.

Dr. Berger is the author of two books for the lay public on doctor-patient communication and on patient preference in the context of medical evidence.

Yoram Unguru, MD, MS, MA

Full Bio

Dr. Unguru is a pediatric hematologist/oncologist with joint faculty appointments at The Herman and Walter Samuelson Children’s Hospital at Sinai and The John Hopkins Berman Institute of Bioethics, where he is a Core Faculty member. He is also Associate Professor in the School of Medicine, Johns Hopkins University. His B.A. in historical studies and M.A. with a concentration in the history of medicine and medical ethics were granted at the University of Maryland, Baltimore County. Dr. Unguru also received a Master of Science (valedictorian) in interdisciplinary studies in biological and physical science at Touro College / Barry Z. Levine School of Health Sciences. He earned his M.D. (valedictorian) at the Technion – Israel Institute of Technology / Bruce Rappaport Faculty of Medicine. He completed his pediatric residency at the Children’s Hospital at Sinai and his pediatric hematology/oncology fellowship at Children’s National Medical Center in Washington DC. Dr. Unguru was a postdoctoral Greenwall Fellow in Bioethics and Public Policy at Johns Hopkins University. Dr. Unguru is board certified both in pediatrics and in pediatric hematology/oncology.

Dr. Unguru’s research interests include clinical and research ethics. His scholarship and publications have focused on the role of children and providers in facilitating shared decision-making, end-of-life decision-making, allocation of scarce lifesaving medications, and ethics education. Dr. Unguru has served as a consultant to the American Academy of Pediatrics Committee on Pediatric Research, the American Medical Association Council on Ethical and Judicial Affairs, the Food Drug and Administration, and the US Senate Committee on Homeland Security and Governmental Affairs. He is on the Editorial Board of Pediatric Ethicscope and serves as a peer reviewer for leading academic medical journals. Dr. Unguru is Chair of the Children’s Oncology Group, Bioethics Steering Committee and past member of the American Society of Clinical Oncology, Ethics Committee.

Dr. Unguru is the Chairman of the Ethics Committee at Sinai Hospital of Baltimore where he implemented and directs a clinical ethics curriculum for the pediatric house staff at The Herman and Walter Samuelson Children’s Hospital at Sinai. He is past recipient of “Teacher of the Year” as chosen by the pediatric house staff at The Herman and Walter Samuelson Children’s Hospital.

Dr. Unguru leads a multidisciplinary, transnational working group examining the ethical and policy implications of chemotherapy shortages in childhood cancer and is a member of the Maryland health system consortium tasked with operationalizing scarce resource allocation processes for public health catastrophes, including the COVID-19 pandemic.

Select Media Appearances

New York Times, “Drug Shortages Forcing Hard Decisions on Rationing Treatments” (Jan. 29, 2016)
NPR’s Diane Rehm Show, “Shortages of Children’s Cancer Drugs and How to Allocate Them” (Feb. 1, 2016)
MSNBC, “Colorado governor signs nation’s first ‘Right to Try’ law” (May 18, 2014)

Ethics for Lunch Discusses Care of Transgender Patients

The panel, led by Paula Neir, Clinical Program Director of the John Hopkins Center for Transgender Health, discussed three cases involving transgender patients. The panel discussed the principle of respect for persons when it comes to transgender health care and explored issues of equity when aspects of routine care within the healthcare system can be viewed as harmful to patients in gender and sexual minorities.

Cynda Hylton Rushton, PhD, RN

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).

Joseph A. Carrese, MD, MPH, FACP

Joseph Carrese, MD, MPH, FACP is Professor of Medicine at the Johns Hopkins University School of Medicine, a member of the Division of General Internal Medicine at the Johns Hopkins Bayview Medical Center, and a core faculty member of the Johns Hopkins Berman Institute of Bioethics.

Dr. Carrese’s scholarship focuses on clinical ethics and professionalism, with a particular interest in medical education, examining ethical issues in the context of cultural diversity and clinical ethics consultation. Dr. Carrese’s peer-reviewed articles have been published in leading medical and bioethics journals, such as JAMA, BMJ, CHEST, Academic Medicine, the Hastings Center Report, the Journal of General Internal Medicine, the Journal of Clinical Ethics, the American Journal of Bioethics and Medical Education. Dr. Carrese has been a visiting professor at several academic medical institutions and he has been invited to speak at many national and international meetings.

Dr. Carrese was on the Board of Directors for the American Society for Bioethics and Humanities from 2012-15. In 2012 Dr. Carrese was a founding Board member and Chair-elect of the Academy for Professionalism in Healthcare (APHC). From 2013-2015 he was Chair of the Board of Directors of APHC and he was the immediate past-Chair 2016-18.

Dr. Carrese received a National Award for Scholarship in Medical Education at the Society of General Internal Medicine annual meeting in April 2008 for his body of work in the area of clinical ethics education. From 2009-2014 Dr. Carrese was a member of the ASBH standing committee on Clinical Ethics Consultation Affairs (CECA) and in October 2011 he received the ASBH Presidential Citation Award for his work on this committee. Dr. Carrese is a Fellow of the Hastings Center.

