2022
Prolonged Unconsciousness is Common in COVID‐19 and Associated with Hypoxemia
Waldrop G, Safavynia S, Barra M, Agarwal S, Berlin D, Boehme A, Brodie D, Choi J, Doyle K, Fins J, Ganglberger W, Hoffman K, Mittel A, Roh D, Mukerji S, Der Nigoghossian C, Park S, Schenck E, Salazar‐Schicchi J, Shen Q, Sholle E, Velazquez A, Walline M, Westover M, Brown E, Victor J, Edlow B, Schiff N, Claassen J. Prolonged Unconsciousness is Common in COVID‐19 and Associated with Hypoxemia. Annals Of Neurology 2022, 91: 740-755. PMID: 35254675, PMCID: PMC9082460, DOI: 10.1002/ana.26342.Peer-Reviewed Original ResearchConceptsCessation of mechanical ventilationAssociated with hypoxemiaMedian timeMechanical ventilationAssociated with more severe hypoxemiaDays of hypoxemiaEvidence of structural brain injurySevere coronavirus disease 2019Cox proportional hazards modelsArterial partial pressure of oxygenImpairment of consciousnessSevere COVID-19Survivors of severe COVID-19Proportional hazards modelArterial partial pressureBrain injuryStructural brain injurySevere hypoxemiaCohort studyLife-sustaining therapyEndotracheal intubationHypoxemiaProlonged unconsciousnessPartial pressure of oxygenPatientsPersonalized medicine and disorders of consciousness
Fins J. Personalized medicine and disorders of consciousness. 2022, 131-140. DOI: 10.1093/oso/9780198863465.003.0010.Peer-Reviewed Original ResearchPersonalized medicineNext-generation personalized medicineDisorders of consciousnessDevelopment of therapeuticsDomain of personalized medicineAccurate diagnostic classificationPathological phenotypesUnique biologyTherapeutic responseMolecular levelIndividual diseasesGuiding treatmentCare of patientsPersonalized therapySide effectsTherapeutic effectMinimally conscious stateBiological characteristicsMolecular biomarkersBiologyDiseaseCharacterize diseaseNeural circuitryPatientsDiagnostic classification
2020
Two Patients: Professional Formation before “Narrative Medicine”
Fins J. Two Patients: Professional Formation before “Narrative Medicine”. Cambridge Quarterly Of Healthcare Ethics 2020, 29: 642-650. PMID: 33135617, DOI: 10.1017/s0963180120000389.Peer-Reviewed Original Research
2019
Disorders of Consciousness in Clinical Practice
Fins J. Disorders of Consciousness in Clinical Practice. 2019, 449-478. DOI: 10.1093/med/9780190208875.003.0011.Peer-Reviewed Original ResearchEnd-of-life careEnd-of-lifeLong-term careImpaired decision-making capacityDisorders of consciousnessClinical practiceDecision-making capacityAncillary care obligationsVulnerable populationsProfessional obligationsCareMinimally conscious stateNeuroimaging assessmentsIntensive careCare obligationsDiagnostic classificationBrain injuryCommunication strategiesCovert consciousnessClinicInitial presentationConscious stateEthical implicationsPatientsRehabilitationWhen No One Notices: Disorders of Consciousness and the Chronic Vegetative State
Fins J. When No One Notices: Disorders of Consciousness and the Chronic Vegetative State. The Hastings Center Report 2019, 49: 14-17. PMID: 31429953, DOI: 10.1002/hast.1030.Peer-Reviewed Original ResearchConceptsNational Institute on DisabilityMulti-Society Task Force ReportDisorders of consciousnessAmerican Academy of NeurologyComprehensive evidence-based reviewEvidence-based reviewRehabilitation researchRehabilitation medicineVegetative stateChronic vegetative stateHealthcare facilitiesTask Force ReportPractice guidelinesIndependent livingPersistent vegetative stateAmerican CollegeAmerican AcademyMisdiagnosis of patientsLevel of consciousnessPermanent vegetative stateForce ReportDiagnostic categoriesPatientsAmericanGuidelines
2018
Disorders of Consciousness, Agency, and Health Care Decision Making: Lessons From a Developmental Model
Wright M, Kraft C, Ulrich M, Fins J. Disorders of Consciousness, Agency, and Health Care Decision Making: Lessons From a Developmental Model. AJOB Neuroscience 2018, 9: 56-64. DOI: 10.1080/21507740.2018.1425755.Peer-Reviewed Original ResearchDisorders of consciousnessHealth care decision makingCare decision makingLegal systemPermanent incapacitySelf-determinationHealthDevelopmental modelDecision-making frameworkDecisionIncreasing roleDisordersPatientsPatient evolutionDecision makingRecovery processIncapacityPersonhoodPhysiciansAgenciesDisabilityMaximal extentParticipantsMediative Fluency and Futility Disputes
Knowlton S, Fins J. Mediative Fluency and Futility Disputes. Perspectives In Biology And Medicine 2018, 60: 373-382. PMID: 29375067, DOI: 10.1353/pbm.2018.0011.Peer-Reviewed Original Research
2016
Neuroethics and Disorders of Consciousness: Discerning Brain States in Clinical Practice and Research
