Robert D. Troug
Professor of Medical Ethics
& Anaesthesia (Pediatrics)
Director of Clinical Ethics
Harvard Medical School
Childrens Hospital Boston
Div. Critical Care Medicine
300 Longwood Ave.
Boston, MA 02115
Dr. Truog is the Prinicipal Investigator on an NIH RO1 grant, developed in collaboration with Dr. Millie Solomon and the Education Department Center. The protocol initially involved the development of tools to evaluate the quality of end-of-life care in the pediatric ICU setting. These tools will then be used to examine the outcomes of fifty consecutive deaths occuring in each of eight geographically dispersed pediatric intensive care units. The study will run over four years, from 2005 - 2009.
Robert Truog’s research focuses on topics in bioethics. Recent areas of interest include:
Improving end-of-life care in pediatric critical care medicine: He recently completed a 5 year NIH funded study that developed tools to evaluate the quality of end-of-life care in the pediatric ICU. These tools were then used to investigate both qualitative and quantitative aspects of fifty consecutive deaths occurring in each of eight geographically dispersed pediatric ICUs, from the perspectives of parents, patients, and clinicians.
Disclosure and apology following adverse events and medical errors: He is engaged in research to improve the skills of clinicians in communicating with patients and families after adverse events and medical errors, and is lead author on a recent book devoted to this topic.
Ethical issues in organ transplantation: He is actively engaged in research on a variety of questions related to organ transplantation, including controversies surrounding the determination of death, the dead donor rule, organ procurement after circulatory determination of death, and the process of obtaining informed consent for organ donation.
Allocation of resources: He has a longstanding interest in the topic of medical futility, and problems surrounding the allocation of scarce resources and rationing, particularly in critical care medicine.
Ethics in clinical research: He is interested in many ethical aspects of clinical research, including placebo controlled trials, first-in-human and phase 1 research, ethical issues in randomized controlled trials, and ethical standards for procuring tissue from patients for research.
Improving communication and relational skills in medical practice: For over ten years he as worked with a team of researchers and educators in the Institute for Professionalism and Ethical Practice to explore ethical aspects of the patient / physician relationship, particularly as they arise in the context of difficult conversations in healthcare.
- Miller FG, Truog RD. Death, Dying, and Organ Transplantation. New York: Oxford University Press; 2012.
- Truog RD, Browning DM, Johnson JA, Gallagher TH, Leape LL. Talking with patients and families about medical error: A guide for education and practice. Baltimore: Johns Hopkins University Press; 2010.
- Truog RD, Kesselheim AS, Joffe S. Research ethics. Paying patients for their tissue: the legacy of Henrietta Lacks. Science 2012;337:37-8.
- Truog RD, Brock DW, White DB. Should patients receive general anesthesia prior to extubation at the end of life? Crit Care Med 2012;40:631-3.
- Truog RD. When does a nudge become a shove in seeking consent for organ donation? The American journal of bioethics : AJOB 2012;12:42-4.
- Truog RD. Patients and doctors--evolution of a relationship. The New England Journal of Medicine 2012;366:581-5.
- Brown SD, Lehman CD, Truog RD, Browning DM, Gallagher TH. Stepping out further from the shadows: disclosure of harmful radiologic errors to patients. Radiology 2012;262:381-6.
- Young MJ, Brown SE, Truog RD, Halpern SD. Rationing in the intensive care unit: To disclose or disguise?*. Crit Care Med 2012;40:261-6.
- Lamiani G, Meyer EC, Leone D, et al. Cross-cultural adaptation of an innovative approach to learning about difficult conversations in healthcare. Med Teach 2011;33:e57-64.
- Truog RD, Miller FG. Counterpoint: are donors after circulatory death really dead, and does it matter? No and not really. Chest 2010;138:16-8; discussion 8-9.
- Truog RD. Is it always wrong to perform futile CPR? N Engl J Med 2010;362:477-9.
- Truog RD. Screening mammography and the "R" word. N Engl J Med 2009;361:2501-3.
- Meyer EC, Sellers DE, Browning DM, McGuffie K, Solomon MZ, Truog RD.
- Difficult conversations: improving communication skills and relational abilities in health care. Pediatr Crit Care Med 2009;10:352-9.
- Truog RD, Miller FG. The dead donor rule and organ transplantation. N Engl J Med 2008;359:674-5.
- Truog RD, Campbell ML, Curtis JR, et al. Recommendations for end-of-life care in the intensive care unit: a consensus statement by the American Academy of Critical Care Medicine. Crit Care Med 2008;36:953-63.
- Truog RD. Consent for organ donation--balancing conflicting ethical obligations. N Engl J Med 2008;358:1209-11.