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David Magnus

David Magnus

· Professor of Teaching (Pediatrics/SCBE)Verified

Stanford University · Human Biology

Active 1995–2025

h-index39
Citations4.6k
Papers12647 last 5y
Funding
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About

David Magnus is a professor associated with the Department of Pediatrics and the Stanford Center for Biomedical Ethics (SCBE) at Stanford University. His research focuses on bioethics, including ethical issues in medicine, research, and public health. As a faculty member, he contributes to the academic community through teaching and research in these areas, emphasizing ethical considerations in biomedical sciences and healthcare.

Research topics

  • Computer Science
  • Political Science
  • Social Science
  • Sociology
  • Law
  • Medicine
  • Public relations
  • Engineering
  • Engineering ethics
  • Family medicine
  • Nursing
  • Business
  • Gerontology
  • Internet privacy
  • Knowledge management
  • Psychology
  • Psychiatry
  • Pathology
  • Human–computer interaction
  • Finance

Selected publications

  • Looking Beyond the IRB

    The American Journal of Bioethics · 2025-01-29 · 2 citations

    letterOpen accessSenior author
  • A Qualitative Analysis of Physician Communication During Brain Death Conversations

    Neurology Clinical Practice · 2025-06-04

    articleSenior author

    Background and Objectives: In recent decades, many legal cases have resulted from physicians ineffectively communicating to a family that their loved one is brain dead (brain dead/death by neurologic criteria [BD/DNC]). Although the definition of BD/DNC has recently undergone revision, little research has been conducted to establish optimal approaches in communicating BD/DNC status to families. The aim of this study was to characterize what highly experienced physicians perceive to be the best communication practices and language choices during BD/DNC conversations. Methods: In this qualitative study, we conducted semistructured, in-depth interviews with physician leaders in the field of BD/DNC between September 2023 and January 2024. All interviews were conducted through Zoom. Twenty expert physician participants were recruited from multiple institutions across the United States through convenience sampling. Participants were current or former attending physicians whose practices at academic institutions involved communication with families about BD/DNC in either the pediatric or adult setting. Participants completed a Qualtrics form containing questions about their demographic background and practice characteristics, including an estimate of the number of times they communicated BD/DNC to patient families. Semistructured interviews were conducted with each of the participants and included hypothetical scenarios and views about best practices. Results: Using 20 qualitative interview transcripts, we identified multiple areas of agreement and disagreement among expert physicians regarding best practices in communicating BD/DNC status. While physicians concurred on specific language to use and avoid, they differed on whether to use the word "coma," on when to introduce the possibility of brain death, and on whether to analogize with cardiac death. There was strong agreement on the utility of visualization through imaging and family attendance at BD/DNC testing. Finally, physicians were in consensus that multiple family meetings with the same providers are crucial for successful BD/DNC communication. Discussion: This study described main convergences and divergences in physician language during BD/DNC conversations and used qualitative data to present a "train journey" theory of ideal physician communication with families. By investigating and improving physician communication styles during BD/DNC conversations, the medical community may ameliorate the legal and medical fallout that results from clinical miscommunication.

  • Asilomar Revisited

    The American Journal of Bioethics · 2025-04-03

    editorial1st authorCorresponding
  • Disentangling informing participants from obtaining their consent

    Learning Health Systems · 2025-04-21 · 2 citations

    articleOpen access

    Introduction: Pragmatic clinical trials conducted in the context of routine care frequently satisfy the regulatory criteria for a waiver of research consent. When they do, investigators and Institutional Review Boards might assume that there is no reason to communicate any information regarding the study to participants. Yet, this approach ignores the possibility that there may be value in providing information to participants, even when the study does not pose significant risks and researchers are not obtaining their consent. Methods: Members of the NIH Collaboratory Ethics and Regulatory Core working group used ethical analysis to determine whether there are reasons to provide information to research participants, other than notifying them of significant risks or obtaining their consent. Study team members then provided examples of trials which illustrate the feasibility and different options for providing information to participants in the context of trials conducted with a waiver of research consent. Results: Communicating information to participants can promote one or more of six goals: respect for persons, participant understanding of the research, participant understanding of their contributions, participant ability to voice any concerns, participant engagement, and trust and trustworthiness. Providing information can also raise potential concerns about feasibility and cost, which need to be balanced against these reasons to inform participants. Depending on the study, a variety of methods can be used to communicate information; for example, letters, email, flyers, posters, as well as brief conversations with clinicians. Conclusion: Even when researchers are not obtaining participants' consent, communicating information can promote one or more of six important goals. Providing information to participants should thus be the default for trials conducted under a waiver of research consent.

