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Paul J. Ford, PhD Teaching Portfolio INDEX I. Philosophy of Teaching/Personal Development II. Mentees/Students III. Teaching Inventory IV. Important Teaching Contributions V. Awards I. Philosophy of Teaching/Personal Development Teaching Philosophy: A blend of cognitive understanding and practical experience provides the foundation for learning that improves understanding and action. This involves a recursive process where each stage provides opportunity for the skilled teacher to provide guidance for students’ educational explorations. In order to understand a context for any practical learning, a basic knowledge and contextual framework must be made explicit to students. After foundational knowledge has been offered, active listening and observation must be encouraged. The active observation requires students to prospectively identify a focus that will form the basis on which they later dialog with their instructor. Finally, attempting to undertake a task either through simulation or supervised practice provides an opportunity to explore the phenomenological experience of the activity as well as to highlight gaps in knowledge. Each of these aspects of learning requires an instructor to enter into a dialogue that is in general Socratic, with occasional need for substantive didactics. Through modeling the teaching and learning process, learners can further be influences to acquire life long learning habits. Personal Development: My efforts for personal development in teaching are at least four fold: gaining knowledge, acquiring new skills, critical self appraisal, and innovation. To the first of these, each year I have attended a CME equivalent of more than eighty hours that ranges across many medical and surgical disciplines as well as in ethics. This breadth is important since I teach individuals from a wide array of specialties. Becoming increasingly well educated in medical issues enhances my teaching by providing more real world applicability to medical students and residents. Going beyond simply lectures, I have also made an effort to observe various surgeries and outpatient clinics to gain first hand knowledge of the practices. Acquiring new knowledge creates a basis for improved teaching that need to be conveyed by means of good teaching methods. Although, some teaching skills emerge intuitively, there are many methods that need to be learned. I actively seek out new methods for educating my students. For example, I participated in the 2008-2009 CCF distinguished teaching program that required participating in five educational seminars (12 contact hours) plus having a teaching session observed and critiqued. In the past, I have also attended several seminars aimed at improving teaching. These have included day long seminars on using narrative in lectures (2005) and

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Paul J. Ford, PhD

Teaching Portfolio

INDEX

I. Philosophy of Teaching/Personal Development

II. Mentees/Students

III. Teaching Inventory

IV. Important Teaching Contributions

V. Awards

I. Philosophy of Teaching/Personal Development

Teaching Philosophy: A blend of cognitive understanding and practical experience

provides the foundation for learning that improves understanding and action. This

involves a recursive process where each stage provides opportunity for the skilled teacher

to provide guidance for students’ educational explorations. In order to understand a

context for any practical learning, a basic knowledge and contextual framework must be

made explicit to students. After foundational knowledge has been offered, active

listening and observation must be encouraged. The active observation requires students

to prospectively identify a focus that will form the basis on which they later dialog with

their instructor. Finally, attempting to undertake a task either through simulation or

supervised practice provides an opportunity to explore the phenomenological experience

of the activity as well as to highlight gaps in knowledge. Each of these aspects of

learning requires an instructor to enter into a dialogue that is in general Socratic, with

occasional need for substantive didactics. Through modeling the teaching and learning

process, learners can further be influences to acquire life long learning habits.

Personal Development: My efforts for personal development in teaching are at least four

fold: gaining knowledge, acquiring new skills, critical self appraisal, and innovation. To

the first of these, each year I have attended a CME equivalent of more than eighty hours

that ranges across many medical and surgical disciplines as well as in ethics. This

breadth is important since I teach individuals from a wide array of specialties. Becoming

increasingly well educated in medical issues enhances my teaching by providing more

real world applicability to medical students and residents. Going beyond simply lectures,

I have also made an effort to observe various surgeries and outpatient clinics to gain first

hand knowledge of the practices. Acquiring new knowledge creates a basis for improved

teaching that need to be conveyed by means of good teaching methods. Although, some

teaching skills emerge intuitively, there are many methods that need to be learned. I

actively seek out new methods for educating my students. For example, I participated in

the 2008-2009 CCF distinguished teaching program that required participating in five

educational seminars (12 contact hours) plus having a teaching session observed and

critiqued. In the past, I have also attended several seminars aimed at improving teaching.

These have included day long seminars on using narrative in lectures (2005) and

Paul J. Ford, PhD

Teaching Portfolio

2

application and techniques in empathy (2008). The next element after knowledge and

methods is continuous improvement. I understand each time I teach as an opportunity to

reflectively evaluate whether the session met the intended objectives. Being humble and

reflective about effectiveness in teaching provides the opportunity to improve and build

on experiences. Finally, to continuously attempt to innovate in teaching provides

incentive for reevaluating content as well as methodology. My ongoing work and

collaboration with the neurosurgery residency program has provided an opportunity to

rethink the model of case-based ethics teaching related to technological advances.

Attempting to integrate film as a kind of text, provides a opportunity to reach out to those

who have different learning styles. Exploring innovative approaches is fundamental to

advancing as a teacher. Improving knowledge, skill, reflection, and innovation are

necessary elements for nurturing me as an educator.

II. Mentees/Students

Medical Students:

Lauren Moore, CCLCM clinical ethics elective rotation, clinical service June 2-6, 2008.

Rebecca Ganetzky, CCLCM clinical ethics elective rotation, clinical service April 21-30,

2008.

Jun Xu, Cleveland Clinic Lerner College of Medicine, Summer Research Rotation,

Summer 2006.

Craig Eldridge, Ohio State University College of Medicine, one month rotation for fourth

year elective, winter 2003.

Dan Valentino, Ohio State University College of Medicine, one month rotation for fourth

year elective, summer 2003.

Bioethics Fellows at CCF:

Courtenay Bruce, JD, Cleveland Fellowship in Advanced Bioethics, Fellow, 2008-2010.

Barbara Chubak, MD, Cleveland Fellowship in Advanced Bioethics, Fellow, 2008-2010.

Monica Gerrek, PhD, Cleveland Fellowship in Advanced Bioethics, Fellow, 2008-2010.

Margo Eves, JD, Cleveland Fellowship in Advanced Bioethics, Fellow, 2007–2009.

Jason Gatliff, PhD, Cleveland Fellowship in Advanced Bioethics, Fellow, 2007–2009.

Hafzah Mueenuddin, JD, Cleveland Fellowship in Advanced Bioethics, Fellow, 2007–

2009.

