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 oxygenPatients
2019
North of Home: Obligations to Families of Undocumented Patients
Fins J, Real de Asúa D. North of Home: Obligations to Families of Undocumented Patients. The Hastings Center Report 2019, 49: 12-14. PMID: 30790302, DOI: 10.1002/hast.972.Peer-Reviewed Original ResearchConceptsLife-sustaining therapyWithdrawal of life-sustaining therapyIncapacitated patientsEthical concernsSocial workersDoctors' desireFurther careFamily inputState lawsUndocumented patientsIntensive care unitDoctorsCare unitMultisystem organ failureObligationsDecision-United StatesOrgan failureDesireFamily
2018
Assessment of Covert Consciousness in the Intensive Care Unit
Edlow B, Fins J. Assessment of Covert Consciousness in the Intensive Care Unit. Journal Of Head Trauma Rehabilitation 2018, 33: 424-434. PMID: 30395042, PMCID: PMC6317885, DOI: 10.1097/htr.0000000000000448.Peer-Reviewed Original ResearchConceptsFunctional magnetic resonance imagingTraumatic brain injuryAcute severe traumatic brain injurySevere traumatic brain injuryIntensive care unitCovert consciousnessEthical challengesIntensive care unit patientsTask-based functional magnetic resonance imagingTask-based fMRILife-sustaining therapyWithdrawal of life-sustaining therapyCare unitEthical frameworkBehavioral assessmentCritically ill patientsEvaluation normsMagnetic resonance imagingConsciousnessBrain injuryGoals of careClinical scenariosIll patientsRecovered consciousnessTreatment decisions
2015
Withdrawal of Life-Sustaining Treatment
Hinderer K, Friedmann E, Fins J. Withdrawal of Life-Sustaining Treatment. Dimensions Of Critical Care Nursing 2015, 34: 91-99. PMID: 25650494, DOI: 10.1097/dcc.0000000000000097.Peer-Reviewed Original ResearchConceptsEOL decisionsEnd-of-lifeCritical care nursesMechanical ventilation withdrawalCare nursesFamilies of critically ill patientsVentilator withdrawalImproving EOL careAdvance care planningPatient-proxy pairsWithdrawal of life-sustaining therapySecondary analysis of dataWithdrawal of mechanical ventilationLife-sustaining therapyEOL careCare planningPatient-directedResponses to questionsDisease trajectoryProxies' decisionsModification of directionSecondary analysisImprove patientAnalysis of dataNurses
2014
Extracorporeal Membrane Oxygenation as a Bridge to Chemotherapy in an Orthodox Jewish Patient
Meltzer E, Ivascu N, Acres C, Stark M, Furman R, Fins J. Extracorporeal Membrane Oxygenation as a Bridge to Chemotherapy in an Orthodox Jewish Patient. The Oncologist 2014, 19: 985-989. PMID: 25096998, PMCID: PMC4153457, DOI: 10.1634/theoncologist.2014-0025.Peer-Reviewed Original ResearchConceptsLife-sustaining therapyVA-ECMOBridge to treatmentExtracorporeal membrane oxygenationOrthodox Jewish womenEthics consultationCardiopulmonary supportMembrane oxygenationVenoarterial extracorporeal membrane oxygenationClinical ethics consultationInitiation of VA-ECMOJewish womenTemporary cardiopulmonary supportAcademic medical centerReceipt of chemotherapyLonger-term therapyVA-ECMO useClinical staffReligious traditionsAbsence of recoveryReligious leadersCultural liaisonsReligious objectsCurable lymphomaChemotherapy induction
2006
Differential Medical and Surgical House Staff Involvement in End-of-Life Decisions: A Retrospective Chart Review
Kelley A, Gold H, Roach K, Fins J. Differential Medical and Surgical House Staff Involvement in End-of-Life Decisions: A Retrospective Chart Review. Journal Of Pain And Symptom Management 2006, 32: 110-117. PMID: 16877178, DOI: 10.1016/j.jpainsymman.2006.02.009.Peer-Reviewed Original ResearchConceptsEnd-of-lifeEnd-of-life discussionsEnd-of-life decisionsHouse officersDocumentation of end-of-life discussionsMedical servicesEnd-of-life communicationSurgical servicesLife-sustaining treatmentWithdrawal of life-sustaining therapyProportion of notesLife-sustaining therapyMedical house officersComplex patient populationWithdrawal of carePhysician involvementCare notesLength of stayStaff involvementMedical patientsRetrospective chart reviewTeam structureChart reviewPatient populationSurgical house officers
2005
Contracts, covenants and advance care planning: an empirical study of the moral obligations of patient and proxy
Fins J, Maltby B, Friedmann E, Greene M, Norris K, Adelman R, Byock I. Contracts, covenants and advance care planning: an empirical study of the moral obligations of patient and proxy. Journal Of Pain And Symptom Management 2005, 29: 55-68. PMID: 15652439, DOI: 10.1016/j.jpainsymman.2004.07.004.Peer-Reviewed Original ResearchConceptsPatient self-determinationMoral obligationSelf-determinationAdvance care planningExercise of autonomyPatient-proxy relationshipLife-sustaining therapyObligations of patientsMoral judgmentCare planningNarrow notionsDisease trajectoryPatient instructionsLegal normsPatient-proxy pairsJudgmentPrincipal autonomyAggressive careAutonomyModified Likert scaleQuality of informationPatient educationCovenantersNegative instructionsCovenants