Fins J. Neuroethics and Disorders of Consciousness: Discerning Brain States in Clinical Practice and Research. The AMA Journal Of Ethic 2016, 18: 1182. PMID: 28009244, DOI: 10.1001/journalofethics.2016.18.12.ecas2-1612.Peer-Reviewed Original ResearchConceptsDisorders of consciousnessMinimally conscious stateEnd-of-life careConscious stateEnd-of-lifeEthical obligationNeuropalliative careDeep brain stimulationPatientsBrain statesClinicians' ethical obligationsClinical practiceCivil rightsConsciousnessScientific advancesDiagnostic discernmentClinical researchBrain stimulationResearch decisionsDisordersFunctional communicationInvestigate useCareNeuroethicsPainA Surgeon's Dilemma
Shuman A, Fins J. A Surgeon's Dilemma. The Hastings Center Report 2016, 46: 9-10. PMID: 27150413, DOI: 10.1002/hast.586.Peer-Reviewed Original ResearchTreatment-refractory cancerCritically ill patientsObstructing tumorAwake tracheotomyIntraoperative deathsProgressive diseasePulmonary embolismAggressive resuscitationPerioperative windowMechanical ventilationIll patientsDifficulty breathingEmergency roomPatientsPatient's desireSurgeonsSurgical staffSignificant riskYoung mothersMortality conferencesMothersEmbolizationSurgeryTracheotomyTumorTransgender Patients, Hospitalists, and Ethical Care
McCarthy M, Reis E, Fins J. Transgender Patients, Hospitalists, and Ethical Care. Perspectives In Biology And Medicine 2016, 59: 234-245. PMID: 37765716, DOI: 10.1353/pbm.2017.0008.Peer-Reviewed Original ResearchElevated risk of HIV infectionTransgender patientsCohort of doctorsRisk of HIV infectionMale-to-female transgender peopleUnique health issuesHealth-care workersRates of violenceCare meetingsMedical careMarginalized patientsMedical processesHealth issuesTrans peopleTransgender peopleTransgender individualsElevated riskMedical issuesMedical concernsRefusal of medical careSubstance abuseCareHIV infectionTransgenderPatients
2015
Neuro-palliative care and disorders of consciousness
Fins J, Pohl B. Neuro-palliative care and disorders of consciousness. 2015, 285-291. DOI: 10.1093/med/9780199656097.003.0103.Peer-Reviewed Original ResearchPalliative care expertiseMinimally conscious stateBrain injuryPalliative carePalliative medicineCare expertiseCareDisorders of consciousnessConscious stateDefinition criteriaNihilistic attitudeInjuryPatientsDistressInterventionSurvivorsTherapeutic interventionsCliniciansDisordersNeuroprosthetic devicesSufferingMedicineAttitudes
2014
Extracorporeal membrane oxygenation in adults: A brief review and ethical considerations for nonspecialist health providers and hospitalists
Meltzer E, Ivascu N, Acres C, Stark M, Kirkpatrick J, Paul S, Sedrakyan A, Fins J. Extracorporeal membrane oxygenation in adults: A brief review and ethical considerations for nonspecialist health providers and hospitalists. Journal Of Hospital Medicine 2014, 9: 808-813. PMID: 25332093, DOI: 10.1002/jhm.2262.Peer-Reviewed Original ResearchConceptsExtracorporeal membrane oxygenationMembrane oxygenationVA-ECMOTreated with extracorporeal membrane oxygenationManaging extracorporeal membrane oxygenationVenoarterial extracorporeal membrane oxygenationVenovenous extracorporeal membrane oxygenationProvision of ECMODiscontinuation of treatmentConsistent with patient preferencesClinical responseRespiratory failureGoals of careHeart failureCardiac arrestCo-manage patientsCounseling familiesPatient preferencesPatientsPatient referralHealth providersHealthcare providersEthical considerationsHospitalistsProvidersDNR and ECMO: a paradox worth exploring.
Meltzer E, Ivascu N, Fins J. DNR and ECMO: a paradox worth exploring. The Journal Of Clinical Ethics 2014, 25: 13-9. PMID: 24779313, DOI: 10.1086/jce201425102.Peer-Reviewed Original ResearchConceptsDo-not-resuscitateDifficult end-of-life decisionsDo-not-resuscitate discussionsEnd-of-life decisionsDo-not-resuscitate ordersHeart-lung bypass machineExtracorporeal membrane oxygenationVA-ECMOStepping-stoneCardiac failurePulmonary dysfunctionCardiopulmonary failureMembrane oxygenationSurgical proceduresBypass machineChest compressionsDiscussionOperating roomConfusionPatientsContext
2013
Surrogate expectations in severe brain injury
Suppes A, Fins J. Surrogate expectations in severe brain injury. Brain Injury 2013, 27: 1141-1147. PMID: 23895513, PMCID: PMC5454804, DOI: 10.3109/02699052.2013.804201.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAdvance Care PlanningAdvance DirectivesBrain InjuriesCaregiversChildComaDecision MakingFamilyFemaleGriefHumansIntensive Care UnitsMaleMiddle AgedNew YorkPersistent Vegetative StatePhysician's RoleProfessional-Family RelationsPrognosisProxySeverity of Illness IndexStress, PsychologicalConceptsSource of injuryExpectations of recoveryPsychosocial featuresDecision-making expectationsQuantitative questionnaireImprove treatment of patientsFamily membersPatient recoveryTreatment of patientsPatient diagnosisRelated factorsDOC patientsBrain injuryPatientsImproved treatmentInjuryCurrent diagnosisExpectationsQuestionnaireDiagnosisCliniciansBrainSurveyFactorsWhat's Not Being Shared in Shared Decision‐Making?
