We wish to thank the following experts for their willingness to be interviewed about the topic of moral distress. None of our contributors received any compensation for their time, and did so out of their desire to educate and contribute to the national dialogue on moral distress. All of the interviews took place March 21-22, 2013 during the 2013 Ethics of Caring conference, Hilton, Universal City, Los Angeles, California.
The biographies below represent the status of the interviewees at the time they were filmed. On the 10th anniversary of the Moral Distress Education Project, click here for an update on where they are now.
Katherine Brown-Saltzman, RN, MA
Co-Director, The UCLA Health Ethics Center
Assistant Clinical Professor, UCLA School of Nursing, Los Angeles, CA
Katherine Brown-Saltzman, R.N., M.A. is the Co-Director of the UCLA Health System Ethics Center and an Assistant Clinical Professor at the UCLA School of Nursing. She received her B.S.N. from Marquette University and her M.A. from Lesley College in Cambridge, MA. Since 1975, her clinical practice has been in end of life care; her work is now focused on ethics and her area of research is centered on nurses' early indicators in ethical issues. She is the co-founder of the UCLA Ethics Center, is a member of three ethics committees and Co-chairs the UCLA Medical Center's Ethics Committee. She has been active in developing interdisciplinary programs on sustaining self-care, moral distress, and ethics education. As the Co-founder of the Ethics of Caring, Katherine has established a non-profit that has been providing annual ethics conferences for Southern California since 1993. That conference became the model for the first National Nursing Ethics Conference in 2011, co-sponsored by the Ethics of Caring and the American Nurses Association, Katherine was the co-chair of the planning committee.
In 2010, in response to moral distress, she created a writing retreat for health care professionals. She has developed pain management and spiritual care conferences for health care professionals. Over the last few years she has been part of an NIH grant developing end of life education for medical students. In 1992 she created a renewal retreat, Circle of Caring, for health care professionals, an experiential weekend of self-care which continues bi-annually to encourage professionals to assume an ethical practice of sustainability. She lectures nationally and internationally, and has published on such diverse topics as, ethics, professional self-care, bereavement, spirituality, psychosocial care and cultural issues. As a consultant, Katherine has worked in health care, building teams and developing renewal programs. In 1994 she received the Oncology Nursing Society’s national award, the MMF Memorial Lectureship, which recognizes a health care provider who has made a substantial contribution to the psychosocial aspects of cancer care. The Southern California Cancer Pain Initiative presented her with the 1999 Award of Excellence in Pain Management for her work with suffering. Her research is focused on nursing ethics.
Elizabeth Epstein, Ph.D., RN
Associate Professor, School of Nursing, University of Virginia, Charlottesville, VA
Dr. Elizabeth G. Epstein is an Associate Professor of Nursing and a member of the faculty of the Center for Biomedical Ethics and Humanities at the University of Virginia. She conducts research in preventive ethics in the critical care setting and teaches ethics in the School of Nursing and in the Center for Bioemedical Ethics and Humanities. She directs the Moral Distress Consult Service at the University of Virginia Health System and is a member of the Ethics Consult Service and the Ethics Committee as well. Dr. Epstein graduated with a BS in biochemistry from the University of Rochester, received her MS in pharmacology, along with her BSN and PhD in nursing, from the University of Virginia.
Stuart Finder, Ph.D.
Director, Center for Healthcare Ethics, Medical Affairs
Associate Professor, Surgery, Biomedical Sciences, and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA
Stuart G. Finder, Ph.D., is the Director of the Center for Healthcare Ethics at Cedars-Sinai Medical Center (CSMC) in Los Angeles, where he also holds appointments as an Associate Professor in CSMC's Department of Surgery and Department of Biomedical Sciences, as well as in the Department of Medicine at the UCLA David Geffen School of Medicine. Dr. Finder also is the Chief of CSMC's Clinical Ethics Consultation Service and is the co-chair of the CSMC's Bioethics Committee, serves as a member of CSMC's Stem Cell Research Oversight Committee/IRB and is the Ethics representative to Cedars-Sinai Medical Staff's Chief of Staff Advisory Council. He also leads the Research Ethics Consortium organized under the UCLA Clinical and Translational Science Institute (in which CSMC, along with Charles Drew University and Harbor UCLA also participate).
