Decision-making in pediatrics
We have developed an ethical framework for critical decision-making in neonatology and pediatrics (I-P-O, impermissible-permissible-obligatory) to help evaluate proposed treatments in pediatrics, assist with decision-making. This framework provides a structure for ethical conversation and decision-making related to a specific patient, as well as in the formation of institutional and national guidelines.
Decision-making at extreme prematurity
Using mixed methodology, multiple projects aim to understand parental preferences on optimal counseling at extreme prematurity, which inform the development and assessment of educational curricula for counseling clinicians.
Advice to Clinicians From Expectant Parents at Extreme Prematurity: A Multimethod Study
Advance care planning (ACP) in neonatology
Through systematic review, we have demonstrated a need for formalizing a role for ACP in the NICU by defining ACP and appraising recent outcomes research, reviewing the current state of parental needs for decisional support and serious illness in the NICU, and describing how ACP may address current limitations in primary and specialty pediatric palliative care and challenges for decision-making in the newborn period. Other projects have evaluated the impact of advance care planning (ACP) on parent-reported end-of-life (EOL) outcomes in the neonatal intensive care unit (NICU), and the research experiences of bereaved parents.
Ethics of maternal-fetal interventions
Recently, our lab has conducted a review of ethical considerations for maternal-fetal interventions, from innovation and research to oversight. Ongoing work involves the development, onboarding, and assessment of a fetal therapy board to oversee maternal-fetal intervention innovation and research.
Innovation, research, and accepted practice
Our lab has contemplated the challenging yet exciting transition of emerging technologies and treatments, and developed frameworks to evaluate.
Lowering the age of vaccine consent for adolescents
This work argued that federal health law should be reformed to allow minors with capacity to consent to their own CDC-approved vaccinations, which aligns with and expands upon current exceptions to limitations on adolescent decision-making.
AI to augment qualitative analyses
Artificial intelligence (AI), particularly ChatGPT, may be helpful in augmenting qualitative analyses, however studies of feasibility are limited, particularly in retaining critical human elements. By comparing codes and themes generated by traditional thematic analysis versus ChatGPT, this study aims to investigate whether ChatGPT is able to address the nuanced aspects of qualitative research, including the interpretation of human sentiment, values, and tone underlying parents' perspectives and other ethical challenges.
Simulation using parent-actors to train faculty and trainees
Our lab has extensive experience using simulation resources and collaborating with professional actors from Boston Children’s Hospital Immersive Design Systems (IDS), previously known as SimPeds, to develop and assess educational curricula for learners, both in-person as well as online through our partnership with OPENPediatricsTM.
Assessment tools to evaluate ethics & professionalism knowledge and performance
Multiple projects have focused on developing and validating assessment tools to assess learner knowledge of neonatal ethics and professionalism (TEK-Neo, a test of ethics knowledge) as well as performance in simulated or real clinical settings in pediatrics (Pedi-EPAT, a competency-based formative assessment tool).
Research ethics, informed consent
Our lab is interested in research ethics and informed consent in pediatrics and neonatology, specifically parental understanding and perspectives surrounding research in pediatrics and neonatology, ranging from innovation to clinical trials, and ways to optimize the informed consent and decision-making process.
Virtue ethics
This multi-center qualitative research study seeks to learn from parents of infants in the NICU their perspectives on what makes a good neonatologist, and what virtues and attributes they prioritize in clinicians caring for their child.