Dr. Carrese is Chair of the Ethics Committee at the Johns Hopkins Bayview Medical Center, Chair of an Institutional Review Board at the Johns Hopkins School of Medicine, and primary care doctor to a panel of patients seen at the Bayview Medical Offices internal medicine clinic on the Johns Hopkins Bayview Medical Center campus.

Dr. Carrese graduated from Williams College and the University at Buffalo School of Medicine. He completed a fellowship in the Robert Wood Johnson Clinical Scholars Program at the University of Washington in Seattle, where he studied medical ethics and anthropology. Dr. Carrese joined the faculty at Johns Hopkins in 1994.

Gail Geller, ScD, MHS

In addition to her work in genetics, Dr. Geller’s other substantive areas of scholarship include the use of complementary and alternative medicine (CAM), the role of palliative care in chronic diseases, and the medical socialization process. She received one of the highly coveted NIH “challenge” grants to explore the integration of palliative care in the management of children, young adults and families affected by chronic, life-threatening disorders (muscular dystrophy and sickle cell disease). She received a prestigious Kornfeld Fellowship to explore the intersection of bioethics and CAM. She has served as co-director of the educational component of the Johns Hopkins CAM Center, ethics representative on the Data Safety & Monitoring Board of the National Center for Complementary & Alternative Medicine (NCCAM), and adjunct faculty at the Tai Sophia Institute in their Master’s Program in Transformative Leadership and Social Change. For 15 years, she co-directed the required Integrative Medicine course for Hopkins medical students, and the Healer’s Art elective. Several of the grants onwhich she has served as PI, Co-PI or Co-I have focused oncultivating respect, trust, empathy, wonder, and tolerance forambiguity among current and future health professionals. The unifying themes that animate her work are communication and decision-making under conditions of uncertainty, and the intrapersonal, interpersonal and social/cultural forces that influence moral development, attitudes and behavior.

Dr. Geller also has longstanding interests in ethics education. She served as Co-Deputy Director of the Greenwall Fellowship Program in Bioethics & Health Policy until 2012, and now, as the Berman Institute’s Director of Education Initiatives, she oversees the Hecht-Levi Fellowship Program in Bioethicsand the Masters in Bioethics . Dr. Geller has occupied several educational leadership positions in the SOM. She was involved in the revision to the undergraduate medical curriculum that took place in 2009. Currently, she co-directs the “culture of medicine” core theme which includes horizontal strands of particular relevance to ethics, professionalism and social justice. In addition, she directs the Scholarly Concentrationcalled the HEART (Humanism, Ethics, and the ‘Art’ ofMedicine), teaches in the “Medical Humanities & Social Medicine” elective, serves on the Advisory Board for the Center for Medical Humanities & Social Medicine, and directs the Program in Arts, Humanities & Health. She is a member of the School of Medicine’s Admissions Committee.

Dr. Geller has served on the Board of Directors of the American Society for Bioethics & Humanities, the scientific review panel for the ELSI Program (Ethical, Legal and Social Issues) at NIH’s National Human Genome Research Institute, the Advisory Board of the Center for Genetics Research Ethics and Law (CGREAL) at Case Western Reserve University, and the IOM Committee on the Review of Omics-Based Tests for Predicting Patient Outcomes in Clinical Trials. She was a Consultant to the Ethics Working Group of the National Children’s Study, the Informed Consent Working Group of the Secretary’s Advisory Committee on Genetic Testing (SACGT), the CDC’s Program in Public Health Genetics, and the Presidential Advisory Committee on Human Radiation Experiments. She is a Fellow of the Hastings Center.

Travis N. Rieder, PhD

Travis’ work tends to fall into one of two, quite distinct research programs. The first concerns ethics and policy questions about sustainability and planetary limits. Much of this research has been on issues in climate change ethics and procreative ethics with a particular focus on the intersection of the two – that is, on the question of responsible procreation in the era of climate change. His publications have appeared in several journals on this topic, as well as in a short book with Springer, entitled Toward a Small Family Ethic (2016). He also works on food ethics related to climate change and sustainability, and is currently a member of the Global Food Ethics and Policy team, focusing on ethical issues concerning high-emissions food, in particular animal-sourced foods.

The second, and much newer, research program concerns ethical and policy issues surrounding America’s opioid epidemic. In this area, Travis has published an essay in Health Affairs concerning physician responsibility for safely weaning patients off prescription opioids, and co-authored a National Academy of Medicine Perspective Paper on Physician Responsibility in combating the opioid crisis.

In addition to his more scholarly writing, Travis is firmly committed to doing bioethics with the public, and to that end writes and interviews regularly for the popular media; his work has appeared in very many high-impact publications, including The Guardian, Washington Post, NPR’s All Things Considered, New Republic, and IFLScience. He writes regularly for The Conversationand blogs occasionally at The Huffington Post and the Berman Institute Bioethics Bulletin.