Carmen Paradis, MD, Cleveland Clinic Department of Bioethics Fellowship, 2005–2006.

(Currently Associate Staff, Cleveland Clinic, Department of Bioethics.)

Paul J. Ford, PhD

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3

Cleveland Clinic Residents/Fellows/Post Doctoral Students (Ethics Research

Mentees):

Lama Chahine, MD, CCF Neurology resident, 2009-Present.

Michael Kelly, MD, CCF Neurosurgery resident, 2009-Present.

Abhishek Deshpande, MD, Neurosciences PhD candidate, 2005- Present. (Currently PhD

student in Neurosciences at Cleveland Clinic/Kent State University.)

Adrienne Boissy, MD, CCF Neurology resident/MS fellow, 2004-2008. (Currently

Associate Staff member of Cleveland Clinic Departments of Bioethics and Mellen Center

for Multiple Sclerosis.)

Randall Edgel, MD, CCF Stroke fellow, 2004-2005. (Currently on staff in Department of

Surgery and Neurology, St. Louis University, Saint Louis, MO.)

Clinical Internships/Rotations (Visiting Scholars):

Toni Nicoletti, PhD candidate, Graduate Student, Vanderbilt University, Nashville, TN.

One week clinical rotation as visiting scholar, June 5-9, 2006

Joseph DeMarco, PhD, Professor of Philosophy, Cleveland State University, Cleveland,

OH. One week clinical rotation as visiting scholar, June 6-10, 2005.

Alexander Curtis, PhD Candidate, Bowling Green State University Department of

Philosophy, CCF rotation-PHIL791, fall semester 2004.

Allyson Robichaud, PhD, Director of Bioethics Center, Cleveland State University,

Cleveland, OH. One week clinical rotation as visiting scholar, June 24-July 1, 2004.

Jenny Sproul-Swindell, PhD Candidate, Bowling Green State University Department of

Philosophy, CCF rotation-PHIL791, spring semester 2004 (Currently Assistant Professor

of medicine and medical ethics with the Center for Medical Ethics and Health Policy at

Baylor College of Medicine.)

Ainsley Newson, PhD, Research Fellow in the Medical Ethics Unit at Imperial College

London, UK. Clinical ethics internship, April-May 2004. (Currently serves as senior

lecturer in Biomedical Ethics at the Centre for Ethics in Medicine, University of Bristol,

UK.)

Jason Gatliff, PhD Candidate, Bowling Green State University Department of

Philosophy, CCF rotation-PHIL791, fall semester 2003 (Currently CFAB fellow as listed

above.)

Kathrin Ohnsorge, lic.Phil, MAS, Institut for Angewandate Ethic und Medizinethik,

Basel, Switzerland. Clinical ethics internship, May-July 2003.

Paul J. Ford, PhD

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4

CWRU Bioethics Masters students / Law Students:

Allison Boyce, Case Western Reserve University Undergraduate Masters Student, Thesis

reader, 2007-2008. (Senior Research Project Coordinator. Johns Hopkins Berman

Institute of Bioethics.)

Daniel Rubin, Case Western Reserve University Undergraduate Masters Student, 2006-

2007.

Rachel Mathoslah, JD student at CWRU Law School, Cleveland Clinic Foundation-Law-

Medicine Center Bioethics Research Program, Summer 2003.

Kendra Weatherhead, JD student at CWRU Law School, participated in Cleveland Clinic

Foundation-Law-Medicine Center Bioethics Research Program, Summer 2002.

Undergraduate Summer Internships:

Kayleigh Sopko, Hiram College Undergraduate Summer Internship, 2006. (Currently

enrolled in MBA/MPH at Case Western Reserve University Weatherhead School of

Management.)

Helen Spink, University of Virginia, Undergraduate Summer Internship, 2005.

(Currently enrolled in MPH at University of Michigan's School of Public Health.)

Stephanie Clough, Hiram College Undergraduate Summer Internship, 2004

Lauren Watson, Hiram College Undergraduate Summer Internship, 2003

III. Teaching Inventory

The following is a list of teaching sessions that includes a blend of audiences ranging for

high school students to attending physicians. The below table summarizes the total

number of teaching sessions since my appointment at the Cleveland Clinic and the

number of teaching session since the year of my appointment in the Case Medical School

(2004).

Summary of Teaching Sessions (Last updated January 2009)

All Years (2001-2009) Subset (2004-2009)

Med Students 34 15

Graduate 24 24

Res/Fellows 122 73

Grand Rounds(CCF) 16 12

CME (other) 53 28

Allied Health 26 15

Regional 24 13

National/International 36 27

Total 335 207

Paul J. Ford, PhD

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5

LOCAL

Medical Students

1. “Decisions at the End of Life,” Third year OSU Medical Students, CCF Cardiac

Rotation, August 23, 2001.

2. “Informed Consent,” Third year OSU Medical Students, CCF Cardiac Rotation,

August 23, 2001.

3. “Decisions at the End of Life,” Third year OSU Medical Students, CCF Cardiac

Rotation, October 15, 2001.

4. “Informed Consent,” Third year OSU Medical Students, CCF Cardiac Rotation,

October 15, 2001.

5. “Decisions at the End of Life,” Third year OSU Medical Students, CCF Cardiac

Rotation, December 12, 2001.

6. “Informed Consent,” Third year OSU Medical Students, CCF Cardiac Rotation,

December 12, 2001.

7. “Decisions at the End of Life,” Third Year OSU Medical Students, CCF Cardiac

Rotation, April 19, 2002.

8. “Informed Consent,” Third Year OSU Medical Students, CCF Cardiac Rotation,

April 19, 2002.

9. “Decisions at the End of Life,” Third Year OSU Medical Students, CCF Cardiac

Rotation, June 26, 2002.

10. “Informed Consent,” Third Year OSU Medical Students, CCF Cardiac Rotation,

June 26, 2002.

11. “Research Ethics,” Summer Research Medical Students, July 23, 2002.

12. “Decisions at the End of Life,” Third Year OSU Medical Students, CCF Cardiac

Rotation, August 21, 2002.

13. “Informed Consent,” Third Year OSU Medical Students, CCF Cardiac Rotation,

August 21, 2002.

14. “Decisions at the End of Life,” Third Year OSU Medical Students, CCF Cardiac

Rotation, December 18, 2002.

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15. “Informed Consent,” Third Year OSU Medical Students, CCF Cardiac Rotation,

December 18, 2002.

