Jeffrey W. Bulger, PhD, HEC-C
CHICAGO MEDICAL SCHOOL
PhD Philosophy—Biomedical Ethics, Clinical Ethics, Epistemology, Social Political Philosophy, and Online Pedagogical Course Development, University of Tennessee—Knoxville, 1994
Dissertation Informed Consent And Rawls’s “Political” Theory Of Justice, 1994
MA Religious Studies, Western Seminary—Portland, 1986
BS Geology/Petroleum Engineering, University of North Dakota—Grand Forks, 1981
HEC-C Healthcare Ethics Consultant Certified. American Society of Bioethics and Humanities—ASBH National Certification Commission, 2019 (Inaugural)
Professor: Bioethics & Humanities
Director: Office of Bioethics & Humanities
Coordinator: Grand Rounds - Interdisciplinary
Master Teacher: Rosalind Franklin University of Medicine & Science
Department: Foundational Sciences & Humanities
College: Chicago Medical School
University: Rosalind Franklin University of Medicine and Science
1. Bioethics M1/COP1*
2. Informed Consent M2
3. Literature in Medicine M3
4. Morning Report - Ethics & Law Focus M3
5. VA Psychiatry Residents Didactics - Philosophy of Mind and Ethics
6. Bioethics M4
7. Pharmacogenomics COP2
8. Palliative Care—Role Play & Education M3
9. Bioethics Distinction M1-M4
10. Humanities Distinction M1-M4
11. Clinical Sciences & Humanities Grand Rounds Organizer CME
*M = Chicago Medical School, COP = College of Pharmacy, 1-4 = Program Years
• Interprofessional Education
• Multidisciplinary Education
• General Education
• Bioethics Education
• Ethical Theory
• Translational Ethics
• Clinical Ethics
• Ethics Consultation
• Faculty Assessment
• Faculty Development
• Interdisciplinary Research
• Institutional Review Board: IRB
• LCME & ACGME Accreditation
• HLC & IBHE Accreditation
• Bioethical Trends and Issues
• Program Design/Assessment
• Online Education
• Pedagogical Technologies
• Learning Management Systems
• Innovative Teaching Techniques
• Website Development
• Website Maintenance
• Learning Success & Retention
• Mentoring: Students & Faculty
As Director of the Office of Bioethics & Humanities:
• Lead the revitalization and expansion of our Office into an institutional Bioethics & Humanities hub that focuses on the fundamental rights and liberties of patients, research subjects, and society.
• Adapted to an ever changing environment and broadening and expanding the Center’s focus to include the practical influence of ethics and policy within the academic, clinical, research, and translational aspects of improved patient care.
• Integrated bioethics and the liberal arts both vertically throughout the curriculum and horizontally throughout the students’ entire academic and clinical medical education.
• Collaborated with other schools within the university on theoretical and empirical research and interprofessional education, and program development.
• Implemented a Bioethics Thread, and a Humanities Thread, that are now being used to track when and where in the curriculum those topics are being addressed.
• Created a popular Bioethics Distinction, and a Humanities Distinction, for the Chicago Medical School. This supports and develops current and future bioethicists, and helps our students stand out when matching for desired residency locations. Soon to be implemented.
• Coordinated interdepartmental Grand Rounds that engage and communicate ethical issues in healthcare to faculty, students, staff and the public.
• Provided Grand Rounds that help equip practitioners, researchers, faculty, students, and staff to be able to deal with both normal day-to-day ethical challenges along with new and novel challenges.
• Stimulated Grand Rounds faculty and student attendance by focusing on current issues and by students pursuing the Bioethics and Humanities Distinctions.
• Cultivated public discussions and debates on important academic, clinical, and public policy concerns.
• Promoted the vision of the Office that by educating the whole person, health and biomedical professionals will be better prepared to treat the whole patient using professional values and conduct that are appropriate for a diverse and pluralistic society.
As a faculty member:
• Taught over 35 different course topics.
• Received exemplary student; ratings, mentoring, satisfaction, success, and retention.
• Sustained scholarly and creative activities.
• Served on numerous committees.
