Christine Mitchell

Christine Mitchell, RN, MS, MTS, HEC-C

Center Member, HMS Center for Bioethics
Lecturer on Global Health and Social Medicine, Harvard Medical School

Christine MitchellChristine Mitchell, RN, MS, MTS, HEC-C, is the executive director of the Center for Bioethics. She received her bachelor’s and master’s degrees in science from Boston University School of Nursing and a master’s degree from Harvard where she majored in philosophical and religious ethics as a Kennedy Fellow in Medical Ethics through the Interfaculty Program at Harvard Medical School, Harvard Divinity School and Harvard School of Public Health. She is also an elected Fellow of the American Academy of Nurses.

Christine founded the ethics program at Boston Children’s Hospital, directing the ethics consultation service and leading the Ethics Advisory Committee for thirty years.  She was also associate director of clinical ethics at Harvard Medical School’s Division of Medical Ethics where she developed the Ethics Leadership Group, an intensive clinical bioethics course, and an all-volunteer citizen Community Ethics Committee for informed public input on ethical aspects of health care and health policies. She leads the monthly Harvard Ethics Consortium discussion of ethics cases and teaches in the HMS Medical Ethics Fellowship program. Her research has focused on ethics consultation, and public engagement in policies regarding resource allocation related to major natural disasters or pandemics. Christine has served on numerous national committees and commissions, including the American Society for Bioethics and Humanities’ Clinical Ethics Consultation Committee and, most recently, the Ethical Legal and Social Aspects Committee for the Human Brain Project funded by the European Commission. She lectures nationally and internationally on issues in clinical ethics.  Her published work includes a documentary film, made with Ben Achtenberg, which was nominated for an Academy Award, and a documentary video that received an international Freddie award for medical media. She edits a regular series of ethics cases for The Journal of Clinical Ethics and has written on numerous topics in bioethics for the American Journal of Nursing, the New England Journal of Medicine, several specialty clinical journals, and Newsweek.  

Publications View
The Value of Virginity.
Authors: Authors: Mitchell C.
J Clin Ethics
View full abstract on Pubmed
Hinduism and death with dignity: historic and contemporary case examples.
Authors: Authors: Dewar R, Cahners N, Mitchell C, Forrow L.
J Clin Ethics
View full abstract on Pubmed
Nurse and physician barriers to spiritual care provision at the end of life.
Authors: Authors: Balboni MJ, Sullivan A, Enzinger AC, Epstein-Peterson ZD, Tseng YD, Mitchell C, Niska J, Zollfrank A, VanderWeele TJ, Balboni TA.
J Pain Symptom Manage
View full abstract on Pubmed
Medical missions to Ghana: The ethics of choosing children for cardiac surgery.
Authors: Authors: Mitchell C.
J Clin Ethics
View full abstract on Pubmed
The ethics of reality medical television.
Authors: Authors: Krakower TM, Montello M, Mitchell C, Truog RD.
J Clin Ethics
View full abstract on Pubmed
HCEC pearls and pitfalls: suggested do's and don't's for healthcare ethics consultants.
Authors: Authors: Carrese JA, Antommaria AH, Berkowitz KA, Berger J, Carrese J, Childs BH, Derse AR, Gallagher C, Gallagher JA, Goodman-Crews P, Heesters A, Jurchak M, Mitchell C, Mokwyune N, Parsi K, Powell T, Powderly KE, Rosell T, Shelton W, Smith ML, Spike J, Tarzian A, Wocial L.
J Clin Ethics
View full abstract on Pubmed
Predicting future staffing needs at teaching hospitals: use of an analytical program with multiple variables.
Authors: Authors: Mitchell CC, Ashley SW, Zinner MJ, Moore FD.
Arch Surg
View full abstract on Pubmed
Futility--from hospital policies to state laws.
Authors: Authors: Truog RD, Mitchell C.
Am J Bioeth
View full abstract on Pubmed
Sex assignment for newborns with ambiguous genitalia and exposure to fetal testosterone: attitudes and practices of pediatric urologists.
Authors: Authors: Diamond DA, Burns JP, Mitchell C, Lamb K, Kartashov AI, Retik AB.
J Pediatr
View full abstract on Pubmed
When a village is not enough.
Authors: Authors: Mitchell C, Truog R.
J Clin Ethics
View full abstract on Pubmed