Stark M, Fins J. What's Not Being Shared in Shared Decision‐Making? The Hastings Center Report 2013, 43: 13-16. PMID: 23842917, DOI: 10.1002/hast.188.Peer-Reviewed Original ResearchConceptsGoals of patient carePatient preferencesHealth care deliveryCare deliveryHealth carePatient carePatient choiceDecision aidMedical decisionsCost containmentMedical interventionsCost curvesDecision-making programCareNot beingHealthTreatment optionsTreatment-specificProgramDecision-makingPatientsPhysiciansPreferencesInterventionDecisionError and Bias in the Evaluation of Prescription Opioid Misuse: Should the FDA Regulate Clinical Assessment Tools?
Meltzer E, Hall W, Fins J. Error and Bias in the Evaluation of Prescription Opioid Misuse: Should the FDA Regulate Clinical Assessment Tools? Pain Medicine 2013, 14: 982-987. PMID: 23594383, DOI: 10.1111/pme.12099.Peer-Reviewed Original ResearchConceptsFood and Drug AdministrationClinical assessment toolScreening toolAssessment toolOpioid-related aberrant behaviorsAberrant medication-related behaviorsOpioid-related risksChronic opioid therapyPrescription opioid misusePredictive of addictionMedication-related behaviorsOpioid therapyPain medicationStandardized questionnaireOpioid misuseIdentified patientsAt-riskDrug AdministrationDiagnose illnessAddictive disordersPatientsAberrant behaviorScreeningComprehensive planAddictionDisorders of Consciousness and Disordered Care: Families, Caregivers, and Narratives of Necessity
Fins J. Disorders of Consciousness and Disordered Care: Families, Caregivers, and Narratives of Necessity. Archives Of Physical Medicine And Rehabilitation 2013, 94: 1934-1939. PMID: 23770277, DOI: 10.1016/j.apmr.2012.12.028.Peer-Reviewed Original ResearchConceptsAmerican health care systemAcute care needsSurrogate decision makersHealth care systemDisorders of consciousnessAffordable Care ActDecision-making capacityCare needsSevere disorders of consciousnessCare decisionsOngoing careCare systemReimbursement frameworkCare ActReimbursement strategiesCareMedical necessityCivil rightsMedical infrastructureRehabilitationEthical challengesReimbursementSevere disordersCaregiversPatients
2012
Clinical ethics consultation in patients with head and neck cancer
Shuman A, McCabe M, Fins J, Kraus D, Shah J, Patel S. Clinical ethics consultation in patients with head and neck cancer. Head & Neck 2012, 35: 1647-1651. PMID: 23161591, DOI: 10.1002/hed.23204.Peer-Reviewed Original ResearchConceptsClinical ethics consultationEthics consultationHead and neck cancerCommunication barriersNeck cancerLife-sustaining treatmentComprehensive cancer centerCode statusAirway management concernsEthical themesSymptom controlCancer CenterEthicsConsultationData abstractionDNRAirway managementCancerPatientsInterpersonal conflictBarriersDatabaseThemesClinical challengeHeadTruth‐Telling and Cancer Diagnoses: Physician Attitudes and Practices in Qatar
del Pozo P, Fins J, Helmy I, Chaki R, Shazly T, Wafadari D, Mahfoud Z. Truth‐Telling and Cancer Diagnoses: Physician Attitudes and Practices in Qatar. The Oncologist 2012, 17: 1469-1474. PMID: 22874085, PMCID: PMC3500369, DOI: 10.1634/theoncologist.2012-0128.Peer-Reviewed Original ResearchLip-reading and the ventilated patient*
Meltzer E, Gallagher J, Suppes A, Fins J. Lip-reading and the ventilated patient*. Critical Care Medicine 2012, 40: 1529-1531. PMID: 22430239, DOI: 10.1097/ccm.0b013e318241e56c.Peer-Reviewed Original ResearchConceptsVentilated patientsTotal body surface area burnBody surface area burnBurn unitUniversity Teaching HospitalSurface area burnAmerican Sign Language interpretersProspective studyVentilator-dependentLip readingArea burnPatientsCircuit formationTeaching hospitalMedical settingsNew York CityYork CitySign language interpretersMouthed wordsTracheostomy