People | Faculty
Douglas B. White, MD, MAS
Associate Professor of Critical Care Medicine and Medicine
Director, Program on Ethics and Decision Making in Critical Illness
Core Faculty Member, Center for Bioethics and Health Law
Dr. White graduated summa cum laude from Dartmouth College in 1995 with a degree in English Literature. He received his MD from UCSF in 1999 and completed a residency in Internal Medicine and a fellowship in Pulmonary and Critical Care Medicine at UCSF. While at UCSF, he also completed a Master’s degree in Epidemiology and Biostatistics and a fellowship in Bioethics under Bernard Lo. He joined the faculty at UCSF in 2005 as an Assistant Professor of Medicine and a Core Faculty of the Program on Medical Ethics. In 2009 he joined the faculty of the University of Pittsburgh in the Departments of Critical Care Medicine and Medicine as an Associate Professor. He was also appointed as a core faculty member in the Center for Bioethics and Health law at the University of Pittsburgh.
Dr. White directs the University of Pittsburgh Program on Ethics and Decision Making in Critical Illness. His research program encompasses both empirical research on and normative ethical analysis of surrogate decision-making for patients with life-threatening illness. He has several ongoing NIH funded studies. He has published widely using both quantitative and qualitative methods to examine the process of surrogate decision making in intensive care units. In conducting this work, he collaborates with a multi-disciplinary group of investigators, which includes faculty with expertise in bioethics, law, philosophy, sociology, biostatistics, and health services research. His empirical research program has two central aims: 1) to identify factors that adversely affect surrogate decision-making for critically ill patients; and 2) to develop and test interventions to improve surrogate decision-making. His normative work focuses on ethical issues that arise in intensive care units, including the allocation of scarce resources, resolving futility disputes, responding to conscience-based treatment refusals by clinicians, and developing fair processes of decision making for incapacitated patients who lack surrogate decision makers.
MD - University of California, San Francisco (1999)
Residency - Internal Medicine, University of California, San Francisco (2002)
Fellowship - Pulmonary and Critical Care Medicine, University of California, San Francisco (2005)
MAS - Epidemiology and Biostatistics, University of California, San Francisco (2006)
Fellowship - Bioethics, University of California, San Francisco (2007)
Awards and Honors
Phi Beta Kappa Honor Society, Dartmouth College (1995)
Alpha Omega Alpha Honor Society; University of California, San Francisco School of Medicine (1999)
Lee Lusted Prize for Outstanding Mentored Research, Society for Medical Decision Making (2006)
Award for Outstanding Ethics Research, Society for Critical Care Medicine (2008)
Greenwall Foundation Faculty Scholar Award in Bioethics, Greenwall Foundation (2008)
Paul B. Beeson Career Development Award in Aging, Starr Foundation, Atlantic Philanthropies, NIA American Federation for Aging Research (AFAR) (2008)
Reza Gandjei Lectureship in Bioethics, University of California San Francisco (2009)
Research Support: Ongoing
1R01HL094553-01 09/01/09 – 08/31/13 NIH/NHLBI
Title: Identifying Effective Strategies to Disclose Prognosis in Patients with ARDS
This award supports a multi-center, mixed-methods, prospective cohort study to identify effective, culturally acceptable strategies to disclose prognostic information to surrogate decision-makers of critically ill patients.
Greenwall Foundation 07/01/08 – 06/30/11
Greenwall Foundation Faculty Scholars Program in Bioethics
Title: The Ethics of Making Life Support Decisions for Incapacitated Patients without Surrogates
This award supports normative and empirical bioethics research addressing how life support decisions should be made for patients who lack decision-making capacity, a surrogate decision-maker, and an advance directive.
1K23AG032875-01 09/01/08 – 08/31/12 NIH/NIA
Paul Beeson Career Development Award in Aging
Title: A randomized trial to improve surrogate decision-making for critically ill elders
This award supports a randomized controlled trial of a multi-faceted intervention to improve surrogate decision-making and life support decisions for critically ill elders at high risk for death or functional impairment in intensive care units.
1R21HL094975-01 Consultant 09/01/09 – 08/31/11
Title: Validation of a Mortality Prediction Model for Prolonged Mechanical Ventilation
A scoring system that can determine the risk of death for patients who become critically ill and require mechanical ventilation for weeks or months has been developed in a single hospital. This study will determine if this scoring system is accurate in patients who require prolonged mechanical ventilation at other hospitals in the U.S.
AG032875-02S1 09/15/09 – 03/31/11
NIH/NIA ARRA Administrative Supplement
Paul Beeson Career Development Award in Aging
Title: A randomized trail to improve surrogate decision-making for critically ill eldersThis award is an ARRA administrative supplement to broaden the scope of the intervenion in the primary project.
