Organizational Ethics Consortia

Hospitals, ACOs, health plans, professional societies, and other health-related organizations are increasingly dealing with the ethical dimensions of policies, procedures, resource allocation decisions, social movements and more. The Organizational Ethics Consortia Series provides a forum for local, national, and international discussion of organizational-level ethical issues and processes to address them, with the aim of cultivating a learning community of practitioners and scholars in this evolving field. 

The consortium invites the participation of bioethicists, health practitioners, managers, and leaders in health-related organizations, as well as faculty, fellows, and students of medicine, nursing, bioethics, public health, management and other relevant disciplines.

The consortium also invites Harvard-affiliated faculty, staff, and students to periodic translational discussions focused on adapting ideas and methods presented in the series for their institutions and projects.

Subscribe to the Organizational Ethics Consortia newsletter to get the latest consortia news and event information.

Past Events

  • Science, Technology, and Trust: New Ideas for Industry

    April 22, 2022

    Innovations in health tech and biotech have the potential to create significant health benefits for diverse populations. However, the erosion of trust in science and skepticism of industry motives may hinder patient and consumer participation in beneficial health innovations. Vaccine hesitancy during the COVID-19 pandemic is one recent example, but others abound.

    How might organizations developing new technologies such as therapeutics, wearable devices, and artificial intelligence for health navigate the dynamics of trust to deliver the benefits of scientific innovation to society? How can industry engage and communicate with the public to become not only worthy of trust, but also trusted?

    This "works in progress" consortium session shared emerging ideas from practitioners and scholars who have worked with industry, as we together explored how ethically-minded industry actors can nurture trust and contribute to the public good from within the market-based system of which they are a part.

    Speakers:
  • How to Develop a Mandatory Vaccination Policy: Organizational Ethics in Action

    March 18, 2022

    The development of safe, effective COVID vaccines has been a game-changer in the pandemic, but despite widespread availability, progress in getting the U.S. population fully vaccinated has been slow.Vaccine mandates increasingly appear to be one of the most effective ways to increase vaccination rates and protect people. Yet efforts to mandate vaccines have been met with pushback and legal challenges, leaving organizational leaders to navigate murky waters when establishing vaccination policies for their employees.

    Houston Methodist led by example when in June 2021 it became the first health care system in the U.S. to mandate the initial series of COVID-19 vaccinations for its 30,000+ employees and physician affiliates. In 2022, Houston Methodist again led the charge in mandating booster vaccinations in the wake of the Omicron variant.

    Susan M. Miller, MD, MPH, a key architect of Houston Methodist's pioneering vaccination policies, took us through the ethics process underlying these mandates, their implementation, and lessons learned. Houston Methodist's experience shared lessons for other health care systems and organizational leaders that extend well beyond the current moment.

    Speaker:
    • Susan M. Miller, MD, MPH
      Chair, Department of Family Medicine, Houston Methodist Hospital
      John S. Dunn Senior Research Chair in General Internal Medicine, Houston Methodist Hospital Department of Medicine
      Professor of Clinical Medicine, Houston Methodist Research Institute
      Associate Professor, Weill Cornell Medical College
    Discussants:
    • Rebecca Weintraub Brendel, MD, JD
      Director, Master of Bioethics Degree Program
      Associate Director, Center for Bioethics, Harvard Medical School
      President-Elect, American Psychiatric Association
    • Elliot Crigger, PhD
      Director of Ethics Policy, American Medical Association
  • Ethics of Hospital Transfers in the COVID-19 Pandemic: Experience and Lessons Learned

    February 25, 2022

    Extreme capacity challenges have been pervasive throughout the COVID-19 pandemic, with hospitals often facing severe shortages of critical resources, including staffing, space and medications. While some states have established effective mechanisms for cross-system resource sharing and patient transfers during the pandemic, many lack such mechanisms or failed to implement them when they were urgently needed. Stories of patients dying while awaiting needed transfers have become too common.

    The current crisis will eventually abate, but it would be imprudent to assume it will be the last. What has been the experience of public health and hospital leaders in states that have activated regional or statewide inter-hospital transfer systems during recent months?  What ethical issues have arisen?  What can be learned for approaching future capacity issues, with or without direct state involvement? 

    In an interactive format, panelists from three states with active transfer systems will identify ethical and practical challenges that have arisen for them in recent months and will explore ongoing questions and lessons learned.

