Center for Bioethics

Dr. Schwartz is Director of the Indiana University Center for Bioethics, and Professor of Medicine and Professor of Bioethics at IU School of Medicine.  He is Professor of Philosophy at the IU School of Liberal Arts at Indiana University - Purdue University, Indianapolis (IUPUI). He directs the Bioethics and Participant Advocacy Program of the Indiana Clinical and Translational Sciences Institute (CTSI), and led the Behavioral Science and Ethics pillar of the IU Precision Health Initiative.  Dr. Schwartz practices adult outpatient medicine in the Eskenazi Health System. 

Dr. Schwartz received his B.A. from Harvard College and his M.D. and Ph.D. in Philosophy from the University of Pennsylvania. He completed his residency in Internal Medicine at the Brigham and Women’s Hospital in Boston, MA.

Dr. Schwartz has conducted research and written on ethical issues in many areas including informed consent, risk communication, electronic health information, opiates, and ideas of health, disease, and risk.  He leads research projects on patient decision-making and risk communication in preventive and precision healthcare, with funding from the American Cancer Society and the Patient Centered Outcomes Research Institute.  He is currently the principal investigator of a project examining the impact of providing personalized risk information to patients due for colorectal cancer screening, and to their providers, funded by the Patient Centered Outcomes Research Institute (PCORI). 

Selected courses:

• Philosophy Department, IUPUI: P393/547 - Biomedical Ethics / Foundations of Bioethics
• Philosophy Department, IUPUI: P383/696 - Ethics, Autonomy, and Consent
• Philosophy Department, IUPUI: P548 - Clinical Ethics Practicum 
• Philosophy Department, IUPUI: P590 - Intensive Reading
• School of Medicine, IUPUI: G506 - Responsible Conduct of Translational Research
• School of Medicine, IUPUI: 937P700 - Medical Ethics and Professionalism

Selected guest lectures:

• “Return Research Findings to Participants,” and “Collaborative Research with Industry” - GRDM-G504 – Introduction to Research Ethics, IUPUI
• “Autonomy and Respect for Persons,” Foundations of Clinical Practice, Year 1, IU School of Medicine
• “Genetic Engineering and Enhancement,” Medical Ethics and Professionalism elective, Year 4, IU School of Medicine
• “Kass on ‘Death with Dignity,” Medical Humanities and Health Studies M301: Perspectives on Health, Disease, and Healing, IUPUI. 
• Panelist for “Challenges and Opportunities in Teaching the Legacy of the Holocaust to Health Professions Students,” Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Virtual (Webinar)
• “Improving Ethical Decision-Making without Measuring Decision Quality,” American Society for Bioethics and Humanities, 21^st Annual Conference, Pittsburgh, PA
• Panelist for “Challenge Studies, Avalanche Testing, and other Approaches to Vaccine Development,” one of a series on Engineering Solutions for the Next Pandemic:  Exploring Ethics Concerns, presented by the Online Ethics Center (OEC) of the National Academy of Engineering.  Virtual (Webinar)
• “Defending Guidelines for Prevention as Ethical Nudges,” Flash presentation, American Society for Bioethics and the Humanities (ASBH), 22^nd Annual meeting, Virtual (Webinar).
• “Reduced Cancer Screening during the Pandemic:  What will the Effect be in the Future?” Virtual presentation, Cancer Agencies National Staff Association, Virtual (Webinar).
• Panelist “At the Crossroad of the Humanities, Medicine, and Technology: A Reading and Discussion of Kurt Vonnegut’s Fortitude,” American Society for Bioethics and the Humanities (ASBH), 23^rd Annual meeting, Virtual (Webinar).
• “The Best Insulin is the One the Patient Can Afford,” American Society for Bioethics and the Humanities (ASBH), 23^rdAnnual meeting, Virtual (Webinar)
• “Public Deliberation to Guide Decision Aid Design:  The Case of Colorectal Cancer Screening,” as part of panel on Public Deliberation in Medical Decision Making.  Society for Medical Decision Making, 43^rd Annual North American meeting, Virtual (Webinar).
• “Trust, Distrust and Danger in the COVID Pandemic: Reflections of a Physician-Bioethicist,” International Virtual Symposium on The Future of Bioethics in the Post-Pandemic Era, Center for Law, Governance, and Policy Studies, His Highness Maharajas Government Law College, India. Virtual (Webinar).