Evans L, Boyd EA, Apatira L, Malvar G, Luce J, Lo, B, White DB. Surrogate decision-makers' perspectives on discussing prognosis in the face of uncertainty. Am J Respir Crit Care Med 2009 Jan; 1:179(1):48-53. PMID: 18931332
White DB, Katz M, Luce JM, Lo B. Who should receive life support during a public health emergency? Using ethical principles to improve allocation decisions. Ann Int Med 2009 Jan; 20:150(2):132-8. PMID: 19153413
Luce JM, White DB. A history of ethics and law in the intensive care unit. Crit Care Clin 2009 Jan; 25: 221–37. PMID: 19268804
Hemphill JC 3rd, White DB. Clinical nihilism in neuroemergencies. Emerg Med Clin North Am 2009 Feb; 27(1):27-37. PMID: 19218017
Zier LS, Burack JH, Micco G, Chipman A, Frank JA, Luce JM, White DB. Surrogate decision-makers’ responses to physicians’ predictions of medical futility. Chest 2009 Jul; 136(1):110-7. PMID: 19318665
White DB, Evans L, Bautista C, Luce JM, Lo B. Are physicians’ recommendations to limit life support beneficial or burdensome? Bringing empirical data to the debate. Am J Respir Crit Care Med. 2009 Aug; 15:180(4):320-5. PMID: 19498057
Cox CE, Docherty SL, Brandon DH, Whaley C, Attix DK, Clay AS, Dore DV, Hough CL, White DB, Tulsky JA. Surviving critical illness: acute respiratory distress syndrome as experienced by patients and their caregivers. Crit Care Med 2009 Oct; 37(10):2702-8. PMID: 19865004
White DB, Engelberg RA, Wenrich MD, Lo B, Curtis JR. The language of prognostication in intensive care units. Med Decis Making. 2010 Jan-Feb;30(1):76-83. PMID: 18753685
White DB, Karr JK. Malvar G, Lo B, Curtis JR. Expanding the paradigm of the physician’s role in surrogate decision making: an empirically-derived framework. Crit Care Med 2010; 38(3):743-50. PMID: 20029347
McAdam, JM, Dracup, KA, White, DB, Fontaine, DK, Puntillo, KA. Symptom experiences of family members of intensive care unit patients at high risk of dying. Crit Care Med. 38(4):1078-1085, April 2010. PMID: 20124890 [PubMed - indexed for MEDLINE]
Bernat JL, Capron AM, Bleck TP, Blosser S, Bratton SL, Childress JF, DeVita MA, Fulda GF, Gries CJ, Mathur M, Nakagawa TA, Rushton CH, Shemie SD, White DB. The circulatory-respiratory determination of death in organ donation. Crit Care Med 2010; 38(3):963-70. PMID: 20124892
Anderson WG, Winters K, Arnold RM, Puntillo KA, White DB, Auerbach AD. Studying physician-patient communication in the acute care setting: The hospitalist rapport study. Patient Educ Couns. 2010 May 3. [Epub ahead of print] PMID: 20444569
Boyd EA, Lo B, Evans LR, Malvar G, Apatira L, Luce JM, White DB. “It’s not just what the doctor tells me:” factors that influence surrogate decision-makers’ perceptions of prognosis. Crit Care Med 2010 May; 38(5):1270-5. PMID: 20228686
Zahuranec DB, Morgenstern LG, Sánchez BN, Resnicow K, White DB, Hemphill JC 3rd. Do-not-resuscitate orders and predictive models after intracerebral hemorrhage. Neurology. 2010 Aug 17;75(7):626-33. PMID: 20610832
Daugherty EL, White DB. Conducting clinical research during disasters. AMA Journal of Ethics: Virtual Mentor. 2010; 12:701-705. http://virtualmentor.ama-assn.org/2010/09/ccas1-1009.html Accessed September 1, 2010.
Yeow, M-E, Mehta RS, White DB, Szmuilowicz E. Using noninvasive ventilation at the end of life. J Palliat Med. 2010 Sep;13(9):1149-51. PMID: 20836641
Lee S, Evans L, Malvar G, White DB. A randomized trial of two methods to disclose prognostic information to surrogate decision-makers. Am J Resp Crit Care Med. 2010 October 182: 905-09. PMID: 20538959
Johnson SK. Bautista CA. Hong S, Weissfeld L. White DB. An Empirical Study of Surrogates’ Preferred Level of Control over Value-Laden Life Support Decisions in Intensive Care Units. Am J Resp Crit Care Med. In press 2010.