NIH Clinical Center Senior Staff
Marion Danis, MD
Dr. Marion Danis is Head of the Section on Ethics and Health Policy in the Department of Bioethics and also serves as chief of the Clinical Center's Bioethics Consultation Service. Her research has focused on strategies for balancing the competing concerns of respect for patient preferences and fair distribution of limited resources. She has conducted studies on advance directives and the effect of patient preferences in end-of-life treatment decisions. Her current work is centered on strategies for public engagement in the rationing of health care, which led Dr. Danis to collaborate with Susan Goold (of University of Michigan Medical School) to design CHAT, "Choosing Healthplans All Together," a simulation exercise.
She is particularly interested in increasing access to care and improving the health of disadvantaged populations. Toward this end she has studied the priorities of low income urban populations regarding interventions to address the social determinants of health and reduce health disparities.
Since the beginning of 2010 her research in collaboration with colleagues has led to the publication of 30 articles and two books. Publications have been in the Journal of the American Medical Association, Hastings Center Report, Social Science and Medicine, and Health Affairs. She led the Bioethics Consultation Service faculty in authoring the book, Research Ethics Consultation: A Casebook, with Oxford University Press. She also led in authoring and editing Fair Resource Allocation and Rationing at the Bedside, with Oxford University Press.
Since 2012, Dr. Danis has served on the Quality Attestation Presidential Task Force of the American Society for Bioethics and Humanities which is developing an approach to evaluating clinical ethics consultants.
In 2014 she was involved in addressing the ethical tensions that have arisen during the Ebola epidemic in West Africa as a member of the World Health Organization Ethics Panel on Use of Investigational Agents during the Ebola Epidemic and as a member of the Interagency Working Group on Ebola in the Department of Health and Human Services.
Following medical school, Dr. Danis trained in internal and critical care medicine at University of North Carolina at Chapel Hill. She served on the faculty of the Division of General Medicine and Clinical Epidemiology at UNC before coming to NIH in 1997. While at UNC, she also directed the medical intensive care unit, chaired the UNC Hospitals Ethics Committee, and served as a faculty member of the Robert Wood Johnson Clinical Scholars Program and as a research associate at the Cecil G.Sheps Health Services Research Center. In addition, she has chaired the Ethics Committee of the Society of Critical Care Medicine.
Selected Honors and Awards
Society of Critical Care Medicine President's Citation Award 2010; Best Doctors 2010; Clinical Center Director's Award, 2005; Paul Ellwood Award 2003, Foundation for Accountability; Internal Medicine Specialty Award, 2002, Society of Critical Care Medicine; Mark S. Ehrenreich Prize in Healthcare Ethics, 2002; President's Citation Award, Society of Critical Care Medicine, 1998; Alpha Omega Alpha Medical Honor Society; and Christer Grenvik Memorial Award for Leadership in Ethical Issues of Critical Care Medicine, Foundation for Critical Care.
From 2008 to 2010 she served as Chair of the International Society on Priorities in Health Care and Secretary of the American Society of Bioethics and Humanities.
Books and Book Chapters
Danis M, Hurst SA, Fleck L, Førde R, and Slowther M.Eds. Fair Resource Allocation and Rationing at the Bedside. Oxford University Press, New York, 2014.
Danis M, Largent E, Grady C. Wendler D, Hull SC, Shah S, Millum J, Berkman B. Research Ethics Consultation: A Casebook. Oxford University Press, New York. 2012.
Danis M, Hanson LC, Garrett JM. Experimental methods in Methods in Medical Ethics, Second Edition. Sugarman J and Sulmasy D, Eds. Georgetown University Press, Washington, DC, 2010.
Danis M, Silverman H, Emanuel E. Ethical considerations in managing critically ill patients. In Critical Care Medicine: Principles of Diagnosis and Management in the Adult, 3rd Edition Parillo J and Phil Dellinger P. Eds. Mosby 2008.
Kurlander JE and Danis M. Organizational Ethics in Health Care in Principles of Health Care Ethics. Ashcroft RE, Dawson A, Draper H, McMillan J. Wiley and Sons, West Sussex, 2006.
Evidence-Based Medicine and Managed Care in Ethical Issues of Evidence Based –Practice in Medicine and Health Care: A Discussion of the Ethical Issues. Meulen R t, Biller-Andorno N, Lenk C and Lie R. Kluwer Academic Publishers: Dordrecht, 2005.
Danis M and Patrick DL. Health policy, vulnerability, and vulnerable populations in Ethical Dimensions of Health Policy, Danis M, Clancy C, Churchill LR, Eds. Oxford University Press, New York 2002.
Danis M, Clancy C, Churchill LR. Eds. Ethical Dimensions of Health Policy, Oxford University Press, New York 2002.
Fetters MD, Danis M. We live too short, and die too long: On Japanese and US physicians' caregiving practices and approaches to withholding life-sustaining treatments. In Caring for The Elderly in Japan and the US. Long SO, Ed. Routledge, London, 2000.