Risk Communication and Quantitative Information in Decision Aids

Selected Publications:

• Schwartz PH. Questioning the quantitative imperative:  decision aids, prevention, and the ethics of disclosure.  Hastings Center Report 2011; 41(2): 30-39
• Schwartz PH.Discounting a surgical risk: Data, understanding, and gist.  [Case Commentary] Virtual Mentor: American Medical Association Journal of Ethics, July 2012; 14(7): 532-538.  
• Schwartz PH, Perkins SM, Schmidt KK, Muriello PF, Althouse S, Rawl SM. Providing quantitative information and a nudge to undergo stool testing in a colorectal cancer screening decision aid: a randomized clinical trial.  Medical Decision Making 2017; 37(6): 688-702. 
• Schwartz PH, Imperiale TF, Perkins SM, Schmidt KK, Althouse S, Rawl SM. Impact of including quantitative information in a decision aid for colorectal cancer screening: A randomized controlled trial. Patient Education and Counseling 2019; 102(3): 494-502. 
• Schwartz PH, Perkins SM, Althouse S, Imperiale T, Schmidt KK, Rawl SM.Including Quantitative Information in a Decision Aid does not Improve Colorectal Cancer Screening Decision Quality: Results of a Randomized Trial. Medical Decision Making Jan 2019; 39 (1): E243-E244.
• Schwartz PH, Imperiale TF, Perkins SM, Burgess MM, O’Doherty KC, Schmidt KK, Althouse S, Bentley C, Rawl SM. Using Numbers in a Decision Aid to Describe Risks and Benefits of Colorectal Cancer Screening Options. Patient-Centered Outcomes Research Institute (PCORI), June 2019. 
• Schwartz PH, O’Doherty KC, Bentley C, Schmidt KK, Burgess MM.Layperson views about the design and evaluation of decision aids about colorectal cancer screening:  A public deliberation. Medical Decision Making2021 (July); 41(5): 527-539. doi: 1177/0272989X21998980.
• Schwartz PH.The Framing Dilemma: Quantitative information, shared decision making, and nudging. Medical Decision Making 2022; 42(6): 726-728.  doi: 10.1177/0272989X221109830
• Schwartz PH, Sachs G.Rethinking decision quality: Measurement, meaning, and bioethics. Hastings Center Report 2022; 52(6): 13-22. doi: 10.1002/hast.1443.

Selected Grants:

Describing the Comparative Effectiveness of Colorectal Cancer Screening Tests:  The Impact of Quantitative Information

• Role: Principle Investigator
• Dates: 2015 – June 2019
• Funder: Patient Centered Outcomes Research Institute (PCORI)
• Description: To provide clinical evidence and patient input to guide decision aid designers on how to present comparative effectiveness information to patients considering colorectal cancer screening.

Precision Prevention

Selected Publications:

• Schwartz PH. Disclosure and rationality: Comparative risk information and decision-making about prevention. Theoretical Medicine and Bioethics 2009; 30(3): 199-213.
• Schwartz PH. The value of information and the ethics of personal-genomic screening.American Journal of Bioethics 2009; 9(4): 26-27.
• Schwartz PH. Comparative risk: Good or bad heuristic?American Journal of Bioethics 2016; 16(5): 20-2.
• Kasperbauer TJ, Schwartz PH.Genetic data aren’t so special: Causes and implications of re-identification. Hastings Center Report 2020; 50 (5):  30-39. doi: 10.1002/hast.1183.

Selected Grants:

Measuring the Impact of Providing Personalized Risk Information to Patients and their Providers on Colorectal Cancer Screening Decisions and Uptake

• Role: PI
• Dates: 2019 – Feb. 2024
• Funder: Patient Centered Outcomes Research Institute (PCORI)
• Description: To test whether providing patients and their providers with personalized messages about the patient’s current chance of having an advanced colorectal neoplasm (ACN) results in higher uptake and decision quality regarding colorectal cancer screening, compared to an approach that does not utilize ACN risk.