16. “Decisions at the End of Life,” Third Year OSU Medical Students, CCF Cardiac

Rotation, February 26, 2003.

17. “Informed Consent,” Third Year OSU Medical Students, CCF Cardiac Rotation,

February 26, 2003.

18. “Research Ethics,” Summer Research Medical Students, July 22, 2003.

19. “Compassionate and Responsible Conversations about Withholding or

Withdrawing Ventilators at the End-of-life,” with Weise K. Year 2; Block 10;

Week 6, CCLCM, February 10, 2006.

20. Mentored summer project for Jun Xu, Summer 2006.

21. "Neuroethics,” Third Year Medical Students, CCLCM, August 23, 2006.

22. “Stroke Ethics,” with Boissy A, Third Year Medical Students, CCLCM,

September 15, 2006.

23. "Neuroethics,” with Kubu C, Third Year Medical Students, CCLCM, October 11,

2006.

24. “Neuroethics,” Third Year Medical Students, CCLCM, November 22, 2006.

25. “Neuroethics,” Third Year Medical Students, CCLCM, February 14, 2007.

26. “Stroke Ethics,” with Boissy A, Third Year Medical Students CCLCM, January

19, 2007.

27. Seminar, “Compassionate and Responsible Conversations about Withholding or

Withdrawing Ventilators at the End-of-life,” with Weise K. Year 2; Block 10;

Week 6, CCLCM, February 16, 2007.

28. “Neuroethics,” Third Year Medical Students, CCLCM, May 2, 2007.

29. “Informed Decision-Making,” with Farrell RM, in session “Foundations of

Clinical Medicine,” First Year Medical Students, CCLCM, May 8, 2007.

30. “Neuroethics,” Third Year Medical Students, CCLCM, June 20, 2007.

31. “Ethics in Stroke,” Stroke Macro, Third Year Medical Students, CCLCM,

September 14, 2007.

Paul J. Ford, PhD

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32. “Surrogate Decision-Making II,” Second Year Medical Students, CCLCM,

October 23, 2007.

33. “Ethics in Stroke,” Stroke Macro, Medical Students, CCLCM, January 18, 2008.

34. “Surrogate Decision-Making.” First Year Medical Students, CCLCM, May 6,

2008.

35. “Surrogate Decision-Making.” First Year Medical Students, CCLCM, February

3, 2009.

36. “Difficult Conversations about Vent Withdrawal.” Second Year Medical

Students, CCLCM, February 13, 2009.

Graduate Students

1. "Ethics Consultation at CCF." CWRU Bioethics Masters Students, September 21,

2005; February 08, 2006; September 20, 2006.

2. Preceptor, CWRU Bioethics Students, Fall Semester, 10 sessions: Sept 12, 26;

Oct 3, 10, 17, 24, 31; Nov. 7, 11, 28, 2007.

3. Preceptor, CWRU Bioethics Students, Spring Semester, 11 sessions: Jan. 14, 28;

Feb. 4, 11, 25; March 3, 17, 24, 31; April 7, 14, 2008.

Cleveland Clinic Residents and Fellows

1. “Issues in Adolescent Care,” Pediatric Residents, September 10, 2001.

2. “Issues in Adolescent Care,” Pediatric Residents, September 10, 2001.

3. “Dilemma’s Arising From Concurrent Research Protocols with Overlapping

Recruitment Pools,” with Agich G, Neurology Resident Journal Club, October 02,

2001.

4. “Ethical Aspects of Oncology Cases,” Hematology/Oncology Fellows

Conference, November 09, 2001.

5. “Critically Ill Patients, Family Anxiety and Depression, and Ethical Decision

Making,” Surgical Intensive Care Resident Journal Club, December. 05, 2001.

6. “Issues in Adolescent Care,” Pediatric Residents, January 21, 2002.

7. “Issues in Adolescent Care,” Pediatric Residents, February 18, 2002.

Paul J. Ford, PhD

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8

8. “Ethical Issues in Pain Management,” Fellowship Program in Pain Management,

February 22, 2002.

9. “Ethics Orientation,” MICU Residents, March 15, 2002.

10. “Ethical Aspects of Oncology Cases,” Hematology/Oncology Fellows

Conference, March 22, 2002.

11. “Cultural Sensitivities and Stereotypes: Finding an Ethical Balance,” Hem/Onc

lecture series on cultural issues in dying, April 11, 2002.

12. “Ethics Orientation,” MICU Residents, April 12, 2002.

13. Case Conference, SICU/CVICU Multidisciplinary Bioethics Conference, May 20,

2002.

14. “Ethical Aspects of Oncology Cases,” with Van Eys J, Hematology/Oncology

Fellows Conference, May 31, 2002.

15. “Ethics Orientation,” MICU Residents, June 7, 2002.

16. “Introduction to Bioethics,” SICU/CVICU Multidisciplinary Bioethics

Conference, June 17, 2002.

17. “Bioethics at the End of Life,” Working rounds for H80 residents, June 20, 2002.

18. “Ethics Orientation,” MICU Residents, July 08, 2002.

19. “Ethics Orientation,” MICU Residents, August 02, 2002.

20. Case Conference, SICU/CVICU Multidisciplinary Bioethics Conference, August

12, 2002.

21. “Ethics Orientation,” MICU Residents, August 30, 2002.

22. “Introduction to Bioethics,” SICU/CVICU Multidisciplinary Bioethics

Conference, September 09, 2002.

23. “Informed Consent Issues for Plastic Surgeons,” Plastic Surgery Residents,

September 10, 2002.

24. “Ethics Orientation,” MICU Residents, September 27, 2002.

25. “Basic Bioethics for Neurologists,” Neurology Resident Noon Conference,

September 30, 2002.

Paul J. Ford, PhD

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9

26. “Ethics Orientation,” MICU Residents, October 21, 2002.

27. SICU Journal Club, researched material and directed Bowling Green State

University Graduate Student, October 30, 2002.

28. Case Conference, with Agich G, SICU/CVICU Multidisciplinary Bioethics

Conference, December 02, 2002.

29. Case Review, Hematology/Oncology Fellows Conference, December 13, 2002.

30. “Ethics Orientation,” MICU Residents, December 20, 2002.

31. “Ethics Orientation,” MICU Residents, January 17, 2003.

32. Case Conference, SICU/CVICU Multidisciplinary Bioethics Conference, January

27, 2003.