Scholarly Papers

Lecture on "Expanded Access": https://vimeo.com/154201394

Source: ResearchGate

Religion, Spirituality, and the Hidden Curriculum: Medical Student and Faculty Reflections
Michael Balboni, Julia Bandini, Christine Mitchell, Zachary D Epstein-Peterson, Ada Amobi, Jonathan Cahill, Andrea C Enzinger, John Peteet, Tracy Balboni
Journal of pain and symptom management 05/2015; DOI:10.1016/j.jpainsymman.2015.04.020

Whose Role? Oncology Practitioners' Perceptions of Their Role in Providing Spiritual Care to Advanced Cancer Patients (S784) 
Danielle Rodin, Michael Balboni, Christine Mitchell, Patrick T Smith, Tyler J VanderWeele, Tracy A Balboni
Journal of Pain and Symptom Management 01/2015; 49(2). DOI:10.1007/s00520-015-2611-2

Hinduism and Death with Dignity: Historic and Contemporary Case Examples. 
Rajan Dewar, Nancy Cahners, Christine Mitchell, Lachlan Forrow
The Journal of clinical ethics 01/2015; 26(1):40-47

Nurse and Physician Barriers to Spiritual Care Provision at the End of Life
Michael J Balboni, Adam Sullivan, Andrea C Enzinger, Zachary D Epstein-Peterson, Yolanda D Tseng, Christine Mitchell, Joshua Niska, Angelika Zollfrank, Tyler J Vanderweele, Tracy A Balboni
Journal of pain and symptom management 01/2014; 48(3). DOI:10.1016/j.jpainsymman.2013.09.020

Qualms of a Believer in Narrative Ethics
Christine Mitchell
The Hastings Center Report 01/2014; 44 Suppl 1:S12-5. DOI:10.1002/hast.262

Medical decision-making capacity: knowledge, attitudes, and assessment practices of physicians in Switzerland. 
Helena Hermann, Manuel Trachsel, Christine Mitchell, Nikola Biller-Andorno
Swiss medical weekly: official journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology 01/2014; 144:w14039. DOI:10.4414/smw.2014.14039

Medical Missions to Ghana: The Ethics of Choosing Children for Cardiac Surgery. 
Christine Mitchell 
The Journal of clinical ethics 01/2014; 25(4):307

Trachsel, M. Mitchell, C., Biller-Andorno, N. Advance Directives: Between Respect for Patient Autonomy and Paternalism, Chapter 11 in P. Lack et al. (eds) Advance Directives, International Library of Ethics, Law, and the New Medicine 54, DOI 10..1007/978-94-007-7377-6_11 (Dordrecht, Springer Science+Business Media) 2014. 
Christine Mitchell, m. Trachsel, N. Biller-Andorno
Advance Directives, International Library of Ethics, Law, and the New Medicine 54, 01/2014: chapter Advance Directives: Between Respect for Patient Autonomy and Paternalism; Dordrecht, Springer Science+Business Media.

INFORMED CONSENT IN ADVANCE CARE PLANNING IN THE PALLIATIVE CARE SETTING: A DECISION AID LIBRARY FOR END OF LIFE CARE.
T Krones, B Loupatatzis, B Steffen-Bürgli, D Otto, M Brunner, N Biller-Andorno, G Eisele, J In der Schmitten, C Mitchell, S Obrist, D Poster, T Rordorf, K Schad, R Spirig, A Volandes, K Zaugg, L Zimmerli
Supportive and Palliative Care 06/2013; 3(2):282. DOI:10.1136/bmjspcare-2013-000491.148

Streuli, Mitchell et al. DSD and Professionalism from a Multilateral view [Advances in Urology 2012] 
Jurg C. Streuli, Knut Werner-Rosen, Christine Mitchell, Birgit Kohler

CMitchell, Ethical Dilemmas
Christine Mitchell

Does professional orientation predict ethical sensitivities? Attitudes of paediatric and obstetric specialists toward fetuses, pregnant women and pregnancy termination
Stephen D Brown, Karen Donelan, Yolanda Martins, Sadath A Sayeed, Christine Mitchell, Terry L Buchmiller, Kelly Burmeister, Jeffrey L Ecker
Journal of medical ethics 04/2013; 40(2). DOI:10.1136/medethics-2012-101126

Decision-making incapacity at the end of life: conceptual and ethical challenges 
Manuel Trachsel, Christine Mitchell, Nikola Biller-Andorno

The ethics of reality medical television. 
Thalia Margalit Krakower, Martha Montello, Christine Mitchell, Robert D Truog
The Journal of clinical ethics 01/2013; 24(1):50-7.