In addition to his clinical and institutional responsibilities, Dr. Finder is also an active researcher and scholar who has presented extensively at professional meetings locally, regionally, nationally, and internationally, and he has authored and co-authored dozens of articles, book chapters, commentaries, and reviews. In all of his endeavors, as a clinician, a teacher, and a researcher, Dr. Finder is interested in exploring the complexity and implications of moral experiences as actualized across the entire spectrum of the healthcare context, from patient care to clinical and basic sciences research.
Annette Greer, Ph.D., MSN, RN
Assistant Professor, Department of Bioethics and Interdisciplinary Studies
Co-Director, Office of Interdisciplinary Health Sciences Education, East Carolina University
Dr. Greer is Assistant Professor, Department of Bioethics and Interdisciplinary Studies and Co-Director, Office of Interdisciplinary Health Sciences Education. She teaches Interdisciplinary Rural Health courses primarily in online environments, teaches public health and adult education, and collaborates with faculty from the College of Human Ecology to teach an Honors Seminar that combines art and health. Dr. Greer has been involved in interdisciplinary education for over twelve years. Along with her advanced degrees in nursing, Dr. Greer has associate degrees in Agriculture Science and Agricultural Business. She serves on the NIH/NCI National Advisory Board of the Agricultural Health Study and represents farm spouses. She has published on interdisciplinary education, service-learning, and distance education pedagogy in allied health and nursing journals. Dr. Greer's dissertation research in learner-centered pedagogy has been published internationally in journal articles, a book chapter, and a recent book release.
Ann Hamric, Ph.D., RN, FAAN (1947–2020)
Professor, Associate Dean of Academic Programs, School of Nursing, Virginia Commonwealth University, Richmond, VA
Dr. Hamric teaches courses in advanced practice nursing role development and ethics. Her current research focuses on the phenomenon of moral distress in healthcare professionals. She has developed an instrument to measure moral distress that is being widely used around the world. She is part of a research team studying moral distress in ICUs in Vancouver, British Columbia, Canada. Dr. Hamric currently co-chair the Bioethics Expert Panel of the American Academy of Nursing. She has consulted with nursing leaders in Canada, Switzerland, Belgium, Japan, and China regarding advanced practice nursing development and education. She served as a member of the American Association of Colleges of Nursing Task Force that developed the Doctor of Nursing Practice (DNP) Essentials. Dr. Hamric was an invited participant on the National Consensus Panel to Develop Ethical Guidelines for Research With Persons at the End of Life, convened at Emory University in 2004. She was an advisor to the Affinity Group for Nursing of the American Society of Bioethics and Humanities in 2006-7.
Vicki Lachman, Ph.D., MBE, APRN, FAAN
President, V.L. Associates, Health Care and Business Consultation, Training, and Coaching, Avalon, NJ and Sarasota, FL
Clinical Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, PA (retired June 2013)
Vicki D. Lachman is president of V. L. Associates, a consulting, training, and coaching firm specializing in the constantly changing needs of the health care industry. An expert in organizational development she has had extensive experience as a consultant to more than 350 medical centers, community hospitals, long-term care facilities, hospices, and offices of health care practitioners.
In 2002, Dr. Lachman completed a Masters in Bioethics from the University of Pennsylvania. Her focus was on organizational ethics and end-of-life ethical dilemmas. She serves on a hospital ethics committee and acts as a consultant on a variety of ethical problems. Dr. Lachman is a trainer for the EPEC and ELNEC curriculums (end-of-life care). Her books, Applied Ethics in Nursing (2005) and Ethical Challenges in Health Care: Developing Your Moral Compass (2009) provide useful information on managing ethical issues.
Dr. Lachman has earned a national reputation for her keen insight into problems impeding the effectiveness of health care organizations and as a developer of innovative strategies for addressing these problems. Training, systems development, and one-on-one coaching are among the methods she utilizes to assist client organizations achieve their objectives. Dr. Lachman has made over 3,000 presentations to organizations and conferences on a variety of topics. She is known for her practical, dynamic, and thought-provoking presentations.
