Overview

Overview

The mission of the Neuroethics Program is to conduct cutting-edge neuroethics research, both scholarly and empirical, provide the highest level of training in clinical neuroethics, and develop and promote best ethical practices in the diagnosis and treatment of neurological diseases. We provide ethics consultation services to patients, families and care providers, and investigate ethical challenges they face. The neuroethics program is also committed to engaging community stakeholders in emerging technologies, as well as mental health needs. Cleveland Clinic’s Neuroethics Program is housed in the Neurological Institute. Paul J. Ford, PhD serves as director of the Neuroethics Program.

A great need exists to address the emerging ethical challenges related to brain-based diseases that patients, families, caretakers, researchers and clinicians face. This is particularly true given the increasing incidence of brain-based diseases and the resulting worldwide burden of suffering and disability. In the Neuroethics Program at Cleveland Clinic, we approach these ethical challenges in a practical manner, starting from the problems that arise in the prevention, diagnosis and treatment of neurological conditions. We undertake research, education and clinical support. And we do this through collaborations with clinicians, clinical researchers, community stakeholders and bioethicists.

Neuroethics Consultation

The Neuroethics Program faculty provides ethics consultation services within Cleveland Clinic to patients, families, clinicians and researchers. Further, we’re actively involved with various neuroethics-related work on both national and international levels.

Other functions in Clinical Neuroethics:

  • Consent monitor for clinical research
  • Participation in specialized patient management conferences, including conferences for epilepsy surgery and deep brain stimulation that highlight patient selection and challenging patient care issues
  • Frequent consults on specific inpatient and outpatient neurosurgical issues (we’re called on over twenty times per year to consult on specific inpatient/outpatient surgical issues)

Opportunities

Dr. Ford and the Cleveland Clinic Neuroethics team welcome collaborators, co-authors, trainees and students interested in the ethical dimensions of neuroscience, neurosurgery and neurological care.

We’re open to inquiries from:

  • Undergraduate and graduate students interested in bioethics, neuroscience, philosophy, or medical humanities
  • Medical students, residents and fellows seeking research, mentorship or ethics-focused clinical experience
  • Faculty or postdoctoral researchers in neurology, neurosurgery, psychiatry, law or related fields
  • Writers, journalists or science communicators exploring ethical topics in brain science
  • Community partners or educators interested in promoting equity and ethical awareness in brain health research

Collaborators may contribute to:

  • Qualitative research (e.g., interviews, thematic analysis)
  • Manuscript development or grant proposals
  • Ethics consultation scholarship
  • Development of educational materials or public-facing work

How To Get Involved

To ask about opportunities, please send a brief statement of interest (one to two paragraphs) and a CV or résumé (PDF) to Dr. Paul Ford at fordp@ccf.org. If you’re a resident or fellow considering a clinical program at Cleveland Clinic and would like to integrate bioethics into your training, we especially encourage you to reach out.