Differing Attitudes Toward Fetal Care by Pediatric and Maternal-Fetal Medicine Specialists 
Stephen D Brown, Karen Donelan, Yolanda Martins, Kelly Burmeister, Terry L Buchmiller, Sadath A Sayeed, Christine Mitchell, Jeffrey L Ecker
PEDIATRICS 11/2012; 130(6). DOI:10.1542/peds.2012-1352

DSD and Professionalism from a Multilateral View: Supplementing the Consensus Statement on the Basis of a Qualitative Survey. 
Jürg C Streuli, Birgit Köhler, Knut Werner-Rosen, Christine Mitchell 
Advances in Urology 07/2012; 2012:185787. DOI:10.1155/2012/185787

Shared decision making and advance care planning-underpinnings, similarities and differences.
T Krones, N Biller Andorno, J In der Schmitten, C Mitchell, R Spirig, K Zaugg]
Supportive and Palliative Care 06/2012; 2(2):173. DOI:10.1136/bmjspcare-2012-000250.10

Prenatally diagnosed fetal conditions in the age of fetal care: does who counsels matter? Stephen D Brown, Jeffrey L Ecker, Johanna R M Ward, Elkan F Halpern, Sadath A Sayeed, Terry L Buchmiller, Christine Mitchell, Karen Donelan
American journal of obstetrics and gynecology 02/2012; 206(5):409.e1-11. DOI:10.1016/j.ajog.2012.01.026

HCEC pearls and pitfalls: suggested do's and don't's for healthcare ethics consultants.
Joseph A Carrese, Armand H Matheny Antommaria, Kenneth A Berkowitz, Jeffrey Berger, Brian H Childs, Arthur R Derse, Colleen Gallagher, John A Gallagher, Paula Goodman-Crews, Ann Heesters, [...], Christine Mitchell,, Nneka Mokwyune, Kayhan Parsi, Tia Powell, Kathleen E Powderly, Tarris Rosell, Wayne Shelton, Martin L Smith, Jeffrey Spike, Anita Tarzian, Lucia Wocial
The Journal of clinical ethics 01/2012; 23(3):234-40.

DSD and Professionalism from a Multilateral View
Jurg C. Streuli, Birgit Kohler, Knut Werner-Rosen, Christine Mitchell

NIH Consensus Development Conference Statement: Inhaled Nitric-Oxide Therapy for Premature Infants
F Sessions Cole, Claudia Alleyne, John D E Barks, Robert J Boyle, John L Carroll, Deborah Dokken, William H Edwards, Michael Georgieff, Katherine Gregory, Michael V Johnston, Michael Kramer, Christine Mitchell, Josef Neu, DeWayne M Pursley, Walter M Robinson, David H Rowitch
PEDIATRICS 02/2011; 127(2):363-9. DOI:10.1542/peds.2010-3507

Burns J, Mitchell C. Do not resuscitate orders and redirection of treatment, Chapter 9 in End of Life Care for Children and Adults with Intellectual and Developmental Disabilities, ed by S. Friedman and D. Helm. Washington DC: AAIDD, 2010: 147-160. 
Christine Mitchell, Jeffrey Burns
End of Life Care for Children and Adults with Intellectual and Developmental Disabilities,, Edited by S. Friedman and D. Helm, 01/2010: chapter Do not resuscitate orders and redirection of treatment: pages 147-160; AAIDD.

Not Fetal Cosmetology
Diamond, DA. Ecker, J. Holm, I., Kornetsky, S., Mitchell, C., Spack, N.
Bioethics Forum, 03/08/2010

Futility - From hospital policies to state laws 
Robert D Truog, Christine Mitchell
The American Journal of Bioethics 10/2006; 6(5):19-21; discussion W30-2. DOI:10.1080/15265160600858989

Sex assignment for newborns with ambiguous genitalia and exposure to fetal testosterone: Attitudes and practices of pediatric urologists 
David A Diamond, Jeffrey P Burns, Christine Mitchell, Kersten Lamb, Alex I Kartashov, Alan B Retik
Journal of Pediatrics 04/2006; 148(4):445-9. DOI:10.1016/j.jpeds.2005.10.043

When a village is not enough. 
Christine Mitchell, Robert Truog
The Journal of clinical ethics 02/2006; 17(1):79.

A mother's death: the story of "Margaret's" children. 
Christine Mitchell 
The Journal of clinical ethics 02/2006; 17(4):331-2.

