Commentary|Videos|September 12, 2025

Shared Decision-Making and Ethics in Complex Neurology Clinical Research: Paul Ford, PhD

Author(s)Isabella Ciccone, MPH
Paul Ford, PhD

Fact checked by: Marco Meglio

The director of the Neuroethics Program at Cleveland Clinic discussed ethics training, shared decision-making, and safeguards in guiding patients, families, and clinicians through complex clinical research decisions. [WATCH TIME: 3 minutes]

WATCH TIME: 3 minutes | Captions are auto-generated and may contain errors.

"The [Cleveland Clinic] Neurological Institute, for 20 years, has been deeply committed to having me collaborate and be a partner—not as an outside police—in developing their research, supporting their researchers, helping multidisciplinary teams select patients for complex surgeries, and meeting with patients and sometimes research participants to help with complex decisions."

Neuroethics is a discipline that examines the ethical, legal, and societal implications of neuroscience. As advances in brain monitoring and modulation raise questions related to privacy, identity, justice, and autonomy, neuroethicists collaborate with neuroscientists to address these issues. Using analytical and philosophical frameworks, they work to identify the perspectives of patients, families, clinicians, and researchers, while anticipating and helping to manage potential conflicts. This process can inform how neuroscience studies are designed, conducted, and applied in both research and clinical practice.¹

At Cleveland Clinic, the Neuroethics Program is part of the Center for Bioethics and functions in partnership with the Neurological Institute. Directed by clinical ethicist Paul Ford, PhD, and Lauren R. Sankary, JD, associate director, the program focuses on ethical challenges associated with brain-based diseases, which are increasingly prevalent and contribute significantly to global disability. Its efforts include research, education, and clinical support in collaboration with clinicians, researchers, and bioethicists, with attention to issues arising in the prevention, diagnosis, and treatment of neurological conditions.²

In a recent interview with NeurologyLive^®, Ford discussed the role of ethics education and structured safeguards in clinical care and research, particularly when patients also serve as research participants. He highlighted the need for clinicians, researchers, patients, and families to build skills for navigating complex technologies and decisions, respectfully and collaboratively. Drawing on lessons from cancer research and his 20 years of work at the Neurological Institute, Ford described how integrating ethics into multidisciplinary teams ensures informed, safe, and patient-centered decision-making.

REFERENCES
1. National Institute of Neurological Disorders and Stroke. Neuroethics. Published January 2022.Accessed September 11, 2025. https://www.ninds.nih.gov/sites/default/files/documents/NINDS%20Neuroethics%20Program%20one-pager%20final_Jan2022_508C.pdf
2. Cleveland Clinic. Neuroethics Program. Accessed September 11, 2025. https://my.clevelandclinic.org/departments/bioethics/neuroethics

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