Publications

Publications

  1. Ford PJ, Morley G, Sankary LR. Attending to Trauma, Balancing Power, and Prioritizing Stakeholders in Ethics Consultation. J Clin Ethics. 2025;36(1):63-68. doi:10.1086/733387
  2. Sankary LR, Rico V, Zelinsky M, et al (including Ford PJ). Building expert consensus regarding sharing of individual research results in Alzheimer’s disease research: a Delphi study protocol. BMJ Open. 2024;14(8):e089242. doi:10.1136/bmjopen-2024-089242
  3. Merner AR, Frazier TW, Ford PJ, et al. A Patient-Centered Perspective on Changes in Personal Characteristics After Deep Brain Stimulation. JAMA Netw Open. 2024;7(9):e2434255. doi:10.1001/jamanetworkopen.2024.34255
  4. Sankary LR, Zelinsky ME, Ford PJ, Blackstone EC, Fox RJ. Overcoming barriers to informed consent in neurological research: Perspectives from a national survey. Res Ethics. 2023;19(1):42-61. doi:10.1177/17470161221131497
  5. Ford PJ, “Neuroethics, Neurodiversity, and Neurodisability.” 2022. Guidance for Healthcare Ethics Committees 2nd edition. Eds. Hester DM & Schonfeld T. Cambridge University Press. 175-182.
  6. Sun XR, Ford PJ, Schulder M. 2022. “History and Ethical Considerations in Functional Neurosurgery.” in Youmans & Winn Neurological Surgery, 8th edition. ed. Winn HR, Elsevier. 792-797.
  7. Feldman FL, Ford PJ, Sankary LR. 2022. “Neuroethics in the clinic: amplifying patient perspectives through enhanced decision-making frameworks” Thorny Issues in Clinical Ethics Consultation. Wasson K & Kuczewski MG, Springer.
  8. Mabel H, Bruno B, Jankowski J, Eves MM, Ford PJ. “Improving Real-World Innovation and Problem Solving in Clinical Ethics: Insights from the First Clinical Ethics Un-Conference.” Journal of Clinical Ethics, 32(4). PMID: 34928861
  9. Sankary LR, Zelinsky M, Machado A, Rush T, White A, Ford PJ. “Exit from Brain Device Research: A Modified Ground Theory Study of Researcher Obligations and Participant Experiences.” AJOB: Neuroscience. DOI: 10.1080/21507740.2021.1938293. PMID: 34255614.
  10. Blackstone E, Ford PJ, Sankary LR. Clarifying Definitions of Palliative Neurosurgery: A Neuroethics Perspective. World Neurosurgery. 2021. DOI: https://doi.org/10.1016/j.wneu.2021.08.148
  11. Ford PJ, Fox RJ, Mercer MB, Cofield SS. 2021. Patient Perceptions of FDA Approval: Gaps in education or variation in value? Neurol Clin Pract Jan 2021, DOI: 10.1212/CPJ.0000000000001034 . PMID: 34484926;
  12. Tilahun BBS, Thompson NR, Sankary LR, Laryea F, Trunick CM, Jehi LE. Outcomes in the treatment of psychogenic nonepileptic seizures (PNES) with CBTip: Response in seizure frequency, depression, anxiety, and quality of life. Epilepsy & Behavior. 2021;123:108277. doi: 10.1016/j.yebeh.2021.108277
  13. Shapiro D, Sankary LR, Ford PJ. Reconciling Supported Decision Making with Shared Decision Making in the Context of Potential Vulnerability. The American Journal of Bioethics. 2021; 21(11): 35-37, DOI: 10.1080/15265161.2021.1980139
  14. Merner AR, Frazier T, Ford PJ, Cooper S, Machado A, Lapin B, Vitek JL, Kubu CS. 2021. “Changes in patients’ desired control of their deep brain stimulation and subjective global control over the course of deep brain stimulation.” Frontiers in Human Neuroscience, DOI: 10.3389/fnhum.2021.642195
  15. Sankary LR, Nallapan A, Hogue O, Machado A, Ford PJ. “Publication of Study Exit Procedures in Clinical Trials of Deep Brain Stimulation: A Focused Literature Review.” Frontiers in Human Neuroscience. doi: 10.3389/fnhum.2020.581090
  16. Shlobin NA, Rosenow JM, Ford PJ. 2020. “Using Functionality Rather Than Elective Nature to Characterize Surgeries in Neurosurgery.” American Journal of Bioethics. 29, 7: 196-198 https://doi.org/10.1080/15265161.2020.1777353

