I spent years in the sociology of homelessness — studying what happens when social systems fail people and health systems manage the consequences. I wonder how much that shapes how I read clinical ethics questions, and whether I inappropriately divest the two lenses at the bedside. #bioethics

ICCEC 2026 — Cleveland, June 10-13. The 20th annual international conference on clinical ethics and consultation. Theme: 'Building Bridges for Purposeful Global Healing.' Worth marking on the calendar. buff.ly/sMpw0WW #bioethics

STAT surveys disability advocates on 2026 concerns: life-sustaining treatment, access to care, and the political environment for disability rights. Worth reading alongside conversations about futility. buff.ly/gQD8xdx #bioethics

With high regularity, studies shows DMC assessments in practice are too quick, too shallow, or biased by clinician assumptions. We've known this for 30 years, but the problem remains that a genuine capacity evaluation takes time and repetition that clinical workflows don't provide. #bioethics

Without being facetious: the clearest explanation I've seen of what private equity does to hospitals. Acquisition timelines, debt-loading, exit dynamics — real consequences for communities with no alternatives. (Foul language, nsfw, etc)

New in AJOB Empirical Bioethics: U.S. hospitals advertise ethics consultation but rarely explain how to request it, who provides it, or what it costs. More than a phone number on a website is needed. buff.ly/fhAfDY7 #bioethics

NEJM perspectives on vaccine communication in a contentious climate — where U.S. policy changes have unsettled what pediatricians can say and how. Worth reading for anyone trying to hold together clinical integrity and patient trust. buff.ly/LgpKEtq #meded

JAMA Network Open on redefining professionalism in medicine. Good piece overall, but I'm skeptical about the common presumption that burnout is about long hours — I think the biggest driver is physicians being alienated from the humanistic aspects of their work. buff.ly/OGWOItw #meded

Large survey of Chinese medical students: medical humanities engagement correlates with lower burnout — even controlling for other factors. Worth reading as accreditation requirements for this content are being dropped under the auspices of purging DEI. buff.ly/R20rMpo #meded

Oni Blackstock in STAT: AI adoption deepens the health care trust deficit. Trust in physicians: 72% (2020) to 40% (2024). Other work casts doubt on how much transparency matters to folks. Will be interesting to see the research accumulate on this. buff.ly/HLm1Ut1 #bioethics

NEJM essay: a pediatrician's tension between her clinical judgment and current CDC guidance — what she owes her patient vs. what she owes the broader public health enterprise. We're working on some related stuff related to conscientious objection in peds. buff.ly/IIOQHOo #bioethics

The lecture-is-bad-pedagogy discourse has gotten out of hand. Every time I hear it, my first instinct is that the person saying it just isn't very good at lecturing. The real issue has never been the modality. It's the execution. #meded

LCME dropped its structural competency requirement. Whether U.S. medical schools continue to teach how social determinants end up in the exam room without the mandate remains to be seen. buff.ly/KgJUPDh #meded

NEJM editorial: AI could accelerate competency-based, individualized trainee development and address variability in reaching safe practice. We considered this in a recent piece, but the rate of change is going to demand more frequent revisions to these competencies buff.ly/juL3Ef0

Scoping review of 40 dementia ACP studies: effective planning is relational and evolving — not a one-time document. Emphasis on ongoing engagement maps to a disconnect I've documented with colleagues. buff.ly/QS0XUIB

The AMA Journal of Ethics on PE's profit timeline (20% ROI in 3-7 years) vs. patient welfare in rural markets where alternatives are scarce. buff.ly/BMzK6o0 #bioethics

On the ethics of involuntary commitment for the unhoused — what it costs those failed by structural policy. Jeff Clair and I have written on this.

Eight states expanding conscience protections well beyond abortion. Colleagues and I argue in a forthcoming AJOB piece that secular hospitals can make institutional conscience claims. kffhealthnews.org/news/article... #bioethics

SCOTUS classifies talk-therapy as First Amendment speech, not regulable professional conduct. Experts warn the logic extends to physician counseling on vaccines, abortion, and COVID. buff.ly/HpLc1nm #bioethics

#Bioethics Seminar: Douglas J. Opel, MD, MPH, "What Are We Talking About When We Talk About Shared Decision-Making?" - Monday, April 13, Noon ET - Open to all, lunch provided, attend in person - Feinstone Hall. Link for more info: @johnshopkinssph.bsky.social mailchi.mp/jhu/bioethic...

Jason Karlawish in STAT: as Alzheimer's treatments reach patients earlier in the disease course, who should be in the room for care conversations, and when? buff.ly/D405Wp0 #bioethics

4th Annual Paul M. Schyve Bioethics Conference at URMC — May 1-2. Focus: AI and health care. Human-AI relationships, algorithmic bias, workforce displacement, neuroethics on the agenda. buff.ly/f4UrkP7 #bioethics

I sometimes felt conflicted consulting as an ethicist for discharge-focused committee in the hospital — obviously finance-centric. A mentor reframed it: throughput is an ethics issue. When patients can't move through the system in ways that get them to the right service and best care, they suffer.

This piece argues advance directives for dementia should override current expressed preferences. We have argued preferences formed now — even under diminished capacity — still carry genuine moral weight. doi.org/10.1002/hast... #bioethics

"Futility" can convert a value judgment into a clinical finding. "Conscientious objection" names the moral basis honestly. The second conversation is harder. It's also the honest one.

Nice piece by Danielle Chammas writes in NEJM about going from a patient's planned death to a PTA meeting, carrying something she couldn't put down. "Where Do I Put This?' On the cost of genuine presence in end-of-life care."

Commentary in AJOB defending principlism against its critics, using Percival as backdrop. Being dismissive of durable frameworks is usually flawed. Basic sociological principle: things endure because they have utility. #bioethics

New special section in Bioethics on medical ethics and assisted dying. One piece makes a beneficence-based case for ethics consultation in MAiD settings — autonomy alone doesn't tell the whole story. #bioethics

Why I got into bioethics: wandered into speech & debate freshman year of high school, early 90s. First topic: 'Resolved: Terminally ill patients have the right to die when and how they choose.' In one way or another, just never really left.

18-year review of ethics consultation cases at a pediatric hospital — what gets referred, how that's shifted, where the ethical stress points are. The kind of longitudinal empirical work the field needs more of. #bioethics