Pharmacogenomics

Selected Publications:

• Halverson CME, Pratt VM, Skaar TC, Schwartz PH.Ending the pharmacogenomic gag rule: The imperative to report all results.  Pharmacogenomics 2021 Mar; 22(4):191-193.

Selected Grants:

Precision Health Pharmacogenetics Program

• Role: Co-Investigator (PI:  Todd Skaar, PhD)
• Dates: 2019 – Dec. 2021
• Funder: IU Precision Health Initiative
• Description: To support the implementation of pharmacogenetic testing in Indiana.  The goals are to 1) make clinical pharmacogenetic testing widely available and used in IU Health for patients diagnosed with myocardial infarction, cancer, or organ transplantation; 2) develop and evaluate an IUH branded PGx Card system for returning the pharmacogenetic genotyping results directly to the patients; and 3) establish a mechanism to link pharmacogenetics genotyping data to the electronic medical records.

Biobank Consent

Selected Publications:

• Schwartz PH, Autonomy and consent in biobanks. The Physiologist 2010; 53(1): 1-7.
• Kasperbauer TJ,Schwartz PH. Measuring understanding and respecting trust in biobank consent. American Journal of Bioethics 2019; 19(5): 29-31.
• Hartsock JA, Schwartz PH, Waltz AC, Ott MA.Anticipatory waivers of consent for pediatric biobanking. Ethics of Human Research 2019; 41(2): 14-21.  doi: 10.1002/eahr.500008.PMID: 30895753
• Kasperbauer TJ, Schmidt KK, Thomas A, Perkins SM, Schwartz PH.Incorporating biobank consent into a healthcare setting: Challenges for patient understanding.AJOB Empirical Bioethics 2021; 12(2): 113-122.  doi:1080/23294515.2020.1851313. 
• Kasperbauer TJ, Halverson C, Garcia Sierra A, Schmidt KK, Schwartz, PH.Biobank participants’ attitudes toward requiring understanding for biobank consent.  Ethics & Human Research 2022; 44(1): 18-28. doi: 10.1002/500114
• Kasperbauer TJ, Waltz A, Hawryluk B, Moore C, Schmidt KK, Schwartz PH.Collecting biospecimens and obtaining biobank consent from patients in a healthcare setting: Practical and ethical considerations.Academic Medicine 2022; 97(1): 62–68. doi:10.1097/ACM.0000000000004418
• Kasperbauer TJ, Halverson CME, Garcia A, Schwartz PH.Biobank participants’ attitudes toward data sharing and privacy: The role of trust in reducing perceived risks. Journal of Empirical Research on Human Research Ethics 2022; 17(1-2): 167-176. doi:10.1177/15562646211055282.
• SchwartzPH, Hartsock JA.Selling clinical biospecimens: Guidance for researchers and private industry. Journal of Law, Medicine, and Ethics (in press).  Accepted April 2022.

Patient Control and Privacy of Electronic Health Information

Selected Publications:

• Schwartz PH, Caine K, Alpert SA, Meslin EM, Carroll AE, Tierney WM. Patient preferences to control access to their electronic health records in a prospective cohort study in primary care.Journal of General Internal Medicine 2015; 30 (Suppl 1):  S25-30. 
• Meslin EM, Schwartz PH. How bioethics principles can aid design of electronic health records to accommodate patient granular control. Journal of General Internal Medicine 2015; 30 (Suppl 1): S3-6.  DOI: 10.1007/s11606-014-3062-z.

Selected Grants:

Aspiring to Awesome: Advanced Query for Patient Care

• Role: Co-Investigator (PI:  Tierney)
• Dates: May 2011 – March 2014
• Funder: S. Office of the National Coordinator for Health Information Technology
• Description: To establish advanced search tools for the electronic health record (EHR) and for patients to determine which providers can view specific parts of their record, and to examine related ethics issues.