National Talks

  1. “Alzheimer’s Disease Research Participant Perspectives on the Return of Individual Research Results.” Sankary, LR. (Poster Presentation). Alzheimer’s Association International Conference. August 3, 2022.
  2. “Ethical Considerations of Loss of Benefit in a Crossover Clinical Trial Design.” Poster. P. Ford, L. Johnson, M. Morell. 8th Annual BRAIN Initiative Meeting, June 21-22, 2022.
  3. “Evolution of an Ethics Rounding Tool: Neuro-Stepdown Unit & Nursing Moral Distress” Ford PJ. Propelling Clinical Ethics Forward: A Working Unconference, Atlanta, GA, April 28, 2022.
  4. “Mental Health First Aid: Grassroots Trust Building for Racial Justice,” Ford PJ. Propelling Clinical Ethics Forward: A Working Unconference, Atlanta, GA, April 28, 2022.
  5. “Ethics Consultation in Brain Diseases: Straddling Role Boundaries as an Ethicist,” Ford PJ. The David F. Kelly Bioethics Lecture, Duquesne University, March 31, 2022.
  6. “The Accelerated Approval of Aduhelm: Implications for Public Trust.” Sankary, LR. (Oral Presentation). Arizona Bioethics Network. January 26, 2022.
  7. “Perceptions of Vulnerability and Moral Distress in Neurological Care.” Sankary, LR. (Grand Rounds Presentation) Marcel and Josephine Patterson Memorial Lecture in the Medical Humanities, University of Texas Medical Branch, Virtual, October 21, 2021.
  8. “Navigating Bioethical Issues in PD: Addressing Barriers to Adherence, DBS & End of Life Issues.” Sankary, LR. (Panel Presentation). 2021 Parkinson Foundation Virtual Centers of Excellence Leadership Conference (CLC), November 18, 2021.
  9. “Challenging Ethics Consultations: Listening to those with fluctuating capacity,” Ford PJ. Healthcare Ethics Grand Rounds, National Veterans Affairs Center for Ethics in Healthcare, November 16, 2021. (virtual with 670 participants)
  10. “Ethical Challenges in Neurology,” Sankary, LR. 22nd Annual Innovations in Neuroscience Conference, Cleveland Clinic, Cleveland, OH, May 14, 2021.
  11. “Dealing with Uncertainty: Neurosurgery, Compromised Capacity, and Ethics,” Ford PJ. Hospital Grand Rounds, Virginia Mason Medical Center, Seattle, WA, July 30, 2021. (virtual)
  12. “Surgical Decision-Making: How Do We Balance Paternalism, Shared Decision-Making and Free Will,” Ford PJ. Panelist in CME program, Navigating the Mind-Field: Practical Applications of Bioethics when the Patient’s Capacity is Compromised, Seattle, WA, July 30, 2021. (virtual)
  13. “Least Restrictive?: Adolescent Eating Disorder and ICU,” Ford PJ. Visiting Faculty Commentator, Harvard Clinical Ethics Consortium, March 5, 2021. (virtual)
  14. “Has the Time Come to Eliminate Controls that Involve Burr Holes in Sham Neurosurgical Research?” Debate between Ford PJ. & M. Kelly, MD, Cambridge-ICM Brain and Spine Institute Neuroethics Network Symposium, February 3, 2021. (virtual)
  15. “Ethics and control for neurological patients: Expressions of values in innovative practices,” Ford PJ. Neurology Grand Rounds (Virtual because of COVID 19 pandemic), University of Arkansas Medical Center, April 17, 2020.
  16. Podcast Interview, “E16 Bioethics and Bioelectronic Medicines an Emerging Area of Intertwined Significance,” Sankary LR and Ford PJ. SKARPS: Stories of scientific brilliance, Recorded 2020: Last viewed 12/15/2020.
  17. “Bioethical Considerations in Today’s Neurology and Neurosurgery Practice,” Sankary LR. April 8, 2020, Neuro Pathways Podcast. https://podcasts.apple.com/us/podcast/bioethical-considerations-in-todays-neurology-neurosurgery/id1467738002?i=1000470876017
  18. I AM HUMAN Documentary | Cleveland Premiere & Panel Discussion, Ford PJ. Panelist, Hanna Theatre, Cleveland, OH, January 30, 2020 (Panel recording at: https://www.youtube.com/watch?v=Q1hUbdDVJjo also see: https://www.eventbrite.com/e/i-am-human-documentary-cleveland-premiere-panel-discussion-tickets-82611580461# )

