Emily Berkman, MD
Emily Berkman, MD
Dr. Emily Berkman is a pediatric critical care medicine fellow and is concurrently in the bioethics fellowship and master’s program. She is interested in ethical resource allocation within the context of critical care medicine delivery. Her interest was sparked by serving on the Ebola team at Seattle Children’s Hospital. The team was studying the experiences of low-resource countries, such as those in West Africa, dealing with Ebola, to identify lessons about decision making related to allocation of limited medical resources.
Although far less extreme, there are resource allocation problems that occur every day in hospitals across the United States. For example, Seattle Children’s is the only institution in Washington, Wyoming, Alaska, Montana and Idaho that offers an advanced form of life support called extracorporeal life support (heart-lung bypass). We are, therefore, the final and only option for many sick and dying children. Extracorporeal life support is a resource-intensive treatment, requiring highly trained medical personnel and expensive equipment. Berkman is examining how decisions are made when there are shortages of beds or healthcare professionals; when resources are limited, the ethical allocation of resources is paramount.
By using surveys and semi-structured interviews of medical directors, Berkman’s current research project is examining how care is provided in large pediatric intensive care units (PICUs) in the U.S. With research mentors Drs. Mithya Lewis-Newby and Douglas Diekema, she aims to develop a framework for ethics consultants to apply when discussing resource allocation in the PICU. “I hope to learn how to rigorously analyze the issues at hand and provide the ethical justifications for the resulting recommendations,” she explains.
Jessica Jeavons, JD
Jessica Jeavons, JD
Jessica Jeavons is a bioethics fellow concurrently enrolled in the bioethics master’s program. She is interested in the intersection of medicine and law, and applies her training in philosophy and law to real-life ethics questions in the public health arena. Through the fellowship program here, she hopes to gain practical experience exploring ethical issues facing healthcare institutions.
Her research focuses on the connection between the role of brain development in moral responsibility and how the law can make use of that information in the development of criminal justice policies. This connection is important for youth populations, who are increasingly incarcerated and whose brains are still developing, meaning that their decision-making capabilities and impulse control are not fully formed.
“It is especially imperative that the criminal justice system strive to close the gap between what is known about the young brain’s capacity to make good choices and the justice system’s handling of these offenders,” she explains. “This knowledge gap is quickly becoming a public health problem as more young people are being treated as criminals when a medical explanation would be more suitable in influencing the outcome.”
Jeavons’ research project is examining how clinicians incorporate the decisions of young people into treatment plans and how these decisions are weighed against those of parents and other caretakers. She is exploring issues of consent, confidentiality and paternalism in the care of adolescents to understand the boundaries regarding pediatric responsibility. Her work will pay specific attention to underlying neuroscientific principles. She will then connect these boundaries to the criminal justice system’s treatment of youth offenders to shape services and improve health in this population.
Jeanne Krick, MD
Jeanne Krick, MD
Dr. Jeanne Krick is a neonatology fellow who is concurrently in the bioethics fellowship and master’s program. Her research interests developed from caring for infants admitted to the neonatal intensive care unit (NICU). “My daily interactions with the encounters between providers and parents in the NICU reignited a long-standing interest I’d had in learning more about the parent experience of having a critically ill baby and how provider communication can impact that experience,” she comments.
In her interactions with families, she strives to build effective relationships with parents to ensure that they are kept informed and feel like valuable members of their infant’s care team. Throughout her medical training, she has come to appreciate how much her medical decision making is influenced by the goals of the family.
With research mentors Drs. Doug Opel and Aaron Wightman, she will focus on elucidating what the experience of uncertainty in the NICU environment is like for parents and how provider communication influences that experience. She is interviewing parents of NICU patients to gain a better appreciation for how they live with and process uncertainty while their child is in the NICU. Her work seeks to identify factors that promote effective interactions with families, with the goal to better inform NICU providers of the parent experience to create more lasting and effective parent-clinician relationships.
After her fellowship, Krick will return to the U.S. Army Medical Corps, where she is a captain, and apply her skills on hospital ethics committees and share with military physicians what she has learned regarding effective communication between patients and physicians.