  • Exploring How Claims of “Suffering” are Operationalized in Pediatric Critical Care

    Journal of Pain and Symptom Management · 2025-05-17

    article
  • Neither Ethical nor Prudent: Why Not to Choose Normothermic Regional Perfusion

    The Hastings Center Report · 2024-05-20 · 13 citations

    articleOpen accessSenior author

    In transplant medicine, the use of normothermic regional perfusion (NRP) in donation after circulatory determination of death raises ethical difficulties. NRP is objectionable because it restores the donor's circulation, thus invalidating a death declaration based on the permanent cessation of circulation. NRP's defenders respond with arguments that are tortuous and factually inaccurate and depend on introducing extraneous concepts into the law. However, results comparable to NRP's-more and higher-quality organs and more efficient allocation-can be achieved by removing organs from deceased donors and using normothermic machine perfusion (NMP) to support the organs outside the body, without jeopardizing confidence in transplantation's legal and ethical foundations. Given the controversy that NRP generates and the convoluted justifications made for it, we recommend a prudential approach we call "ethical parsimony," which holds that, in the choice between competing means of achieving a result, the ethically simpler one is to be preferred. This approach makes clear that policy-makers should favor NMP over NRP.

  • Qatar’s Bioethics Meeting

    The American Journal of Bioethics · 2024-03-26 · 3 citations

    editorialOpen access1st authorCorresponding
  • Adam Omelianchuk, Alexander Morgan Capron, Lainie Friedman Ross, Arthur R. Derse, James L. Bernat, and David Magnus reply:

    The Hastings Center Report · 2024-09-01

    letterSenior author

    This letter responds to letters by Garson Leder and by Harrison Lee in the same issue, September-October 2024, of the Hastings Center Report.

  • Physician Perspectives on Challenges in Understanding Patient Preferences for Emergency Intubation

    CHEST Critical Care · 2024-02-01 · 4 citations

    articleOpen access

    BACKGROUND: Code status orders (eg, do not resuscitate [DNR], do not intubate [DNI]) are used to guide treatment in emergency scenarios when patient preferences cannot reliably be obtained.However, some code status orders (eg, partial code orders, combined DNR/DNI orders) have been criticized for lack of clarity regarding intubation.RESEARCH QUESTION: What are physician perspectives on the design of code status orders and their ability to clearly convey patient preferences regarding intubation in clinical emergencies?STUDY DESIGN AND METHODS: This was a qualitative study across seven purposively sampled US hospitals characterizing code status order designs through review of code status policy documents, code status ordering menus, and semi-structured physician interviews.Interviews were conducted with physicians from specialties that routinely interact with code status orders.Based on themes from interviews, criteria were generated to assess whether code status order designs effectively convey patient preferences for emergency intubation.RESULTS: Six order designs were identified that differed in their approach to emergency intubation.The designs differed primarily in how the resuscitation portion of the order (eg, DNR) was related to the intubation portion of the order (eg, DNI).Each design was assessed by using the criteria generated from interviews: (1) whether the orders differentiate intubation during CPR from intubation for pre-arrest respiratory failure; (2) whether the orders allow three options that physicians felt should be routinely offered (ie, full code, DNR/may intubate, DNR/DNI); and (3) whether the orders prevent the option physicians felt should not be routinely offered (ie, full code but DNI).Only two order designs met all three criteria.INTERPRETATION: Some code status order designs create ambiguity for physicians about patient preferences for emergency intubation, placing patients at risk for unwanted intubation or failure to intubate in life-threatening scenarios.This study identified two order designs that hospitals can adopt to address this ambiguity.

  • Resuscitating the Dead: NRP and Language

    The American Journal of Bioethics · 2024-06-02 · 4 citations

    articleOpen access1st authorCorresponding

Frequent coauthors

  • Jason N. Batten

    94 shared
  • Sarah Wieten

    Stanford Medicine

    88 shared
  • Jacob A. Blythe

    85 shared
  • Joshua B. Kayser

    University of Pennsylvania

    84 shared
  • Stephanie Harman

    84 shared
  • Miriam Piven Cotler

    83 shared
  • Karin Porter-Williamson

    University of California, San Francisco

    83 shared
  • Elizabeth Dzeng

    83 shared

Education

  • Ph.D., Human Biology

    Stanford University

    1990
  • M.D., Medicine

    Stanford University School of Medicine

    1985
  • B.A., Human Biology

    Stanford University

    1981
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