33. “Ethics Orientation,” MICU Residents, February 14, 2003.

34. “Ethics Orientation,” MICU Residents, March 14, 2003.

35. Journal Club, Hematology/Oncology Fellows Conference, March 21, 2003.

36. Case Conference, SICU/CVICU Multidisciplinary Bioethics Conference, March

24, 2003.

37. “Ethical Issues in Pain Management,” Pain Management Fellows, March 20,

2003.

38. SICU Journal Club, April 23, 2003.

39. “Ethics Orientation,” MICU Residents, May 09, 2003.

40. “Introduction to Bioethics,” SICU/CVICU Multidisciplinary Bioethics

Conference, June 16, 2003.

41. “Ethics Orientation,” MICU Residents, August 01, 2003.

42. “Hot Topics in Neurology,” Neurology Resident Conference, August 08, 2003.

43. Case Conference, with Weise K, SICU/CVICU Multidisciplinary Bioethics

Conference, August 11, 2003.

44. “Ethics Orientation,” MICU Residents, August 29, 2003.

45. “Ethics Orientation,” MICU Residents, September 29, 2003.

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46. Case Conference, SICU/CVICU Multidisciplinary Bioethics Conference, October

10, 2003.

47. “Introduction to Bioethics,” SICU/CVICU Multidisciplinary Bioethics

Conference, November 03, 2003.

48. “Ethics Orientation,” MICU Residents, November 24, 2003.

49. “Ethics Orientation,” MICU Residents, December 19, 2003.

50. Ethics Case Review, Hematology/Oncology Fellows Conference, January 09,

2004.

51. “Ethics Orientation,” MICU Residents, January 16, 2004.

52. “Introduction to Bioethics,” SICU/CVICU Multidisciplinary Bioethics

Conference, January 26, 2003.

53. SICU Journal Club, with Sproul-Swindell J, February 04, 2004.

54. “Ethics Orientation,” MICU Residents, February 13, 2004.

55. “Ethics Orientation,” MICU Residents, March 12, 2004.

56. Journal Club, Hematology/Oncology Fellows Conference, March 19, 2004.

57. Journal Club, Neurology Resident Conference, Sproul-Swindell J, March 22,

2004.

58. “Ethics Orientation,” SICU Journal Club, MICU Residents, April 09, 2004.

59. “Ethics Orientation,” MICU Residents, May 7, 2004.

60. “Ethics Orientation,” MICU Residents, July 9, 2004.

61. “Ethics Orientation,” MICU Residents, August 6, 2004.

62. Case Conference, SICU/CVICU Multidisciplinary Bioethics Conference, August

16, 2004.

63. “Neuro Genetics,” Pediatric Neurology Journal Club, November 8, 2004.

64. “Issues in Pain Management,” Pain Management Fellows, January 11, 2005.

65. “Basic Bioethics,” MICU Residents, January 21, 2005.

Paul J. Ford, PhD

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66. Neurology Case Review, Neurology Residents, January 21, 2005.

67. Ethics Case Review, Neurology Residents, February 11, 2005.

68. “Introductions to Ethics,” MICU resident, March 15, 2005.

69. Ethics Case Discussion, Hematology/Oncology Fellows, March 29, 2005.

70. Journal Club, SICU residents, April 13, 2005.

71. “Introductions to Ethics,” MICU residents, April 15, 2005.

72. “Intraoperative Revocation of Consent: Harm, Autonomy, and Justice,”

Neuropsychology Fellows, April 19, 2005.

73. “Introduction to Bioethics,” SICU/CVICU Residents. April 25, 2005.

74. “Religion, Translation, and Medicine,” Palliative Medicine Fellows, April 27,

2005.

75. “Cardiovascular Intensive Care Unit Case Discussion,” SICU/CVICU Residents,

May 23, 2005.

76. “Introductions to Ethics,” MICU residents, July 8, 2005.

77. “Ethics Issues in Neurosurgery,” Neurosurgery Residents, July 21, 2005.

78. “NICU Ethics Case” NICU/SICU/CVICU Residents, August 8, 2005.

79. “Organ Donation” with Smith C, Neurology Residents, August 8, 2005.

80. “Ethics in a Palliative Care Setting,” with Davis MP, Palliative Medicine Fellows,

August, 31, 2005.

81. Journal Club, SICU residents, September 21, 2005.

82. “SICU Ethics Case,” NICU/SICU/CVICU Residents, October 31, 2005.

83. “Epistemology and Ethics in Neuropsychology,” Neuropsychology Fellows,

November 29, 2005.

84. “A Jehovah’s Witness Evaluated for an Epilepsy Resection,” Neurosurgery

Residents, December 15, 2005.

85. Case Discussion, Hematology/Oncology Fellows, January 31, 2006.

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86. “Cultural Sensitivities and Stereotypes: Finding an Ethical Balance,” with

Nicoletti T, Hematology/Oncology Fellows, January 16, 2006.

87. Brain Death, Apnea Tests, and Ventilator Withdrawal: Ethics Cases,” Neurology

Residents, February 13, 2006.

88. “Tx to Comfort, To Donation,” SICU Case Review, March 20, 2006.

89. “Writing a Neuroethics Case: 5 Easy Steps,” Neurosurgery Residents, May 04,

2006.

90. “Neuroethics: PVS,” Neurology Journal Club, June 7, 2006.

91. “Psychiatric Ethics,” Psychiatric Residents, November 9, 2006.

92. “Ethical Considerations in Competing Clinical Trials,” Stroke Staff and Residents,

Cleveland Clinic, December 6, 2006.

93. “Further Neurosurgery Ethics Cases,” Neurosurgery Residents, December 21,

2006.

94. “Advanced Ethics for Psychiatrists,” Psychiatric Residents, January 24, 2007.

95. “Abandonment, Responsibility and Honesty: Ethics in Pain Management,” Pain

Management Fellows, March 22, 2007.

96. “An Altered Advance Directive,” Multidisciplinary NICU Rounds, Cleveland

Clinic, June 18, 2007.

97. “Providing a Feeding Tube for a Demented Patient Without a Surrogate,”

Neurology Residents, August 8, 2007.

98. “Conflicts of Interests in Residency Education,” Neurology Journal Club,

Neurology Residents, August 15, 2007.

99. “Withdrawing After Only Three Days,” Multidisciplinary Rounds –

SICU/CVICU/NICU, Cleveland Clinic, October 8, 2007.