Danis M. Role of Ethnicity, Race, Religion, and Socio-Economic Status in End of Life Care in the ICU in The Transition From Cure to Comfort: Managing Death in the Intensive Care Unit. Curtis JR and Rubenfeld GD, Eds. Oxford University Press, Oxford 2000.
Clancy CM and Danis M. Setting Priorities: American Style in The Global Challenge of Health Care Rationing. Ham C and Coulter A, Eds. Open University Press, 1999.
Selected Journal Articles
Marion Danis M, Taylor DH, Jr., Zafar SY, Samsa GP, Wolf SP, Abernethy AP. A Decision exercise to engage cancer patients and families in deliberation about Medicare coverage for advanced cancer care. BMC Health Services Research. 2014;14:315-326.
Knebel AR, Sharpe VA, Danis M, Toomey LM, Knickerbocker DK. Informing the Gestalt: An Ethical Framework for Allocating Scarce Federal Public Health and Medical Resources to States During Disasters. Disaster Medicine and Public Health Preparedness. 2014;8:80-88.
Tilburt JC, Wynia M; Robert D. Sheeler RD, Thorsteinsdottir B, James KM, Egginton JS, Liebow M, Hurst S, Danis M, Goold SD. Views of US physicians about controlling health care costs. JAMA. 2013;310:380-388.
White A, Danis M. Enhancing patient-centered communication and collaboration by using the electronic health record in the examination room. JAMA. 2013;309:2327-8.
Danis M. Solomon M. ANALYSIS & COMMENTARY: Providers, Payers, The Community, And Patients Are All Obliged To Get Patient Activation And Engagement Ethically Right. Health Affairs. 2013 32:401-407.
Sommers R, Goold SD, McGlynn EA, Pearson SD, Danis M. Focus Groups Highlight That Many Patients Object To Clinicians' Focusing On Costs Health Affairs. 2013 32:338-346.
Donley G. and Danis M.Making the case for talking to patients about the costs of end-of-Life Care. Journal of Law, Medicine and Ethics. 2011; 39:183-93.
Pesce J, Kapaduwa C, Danis M. Deliberation to enhance awareness of and prioritize socioeconomic interventions for health. Social Science and Medicine. 2011;72:789-97.
Strech D, Hurst S, Danis M. The role of ethics committees and ethics consultation in allocation decisions. A four-stage process. Medical Care. 2010;48:821-6.
Danis M, Ginsburg M, Goold S. Experiences of engaging the public in priority setting for health through structured small group decision exercises. Journal of Ambulatory Care Management. 2010;33:205-14.
Kotwani N, Danis M. Expanding the Current Health Care Reform Debate: Making the Case for Socio-Economic Interventions for Low Income Young Adults. Journal of Health Care Law and Policy. 2009;12:17-45.
Hurst SA, Reiter-Theil S, Slowther A, Pegoraro R, Forde Reidun, Danis M. Should ethics consultants help clinicians face scarcity in their practice? Journal of Medical Ethics 2008;34:241-6.
Danis M, Lovett F, Sabik L, Adikes K, Cheng G, Aomo T. Low-income employees choose employment benefits aimed at improving the socio-economic determinants of health. Am J Public Health 2007; 97:1650-1657.
Dror D, Koren R, Ost A, Binnendijk E, Vellakkal S, Danis M. Health insurance benefit packages that low income clients in India prioritize: Three criteria to estimate effectiveness of choice. Social Science and Medicine 2007 Feb;64(4):884-96.
Ginsburg M, Goold SD, Danis M. (De)constructing "Basic": Consumers Define The Core Elements Of Coverage Health Affairs 2006;25:1648-1655.
Hurst SA, Slowther AM, Forde R, Pegoraro R, Reiter-Theil S, Perrier A, Elizabeth Garrett-Mayer E, Danis M. Prevalence and determinants of physician bedside rationing: Data from Europe. J Gen Intern Med. 2006; 21:1138-1143.
Goold SD, Biddle SK, Klipp G, Hall CN, Danis M. Choosing Healthplans All Together: A deliberative exercise for allocating limited health care resources. Journal of Health Politics, Policy, and Law 2005;30:563-601.
Danis M, Biddle A, Goold SD. Insurance benefit preferences of the low-income uninsured. J Gen Intern Med. 2002;17: 125-133.
Danis M, Southerland LI, Garrett JM, Smith JL, Hielema F, Pickard G, Egner DM, Patrick DL. A Prospective Study of Advance Directives for Life-Sustaining Care. New Engl J Med. 1991; 324:882-888.
Danis M, Churchill LR. Autonomy and the Common Weal. Hastings Center Report 1991; 21:25-31.
Danis M, Patrick DL, Southerland LI, Green ML. Patients' and Families' Preferences for Medical Intensive Care. JAMA 1988; 260:797-802.