Grants

  1. “Optimizing Decision Support for Alzheimer’s Disease Research,” Alzheimer’s Association Research Grant (AARG-22-974462) Roles: PI: Lauren Sankary, JD., Co-I Paul Ford, PhD. 09/2022-06/2025.
  2. “COVID-19 Related Barriers to Informed Consent in Aging and Cognitively Vulnerable Patients,” National Institute on Aging (NIA) (3P30AG062428-02S2). Roles: Co-I: Lauren Sankary, JD. 09/2020-present.
  3. “Summit and Consortium for Mental Health First Aid,” Cleveland Clinic Caregiver Catalyst Grant, Role: Awardee/organize, 07/01/22-06/30/23.
  4. “Mental health First Aid: A CCF/Glenville Collaboration,” Cleveland Partnership Award, Cleveland Clinic Community Health & Partnerships, ($17,250) Role: Program Partner and Grant writer, Awardee: Khnemu Foundation. 05/10/22-05/09/23.
  5. “Neurologist-in-Training Clinical Ethics Elective,” The American Academy of Neurology, American Neurological Association, and the Child Neurology Society, Mentor: Paul Ford, PhD. Awardee: S. Tavella-Burka. 01/07/22-30/06/23.
  6. “Shor Study: The Effects of Integrative Behavioral and Wellness-Based Interventions for Patients with Epilepsy,” Philanthropy donor Charles Shor, Co-investigator: Paul Ford,; 01/01/21 – Present.
  7. “Cleveland Clinic Brain Study,” Cleveland Clinic Funded, Co-investigator: Lauren Sankary, JD , Paul Ford, PhD; 01/01/21 – Present.
  8. “Ethics of Choice of Invasive versus Non-invasive Neurosurgery: Different Stakeholders’ Perspectives, NIMH NIH Surgical Decision-making, and Impact on Patient Sense of Control,” Mechanism: RF1,PI: Cynthia Kubu, PhD. Co-I: Lauren Sankary, JD , Paul Ford, PhD 7/20/2020-7/19/2024.
  9. "Ethical Safeguards for Exit and Withdrawal from Implanted Neurotechnology Research,” National Institute of Neurological Disorders and Stroke (1F32MH115419). PI: Lauren Sankary, JD, 09/2017-01/2020
  10. “Electrical Stimulation of the Dentate Nucleus for Upper Extremity Hemiparesis Due to Ischemic Stroke (EDEN),” National Institute of Neurological Disorders and Stroke (UH3NS100543-01). Consent Monitor: Lauren Sankary, JD, Paul Ford, PhD. 09/2016 – 06/2022.

Conferences, Symposia, and Courses

Building Skills and Destigmatizing Mental Health: A Working Summit
Date: February 23, 2023
Location: Warrensville Heights, Ohio
Format: Day-long conference of community stakeholders
Directors: Paul J. Ford, PhD; Jalayne Arias, JD
Watch the full playlist

Emerging Ethical and Legal Challenges in Chronic Neurological Conditions
Date: October 8–9, 2014
Location: Global Center for Health Innovation and Cleveland Convention Center, Cleveland, OH
Directors: Paul J. Ford, PhD; Jalayne Arias, JD
View the agenda

Brain Matters 3: Values at the Crossroads of Neurology, Psychiatry and Psychology
Date: October 23–25, 2012
Location: Cleveland, OH
Director: Paul J. Ford, PhD
Funding: Cleveland Clinic Epilepsy Center; NIH R13 Grant (#1R13NS080513-01)
Watch the conference sessions

Members & Collaborations

Members & Collaborations

Neuroethics Collaborators

Neuroethics at Cleveland Clinic is inherently multidisciplinary, grounded in the ethical complexities that emerge from neurological care, research and innovation. Our program brings together investigators and clinicians across departments — such as the Epilepsy Center, Center for Neurological Restoration, Lou Ruvo Center for Brain Health, Biomedical Engineering, Quantitative Health Sciences and Bioethics — to explore real-world ethical challenges. Team members and collaborators contribute expertise from neurology, neurosurgery, psychiatry, neuropsychology, bioethics, biostatistics and clinical and translational science. This diverse group reflects the integrative nature of neuroethics that focuses on understanding and improving patient-centered decision-making, ethical research practices and health system approaches to brain-based conditions.

Paul Ford, PhD
Megan Zelinsky, MA
Valerie Rico
Olivia Hogue, PhD, MPH
Rosa Gonzalez, PA-C
Xin Xin Yu, MD, MS
Jagan Pillai, MD, PhD
Paul Marasco, PhD
Kayela Arrotta, PhD
Anny Reyes, PhD

 External Relationships and Collaborations

  • Lauren Sankary, JD, MA, Assistant Professor, UT Southwestern