• Recruited underrepresented groups.
• Protected rights and liberties of research subjects.
• Practiced interdisciplinary and interprofessional education, research, and service
• Advanced the mission, vision, and values of the healthcare professions, sciences & liberal arts.
“This class was extremely enjoyable and lectures were very interesting to attend. Dr. Bulger is an enthusiastic and knowledgeable teacher of philosophy and bioethics. The weekly online assignments, readings, and quizzes helped to fortify the knowledge I gleaned from lectures. Thank you for this immersive course.” Chicago Medical School 2017
“Thank you for a very informative and thoughtful course. I have already started applying many of the things I learned in this course to my personal life, and the questions and implications that have risen from thinking about the course content have greatly influenced my worldview and my ideas of what it means to be a physician. I never would have guessed medical school would make me want to study philosophy!” Jin-Huon Jou, Chicago Medical School 2017
• PhD in Philosophy with a concentration in: Biomedical Ethics, Clinical Ethics, and Online Pedagogical Course Development; MA Religious Studies; BS Engineering.
Teaching, service, and research has always been implemented in order to managed initiatives to promote patient rights and liberties as evidenced by well-informed shared decision-making and to cultivate student and health-care professional satisfaction, success, and retention through the use of innovative pedagogical approaches, computer technology, and mentoring.
• HEC-C—Healthcare Ethics Consultant-Certified (Inaugural 2019)
First-ever certification program that identifies and assesses a national standard for the professional practice of clinical healthcare ethics consulting. Established by the American Society of Bioethics and Humanities—ASBH Certification Commission, the HEC-C credential endorses knowledge of key concepts in healthcare ethics and affirms expertise, competence, and skillset. The HEC-C credential is a valuable asset to both practicing healthcare ethics consultants and those serving in leadership roles within their institutions' healthcare ethics initiatives. This program evaluates knowledge and skills in assessing factual information about medical ethics concerns, analysis of ethical questions to resolve issues and conflicts using consistent processes that adhere to healthcare ethics competencies, and the evaluation of outcomes and implications of ethics consultations.
• Taught and developed a variety of face-to-face, blended and online courses and special programs, hallmarked by exceptional success as evidenced by Student Ratings of Instructor, and Student Learning Outcomes. Sensitive to socio-economic, academic, cultural, and ethnic diversity within the educational, health-care, clinical, and patient populations and I have an understanding of physical and/or learning disabilities and differences in learning styles. Mentored 50 students who successfully competed in the academically peer reviewed National Conference of Undergraduate Research—NCUR.
• Service on clinical, educational and research institutional governance committees helping to coordinate and develop administrative policies in full compliance with the institutional mission, all federal, state and institutional regulations and policies, and HLC, IBHE, LCME and ACGME accreditation principles, practices and requirements. I have also actively served on community hospital ethics committees teaching and collaborating with health-care professionals and administration for the advancement of advisory decision-making processes and outcomes.
• Research & Publications have ranged from the writing of Biomedical ethics course textbooks, creation of new courses, developing effective online course delivery structures, and the publication and presentation of a variety of traditional academic papers. Current research is on the emerging fields of artificial intelligence and ethics. This multidisciplinary topic will require both intradepartmental and interdepartmental connections and collaborations with various STEM disciplines. Convolutional Neural Networks in which deep-learning is combined with computer-vision systems, are now surpassing human capacities in areas of facial recognition, autonomous self-driving vehicles, and in a variety of healthcare; screening, diagnosis, and treatment plans. When this is accomplished through the use of an algorithmic “expert-system” and a smartphone camera the result can be a low-cost alternative for some types of “universal healthcare” access. But this intersection of science, technology and ethics can also result in what can be described as Libertarian Paternalism. For example, a patient may be “paternalistically” directed towards a particular end by means of a prescribed treatment plan, yet the patient still has the “libertarian” choice of rejecting that treatment. If the suggested plan is rejected by the patient, then a new treatment plan can be generated that still promotes the goal or end that the patient desires that is also in alignment with the patient’s personal values and social worldview. This is much like the recalculation that a Garmin navigation system does in response to a driver’s rejection of a proposed path to get to a particular destination. The evidence based neuroethical question that my research focuses on is:
What are the necessary and sufficient conditions and responsibilities for categorizing shared decision-making as being a valid informed consent, and how do those necessary and sufficient conditions and responsibilities differ for the patient, the institution, and public policy?