100. “Post-operative Control of Neuro Devices,” Neurosurgery Residents, October 22,

2007.

101. “Ethics Case Discussion,” with Gillett G, Neurology Residents, November 6,

2007.

102. “Neuro ICU Ethics,” Neuro ICU Fellows, November 14, 2007.

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103. “Abandonment, Responsibility and Honesty: Ethics in Pain Management,” Pain

Management Residents and Fellows, November 29, 2007.

104. “94-year-old with Infected Joints,” Multi-disciplinary ICU noon conference,

December 3, 2007.

105. “Ethics in Pain Research,” with Gatliff J, Pain Management Residents and

Fellows, January 17, 2008.

106. “Outpatient Ethics Cases,” Neurology Residents Noon Conference, February 12,

2008.

107. “Death by Neurological Criteria,” Ethical Issues in NICU, NICU Fellows, March

19, 2008.

108. “Ethics Case: Tantamount to Killing,” CVICU Case Conference, April 21, 2008.

109. Ethics Teaching Rounds, Cardiac Care Unit, June 6, 2008.

110. “Industry Relations,” with Eves M, Medical Spine Fellows, Cleveland Clinic,

June 6, 2008.

111. “Ethics in Neuropsychology: Scientific and Clinical Considerations,”

Neuropsychology Fellows, July 15, 2008.

112. “Brain Death/Vegetative State,” Neurology Residency Conference, August 1,

2008.

113. Ethic Teaching Rounds, Cardiac Care Unit, August 6, 2008.

114. Ethic Teaching Rounds, Cardiac Care Unit, August 20, 2008.

115. “Introduction to Ethics” Peds/Adolescent Psychiatry Staff and Fellows, Cleveland

Clinic, September 3, 2008.

116. Case Analysis, supervised Gerrek M, Peds/Adolescent Psychiatry Staff and

Fellows, Cleveland Clinic, September 10, 2008.

117. “Narrative in Bioethics Research,” Methods in Research Course, Cleveland

Fellowship in Advanced Bioethics Fellows, September 16, 2008.

118. “Research Ethics/Industry Ethics,” Peds/Adolescent Psychiatry Staff and Fellows,

Cleveland Clinic, September 17, 2008.

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119. “DNR and Withdrawal of Care,” with Eves M, Neurology Residency Conference,

October 31, 2008.

120. Ethics Teaching Rounds, Cardiac Care Unit, November 26, 2008.

121. Ethic Teaching Rounds, Cardiac Care Unit, January 7, 2009.

122. “End-of-Life Issues in Neuro Intensive Care Unit,” NICU Residents, January 22,

2009.

Continuing Medical Education

Cleveland Clinic Grand Rounds

1. “Recipient Criteria in Non-directed Unrelated Living Kidney Donation,”

Transplantation Grand Rounds, January 23, 2001.

2. “Overcoming Problems in Attaining Consent,” Research Grand Rounds,

September 25, 2001.

3. “Issues in Paying for Organs,” Nephrology and Hypertension Grand Rounds, May

23, 2003.

4. “Principles of Bioethics,” with Davis M, Palliative Care Grand Rounds, August

06, 2003.

5. “Ethical Challenges of Comfort Care: Severe Fetal Anomalies and Perinatal

Planning,” OB/GYN Grand Rounds, June 21, 2004.

6. “Intraoperative Revocation of Consent in Awake Neurosurgeries,” Neurosurgery

Grand Rounds, May 20, 2005.

7. “Ethics Consultation for Epilepsy Surgery Candidates: A 15-Year Retrospective

Review,” Epilepsy Grand Rounds, July 08, 2005.

8. “Deep Brain Stimulation for Epilepsy: Scientific and Ethical Challenges,” with

Najm I, Grand Rounds for Clinical Research, May 23, 2006.

9. “Neuroethics and Functional Neurosurgery Multidisciplinary Team,” with Kubu

CS, Psychiatry and Psychology Grand Rounds, April 13, 2006.

10. “Brain, Mind, Self: Neuroethics for Clinicians and Researchers,” Neuroscience

Grand Rounds, June 25, 2007.

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11. “Three Cases of Refractory Status Epilepticus,” with Mays J, Neuroscience

Grand Rounds, July 23, 2007.

12. “Five Pressing Ethical Challenges in Medical Refractory Epilepsy,” Epilepsy

Grand Rounds, November 02, 2007.

13. “Towards a Culture of Innovation: Ethical and Organizational Challenges,” with

Benzel, E and Gilberston L, Neurosurgery Grand Rounds, January 16, 2008.

14. “Ethical Issues in Status Epilepticus: Innovating, Withdrawing, and Waiting,”

Epilepsy Grand Rounds, April 4, 2008.

15. “Risk Management and Sentinel Events,” with Bautista J, Neurosurgery Grand

Rounds, July 23, 2008.

16. “Cases that Haunt Us: Reflections on Ethics Consultation,” Moderator of

Bioethics Grand Rounds with speaker Dudzinski D and panelists Griggins C,

DeMarco J, November 4, 2008.

Others

1. Ethics Consultation Service Case Review Session, July 26, 2001.

2. Ethics Consultation Service Case Review Session, August 09, 2001.

3. “Disclosure, Assent, and Prognosis in Pediatric Medicine,” CCF Children’s

Hospital for Rehabilitation, September 06, 2001.

4. Ethics Consultation Service Case Review Session, September 13, 2001.

5. “Processes and Procedures: Case Presentation,” Cleveland Clinic Health System

Ethics Committee’s Retreat, September 14, 2001.

6. Ethics Consultation Service Case Review Session, October 25, 2001.

7. Ethics Consultation Service Case Review Session, November 08, 2001.

8. Ethics Consultation Service Case Review Session, January 31, 2002.

9. Ethics Consultation Service Case Review Session, February 14, 2002.

10. “Cultural Sensitivities and Stereotypes: Finding an Ethical Balance,” Cultural

Issues In Dying Lecture Series, Cleveland Clinic Foundation, April 11, 2002.

11. Ethics Consultation Service Case Review Session, June 12, 2002.

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12. Ethics Consultation Service Case Review Session, June 26, 2002.

13. Ethics Consultation Service Case Review Session, August 07, 2002.

14. Ethics Consultation Service Case Review Session, August 21, 2002.

15. Ethics Consultation Service Case Review Session, September 20, 2002.

16. “Issues in Genetic Testing: Prenatal and Preimplantation Diagnosis,” CCF

Children’s Hospital for Rehabilitation, October 10, 2002.