Accusations of murder and euthanasia in end-of-life care 
Lewis Cohen, Linda Ganzini, Christine Mitchell, Stephen Arons, Elizabeth Goy, James Cleary
Journal of Palliative Medicine 01/2006; 8(6):1096-104. DOI:10.1089/jpm.2005.8.1096

Is there any consensus about end-of-life care in pediatrics?
Jeffrey P Burns, Christine Mitchell
Archives of Pediatrics and Adolescent Medicine 10/2005; 159(9):889-91. DOI:10.1001/archpedi.159.9.889

Excerpts from the ethics consult report: MT. 
Christine Mitchell, Robert D Truog
The Journal of clinical ethics 02/2004; 15(3):302-6.

Baby Michael's Short Story
Christine Mitchell, Robert Truog
The Journal of clinical ethics 01/2004; 15(3):291.

A Bridge to Nowhere
Christine Mitchell, Robert Truog
The Journal of clinical ethics 02/2003; 14(3):189. DOI:10.1038/nbt1095-1030b

Seeking Blinded Consent
Christine Mitchell, Robert Truog
The Journal of clinical ethics 01/2003; 14 (1-2):88-89

Case reports from the Harvard Ethics Consortium
Christine Mitchell, Robert Truog
The Journal of clinical ethics 02/2002; 13(1):49-53

Irene's story
Christine Mitchell, Robert Truog
The Journal of clinical ethics 02/2002; 13(3):230-1.

An epilogue to "Jamie's story".
Christine Mitchell 
The Journal of clinical ethics 02/2002; 13(2):151-3.

The Moral of the Story
Christine Mitchell 
The Journal of clinical ethics 01/2002; 13(2):153-159

End-of-life care in the pediatric intensive care unit: attitudes and practices of pediatric critical care physicians and nurses. 
Jeffrey P. Burns, Christine Mitchell, John L. Griffith, Robert D. Truog
Critical Care Medicine 04/2001; 29(3):658-64. DOI:10.1097/00003246-200103000-00036

End-of-life care in the pediatric intensive care unit after the forgoing of life-sustaining treatment. 
Jeffrey P. Burns, Christine Mitchell, Kristan M. Outwater, Maggie Geller, John L. Griffith, I. David Todres, Robert D. Truog
Critical Care Medicine 09/2000; 28(8):3060-6. DOI:10.1097/00003246-200008000-00064

When living is a fate worse than death.
C Mitchell
Newsweek 09/2000; 136(9):12.

Autopsy consent practice at US teaching hospitals: results of a national survey. 
Glen E. Rosenbaum, Jeffrey Burns, Judy Johnson, Christine Mitchell, Mary Robinson, Robert D. Truog
Archives of Internal Medicine 03/2000; 160(3):374-80. DOI:10.1001/archinte.160.3.374

Pharmacologic paralysis and withdrawal of mechanical ventilation at the end of life.
Robert D. Truog, Jeffrey P. Burns, Christine Mitchell, Judy Johnson, Walter Robinson
New England Journal of Medicine 03/2000; 342(7):508-11. DOI:10.1056/NEJM200002173420712

Truog, R. Mitchell, C. Guest Editors, Special Issue on Ethics in Pediatrics, The Journal of Clinical Ethics, 11 (2), Summer 2000. 
Christine Mitchell

From the files of a pediatric ethics committee. 
C Mitchell, R D Truog
The Journal of clinical ethics 02/2000; 11(2):112-20.

Responding to parental requests to forego pediatric nutrition and hydration. 
J Johnson, C Mitchell
The Journal of clinical ethics 02/2000; 11(2):128-35.

Editor's introduction (to a set of articles by P.H. Jos et al.; H.L. Nelson; B. Spielman; J.L. Nelson; M.A. Rie; J.S. Alper; E. Parens; and J. Spike and J. Greenlaw) 
Christine Mitchell 
The Journal of Law Medicine & Ethics 02/1995; 23(2):117-9.

The Child Health Advisory Plan: A Health Care Directive for Families, 1994. 
Christine Mitchell, Robert Wharton, et al

Barbiturates in the care of the terminally ill. 
Robert D. Truog, Charles B. Berde, Christine Mitchell, Holcombe E. Grier
New England Journal of Medicine 01/1993; 327(23):1678-82. DOI:10.1056/NEJM199212033272311

Dilemmas in Practice: Her Only Chance.
Elaine Caron, Christine Mitchell 
The American Journal of Nursing 10/1991; 91(9):19-20. DOI:10.1097/00000446-199109000-00007

Coordinating Council on Life-Sustaining Medical Treatment Decision Making by the Courts, Guidelines for State Court Decision Making in Authorizing or Withholding Life-Sustaining Medical Treatment, first edition 1991, Revised second edition 1993. (St. Paul, Minnesota, West Publishing Co.) 
Christine Mitchell, Coordinating Council on Life-Sustaining Medical Treatment Decision Making by the Courts
1 01/1991; West Publishing Co..