• Creation, migration and implementation of online/hybrid courses and training programs (D2L/Brightspace, Canvas, Blackboard, Active pdfs) as based on cognitive science and experiential learning principles that have empirically shown the maximization of teaching and learning excellence as made evidenced by student engagement, success and retention.
• Collaborative work in the planning, implementation, managing and evaluation of online training and educational programs for the purpose of exemplary online learning and innovative teaching and learning advancement.
• Instructional design and development, program marketing, scheduling and utilization of distance learning technologies that are appropriate for respective subject areas and for meeting the needs of a broad and diverse multicultural worldwide population.
1. HEC-C: Healthcare Ethics Consultant Certified—HEC-C. National certification that the clinical ethics consultant has the necessary competencies, skills, knowledge, professional attributes, attitudes, and behaviors for effective institutional, interprofessional, and patient resolutions. (Inaugural 2019)
2. LCME Standard 3 & 7: Accreditation Committees for LCME Standards 3 & 7
Standard 3: Academic Learning Environments
3.1 Resident Participation in Medical Student Education
3.2 Community of Scholars/Research Opportunities
3.3 Diversity/Pipeline Programs and Partnerships
3.4 Anti-Discrimination Policy
3.5 Learning Environment/Professionalism
3.6 Student Mistreatment
Standard 7: Curricular Content
7.1 Biomedical, Behavioral, Social Sciences
7.2 Organ Systems/Life Cycle/Primary Care/Prevention/Wellness/Symptoms/Signs/Differential Diagnosis, Treatment Planning, Impact of Behavioral and Social Factors
7.3 Scientific Method/Clinical/Translational Research
7.4 Critical Judgment/Problem-Solving Skills
7.5 Societal Problems
7.6 Cultural Competence and Health Care Disparities
7.7 Medical Ethics
7.8 Communication Skills
7.8 Interprofessional Collaborative Skills
3. Psychiatry Residency: Development and presentation of graduate level education on Epistemology and Metaphysics, Philosophy of Mind and Philosophy of Language for the VA psychiatry residents—P1-P3. 2018 - Present
4. Morning Report: Personally interact using small group formats (5-6 students) with every CMS M3 student (190) regarding their clerkship experiences. Each discussion is uniquely tailored to the needs and interests of the individual student, legal issues related to withholding and withdrawing life-sustaining treatment, patient medical record documentation. These activities are part of RFUMS’s acclaimed Simulation Lab experiences. 2017 - Present
5. Informed Consent: Creating, designing and developing a new onLine Informed Consent elective course for M4 students as an intensive two-week clerkship rotation. This course will be a necessary requirement for those medical students who wish to pursue an added MD Distinction in Bioethics. 2018 - Present.
6. Literature in Medicine: Actively engaged in the development and teaching of the onLine Literature in Medicine elective course for M4 students as an intensive two-week clerkship rotation. This course will be a necessary requirement for those medical students who wish to pursue an added MD Distinction in the Humanities. 2018 - Present.
7. Bioethics: Creating, designing and developing a new Bioethics course for all M1 (first year medical students—190) and COP1 (first year pharmacy students—60), presented as face-to-face classes incorporating an innovative and progressive; curriculum, educational methodology, and interprofessional education. Weekly assignments are built around weekly modules of readings, videos, ethical case studies, and quizzes using advanced Desire2Learn—D2L Learning Management System—LMS and active pdfs. 2016 - present
8. Pharmacogenomics: Creating, designing and developing a new 2 hour bioethics presentation for the COP2 Pharmacogenomics course (second year pharmacy students) that brings to focus the humanistic and ethical dimensions of the pharmacogenomics enterprise. College of Pharmacy. 2016 - Present
9. Bioethics Senior Elective Course: Creating, designing and developing a new Bioethics elective course for M4 students as an intensive two-week Sub-Internship rotation. 2016 - Present
10. Mission and Vision: Centrally involved in the rewriting of the mission and vision statements for the Chicago Medical School and the Chicago Medical School Admissions Committee. 2016, 2017, and 2018
11. Editorial Board: Synapses. Part of the co-founding team that created the Synapsis medical humanities journal consisting of Art, Photography, Poetry, Fiction and Nonfiction writings, exemplifying the human condition as related to healthcare. 2016 - Present