Dr. Lachman's understanding of the dynamics of health care organizations is derived from academic, clinical, and managerial experience gained from more than 35 years of involvement in this field. She is a Masters graduate of the University of Pennsylvania in psychiatric nursing and also holds a PhD in education from Temple University, where her focus was on organizational development. She is also ANNC certified as a nurse executive, advanced and as a psychiatric clinical specialist.
As the author of over 100 articles and book chapters, Dr. Lachman has appeared on radio, television, and satellite conference programs where she has offered expert advice.
Dr. Lachman's skills are a unique blend of first-hand practical experience and academic training, and has produced creative and cost-effective results for clients in today's demanding health care climate.
Cynda Rushton, Ph.D., RN, FAAN
Anne and George L. Bunting Chair in Clinical Ethics
Professor of Nursing and Pediatrics, Johns Hopkins University, Baltimore, MD
Dr. Cynda Hylton Rushton, an internationally recognized expert in bioethics and palliative care, shares her knowledge through clinical practice, teaching, research, consultation, and scholarship. She holds a joint appointment in the Johns Hopkins University schools of Nursing and Medicine - Department of Pediatrics - and is Berman Institute of Bioethics core faculty. She serves as Co-Chair of the Johns Hopkins Hospital's Ethics Consultation Service and as Program Director of the Hopkins Children's Center's Harriet Lane Compassionate Care Program. Her scholarship focuses on palliative care, moral distress, and caregiver suffering, and conceptual foundations of integrity, respect, trust, and betrayal. She was named a Robert Wood Johnson Foundation Nurse Executive Fellow (2006-2009), has served on the Institute of Medicine's Committee on increasing rates of organ donation and was a consultant to their project When Children Die. She also was appointed the first Chair of the Maryland State Council on Quality Care at the End-of-Life, has been recognized as one of Maryland's Top 100 Women, and is an American Academy of Nursing "Edgerunner." She now serves as an International Co-Director of the Nightingale Initiative for Global Health. Her current work centers on the integration of palliative care into the care of children with chronic pediatric diseases and the ethical issues faced by neuromuscular clinicians.
Tilda Shalof, RN, BScN, CNCC (C)
Medical-Surgical Intensive Care Unit, University Health Network, University of Toronto, Toronto, Canada
Tilda Shalof is an experienced intensive care unit (ICU) nurse and has recounted in her books her experiences in the ICU, as a camp nurse, and most recently as a patient herself.
Tilda Shalof has been a caregiver all her life — at home for her family, at work for strangers — but her skills didn’t come easily. From when she was a child taking care of her sick parents to her current position on an ICU team in one of Canada’s largest hospitals, there have always been daunting challenges and worthy rewards for her work. With her trademark humour, unflinching honesty, and skilled storytelling, Tilda’s books describe her experiences becoming the expert nurse she is today.
Marilyn Shirk, MN, RN, CNS-BC
Mental Health CNS, Nursing Liaison, Cedars-Sinai Medical Center, Los Angeles, CA
Marilyn Shirk is the Mental Health Clinical Nurse Specialist, Nursing Liaison at Cedars-Sinai Medical Center in Los Angeles. In this role, which she created in 1984, she provides support to nursing staff and other caregivers. She is consulted on a variety of work-related concerns, such as interpersonal and psychosocial issues, teambuilding, stress management, and ethical decision-making. In short, she describes her role as “caring for the caregivers.” She has been an active member of Cedars-Sinai’s Bioethics Committee for over 25 years, providing input on ethics education, policy and clinical consultation.
Marilyn’s professional experience includes pediatric nursing, inpatient adolescent psychiatry, outpatient adult mental health, crisis/emergency psychiatry and mental health consultation. Her BSN is from Mount Saint Mary’s College, Los Angeles and her MN in Psychiatric/Community Mental Health Nursing from UCLA. She is Board Certified by the American Nurses Credentialing Center (ANCC) as a Clinical Nurse Specialist (CNS-BC). Marilyn has presented nationally on topics related to ethical decision-making, communication skills, collegial relationships, compassionate care and self-care. Her publications include articles on nursing ethics and subjects related to nurses’ self-care and development.