17. Ethics Consultation Service Case Review Session, January 23, 2003.

18. Ethics Consultation Service Case Review Session, March 13, 2003.

19. Ethics Consultation Service Case Review Session, April 24, 2003.

20. Ethics Consultation Service Case Review Session, May 15, 2003.

21. Ethics Consultation Service Case Review Session, July 17, 2003.

22. “Killing and Letting Die: Evaluating Distinctions,” CCF Ethics Committee

Education Seminar, September 26, 2003.

23. Ethics Consultation Service Case Review Session, September 25, 2003.

24. “Charity Care,” with Weise K, Bioethics Research Seminar, October 21, 2003.

25. Ethics Consultation Service Case Review Session, November 13, 2003.

26. Ethics Consultation Service Case Review Session, January 06, 2004.

27. Journal Club, Bioethics Research Seminar, January 13, 2004.

28. “Life, Health, Death,” CCF Ethics Committee Education Seminar, January 23,

2004.

29. Journal Club, Bioethics Research Seminar, January 27, 2004.

30. “Deep Brain Stimulation And Ethics: Evolving Issues in Neuromodulation,”

Bioethics Conversations at CWRU School of Medicine, January 28, 2004.

31. “Epilepsy Pre-surgery Consultation: Retrospective Review,” Bioethics Research

Seminar, March 09, 2004.

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32. Ethics Consultation Service Case Review Session, supervising Sproul-Swindel J,

March 16, 2004.

33. Ethics Consultation Service Case Review Session, April 06, 2004.

34. Ethics Consultation Service Case Review Session, April 20, 2004.

35. Ethics Consultation Service Case Review Session, May 4, 2004.

36. Ethics Consultation Service Case Review Session, May 18, 2004.

37. Ethics Consultation Service Case Review Session, June 1, 2004.

38. Ethics Consultation Service Case Review Session, June 15, 2004.

39. Ethics Consultation Service Case Review Session, September 21, 2004.

40. “Neuro Ethics: Three Brief Presentations,” Bioethics Research Seminar,

September 28, 2004.

41. Ethics Consultation Service Case Review Session, November 16, 2004.

42. “Complex Clinical Ethics Consultation: Intake Issues,” CCF Western Region

Ethics Committees, January 20, 2005.

43. In Depth Case Discussion, Department of Bioethics, March 15, 2005.

44. “Basic Research Ethics Case Discussion,” Lerner Institute Ethics Training

Course, June 28, 2005.

45. “Neurosurgery and Family Interests: A Case of Decreased Burden of Care,” Bioethics

Research Seminar, October 04, 2005.

46. “PGD for HLA Match,” Department of Bioethics, October 18, 2005.

47. “Waking a Patient up for Consent: How Much Pain and Burden?” Department of

Bioethics, February 21, 2006.

48. “Ethics of Neuro Implants,” Bioethics Department Seminar, October 3, 2006.

49. “Conflict Resolution and Mediation in the Family Meeting,” with Paradis, C,

Warmuth, A, Cannady, G, CCHS Ethics Education Day, October 31, 2006.

50. “Can Epilepsy Surgery Trials Be Performed?” Co-Chair of Epilepsy Ethics Panel

with Jacobs M, Cleveland Clinic, June 28, 2007.

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51. “Anonymous Reports about Patient Behavior: An Ethics Consultation About

Crack,” Bioethics In-Depth Case Presentation, August 21, 2007.

52. “A Child in Refractory Status Epilepticus.” Bioethics In-Depth Case

Presentation, April 15, 2008.

53. Ethics Consultation Service Case Review Session with Mueenuddin H, January

13, 2009.

Allied Health Education

1. “Engineering Research Ethics: A Macro View,” Biomedical Engineering

Students, Cleveland Clinic, August 02, 2001.

2. “Medical Ethics,” Radiation Technology Students, August 06, 2001.

3. “Engineering Research Ethics: Personal Responsibility,” Biomedical Engineering

Students, Cleveland Clinic, August 06, 2001.

4. “Engineering Research Ethics: A Macro View,” Biomedical Engineering

Students, Cleveland Clinic, July 11, 2002.

5. “Engineering Research Ethics: Personal Responsibility,” Biomedical Engineering

Students, Cleveland Clinic, July 18, 2002.

6. “Research Ethics,” John Hays High School Interns, July 26, 2002.

7. “Introduction to Ethical Issues in Radiation Technology,” Radiation Technology

Students, August 05, 2002.

8. “Ethical and Philosophical Issues in Deep Brain Stimulators” Connecticut

College, New London, CT, October 23, 2002.

9. “Research Ethics,” John Hay High School Interns, July 18, 2003.

10. “Engineering Research Ethics: Personal Responsibility,” Biomedical Engineering

Students, Cleveland Clinic, July 21, 2003.

11. “Introduction to Ethical Issues in Radiation Technology,” Radiation Technology

Students, Cleveland Clinic, August 07, 2003.

12. “Engineering Research Ethics: A Macro View,” Biomedical Engineering

Students, Cleveland Clinic, July 1, 2004.

13. “Engineering Research Ethics: Personal Responsibility,” Biomedical Engineering

Students, Cleveland Clinic, July 8, 2004.

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14. “Engineering Research Ethics: A Macro View,” Biomedical Engineering

Students, Cleveland Clinic, June 30, 2005.

15. “Engineering Research Ethics: Personal Responsibility,” Biomedical Engineering

Students, Cleveland Clinic, July 7, 2005.

16. Bioethics Journal Club, Summer Bioethics Students (6 sessions), June 6, June 15,

June 29, July 06, July 13 & July 27, 2005.

17. “Introduction to Ethical Issues in Radiation Technology,” Radiation Technology

Students, Cleveland Clinic, August 11, 2005.

18. “Engineering Research Ethics: A Macro View,” Biomedical Engineering

Students, Cleveland Clinic, July 6, 2006.

19. “Engineering Research Ethics: Personal Responsibility,” Biomedical Engineering

Students, Cleveland Clinic, July 13, 2006.

20. Bioethics Summer Journal Club, Summer Bioethics Students, Cleveland Clinic, 6

sessions 2006.

21. “Engineering Ethics,” Biomedical Engineering Students, Cleveland Clinic,

July 5, 2007.

22. “Engineering Ethics,” Biomedical Engineering Students, Cleveland Clinic,

July 17, 2007.