12. Professionalism Website: Designed and built for the Chicago Medical School. Parts of it were implemented.
13. Medical Humanities Club: Faculty Advisor, Chicago Medical School. 2016 - Present
14. Moral Philosophy Vol. 1-8: Wrote and published with McGraw-Hill an eight-volume monograph, nationally peered reviewed text: Moral Philosophy: A Theoretical and Practical Approach to Moral Decision-Making, 1,100 pages, copyright 2015, ISBN: 1259234460, along with a complementary Canvas/Connect LMS, for on-line DE courses.
15. Plato’s Press: Designed, built and put online PlatosPress.com, 2015 - Present
I. Professor, Chicago Medical School, Rosalind Franklin University of Medicine & Science—Chicago, 2016-Present
II. Professor—Tenured, Associate Professor—Tenured, and Assistant Professor, Utah Valley University—Orem, 1996-2015
III. Lecturer, California State University—Chico, 1995-96
IV. Assistant Professor, Stetson University—DeLand, FL, 1994-95
V. Teaching Associate, University of Tennessee—Knoxville, 1991-94
VI. Adjunct Faculty, Pellissippi State College—Knoxville, 1990-91
PLATO’S PRESS, LLC
Director of PLATO’S PRESS, LLC—Orem, 2012-Present
1. Designed, created, and implemented an online and hybrid Bioethics course, (Published by McGraw-Hill, 2015)
2. Designed, created, and implemented an online and hybrid Ethics & Values course, (Published by McGraw-Hill, 2015) Designed, created, and implemented online pdf LMS
3. Authored 8 volume monograph, MORAL PHILOSOPHY: A Theoretical and Practical Approach to Moral Decision-Making, 1,100 pp., Published by McGraw-Hill, 2015
4. Designed, created, and implemented online pdf LMS RED BOOK: Is The Human Subject Exempt From IRB Purview? - Professional Compliance LMS (Ready for publishing)
5. Designed, created, and implemented online pdf LMS GREEN BOOK: Am I Engaged in Human Subject Research According To CFR? - Professional Compliance LMS (Ready for publishing)
6. Designed, created, and implemented online pdf LMS BLUE BOOK: Do I Need to Get Informed Consent According to CFR? - Professional Compliance LMS (Ready for publishing)
SABBATICAL AND FACULTY FELLOWSHIP AWARDS
1. Faculty Fellowship, Utah Valley University, Fall 2010 – Spring 2011
2. Sabbatical, Utah Valley University, Spring 2010
PROFESSIONAL ACTIVITIES (Recent)
I. TEACHING AWARDS AND RECOGNITIONS (Recent)
Master Teacher: Master Teacher Guild, Rosalind Franklin University of Medicine & Science, Fall 2018
II. EDITOR AND FACULTY ADVISOR (Recent)
1. Editorial Board, Synapses, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, 2017- Present
2. Medical Humanities Club, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, 2017- Present
III. PUBLIC PRESENTATIONS (Recent)
1. Ethics & Humanities in the Chicago Medical School Curriculum, Chicago Medical School Alumni, Chicago Art Institute, October 5, 2019
2. Kant’s Rationalism and Deontological Ethics, Psychiatry Residents Didactic Session. September 19, 2019
3. Vaping, SIMHuntleyInternal MedicineClerkship Workshop Palliative Care Day. September 17, 2019
4. Primary and Secondary Qualities and What Can Be Known, Psychiatry Residents Didactic Session. August 15, 2019
5. Pimping and the Socratic Method, SIMHuntleyInternal MedicineClerkship Workshop Palliative Care Day. July 23, 2019
6. Withholding & Withdrawing Life Sustaining Treatment, SIMHuntleyInternal MedicineClerkship Workshop Palliative Care Day. May 16, 2019
7. How The Humanities Contributes Towards Intersubjective Communication, Actualizing The Art Of Medicine, For The Patient’s Best Interests. (Pecha Kucha), Faculty Development, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, May 15, 2019
8. Bioethics & Humanities Program: Creation, Development, Funding & Implementation, Association of Bioethics and Humanities Program Directors—ABPD National Conference, Houston, TX, April 8, 2019