Carol Taylor, Ph.D., MSN
Senior Research Scholar, Kennedy Institute of Ethics
Professor of Medicine and Nursing, Georgetown University, Washington, D.C.
Dr. Taylor is a founding member and previous director of the Center for Clinical Bioethics, a senior research scholar at the Kennedy Institute of Ethics, and professor in the Department of Medicine and in the School of Nursing & Health Studies at Georgetown University. Experienced in caring for chronically and critically ill patients and their families, she now works closely with health care professionals who are exploring the ethical dimensions of their practice. She lectures and writes on various issues in healthcare ethics and serves as an ethics consultant to systems and professional organizations. Dr. Taylor's research interests include professional and organizational ethics and health care decision making.
Mary Walton, MSN, MBE, RN
Director of Patient and Family Centered Care and Nurse Ethicist, Hospital of the University of Pennsylvania, Philadelphia, PA
Mary Walton is Nurse Ethicist and Director of Patient and Family Centered Care at the Hospital of the University of Pennsylvania. Ms. Walton received her BSN and MSN from the University of Pennsylvania and earned a master of bioethics degree and a certificate in clinical ethics mediation from the University of Pennsylvania School of Medicine. She has practiced in academic healthcare settings for over 35 years and has a progressive history of leadership. Roles of clinical nurse specialist and nurse manager included responsibility for clinical ethics committees and ethics consultation services, cultural competency training, and establishing evidence-based practice standards. Currently, she is responsible for organizational initiatives focused on clinical ethics and improving the patient and family experience of care. She has published in the areas of collaboration, advocacy, healthy work environment, nursing history, and patient-centered care.
Neil Wenger, MD, MPH
Director, The UCLA Health Ethics Center
Professor of Medicine and Health Services Research, UCLA, Los Angeles, CA
Neil S. Wenger is Professor of Medicine in the Division of General Internal Medicine at UCLA and a consulting researcher at RAND. He is director of the UCLA Healthcare Ethics Center and is chair of the Ethics Committee at the UCLA Medical Center. He also is director of the NRSA Primary Care Research Fellowship in the UCLA Division of General Internal Medicine and Health Services Research. Dr. Wenger is an active general internist and carries out research in the empirical study of clinical ethics, care of and decision making for the older patient, and quality of health care. He directs the Assessing Care of the Vulnerable Elders project, which has developed a quality-of-care assessment system for vulnerable older persons and interventions to improve care for this group. Other areas of interest include medication adherence, teaching clinical ethics, and measuring the quality of end-of-life care.
Lucia Wocial, Ph.D., RN
Nurse Ethicist, Program Leader for the Fairbanks Program in Nursing Ethics
Charles Warren Fairbanks Center for Medical Ethics, Indiana University Health, Indianapolis, IN
Dr. Wocial received a Bachelor’s Degree in Psychology from Macalester College in Saint Paul, MN and her Bachelor’s, Master’s and Doctorate degrees in Nursing from the Oregon Health Sciences University in Portland, OR. She has been in clinical practice for more than 20 years. Her clinical background is in neonatal intensive care. Her doctoral dissertation, Life Support Decisions Involving Imperiled Infants, examined parents’ experience with the ethical dilemma of considering withdrawing or withholding treatment from their newborns.
Prior to joining the Fairbanks Center in July, 2007, Dr. Wocial worked in a variety of health care organizations from small private hospitals to large academic teaching centers. She is highly regarded as a lecturer, educator, researcher, consultant and practitioner in the field of medical ethics, particularly as it applies to the nursing profession. Wocial comes to the Fairbanks program from the Cleveland Clinic Children’s Hospital, where she served as a Neonatal Clinical Nurse Specialist. She has been a Nursing Thought Expert Consultant for Web-based product development for Elsevier Publishing in St. Louis, MO. She has also served as a member of the Ethics Consultation service for the Mayo Clinic in Rochester, MN, and was a special assistant for the Commission on Determining Nursing Workforce Policy with the National League for Nursing.