I have more than 20 years of experience working with hospitals, health care systems, academic institutions, professional societies, corporations, government agencies, and individuals to develop practical, evidence-based solutions to meet their needs. I specialize in health care ethics program assessment, design, implementation, management, and quality improvement. I also coach and train aspiring healthcare ethics consultants. Fox Ethics offers the following services: • Subject matter expertise and consultation to organizations on COVID-19 back-to-school and back-to-work planning, including identification and use of personal protective equipment and tests, and protocols for symptom screening, diagnosis, population monitoring, social distancing, isolation, and quarantine.• Subject matter expertise in clinical and organizational ethics including expert witness work• Ethics program assessment, design, implementation, management, and quality improvement • Clarifying ethics program vision, priorities, goals, and needs from the perspective of leaders and staff • Analyzing ethics program structures, systems, and procedures compared with organizational needs • Benchmarking ethics programs against other organizations, professional standards, and best practices• Strategic planning and operational planning to maximize ethics program effectiveness • Developing solutions to manage ethics programs across multiple sites in a health care system• Providing consultation and advice to other ethics consultants, ethics programs, and executives • Innovative training for ethics practitioners, ethics committee members and health care executives • Coaching and training professionals who wish to transition into a health care ethics career • Coaching and training health care ethics practitioners to further develop their skills • Coaching and training executives on ethical leadership behaviors • Helping organizations recruiting and select high qualified health care ethics staff

I directed Altarum Institute's Center for Ethics in Health Care. My focus was on improving health care by improving ethics programs and practices through a research project examining healthcare ethics consultation (HEC) in U.S. hospitals. HEC is a service that is routinely offered by U.S. hospitals to help patients, families, and healthcare providers resolve ethical concerns. In recent years, concerns have been raised about the quality of HEC and the fact that HEC services operate with little oversight. Bioethics experts have been actively debating how best to improve HEC practices. The problem is that these experts lack critical information about the hospitals they seek to change. This new research study will provide much-needed data about how HEC is currently practiced, the gap between current HEC practices and newly established quality standards, and perspectives of key stakeholders who are responsible for HEC. My research team will contact HEC practitioners at 600 U.S. hospitals and ask them about their hospitals’ HEC practices and their views on potential improvement strategies. We will also assess current HEC quality using expert reviews of written HEC records. This information will give policymakers the information they need to determine the best strategies to improve HEC quality nationwide.

I designed and taught the Online Clinical Ethics Practicum course for the Masters-level bioethics degree program of Clarkson University and the Icahn School of Medicine at Mount Sinai.

I built and led VA's primary office for addressing the complex ethical issues that arise in patient care, health care management and research. I served as the principal advisor on health care ethics to the Under Secretary for Health. I advised other VA leaders on matters pertaining to health care ethics. I oversaw a $5 million budget and large contracts up to $10 million. I identified, analyzed, and proactively managed emerging issues, achieving concurrence by diverse stakeholder groups. I crafted national policy and guidelines related to health care ethics and provided consultation and advice to health care leaders at hospitals, regional network offices, and national headquarters. I established standards and provided guidance to ethics committee chairs and members at 156 medical centers and >1,500 clinics, nursing homes, and other affiliated sites of care. I served as a resource to VA national program offices, external stakeholders, and governmental agencies outside of VA. I developed and disseminated information, resources, and networking tools to facilitate the effective exchange of ideas. I designed and delivered innovative education programs, and created and implemented validated assessment tools to evaluate and improve the quality of health care ethics programs and practices across the system. I oversaw VA's National Ethics Committee and served on the National Leadership Board, the Strategic Planning Committee, and many other VA committees and work groups. I represented VA at national and international meetings such as those of the American Society for Bioethics and Humanities, the Association of Bioethics Program Directors, the American Medical Association, and the Canadian Bioethics Society.

I served as principal investigator on a national study on ethics consultation in U.S. hospitals funded by the Agency for Healthcare Research and Quality. The study was published in the American Journal of Bioethics, and recognized as the #1 most highly cited article in the journal’s 20 year history. I also wrote and published articles relating to the Study to Understand Preferences and Prognoses for Outcomes and Risks of Treatments (SUPPORT). Served as faculty for the Breakthrough Series on Treatment of Patients with Serious Chronic Disease with the Institute for Healthcare Improvement (IHI). Served as consultant to the Director (Dr. Joanne Lynn) in planning and executing other projects relating to ethics and end-of-life care.

I served as the AMA’s designated expert on ethical issues in end-of-life care. I reconceptualized and directed the ambitious and pioneering Education on Palliative and End-of-Life Care (EPEC) Project, funded by the Robert Wood Johnson Foundation. I designed a train-the-trainer program to provide physicians nationwide with core competencies about end-of-life care. I managed a $1.54 million budget and hired and supervised multiple employees and consultants. I developed, published, and administered an extensive resource guide, speakers bureau, and web site. I provided advice and consultation in response to requests for information or analysis on ethics and/or end-of-life care and collaborated on national AMA initiatives in related areas.

I created and led a new academic program for clinical ethics education, consultation, and research. Held academic appointments in Medicine (General Internal Medicine) and Medical Education (Medical Humanities). Co-Chaired the hospital ethics committee. Served on the IRB and other hospital and medical school committees. Served as ethics consultant for the hospital and health care system. Taught ethics to medical students, resident trainees, and practicing clinicians. Developed and directed the intensive clinical ethics seminar, a year-long course for graduate students in the health sciences. Established a fellowship training program for physicians, nurses, and chaplains in clinical ethics consultation and education. Conducted grant-funded projects and produce scholarly work. Served as an attending physician in internal medicine. Maintained an active primary care practice (until 1999).

I developed and directed the required overview course for ethics fellows called topics in clinical ethics. Played an instrumental role in transforming one of the least popular courses in the medical school to one of the most popular within one year. Performed ethics consultation in acute care, primary care, nursing home, community hospital, chronic disease hospital, and rehabilitation settings. Conducted research on ethics consultation. Produced scholarly publications. Served as an attending physician in internal medicine. Maintained an active outpatient geriatrics practice.