Alexandra F. M. Cist

Alexandra F. M. Cist, MD

Pulmonary & Critical Care Medicine, Massachusetts General Hospital (MGH)
Faculty, Harvard Medical School and the Center for Bioethics

Alexandra F. M. Cist, MD, is an active member of several Ethics committees and performs clinical ethics services at MGH. She completed fellowships in Pulmonary and Critical Care Medicine and in Clinical Ethics at Harvard Medical School, and has combined these interests in her clinical work at MGH since 1992.  She focuses on clinical ethics—especially in end-of-life care and in intensive care units; and she trains new members of Ethics committees in ethics consultation at MGH and other Partners hospitals.  She advocates for holding multidisciplinary Ethics Rounds in many venues around the hospital as a means of “keeping moral spaces open."  Her particular interest in manifestations of religion and spirituality among patients, families and staff informs her bio-psycho-social-spiritual support approach to ethics consultation and conflict resolution.  She is a consultant to the MGH Emergency Preparedness group and to the Disaster Relief Ethics and Management team (DREAM team). She teaches in the ethics curriculum at Harvard Medical School; and she serves on the MGH Optimum Care Committee, the MGH Ethics in Clinical Practice Committee, the Partners Ethics Leaders Group, the Harvard Ethics Leaders Group, and the Harvard Task Force on Ethical Issues in Emergency Preparedness. She particularly enjoys going for walks in the woods with her dog and anyone interested in having a long conversation about matters of consequence.

Publications View
Structure, Operation, and Experience of Clinical Ethics Consultation 2007-2013: A Report from the Massachusetts General Hospital Optimum Care Committee.
Authors: Authors: Robinson EM, Cage W, Erler K, Brackett S, Bandini J, Cist A, Cremens MC, Krakauer EL, Courtwright A.
J Clin Ethics
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The changing composition of a hospital ethics committee: a tertiary care center's experience.
Authors: Authors: Courtwright A, Brackett S, Cist A, Cremens MC, Krakauer EL, Robinson EM.
HEC Forum
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Merging cultures: palliative care specialists in the medical intensive care unit.
Authors: Authors: Billings JA, Keeley A, Bauman J, Cist A, Coakley E, Dahlin C, Montgomery P, Thompson BT, Wise M.
Crit Care Med
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Recommendations for end-of-life care in the intensive care unit: The Ethics Committee of the Society of Critical Care Medicine.
Authors: Authors: Truog RD, Cist AF, Brackett SE, Burns JP, Curley MA, Danis M, DeVita MA, Rosenbaum SH, Rothenberg DM, Sprung CL, Webb SA, Wlody GS, Hurford WE.
Crit Care Med
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Practical guidelines on the withdrawal of life-sustaining therapies.
Authors: Authors: Cist AF, Truog RD, Brackett SE, Hurford WE.
Int Anesthesiol Clin
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"Ethics Rounds in the Medical Intensive Care Unit."
Authors: Authors: Flather-Morgan AW, Quealy A, Thompson BT
American Journal of Respiratory and Critical Care Medicine
"Quality of Life in Survivors of ARDS."
Authors: Authors: Flather-Morgan AW, Stern TA, Thompson BT
American Journal of Respiratory and Critical Care Medicine
"The Renaissance of Medical Ethics: The Emergence of the Bioethics Movement in the late l960's."
Authors: Authors: Flather-Morgan AW, Levine RJ
The Yale Journal of Biology and Medicine
Advance Directives Policy, Clinical Policy, Massachusetts General Hospital
Authors: Authors: MGH Ethics in Clinical Practice Committee,Clinical Policy and Records Committee, Medical Policy Committee

MGH Clinical Policies and Procedures
"Treatment Decisions at the End of Life"
Authors: Authors: Kim S, Flather-Morgan A

The MGH Guide to Psychiatry in Primary Care