9. Art of Medicine & The Limits of AI Machine Learning, Clinical Sciences & Humanities Grand Rounds, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, April 1, 2019
10. Philosophy of Language: Structure and Limits, Medical Grand Rounds, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, May 31, 2018
11. Philosophy of Mind: Foundations of Knowledge, Medical Grand Rounds, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, March 29, 2018
12. Gold Humanism Award: Welcome Address, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, Spring, 2018
13. A PROCLAMATION: Revisiting the Hippocratic Oath and the Declaration of Geneva using medical school accreditation and professional medical practice mandates, Academy for Professionalism in Health Care—APHC, Baltimore, Spring 2018 (Accepted for presentation but could not attend)
14. Pharmacogenomics—COP YPHS 609, Rosalind Franklin University of Medicine and Science, College of Pharmacy—Chicago, Spring 2017 and Spring 2018
15. JUSTICE: Political Ideologies and Health-Care Allocation Policies, Medical Grand Rounds, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, May 11, 2016
IV. COMMITTEES & APPOINTMENTS (Recent)
1. Director for the Center of Bioethics and Humanities, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, 2016 - Present
2. Institutional Review Board—IRB, Rosalind Franklin University of Medicine and Science—Chicago, 2016 - Present
3. Humanities ThreadHead, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, 2017 - Present
4. Ethics ThreadHead, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, 2017 - Present
5. Strategic Planning Committee, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, 2017 - Present
6. LCME Standard 3 Committee, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, 2017 - Present
7. LCME Standard 7 Committee, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, 2017 - Present
8. Admissions Committee, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, 2016 - Present
9. Professionalism Committee, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, 2016 - Present
10. Faculty Senator, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, 2017 - Present
11. Editorial Board, Synapses Journal, Rosalind Franklin University of Medicine and Science, Chicago Medical School—Chicago, 2016 - Present
V. STUDENT RESEARCH MENTORING—NCUR
• 26th National Conference on Undergraduate Research (NCUR), University of Wisconsin, La Crosse, April 11-13, 2013.
1. Sasha Wakefield: Morality vs. Immorality of Animal Drug Testing
• 7th Annual Utah Conference on Undergraduate Research (UCUR), Utah State University, Logan, Utah, February 22, 2013
1. Michael M. Washburn: Biting the Hand That Feeds You: Why Economic and Political Aggression Towards Organized Labor Is Unethical and Damages The Economy
• 25th National Conference on Undergraduate Research (NCUR), Ithaca College, New York, March 31–April 2, 2012.
1. Autumn Lilly-Harari: Veganism, Principlism and the National School Lunch Program.
2. Karleigh Ellsworth: From Ana and Mia With Love: The Effects of Pro-Anorexia and Pro-Bulimia Websites.
• 24th National Conference on Undergraduate Research (NCUR), University of Montana, Missoula, April 15-17, 2010.
1. Amanda Putman: No Exercised Autonomy on Food Choices
2. Christopher Nelson: Food Fads
3. Pat Runyan: Colony Collapse Disorder: The Extinction of the Honeybee and its Implications on Mankind
• 23rd Annual National Conference on Undergraduate Research (NCUR), University of Wisconsin, La Cross, Wisconsin, April 16-18, 2009
1. Arthur VanValkenburg: Threatening Treatment
2. Chad Howz: Principles Gone to Pot
3. Charles Broadbent: What’s in Your Plastics? A Principlist Approach to Bisphenol-A
4. James Fuqua: The Mapped Human Genome: Pandora’s Box?
5. Kyle Bowler: Patient Assisted Suicide
6. Zackary Weber: Insurance Providers versus The Patient: The Violation of the Biomedical Ethical Principles Protecting the Patient.
