About

Arlene M. Davis is a professor of Social Medicine at the University of North Carolina at Chapel Hill and serves as the Director of the UNC Center for Bioethics. She is also the Director of the UNC Hospitals Clinic Ethics Service and an adjunct professor in the Departments of Pediatrics and Psychiatry. Davis is an attorney and a member of the North Carolina State Bar, with a background that includes private practice and experience in pediatric, psychiatric, and public health nursing. Her work primarily focuses on practical ethics in clinical and research settings, emphasizing health law and ethics education within the School of Medicine and beyond. She actively participates in hospital ethics, co-chairs the UNC Hospitals Ethics Committee, and conducts ethics consultations for patients across the hospital system. Davis has been involved in research since 1996, including projects on human subjects protection, genetic information, gene editing, and ethical issues in medical research and practice. She has collaborated on interdisciplinary projects examining ethical issues in research on the newly dead, professionalism in residency programs, emotional labor in healthcare teams, surrogate decision-making, and hospital visitor policies during pandemics. Additionally, she has contributed to legal research on pregnant and parenting adolescents in North Carolina, producing legal guides and informing state law. Davis is committed to education, leading multiple ethics training sessions, electives for medical students and residents, and organizing issues-based meetings for hospital ethics committees. Her work integrates clinical ethics, legal considerations, and policy development to address complex ethical challenges in healthcare.

Research topics

• Political Science
• Computer Science
• Sociology
• Business
• Medicine
• Engineering ethics
• Social Science
• Law
• Psychology
• Engineering
• Public relations
• Public administration
• Management
• Genetics
• Social psychology
• Pediatrics
• Virology
• Biology

Selected publications

• The public-private research ecosystem in the genome editing era

  UNC Libraries · 2025-01-28

  articleOpen access1st authorCorresponding
  PublisherDOI

• Scientists' Views on Scientific Self-Governance for Human Genome Editing Research

  UNC Libraries · 2025-02-25

  articleOpen access

  As research on human gene editing has grown, a variety of prominent international organizations are considering how best to govern such research. But what role do scientists engaged in genome editing think they should have in developing research governance? In this study, we present results from a survey of 212 U.S.-based scientists regarding views on human genome editing governance. Most did not believe that scientists should be allowed to self-govern human genome editing research. Open-ended responses revealed four main reasons: conflicts of interest, the inevitability of rare "bad apples," historical evidence to the contrary, and the limitations of scientific expertise. Analyses of open-ended responses also revealed scientists' views on how human gene editing research should be governed. These views emphasize interdisciplinary professional and public input. The study results illustrate a noteworthy shift in the scientific community's traditional vision of professional autonomy and can inform ongoing efforts to develop research governance approaches.

  PublisherDOI

• The Promise and Reality of Public Engagement in the Governance of Human Genome Editing Research

  UNC Libraries · 2025-02-25

  articleOpen access

  This paper analyses the activities of five organizations shaping the debate over the global governance of genome editing in order to assess current approaches to public engagement (PE). We compare the recommendations of each group with its own practices. All recommend broad engagement with the general public, but their practices vary from expert-driven models dominated by scientists, experts, and civil society groups to citizen deliberation-driven models that feature bidirectional consultation with local citizens, as well as hybrid models that combine elements of both approaches. Only one group practices PE that seeks community perspectives to advance equity. In most cases, PE does little more than record already well-known views held by the most vocal groups, and thus is unlikely to produce more just or equitable processes or policy outcomes. Our exploration of the strengths, weaknesses, and possibilities of current forms of PE suggests a need to rethink both "public" and "engagement."