    Moderator:
    • Matthew Wynia, MD, MPH, FACP
      Director, Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus
    Panelists:
    • Darlene Tad-y, MD, MBA
      Vice President, Clinical Affairs, Colorado Hospital Association
    • John L. Hick, MD
      Emergency Medicine, Hennepin County Medical Center
    • Erin Talati Paquette, MD, JD, MBe, HEC-C, FAAP
      Assistant Professor of Pediatrics, Northwestern University Feinberg School of Medicine
      Assistant Professor of Law, Northwestern University Pritzker School of Law, by courtesy
      Chair, Ethics Advisory Board and Associate Director of Clinical and Organizational Ethics
      Attending Physician, Pediatric Critical Care, Ann & Robert H. Lurie Children's Hospital of Chicago
    • Elke Shaw-Tulloch, MHS
      Administrator, Division of Public Health, Idaho Department of Health and Welfare
  • Upholding Ethics in Organized Psychiatry: The Contributions of Empirical Bioethics 

    October 22, 2021

    The practice of psychiatry raises unique ethical challenges, with new ethical demands frequently emerging in moments of social and political crisis. Consider, for example, the recent resurgence of dialogue around racial determinants of health and the Goldwater Rule prohibiting diagnostic statements about public figures.

    The American Psychiatric Association (APA), the largest and most influential professional psychiatric organization globally, holds an important role setting and monitoring ethical and professional norms to guide its nearly 38,000 psychiatrist members.  

    How does the APA fulfill this crucial role, and what can other organizations and communities facing controversies of professionalism, violence, racism, and political upheaval learn from its approach? In this session of the Organizational Ethics Consortium, members of the APA’s Ethics Committee discuss the APA’s approach to ethics oversight, focusing on its use of data to keep the organization responsive to evolving ethics themes. Presenters will share recent empirical work examining APA’s ethics process, discuss the role of empirical bioethics in organizational ethics, and consider how similar approaches can shed light on broader challenges like inequity and social polarization. 

    Presenters:
    • Philip Candilis, MD, DFAPA
      Director of Medical Affairs, Saint Elizabeths Hospital
      Professor of Psychiatry, George Washington University School of Medicine 
    • Michelle Hume, MD, PhD
      Forensic Psychiatrist, Mendota Mental Health Institute 
    Discussant: 
    • Donna T. Chen, MD, MPH
      Associate Professor, Center for Health Humanities and Ethics, Department of Public Health Sciences,
      Department of Psychiatry and Neurobehavioral Sciences, University of Virginia
    • Jeremy Lazarus, MD
      Clinical Professor of Psychiatry, University of Colorado Denver School of Medicine
      Past-President, American Medical Association
      Member, Council on Ethical & Judicial Affairs, American Medical Association

  • Building Bioethics at Google

    September 24, 2021

    While bioethics has flourished in academic and health care settings, it has gained relatively little ground in industry. Change is happening, as a wider range of companies consider the strategic and moral importance of drawing on bioethics frameworks when developing their technologies for use in public, clinical, and personal health. How does one build a robust bioethics program in an industry setting? What can newly emerging bioethics programs learn from more mature programs in other settings, such as healthcare delivery, payer, and policy organizations? What are the norms that ought to guide bioethics program development, and the challenges of program-building? How do bioethics and trust intersect, and what does it take to build trust with diverse stakeholders and communities?

    Lisa S. Lehmann, MD, PhD, director of the new Bioethics and Health Trust Program at Google, will discuss the process of building bioethics and trust at Google from the ground-up. She will be joined by a panel of bioethics and health equity leaders to reflect on approaches to developing bioethics and trustworthiness in a company setting.

    Speakers:
    • Lachlan Forrow, MD
      Associate Professor of Medicine, Harvard Medical School
    • Lisa Lehmann, PhD, MD
      Director, Bioethics and Health Trust Program, Google
    • Kwame McKenzie, MD
      Chief Executive Officer Wellesley Institute
    • James Sabin, MD
      Professor of Population Medicine, Harvard Medical School
    • Peter Singer, MD, MPH
      Special Advisor to the Director General, World Health Organization
  • The Ethics of Innovation in Personalized Experimental Therapeutics: Emerging Issues & Institutional Governance

    April 23, 2021

    Technological advances have made it possible for drug discovery and development to be tailored to single patients with rare genetic diseases, with this work conducted at academic medical centers. Such a process allows clinician-investigators to provide treatment through an individual FDA expanded access request. While FDA previously allowed a waiver of full IRB review, it has recently issued limited draft guidance for IRB involvement. In this unusual and evolving scientific and regulatory environment, what issues of ethics and governance are posed for the institution? What institutional measures can effectively address the challenges?

