Ethics is a general core competency in undergraduate medical education (UME) and represents an ac... more Ethics is a general core competency in undergraduate medical education (UME) and represents an accepted and established component of the contemporary medical curriculum as required by the Liaison Committee on Medical Education (LCME). Similarly, ethics is a key element in many professional degrees of public health, including the Master and Doctor of Public Health programs, as mandated by the Council on Education for Public Health (CEPH). The recent rise of dual-degree programs integrating Doctor of Medicine or Doctor of Osteopathic Medicine training with Master's in Public Health, coupled with the lack of formal educational guidelines for integrating ethics into such programs, represents a new challenge to educators. In 2011, the University of Miami Miller School of Medicine (UMMSM) launched the nation's largest MD/MPH dual-degree cohort. This initiative serves as a case study of ethics playing a supporting role in such dual-degree programs. Although preliminary assessments are encouraging, additional evaluation is necessary to determine the effectiveness of integrating ethics training in dualdegree programs.
Our health care system spends a significant amount of resources on futile care, ie, continued med... more Our health care system spends a significant amount of resources on futile care, ie, continued medical therapy when there is no reasonable hope of cure or benefit. Nowhere is this more evident than in the neuroscience intensive care unit (NSICU), because intensive care medicine has become exceedingly proficient at maintaining cardiopulmonary function even in the face of catastrophic brain injury. We identified patients who were admitted to the NSICU with partial loss of brainstem reflexes even after initial stabilization. Sixty-six patients were included and were followed prospectively. At the end of our follow-up period, 47 patients had died. Five patients intermittently followed simple commands but were bedridden, incontinent, and dependent on a tracheostomy. Fourteen were comatose, vegetative, or locked in. In 46 of 66 patients a do not resuscitate (DNR) conversation was documented after an average stay of 5.6 days. In 35 of those cases (76%) proxies agreed to DNR. Average ICU sta...
Journal of Empirical Research on Human Research Ethics: An International Journal, 2013
we used bibliometric analysis to evaluate the citations associated with publications by trainees ... more we used bibliometric analysis to evaluate the citations associated with publications by trainees in the Fogarty International Center's Inter national Research Ethics Education and Curriculum Development program. Papers published between 2004 and 2008 were identified for analysis. The outcome mea sures were total citations, hindex, and i10. A total of 328 manuscripts were identified, with a yearly average of 66 publications and 363 citations. The median number of citations per paper is 3 (IQR Q1-Q3:6). 12.6% (n = 53) of papers were cited over 10 times and the hindex is 22, indicating that 22 papers had been cited at least 22 times. The data indicate that trainees have been productive and contributed to the scholarly literature. Future studies to benchmark this performance with other bioethics edu cation programs are required to make interpretation of citation analysis more meaningful.
Ethics is a general core competency in undergraduate medical education (UME) and represents an ac... more Ethics is a general core competency in undergraduate medical education (UME) and represents an accepted and established component of the contemporary medical curriculum as required by the Liaison Committee on Medical Education (LCME). Similarly, ethics is a key element in many professional degrees of public health, including the Master and Doctor of Public Health programs, as mandated by the Council on Education for Public Health (CEPH). The recent rise of dual-degree programs integrating Doctor of Medicine or Doctor of Osteopathic Medicine training with Master's in Public Health, coupled with the lack of formal educational guidelines for integrating ethics into such programs, represents a new challenge to educators. In 2011, the University of Miami Miller School of Medicine (UMMSM) launched the nation's largest MD/MPH dual-degree cohort. This initiative serves as a case study of ethics playing a supporting role in such dual-degree programs. Although preliminary assessments are encouraging, additional evaluation is necessary to determine the effectiveness of integrating ethics training in dualdegree programs.
Our health care system spends a significant amount of resources on futile care, ie, continued med... more Our health care system spends a significant amount of resources on futile care, ie, continued medical therapy when there is no reasonable hope of cure or benefit. Nowhere is this more evident than in the neuroscience intensive care unit (NSICU), because intensive care medicine has become exceedingly proficient at maintaining cardiopulmonary function even in the face of catastrophic brain injury. We identified patients who were admitted to the NSICU with partial loss of brainstem reflexes even after initial stabilization. Sixty-six patients were included and were followed prospectively. At the end of our follow-up period, 47 patients had died. Five patients intermittently followed simple commands but were bedridden, incontinent, and dependent on a tracheostomy. Fourteen were comatose, vegetative, or locked in. In 46 of 66 patients a do not resuscitate (DNR) conversation was documented after an average stay of 5.6 days. In 35 of those cases (76%) proxies agreed to DNR. Average ICU sta...
Journal of Empirical Research on Human Research Ethics: An International Journal, 2013
we used bibliometric analysis to evaluate the citations associated with publications by trainees ... more we used bibliometric analysis to evaluate the citations associated with publications by trainees in the Fogarty International Center's Inter national Research Ethics Education and Curriculum Development program. Papers published between 2004 and 2008 were identified for analysis. The outcome mea sures were total citations, hindex, and i10. A total of 328 manuscripts were identified, with a yearly average of 66 publications and 363 citations. The median number of citations per paper is 3 (IQR Q1-Q3:6). 12.6% (n = 53) of papers were cited over 10 times and the hindex is 22, indicating that 22 papers had been cited at least 22 times. The data indicate that trainees have been productive and contributed to the scholarly literature. Future studies to benchmark this performance with other bioethics edu cation programs are required to make interpretation of citation analysis more meaningful.
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Papers by Ken Goodman