  PublisherDOI

• Resident Physician Burnout in the Medical Intensive Care Unit: A Prospective, Mixed-Methods Study

  ATS Scholar · 2025-10-01

  articleOpen access

  BACKGROUND: Burnout, characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment, negatively affects resident physicians and patients. Although burnout is common among intensive care unit (ICU) healthcare workers, data on its impact on resident physicians during their medical ICU (MICU) rotations are limited. OBJECTIVE: This study aimed to determine the prevalence, key drivers, and mitigating factors for burnout among resident physicians rotating through the MICU. METHODS: We conducted a single-center, mixed-methods prospective cohort study in the MICU of an academic quaternary care hospital. Over the course of a 9-month period, we surveyed residents at the end of their MICU rotation and assessed the prevalence of burnout using the Maslach Burnout Inventory, as well as perceived drivers and mitigators of burnout. Focus groups were conducted to further explore internal medicine (IM) residents' perceptions of drivers and mitigators of MICU-related burnout. RESULTS: Forty-nine residents completed the survey (80% response rate), and 25 IM residents participated in focus groups. The overall burnout prevalence was 88%. Although not statistically significant, higher burnout rates were observed among first-year residents (94% vs. 78%; P = 0.12) and non-IM residents (100% vs. 81%; P = 0.07). Fifty-three percent of residents believed that there was more burnout in the MICU than other ICU rotations. Three themes emerged as drivers of burnout: patient factors (high acuity, adverse outcomes, ethical dilemmas), team and unit dynamics (interdisciplinary tensions, MICU insider-outsider bias), and the clinical learning environment (limited work-life balance, steep learning curve, normalization of burnout). The primary mitigating factors were meaningful patient interactions, supportive team dynamics, structured debriefing, protected time, and focused skill development. CONCLUSION: Burnout in residents rotating through the MICU is extremely high, higher than the previously reported baseline resident burnout rate of 50-75%. First-year and non-IM residents may be especially vulnerable because of unfamiliarity with the unique team and unit dynamics and clinical learning environment of the MICU (high acuity, high intensity, frequent exposure to dying patients, and unit insider-outsider bias). This study highlights unique factors, which contribute to burnout among MICU residents, that differ from those affecting other critical care staff and could be addressed through targeted interventions.

  PublisherDOI

• A New Governance Approach to Regulating Human Genome Editing.

  North Carolina journal of law & technology · 2025 · 6 citations

  • Political Science
  • Political Science
  • Public relations

  For years, genomic medicine-medicine based on the growing understanding of the genetic contribution to many diseases and conditions-has been hailed as the future of medical treatment, but it has thus far had limited effect on day-to-day medical practice. The ultimate goal of genomic medicine has always been the ability not just to identify dangerous gene mutations, but to fix them. Now CRISPR and related genome-editing technologies may have the potential to provide a safe and effective way to repair dangerous mutations. In the wake of ethically dubious experiments with human embryos in China, the international governance of human genome editing is emerging as an urgent topic for scientists, regulators, and the public. Efforts to develop a governance model are underway at national and international levels. These efforts are the subject of multiple initiatives by national and international health and science organizations and are topics of discussion at scientific conferences, summits, and meetings. This Article reports on the Authors' multi-year, interdisciplinary project to identify and investigate the practical, ethical, and policy considerations that are emerging as the greatest concerns about human genome editing, and ultimately to develop policy options. The project involves monitoring the discussions of groups, both government-sponsored and private, that are considering how genome editing should be governed; observing conferences where the topic is discussed; analyzing emerging policy reports by national and international bodies; and interviewing a wide range of stakeholders, including scientists, ethicists, and those who make and comment on public policy. The Article identifies several stakeholder concerns that are especially prominent in the research to date and begins to explore the implications of these concerns for alternative models of governance. There are current indications that, for practical purposes, a focus on "soft," hybrid forms of governance based on networks of multiple public and private stakeholders may turn out to be the most promising course to pursue. The "new governance" paradigm developed in the corporate and financial sectors offers a useful model for understanding the dynamics of this approach.

  PublisherOA PDF

• Preventive Human Genome Editing and Enhancement: Candidate Criteria for Governance

  The Hastings Center Report · 2024-09-01 · 1 citations

  articleOpen access

  While somatic cell editing to treat disease is widely accepted, the use of human genome editing for "enhancement" remains contested. Scientists and policy-makers routinely cite the prospect of enhancement as a salient ethical challenge for human genome editing research. If preventive genome editing projects are perceived as pursuing human enhancement, they could face heightened barriers to scientific, public, and regulatory approval. This article outlines what we call "preventive strengthening research" (or "PSR") to explore, through this example, how working to strengthen individuals' resistance to disease beyond what biomedicine considers to be the human functional range may be interpreted as pursuing human enhancement. Those involved in developing guidance for PSR will need to navigate the interface between preventive goals and enhancement implications. This article identifies and critiques three of these ideas in the interest of anticipating the wider emergence of PSR and the need for a normative approach for its pursuit. All three "candidate criteria" merit attention, but each also faces challenges that will need to be addressed as further research policy is developed.

