As the leader for ethics evaluation activities in the National Center for Ethics in Health Care, Dr. Pearlman is responsible for developing and testing assessment tools that measure ethics quality. Recently, he developed and field-tested a staff survey on clinical and organizational ethics and a facility workbook that helps senior leaders identify gaps in ethics programs (by assessing the mechanisms, processes and systems that a facility has in place to promote ethics quality). Both tools are intended to feed into quality improvement, and early pilot work demonstrates this use. His previous studies pertained to ethics in end-of-life care. His research documented that clinicians often do not know their patients’ preferences and values about life-sustaining treatment, so consequently he developed a patient-centered workbook to assist in advance care planning. He also studied the relationship between “states worse than death” and preferences to forego life-sustaining treatment. Other studies have focused on quality of life in decision making, informed consent, and motivation for assisted suicide. The goal of his earlier studies and current activities is to improve ethical practices in delivering health care to older patients.

Dr. Pearlman also serves as a faculty mentor and supervisor for trainees in internal medicine and geriatric medicine. He attends on both the internal medicine and geriatric medicine services. Historically, he has seen older outpatients in weekly clinics. However, starting in 2007 he will be instituting an outpatient palliative care clinic. Dr. Pearlman also provides ethics consultations (approximately 4 months per year), and directs the ethics program at VA Puget Sound Health Care System. As the director of this program, he oversees the clinical ethics program, the ethics council which is responsible for addressing ethics concerns at the systems level, and the ethics education program.