    David Williams, MD, Chief Scientific Officer at Boston Children's Hospital (BCH), will describe the creation and operation of the hospital's Oversight Committee for Personalized Experimental Therapeutics (OCPET), which is charged with reviewing proposed studies of such therapies, in the context of the Boston Children's Hospital research community of 3000 researchers and scientific staff. Dr. Williams will identify and comment on scientific and ethical issues arising in such studies. Additional perspectives will be offered by leaders in the research administration and ethics committee at BCH. Commentary will be provided by surgeon Martin McKneally, MD PhD, who has worked extensively with oversight of innovative treatment.

    Presenters:
    • David A. Williams, MD
      Senior Vice President for Research, Chief Science Officer, Boston Children's Hospital
      Leland Fikes Professor of Pediatrics, Harvard Medical School
    • Tina Poussaint, MD
      Attending Neuroradiologist, Boston Children's Hospital
      Professor of Radiology, Harvard Medical School
    • Susan Kornetsky, MPH
      Director of Clinical Research Compliance
      Boston Children's Hospital
    • David Urion, MD, FAAN
      Charles F. Barlow Chair, Neurobiology
      Associate Director, Child Neurology and Neurodevelopment Disabilities Residency, Boston Children's Hospital
      Associate Professor of Neurology, Harvard Medical School
    Discussant:
    • Martin McKneally, MD, PhD
      Visiting Lecturer, Department of Surgery, Beth Israel Deaconess Medical Center
      Co-Chair, Surgical Ethics Working Group, Center for Bioethics, Harvard Medical School
      Professor Emeritus of Surgery, University of Toronto
  • Securing Workers' Health During COVID-19: Ethics consultation for essential industries

    March 19, 2021

    Workers in essential industries have been exceptionally vulnerable in the COVID-19 pandemic. How might a body of public health ethics experts advise on industry's specific obligations to protect the health and safety of essential workers and their communities in this pandemic? What challenges can be entailed in ethics advising under such circumstances? The Global Center for Health Security at the University of Nebraska Medical Center established its Ethics Advisory Committee in the early stages of the COVID-19 outbreak. With a multidisciplinary panel of experts in disaster and public health emergency ethics, the Committee offers ethics consultation services to public health, civic, health care, and professional organizations.  Committee members shared their approaches and experience in consultations involving the meat-packing industry and other entities grappling with their ethical obligations in the pandemic.

    Presenters:
    • Kelly K. Dineen, RN, JD, PhD
      Director, Associate Professor, Health Law Program, Creighton University School of Law
    • Abbey Lowe, MA
      Director , Ethics and Public Health Preparedness, Center for Preparedness Education, University of Nebraska Medical Center, College of Public Health
    • Matthew K. Wynia, MD, MPH
      Director, Center for Bioethics and Humanities, University of Colorado
      Professor, University of Colorado School of Medicine, Colorado School of Public Health
    Discussant:
    • Ruqaiijah Yearby, JD, MPH
      Executive Director and Co-Founder Institute for Healing Justice and Equity, Saint Louis University
      Professor, Saint Louis University School of Law
  • How can a Pharmaceutical Manufacturer Navigate COVID-19 Drug Shortages? An Ethics Consult Process

    February 26, 2021

    Surges in health need and demand for potential COVID-19 therapeutics have contributed to emergent drug shortages during the pandemic. Whereas health care provider organizations can draw on numerous ethical frameworks to navigate the allocation dilemmas these drug shortages raise, a similar source of guidance is still lacking for the biopharmaceutical industry. This gap creates challenges for ethically-minded manufacturers of emerging COVID-19 drugs, who are exploring how to manage and distribute their products in the setting of overwhelming local and global demand. This session explored the experience of one private biopharmaceutical company as it navigates the ethical complexities associated with managing an FDA-approved drug that is being explored for secondary use in the COVID-19 pandemic, and the ethics process the company has convened to support its decision making. Members of the company's executive team were in attendance to discuss the case.