  PublisherOA PDFDOI

• The public-private research ecosystem in the genome editing era

  iScience · 2024-05-03 · 3 citations

  articleOpen access

  Biomedical research in the US has long been conducted in a public-private (PP) "ecosystem." Today, especially with gene therapies and genome editing-based medicine, publicly funded researchers frequently hand off their research to the private sector for clinical development, often to small, venture capital-funded startups in which they have a financial interest. This trend raises ethical questions about conflicts of interest, effectiveness of regulatory oversight, and justice in therapy access, that we are addressing in a multi-year, multidisciplinary study of the evolving governance of genome editing. This paper draws on interviews with scientists working across the PP divide and their private sector business and financial partners. We find little concern about potential ethical dilemmas, with two exceptions expressed by public sector scientists: concerns about inequitable access to treatments due to disparities in wealth, ethnicity, and health insurance benefits; and about whether their private collaborators' profit motive may affect their research objectives.

  PublisherDOI

• Medical training: emotions, empathy, and belonging

  The Lancet · 2024-08-01

  letterSenior author
  PublisherDOI

• Life and Choice: Navigating Palliative Care in a Shifting Legal Landscape

  Journal of Pain and Symptom Management · 2024-04-18

  articleOpen access
  PublisherOA PDFDOI

• A critical review of health research ethical guidelines regarding caregiver consent for HIV research involving minors in South Africa: Ethical and legal issues

  UNC Libraries · 2024-07-25

  reviewOpen access1st authorCorresponding

  Background. Over the past decades there have been tremendous efforts to improve the ethical conduct of research involving humans throughout the world. As a one-size-fits-all philosophy can no longer work, most countries have developed specific legal and ethical guidelines for research, tailored to their own context. We reviewed South African (SA) ethical guidelines and Health Research Acts as they pertain to the role of caregivers in consent practices for minors’ participation in HIV/AIDS-related research. Methods . An argument-driven review was conducted on two SA Acts and Guidelines respectively: the SA National Health Act of 2003; the Children’s Act No. 38 of 2005 and the Department of Health Ethics in Health Research Guidelines 2nd edition of 2015 and the Good Clinical Practice Guidelines of 2006, with a particular focus on minors as research participants. We also examined the relevant ethical and legal guidance using an exemplar of paediatric HIV testing within research conducted in SA. Results . Available ethical guidelines for caregivers’ consent in research involving minors are still not comprehensive or aligned with SA regulations governing research with minors. The recent revision and development of the National Health Research Ethics Guidelines (2015), regarding the role of caregivers in consent practice for minors’ participation in health research, may be a positive move in clarifying the proper role for caregivers when enrolling minors in research. Conclusion. Caregivers are deemed to have a role to play in research involving minors. Therefore, the inconsistencies in existing ethical guidelines and governing regulations regarding the role of caregivers in paediatric HIV research, need to be addressed following the recent ethical paradigm change.

  PublisherDOI

Frequent coauthors

• Gail E. Henderson

  30 shared

• R. Jean Cadigan

  28 shared

• John M. Conley

  University of North Carolina at Chapel Hill

  21 shared

• Jill A. Fisher

  University of North Carolina at Chapel Hill

  17 shared

• Lisa McManus

  Wake Technical Community College

  16 shared

• Rebecca L Forcier

  North Carolina State University

  16 shared

• Benny L. Joyner

  University of North Carolina at Chapel Hill

  13 shared

• Larry R. Churchill

  Vanderbilt University Medical Center

  12 shared

Education

• Other

  University of Washington

• B.S., Nursing

  South Dakota State

Awards & honors

• Innovation in Teaching Award from the UNC Academy of Educato…