23. “Ethics for Engineers,” Biomedical Engineering Students, Cleveland Clinic,

November 29, 2007.

24. “Ethical Issues in Engineering,” Biomedical Engineering Students, Cleveland

Clinic, July 10, 2008.

25. “Personal Ethics Issues in Engineering,” with Gatliff J, Biomedical Engineering

Students, Cleveland Clinic, July 24, 2008.

26. “Introduction to Consult Services,” Neurological Institute Nurses, Cleveland

Clinic, September 8, 2008.

REGIONAL

1. Moderator for panel at “Is There a Pink Slip in Your Genes?” Cleveland State

Marshal School of Law, Cleveland, OH, December 07, 2001.

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2. “Issues in Organ Transplantation,” Surgical Residents at Fairview Hospital,

Cleveland, OH, Feb 07, 2002.

3. “Ethics in Clinical Practice,” Surgical Residents at Fairview Hospital, Cleveland,

OH, March 07, 2002.

4. “Issues in Genetic Testing: Prenatal and Preimplantation Diagnosis,” CCF

Children’s Hospital for Rehabilitation, Cleveland, OH, October 10, 2002.

5. “Clinical Issues in Pain Management,” Symposium on Ethical Issues in Pain

Management, Cleveland State University, Cleveland, OH, March 01, 2003.

6. “Ethics, Narratives, and Pain,” Symposium on Ethical Issues in Pain

Management, Cleveland State University, Cleveland, OH, March 01, 2003.

7. “Issues Related to Transplant Recipients,” Bioethics Course, Case Western

Reserve University, Cleveland, OH, March 20, 2003.

8. “Issues in Solid Organ Transplantation,” Bioethics Course, Case Western Reserve

University, Cleveland, OH, March 25, 2003

9. “Ethical Issues in Futility,” Metro-Health Medical Center, Cleveland, OH, May

29, 2003.

10. “Technology Dependent Children: Ethically challenging Questions,” with Weise

K, Summer Retreat for ventilator Dependent Children, June 10, 2003.

11. “Seminar in Clinical Ethics Consultation,” Western Cleveland Clinic Health

System Hospitals, September 13, 2003 (3.5 hour seminar)

12. “Deep Brain Stimulation And Ethics: Evolving Issues In Neuromodulation,”

Bioethics Conversations, Case Western Reserve University School of Medicine,

Cleveland, OH, January 28, 2004.

13. “Case Discussion,” City-wide Ethics - A Joint Program between: CCF, CWRU,

MetroHealth, & University Hospitals, City-wide Ethics Case Discussion, April 2,

2004.

14. “Advanced Clinical Ethics Consultations: Pitfalls and Challenges,” Bioethics

Network of Ohio Conference, Lakewood, OH, May 13, 2004.

15. “Assessing the Terri Schiavo Case,” Ethics Grand Rounds Panel, Bioethics

Network of Ohio Conference, Lakewood, OH, May 14, 2004.

16. A Joint Program between: CCF, CWRU, MetroHealth and University Hospitals,

City-Wide Ethics Case Discussion, December 3, 2004.

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17. “Complex Ethical Consultation,” CCHS Western Region Ethics Committee,

January 20, 2005.

18. “Ethics in Clinical Neuropsychology,” with Griggins C. Ohio Neuropsychology

Group, Columbus, OH, November 04, 2005.

19. “Ethical Issues in Futility,” Palliative Care Intensive Course, Breen School of

Nursing, Ursuline College, Pepper Pike, OH, September 09, 2005.

20. “Hospital Ethics Consultation: Process, Design, and Issues,” 15th Annual

Bioethics Network of Ohio Conference, Lakewood, OH, May 11, 2005. (3 hour

pre-conference workshop)

21. “Ethics in Psychosurgery and Neuromodulation: Learning from the Past and

Looking to the Future,” Wooster College, Wooster, OH, April 24, 2006.

22. “Clinical Neuroethics,” with Boulis N, Hiram Students at Cleveland Clinic, May

3, 2007.

23. “Neuroethics and Clinical Bioethics,” Lakewood High School, Lakewood, OH,

May 7, 2007.

24. “Ethics in Functional Neurosurgery: Ablations, Resections, and Brain Implants.”

Philosophy Department, Cleveland State University, Cleveland, OH, December

3, 2008.

NATIONAL/INTERNATIONAL

1. "How many organs? How many lives?: Ethical Issues Surrounding Multi-organ

Transplantation," DCI Ethics Transplantation Lecture Series, Nashville, TN,

October 19, 2001.

2. “Hi-Tech Surgeries and Devices: Challenges to Consent, Research Structure, and

Responsibility,” 30th

Annual Conference on Value Inquiry, Milwaukee, WI, April

05, 2002.

3. “Ethical and Philosophical Issues in Deep Brain Stimulators,” Connecticut

College, New London, CT, October 23, 2002.

4. “Ethics Consultation in the ICU: Philosophical Ethics Meets End of Life

Suffering,” Connecticut College, New London, CT, October 24, 2002.

5. “Advancing from Treatment to Enhancement in Deep Brain Stimulation: A

Question of Research Ethics,” Should Everyone Be Above Average? Medical

Enhancement - Reconsidering the Promises, Tulsa, OK, February 22, 2003.

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6. “Appropriate Extent and Length of Involvement,” 1st International Summit on

Clinical Ethics Consultation, Cleveland, OH, April 06, 2003.

7. “When Chips Gain Teeth: Issues in Autonomous Surgical Micro-bots,” Medicine

and Philosophy session, American Philosophical Association Meeting, Cleveland,

OH, April 25, 2003.

8. “Ethical and Philosophical Issues in Deep Brain Stimulators,” 5th

annual

Bioethics Retreat, Shanty Creek, MI, June 28, 2003

9. “Ethical Problems in Providing Free Care: Exploring One Community’s

Experience,” with Weise K, Griggins C, Aulisio M, and Hiller H, American

Society for Bioethics and Humanities, Montreal, QC, Canada, October 25, 2003.

10. “Cases that Haunt Us,” Bioethics Summer Retreat, Wintergreen, VA, June 17,

2004.

11. “Ethics Consultation for Epilepsy Surgery Candidates,” Ethics Grand Rounds,

The Hospital for Sick Children, Toronto, Canada, May 26, 2005.

12. “Pre-surgery Ethics Consultation,” Seminar, Joint Centre for Bioethics of the

University of Toronto, Toronto, Canada, May 25, 2005.

