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Author Archive: Ellen Fox


Don’t Miss this Opportunity to Shape Federal Policy!

by Ellen Fox, MD

Yesterday, the Federal Register published a long-awaited Notice of Proposed Rulemaking to “modernize, strengthen, and make more effective” the Federal Policy for the Protection of Human Subjects known as “the Common Rule.” The proposed changes are endorsed by 16 Federal agencies, plus several others that “intend to adopt the proposed rule” through a separate rulemaking. This event is momentous for several reasons. First, there have been almost no changes to the Common Rule for over 30 years. Most of the current language in the Common Rule was first published by the Department of Health, Education, and Welfare in 1981.…

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by Ellen Fox, MD

It’s been five years since the media firestorm around “death panels” – a term coined by Sarah Palin to refer to a provision in Obamacare that would have authorized Medicare payments for advance care planning discussions. Though the initial blaze died down quickly, the fire has continued to smolder (as shown in this graph I generated using “Google Trends”). The long-term fallout from death panels has been profound, and has extended far beyond issues of Medicare reimbursement.

In my former role as director of the National Center for Ethics in Health Care within the U.S. Department Veterans Affairs (VA) health care system, I experienced the heat of the “death panel” conflagration firsthand when, in 2009, an advance care planning workbook that had been developed at the Seattle VA hospital in the mid 1990’s became “a lightning rod in the health care debate.”

At the time the media frenzy erupted, we were already overhauling the outdated workbook for national distribution.…

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Evaluating Ethics Quality: The Time Has Come

Ellen Fox, M.D.

The idea of evaluating ethics quality in health care is not new—but until now, it has proven to be easier said than done. The latest issue of AJOB Primary Research aims to jumpstart progress on ethics quality evaluation. It features six Open Access articles from the VA’s National Center for Ethics in Health Care that describe our real-world experience evaluating ethics quality as part of IntegratedEthicsTM (IE)—our comprehensive model for managing ethics in health care organizations. Ethics quality is the foundation on which IE is built. IE’s concept of ethics quality is broad, encompassing practices from the bedside to the boardroom, and described here.…

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