    Key Questions:
    • How should a private biopharmaceutical company plan for an unanticipated surge in demand for its product in the context of COVID-19? 
    • How should it consider preserving access to drug inventory for patient populations it already serves? How should it consider targeting supply for new, COVID-19 populations?
    • What role, if any, should a biopharmaceutical company play in drug allocation? What values should guide it?
    • What opportunities/ challenges are presented by ethics consultations in the biopharma setting?
    Ethics Consultants:
    • Kelsey Berry, PhD
      Postdoctoral Fellow, Center for Bioethics, Harvard Medical School
    • Nikola Biller-Andorno, MD, PhD
      Professor of Biomedical Ethics, Director, Institute of Biomedical Ethics and History of Medicine/Center for Medical Humanities, University of Zurich, Switzerland
    • Jonathan Marron, MD, MPH
      Pediatric Oncologist and Ethicist, Boston Children's Hospital and Dana-Farber Cancer Institute
      Teaching Faculty, Center for Bioethics, Harvard Medical School
    • Christine Mitchell, RN, MS, MTS
      Executive Director, Center for Bioethics, Harvard Medical School
    Discussant:
    • Jennifer E. Miller, PhD
      Assistant Professor, Yale Medical School
  • If racially concordant care is a benefit for Black patients, how should health care organizations respond?

    January 22, 2021

    Reducing racial disparities in health outcomes is an urgent priority for many health care organizations, leading to a continual search for novel organization-level interventions that can yield substantive health gains for Black patients in particular. One emerging line of research demonstrates that Black patients treated by Black physicians achieve better health outcomes in several domains compared with Black patients seen by non-Black physicians. Recent studies demonstrate a 50% reduction in Black-White infant mortality gaps and a 19% decline in male cardiovascular mortality with racially concordant care.

    Key Questions:
    • What implications does this line of research have for developing an organizational approach to reducing racial disparities?
    • Do these studies merely underscore the need to improve the diversity of the physician workforce?
    • Should administrators looking to create an anti-racist health care organization take proactive steps to match Black patients with available Black physicians?
    • How might such programs be understood in the context of the historical effort to desegregate medicine?

    Presenters:
    Ethicist and management scholar Lauren Taylor (NYU Langone), in conversation with historian Adam Biggs (University of South Carolina) and 4th year medical student and MBA Osaze Udeagbala (NYU Medicine), discussed how health care organizations can identify appropriate responses to the morally urgent project of closing racial disparities.

  • Pursuing Equity through Systems Improvement: Challenges and Learnings from the Pursing Equity Initiative

    October 23, 2020

    Improving health equity is an important goal for many health care institutions, but turning values into sustainable action can be challenging in today's complex social, political, and economic conditions.
    What has been the experience of hospitals, health systems and other healthcare institutions that have invested in health equity efforts in recent years, using tools and understandings from improvement science?
    The Pursuing Equity initiative of the Institute for Healthcare Improvement (IHI) has brought together a group of institutions to tailor improvement strategies for their respective patient populations and circumstances, and to share experience and learnings in a collaborative action network. 

    Presenters:
    • Kedar Mate, MD
      President and CEO
      Institute for Healthcare Improvement
    • David Ansell, MD, MPH
      Senior Vice President for Community Health Equity
      Rush University Medical Center
      Associate Provost for Community Affairs
      Rush University
    • Nancy Berlinger, PhD
      Research Scholar 
      The Hastings Center
  • Building Bridges for Better Health: Can transorganizational ethics contribute?

    September 25, 2020

    The U.S. health system separates community health, treatment of illness, and financial stewardship into separate silos and separate organizations.
    In this event, ethics leaders from three typically separate silos will discuss the challenge of interorganizational or transorganizational ethics. The discussion will address the question of how joint organizational ethics might contribute to moving from a reactive stance within organizations to one proactively promoting community health and well-being across organizations.

    Presenters:
    • Anita Wagner, PharmD, MPH, DrPH
      Director, Ethics Program
      Harvard Pilgrim Health Care
    • Jonathan Harland, MD
      Director, Ethics Program
      Atrius Health
    • Lachlan Farrow, MD
      HMS Associate Professor of Medicine
      Beth Israel Deaconess Medical Center
    Moderator:
    • Sharon Levine, MD
      Physician, Southern California Permanente Medical Group
      Former Director and Senior Advisor, The Permanente Medical Group
Associate Faculty Director of the Master of Science in Bioethics Degree Program
Co-Director of the Virtual Master of Science in Bioethics Degree Program
Lecturer in Global Health and Social Medicine