On Heroes and Villains in the Linares Drama
Christine Mitchell
Law, medicine & health care: a publication of the American Society of Law & Medicine 01/1990; 17(4).

Ethical Dilemmas
Christine Mitchell 
Critical Care Nursing Clinics of North America 01/1990; 2(3):427-430.

Which child gets the transplant? 
INGRID ERIKSON, CHRISTINE MITCHELL
The American Journal of Nursing 04/1988; 88(3):287-8. DOI:10.1097/00000446-198803000-00011

If it's AIDS, please don't tell. 
C Mitchell, L Smith
The American Journal of Nursing 08/1987; 87(7):911-2, 914.

Dilemmas in Practice: the Fragile Survivor
CHRISTINE MITCHELL, PATRICIA A. RUTHERFORD
The American Journal of Nursing 04/1987; 87(5):603-605. DOI:10.1097/00000446-198705000-00008

Steadying the Hand that Feeds
Christine Mitchell 
The American Journal obg Nursing 01/1987 293-96

Considering the Principle of Fidelity
Christine Mitchell
Nursing Life, 26-30, September/October 1986

Considering the Principle of Justice
Christine Mitchell
Nursing Life, 50-54, May/June 1986

Considering the Principle of Autonomy
Christine Mitchell
Nursing Life, 26-30, March/April 1986

The Practice of Perinatal/Neonatal Nursing: A Clinical Handbook. 
Edited by Angelini, D, Knapp, CW, Gibes, R, 01/1986: Christine Mitchell, chapter Ethical Issues in Perinatal Nursing,: pages 429-437, Blackwell Scientific Publications, Inc.

The Nurse-Patient Relationship: A Source of Some Moral Duties
Christine Mitchell 
The Connecticut Scholar, 1986

Considering the Principle of Beneficence
Christine Mitchell
Nursing Life, 18-23, January/February 1986

Care of Severely Impaired Infant Raises Ethical Issues
Christine Mitchell 
The American nurse 01/1984; 16(3)

Legal, Medical and Ethical Problems of the Baby Jane Doe Issue: A Nurse's Reaction
Christine Mitchell
Law, Science, and Technology Monograph Series. Levandoski, D. and Seitz, P. (eds), Concord, NH, Franklin Pierce Law Center, 1984

Infant Death Problem Must Go Beyond the Nursery
Christine Mitchell, Susan M Shaw
Boston Globe, p 25, March 1983

Report of the Special Committee on Biomedical Ethics (Chair, Hoffman, P. Mitchell, C.) Values in Conflict: Resolving Ethical Issues in Hospital Care. 
Christine Mitchell
Chicago, IL, American Hospital Association, 1985. (2nd edition, 1993)

Integrity in Interprofessional Relationships in Responsibility in Health Care, Philosophy and Medicine Series, Volume 15, Agich, GJ, (ed), Boston, MA and Dordrecht, Holland, D. Reidel Publishing C, 163-184, 1982. 
[Reprinted in Edwards, RB and Graber, GC. Bioethics, New York, Harcourt Brace Jovanovich Publishers, 63-72, 1989.]
Christine Mitchell
Responsibility in Health Care, Edited by G.J. Agich, 01/1982: chapter Integrity in Interprofessional Relationships: pages 163-184; D. Reidel Publishing.

New directions in nursing ethics.
Christine Mitchell
Bulletin of the Massachusetts Nurses Association 08/1981; 50(7):7-10.

The Infertile Family in Chapter 1 Prenatal Health, Part II Maternity Nursing in Blakiston Handbook of Clinical Nursing, 1st edition. Dickson, J, et al (eds.). NY, McGraw-Hill Book Co, 1979. 
Christine Mitchell
Blakiston Handbook of Clinical Nursing, 1st edited by J Dickson, et al, 01/1979: chapter The Infertile Family; McGraw Hill.

Code gray: ethical dilemmas in nursing. 
J Sawyer, B Actenberg, C Mitchell 
NursingLife 6(1):18-23.

Autopsy Consent Practice at US Teaching Hospitals
Glen E. Rosenbaum, Jeffrey Burns, Judy Johnson, Christine Mitchell, Mary Robinson, Robert D. Truog

[If it is AIDS, please don't tell anyone]. 
C Mitchell, L Smith
Servir (Lisbon, Portugal) 36(4):208-11.