13. “Slicing the Brain, Slicing the Mind: Neuromodulation, Neuroimaging, and

Ethics,” Ford PJ. Ethics Grand Rounds, Methodist Medical Center, Houston, TX,

May 18, 2006.

14. “Deep Brain Stimulation and Ethics,” Massachusetts General Hospital, August

28, 2006.

15. “Difficult Consultations that Haunt Us,” Joint Ethics Conference – 18th

Canadian

Bioethics Society Conference and 3rd

International Conference on Clinical Ethics

and Consultation, Toronto, Canada, June 1, 2007.

16. “Deception, Ulysses and Confinement: Ethical Challenges in Mental Health,”

Ethics Committee Seminar, Community Hospice of Northeast Florida,

Jacksonville, FL, March 8, 2007.

17. “Reflections in Neuroethics: Can My Brain Chip be Repossessed?” Philosophy

Seminar, University of North Florida, Jacksonville, FL, March 8, 2007.

18. “Ethics in CNS Trials,” Faculty for CNS Clinical Trials, Institute for

International Research, Orlando, FL, April 11, 2007.

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19. “A Cautionary Tail: Teaching Neuroethics Using Were-Rabbit,” Humanities and

Neuroscience Conference, Bucknell University, Lewisburg, PA, April 20, 2007.

20. “Clinical Ethics Meets Neurosciences: Functional Neurosurgery and Brain

Imaging,” 17th

Annual Bioethics Network of Ohio Conference, Columbus, OH,

May 11, 2007.

21. “Ethical Challenges in Neural Implants: Researcher’s Perspective”

(Organizer/Moderator), International Conference – Implanting Change: The

Ethics of Neural Prosthetics, Pennsylvania State University, University Park, PA,

August 27, 2007.

22. “How Much Device Control for Subject/Patient?” International Conference

“Implanting Change: The Ethics of Neural Prosthetics,” Pennsylvania State

University, University Park, PA, August 27, 2007.

23. “Special Ethical Consideration for Psychiatric Patients” (Facilitator), International

Conference “Implanting Change: The Ethics of Neural Prosthetics,”

Pennsylvania State University, University Park, PA, August 27, 2007.

24. “Ethical Issues in Managing Patients in PVA,” Joint Conference: 5th

Annual

Neurocritical Care and Stroke Conference and 10th

Annual Neuroscience Nursing

Conference, Cleveland, OH, October 6, 2007.

25. “How To” Panel, “Effective Ethics Consults: Finding Surrogate Decision-

Makers,” (Moderator), 2007 American Society for Bioethics and Humanities

Annual Meeting, Washington, DC, October 19, 2007.

26. “Who Gets the Controls? The Ethics of Brain Implants and Post-Operative

Settings,” Law and Ethics Center Lecture Series, Columbia-Presbyterian

Hospital, New York, NY, December 6, 2007.

27. “Patients with Focal Deficits in Decision-Making: Forced Treatment and Free

Will.” Canadian Institutes of Health Research Work Group, Banff, Canada, May

9, 2008.

28. “Ethical Challenges in Forced Treatment in Patients with Focal Cognitive

Deficits.” Internal Medicine Residents, University of Washington School of

Medicine, Seattle, WA, May 21, 2008.

29. “Ethical Issues in Managing Patients in PVS/MCS/LIS,” Ethics Department,

University of Washington School of Medicine, Seattle, WA, May 22, 2008.

30. “Refractory Generalized Status Epilepticus: Uncertainty, Complexity, and Self-

Fulfilling Prophecies,” in Session “End-of-Life Decision-Making for Severely Ill

Neurological Patients: Developing Research and Collaboration to Engage

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Providers, Families, and the Public.” 19th

Canadian Bioethics Society

Conference, Memorial University, St. John’s NF, Canada, June 19, 2008.

31. “Group Homes as Family,” in Session “Experientially Challenging Ethics

Consultations with Non-Traditional Family Configurations,” 19th

Canadian

Bioethics Society Conference, Memorial University, St. John’s NF, Canada, June

19, 2008.

32. “Ethical Challenges of Treating Refractory Status Epilepticus,” Neurology Grand

Rounds, University of Washington School of Medicine, Seattle, WA, May 22,

2008.

33. Moderator of Paper Session, “Neuroscience and Identity,” 2008 ASBH Annual

Meeting, Cleveland, October 24, 2008.

34. “Ethics in Neuromodulation: What Role for the Non-MD Clinician?’ Pre-

Conference Presentation, Annual Meeting of the North American

Neuromodulation Society, Las Vegas, NV, December 5, 2008.

35. “Ethics in Neuromodulation: Clinical Challenges Beyond Conflicts of Interest.”

Invited Plenary Presentation, Annual Meeting of the North American

Neuromodulation Society, Las Vegas, NV, December 6, 2008.

36. “Innovating the Brain: Ethical Issues with Neuro Technologies,” The Center for

Translational Neuroscience Distinguished Lecture, University of Arkansas for

Medical Sciences, Little Rock, AR, January 29, 2009.

37. “Ethics of Technological Advances in Neurosurgery,” Arkansas Medical Society

Distinguished Lecture, University of Arkansas for Medical Sciences, January 29,

2009.

IV. Important Teaching Contributions

My most important teaching contributions are found in curriculum development,

publishing, and a creation of a tool for ethics case write-ups. Curriculum development

has involved creating ethics threads through several of the CCLCM modules as well as

creating several seminars specializing in ethics. The second important contribution

relates to a recently published book. My coeditor and I of Complex Ethical

Consultations: Cases that Haunt Us (Cambridge University Press 2008) explicitly

developed the material in the book to fit the educational needs of ethics committee

members and clinical ethicists. It was designed specifically for relevance of language,

format, and length that would suit mature learners. There is an entire chapter describing

various pedagogies for the application of the cases in various contexts. Given the gap in

advanced ethics consultation, this carefully constructed case-book constitutes an

important educational advancement. Finally, along with a PhD student and the chair of

neurosurgery, I developed a template and guidelines for improving the educational value

Paul J. Ford, PhD

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of ethics cases written by residents. This template has been shared with other residency

and fellowship programs that are evaluating its application.

V. Awards

Award/Certificate:

Distinguished Educator Level I Certificate, Cleveland Clinic Division of Education,

Conferred 2009.

Last Updated March 11, 2009