Current Research Projects
Morality and Nurses' Communicative Work Regarding Four Trajectories of Dying in Intensive Care Units - funded by the Minnesota Nurses' Association Foundation
The overall purpose of the study is to identify and describe the moral communicative work done by nurses around end-of-life care in ICU as
understood through a feminist view of morality. Specifically, the aims of
the study are to: 1) identify and describe the implicit processes nurses use
to facilitate and negotiate consensus on the withdrawal of treatment and/or
shift to comfort care in the ICU. This aim will focus on four trajectories
of dying: within 72 hours of admission, a trajectory of underlying chronic
illness, when patients have been in the ICU and intubated for two weeks
without signs of improvement, and a trajectory of organ failure with no
improvement; and 2) describe the morality of nursing practice in the above
situation through Margaret Urban Walker's (1998) feminist view of morality.
The relevance and implications of this research will make explicit the
communication practices between nurses, physicians, patients, and families
to build consensus regarding withdrawal of life support and or a shift to
comfort care. The proposed study will also contribute to the discipline of
nursing by demonstrating key aspects of nursing practice at the end-of-life
that fall into a framework of feminist ethics. The principal investigator is Joan Liaschenko, PhD, RN, FAAN, Center for Bioethics and School of Nursing, University of Minnesota; and co-investigator is Cynthia Peden-McAlpine, PhD, RN, School of Nursing, University of Minnesota.
Transforming Caring into Bytes: How the Electronic Health Record Impacts Patient Care - funded by the Minnesota Nurses' Association Foundation
The patient record has evolved greatly in the past century. From its initial purpose of being a record of the individual patient’s health condition it has evolved into a tool used for institutional risk management, policy making, a source of data for research, and reimbursement and quality control purposes. Although the data entered into the electronic health record (EHR) are being used for multiple purposes, little is known about how the work of everyday nursing practice and patient care has been impacted by the use of EHRs. This study examines the influence of the EHR on nurses and their delivery of care in the acute mental health setting and, in particular, the patient-nurse relationship. The specific aims of the study are to: 1) identify the ways in which nursing work (actions and observations) are translated into the EHR; 2) identify how nursing work is represented in the EHR, that is what does nursing work look like as represented in the EHR; 3) identify the ways in which the EHR impacts care, specifically, the patient-nurse relationship; and 4) identify any moral concerns that arise in the use of the EHR. The principal investigator is Hans-Peter de Ruiter, PhD, RN, School of Nursing, Minnesota State University, Mankato; and co-investiagor is Joan Liaschenko, PhD, RN, FAAN; Center for Bioethics and School of Nursing, University of Minnesota
Past Research Projects
Development of an Ethical Framework for Influenza Pandemic
The Minnesota Department of Health (MDH) is preparing to address some critical ethical issues that are likely to arise during a severe influenza pandemic. MDH has contracted with the Minnesota Center for Health Care Ethics (MCHCE) and the University of Minnesota Center for Bioethics to produce a set of ethical procedures for allocating medications, vaccines, protective equipment, and other health care and medical items that may be in short supply in a pandemic. Jeffrey Kahn, PhD, MPH, and Debra DeBruin, PhD, will lead the Center for Bioethics’ work on this project. Other Center faculty participants include Joan Liaschenko, RN, PhD, FAAN; Mary Faith Marshall, PhD, FCCM; Steven Miles, MD; Carol Tauer, PhD; and Susan Wolf, JD.
Ethics and Pharmaceutical Marketing
Principal Investigator Carl Elliott, MD, PhD, was awarded grants from the National Institutes of Health (NIH), National Library of Medicine (NLM) Grant for Scholarly Workings in Biomedicine and Health; and from the University of Minnesota Graduate School for research on ethics and pharmaceutical marketing.
EthicShare
The University of Minnesota Center for Bioethics, in collaboration with the University of Minnesota Libraries, received funding from the Council on Library and Information Resources through a grant from The Andrew W. Mellon Foundation, to plan for a new program called EthicShare. Jeffrey Kahn, PhD, MPH, is principal investigator.
Homelessness & End of Life
While focusing much energy on providing good end-of-life (EOL) care, the American health care system has ignored a specific population made up of those who die without loved ones by their sides, regular medical care, or safe and stable housing. Therefore, we know little about the concerns of those less fortunate. With funding by the National Institutes of Health (NIH), John Song, MD, MPH, MAT; Edward Ratner, MD; and Dianne Bartels PhD, RN, MA, have conducted research showing that people who are homeless have unique concerns regarding care as they near the end of their lives. This team of investigators is developing approaches to implement and evaluate interventions to address these concerns.
Looking Into Practices of Gene Therapy Research
There is heightened optimism and attention on the safety and scientific merit of gene therapy studies. Rather than sensationalizing individual cases, institutions, or principal investigators for violating integrity when clinical practices go awry, it should be possible to discover how to prevent unintended mishaps. The researchers, principal investigator, Gwenievere Anderson, PhD, School of Nursing, San Diego State University and Debra DeBruin, PhD, co-investigator were funded by the National Institutes if Health (NIH), National, Heart, Lung and Blood Institute (NHLBI) to elucidate in great detail the real-world, taken-for-granted, day-to-day operations and decisions that bear on gene therapy clinical trials and regulatory paper work.
more information forthcoming.
Managing Incidental Findings in Human Subjects Research: From Imaging to Genomics
Principal investigator Susan M. Wolf, JD, University of Minnesota's Consortium on Law and Values in Health, Environment & the Life Sciences, in collaboration with co-investigators Jeffrey Kahn, PhD, MPH, Center for Bioethics; Frances Lawrenz, Department of Educational Psychology; and Charles Nelson, Children's Hospital, Harvard University and a working group of prominent national scholars, were awarded a grant from the National Institutes of Health (NIH)/National Human Genome Research Institute (NHGRI) to examine how researchers should handle incidental findings identified during research.
Understanding Barriers to Living Donor Lung Transplantation
Maryam Valapour, MD, has received a $750,000 grant from the National Institutes of Health (NIH) to study living-donor lung transplantation. Valapour, Assistant Professor of Medicine in the Pulmonary and Critical Care division and faculty member of the University’s Center for Bioethics, will analyze the ethical and policy issues surrounding living donor lung transplants.
This conference, held in June 2002, was a national gathering of scholars, community members, and religious leaders in a dialogue on the importance and implications of using technologies and genealogical methods to reconstruct an African identity.
Genetics and Disability Insurance: Ethics, Law & Policy
The Center was awarded a grant from the National Human Genome Research Institute (NIH) in 2000 for a project entitled "Genetic Testing and the Future of Disability Insurance: Ethics, Law & Policy," with Jeffrey Kahn acting as principal investigator and Susan M. Wolf as co-investigator.
The Genetics and Identity Project explores the ways in which research on genetic variation may affect concepts of ethnic, racial and familial identity. It examines how individuals and groups will respond to potential challenges to, or validations of, their inclusion in a continuum of social, cultural and political ties.
Debra DeBruin, PhD, project director, and Jeffrey Kahn, PhD, MPH, were part of a working group of researchers from across the country to investigate effective strategies for teaching the responsible conduct of clinical research. This collaborative project with the American Society of Bioethics and Humanities was funded by the U.S. Office of Research Integrity of the Department of Health and Human Services and the Association of American Medical Colleges.