• 3rd Annual Utah Conference on Undergraduate Research (UCUR), Hosted by Westminster College, Salt Lake City, Friday, February 20, 2009
1. Caitlin Anderson: Caution: This Paper Is Composed Primarily Of Soy; An Ethical Look At The Use of The Soybean In America
2. LeAnne Tolley: Lights, Cam Action: A Foundation for Physicians of Finesse
3. Craig L. Bounous: Principlism Applied to the Military’s Responsibility of Care
4. Chad Howse: Marijuana and Morality
5. C. Steven Broadbent: What’s in Your Plastics? A Principlist Approach to Bisphenol A
• 22nd Annual National Conference on Undergraduate Research (NCUR), Salisbury University in Salisbury, Maryland. April 10-12, 2008
1. Whitney May: Circumcision In Today’s Society
2. Miguel Arturo Saldana: Socialized Medicine: Healthcare For All
3. Richard Cook: Animal Testing and Principlism in BioMedical Ethics
4. Craig Bounous: Principlism Applied To The Military’s Responsibility Of Care
• 2nd Annual Utah Conference on Undergraduate Research (UCUR) co-hosted by BYU and UVU at Utah Valley University, Orem, Utah, Friday, February 29, 2008
1. UCUR Whitney May: Circumcision in Today’s Society
• Annual Undergraduate Philosophy Conference, Utah Valley University, Orem, Utah, April 3, 2008 (Each student received a $100 stipend)
1. J. Eric Gentile: Clinton v Obama v McCain on Healthcare Issues from a Principlistic Approach
2. Mitchel Martin: Circumcision is Wacked, Keep His Manhood Intact
3. Chad Howze: Marijuana and Morality
4. James B. Fuqua: The Mapped Human Genome: Pandora’s Box?
5. Seth Wright: Healthcare: A Duty to All?
6. Jake Spencer: Is it okay to smoke with young children in the car?
7. Sylvia Bentley: Gene Therapy: Capitalism or just classism
8. Adam K. Gibbons: Surrogate Decision Making
• 21st National Conference on Undergraduate Research (NCUR), Dominican University of California, April 12-14, 2007.
1. Austin Miller: The Historical Oath
• 19th National Conference on Undergraduate Research (NCUR), Virginia Military Institute and Washington and Lee University, Lexington, VA April 21-23, 2005
1. Lyndee Litchfield: Doctrine of Right in the War with Iraq
2. Arron Medford: The Philosophy of sales from a Kantian Perspective
3. Arron Medford: Circumcision
4. Damon MacArthur: Kantian Ethics and the Morality of Terrorism
5. Jeffrey Barth: The Democratic Liberty of Iraq
6. Jake Pead: Immanuel Kant and Global Warming Measures
7. Samuel Harrison: Immanuel Kant & The Destruction of Theocratic Governments
8. Trevor W. Hill: Land Acquisition and Ownership in Restricted area of Mexico
9. Ryan Albrecht: Liberation for the oppressed
10. Ryan Albrecht: Women and Social Reform in Boston
• 18th National Conference on Undergraduate Research (NCUR), Lafayette, Easton, PA, April 15-17, 2004
1. Jared Sumsion: Complementary and Alternative Medicine
2. Ray E. Webb: Aquinas Supports The Weed
3. Rebeka Dewey: The Right to Die: Six Criticisms Against the Creation of Living Wills
• 17th National Conference on Undergraduate Research (NCUR), University of Utah, Salt Lake City, Utah, March 13-15, 2003
1. Sam Taylor: Ticking Bombs and Truth Serums: Ethics and Interrogation at Guantanamo Bay
2. Spencer Gale: NOTA HHS HRSA OSP DoT OAB URREA UNOS OPTN: The Transplant Organization And How It Works For The Patient
3. Swen Swenson: The Truth About Therapeutic Cloning
4. Julie Johnson: Elective Fetal Tissue Research.