Research Professor, Bioethics
I serve as a research professor in the Department of Psychology, and as the Director of the National Rural Bioethics Project. I have formal interdisciplinary training and practical experience in health sciences research, social science methodology, bioethics, values development, and public policy. In addition to these academic areas of interest, I have more than 30 years of project management experience that includes the development and evaluation of health, education, and social service initiatives in rural communities throughout the West. I have served as the principal investigator for interdisciplinary research studies that have been supported by the Culpeper/Rockefeller Foundation, the Greenwall Foundation, the Agency for Healthcare Research and Quality, the National Institute for Environmental Health Sciences, and the National Science Foundation. With respect to teaching activities, I have served as faculty for the Davidson Honors College, the Master in Public Health Program, and as a research and training mentor for junior faculty. I have also also served as visiting faculty for Native American education programs such as BRIDGES and Montana Health Careers Opportunity Program (MHCOP), and as a mentor for Native American graduate students. I routinely serve on various NIH study sections. Past research activities have supported collaborations within the University of Montana, with other universities, with rural communities and with Indian Health Services. Recent research studies have focused on ethical issues and patient safety issues that develop in rural communities, ethical issues that develop in environmentally damaged rural communities, and ethical issues that emerge when making decisions about approving and participating in clinical research studies.
Research that advances our scientific, engineering, biomedical, and technological knowledge often requires the participation of human subjects. Conducting such research in an ethical manner requires both a rigorous oversight system and ethically attuned scientists. Institutional Review Boards (IRBs) were created to optimize protection of human subjects in accordance with the tenets outlined in the Belmont Report and codified in the Common Rule. Researchers are expected to be knowledgeable about the ethical principles that govern human subject research and adhere to those principles in the research they undertake. When researchers submit their research proposals to the IRBs they are expected to describe their research protocols, identify risks and benefits, and provide any information that could pose ethical threats to the research participants. Ideally, the combination of morally courageous IRBs, ethically attuned scientists, and informed participants will optimize the protection of human subjects.
Through funding support from the National Science Foundation my colleague, Dr. Hoas, and I are exploring the perspectives of IRB members and research participants regarding the ethical norms of research including the protection of human subjects. Findings from this study will shed light on how these ethical norms influence decisions about what information researchers disclose to IRBs when seeking approval, how that information influences the IRB approval process, and what information is conveyed to research participants during the consent process. The study is further exploring how persons make decisions about participating or declining opportunities to participate when invited to join research studies.
Ethical Issues in Public Health - PUBH 570
Cook, A., Hoas, H., Guttmannova, K. & Joyner, J. (2004). An error by any other name. American Journal of Nursing 104(6):32-44.
Cook, A. & Hoas, H. (2004). You have to see errors to fix them. Modern Healthcare. December 6, p22
Cook, A, Hoas, H. & Kennedy, J. (2005). R.Ph.s’. take on patient safety: They’re caught in the middle. Drug Topics, a publication of Advanstar Medical Economics (July 25):6-8.
Cook, A., & Hoas, H. (2006). Re-framing the question: A commentary on rural bioethics. American Journal of Bioethics, 6(2):51-53.
Cook, A., & Hoas, H. (2007). Hide and seek: The elusive rural psychiatrist. Academic Psychiatry, 31(6) 419-422.
Cook, A., & Hoas, H. (2008). Ethics and rural healthcare: What really happens, what might help? American Journal of Bioethics 8(4):52-56.
Cook, A., & Hoas, H. (2008). Revisiting ethics and rural healthcare: What really happens, what might help? American Journal of Bioethics. In Focus, June. Available at: http://www.informaworld.com/smpp/section?content=a794419479&fulltext=713240928.
Cook, A., & Hoas, H. (2008). The landscape of asbestos: Libby and Beyond. International Journal of Risk Research. 12(1);105-113.
Cook, A., Hoas, H., Guttmannova, K. (2005). From here to there: Lessons from an integrative patient safety project in rural healthcare settings. In (Kerm Henriksen, James B. Battles, Eric Marks, and David I. Lewin, Eds.). Advances in Patient Safety: From Research to Implementation, 1: 381-90. Agency for Healthcare Research and Quality.
Cook, A. & Hoas, H. (2006). From good intentions to good actions: A patient safety manual for rural healthcare settings. Available at: http://www.umt.edu/bioethics/research_studies/manual.pdf
Cook, A. & Hoas, H. (2006). Ethics: A bridge for Communities and Scientists – A curriculum for community education and outreach. Available at: http://www.umt.edu/libbyhealth/introduction/documents/Ethics.ABridge.pdf
Cook, A. & Hoas, H. (2008). Healthcare in rural communities: Ethics, errors and where we go from here. In: Craig M. Klugman and Pamela M. Dalinis, (eds). Ethical Issues in Rural Health Care. Baltimore: The Johns Hopkins University Press.
Cook, A & Hoas H. (2009). Ethics conflicts in rural communities; Recognizing and disclosing medical errors. In William Nelson (ed) Handbook for Rural Healthcare Ethics. Hanover, NH:Trustrees of Dartmouth College. Available at:
Cook, A., & Hoas, H. (June 1999). Are healthcare ethics committees necessary in rural hospitals? Healthcare Ethics Committee Forum, 11, 2, 134-39.
Cook, A, Hoas, H. and Guttmannova, K. (2000). A description of bioethics activities in rural hospitals Cambridge Quarterly of Healthcare Ethics 9, 2:230-238.
Cook, A., Hoas, H., and Joyner, J. (2000). Ethics and the rural nurse: A study of problems, values and needs. Journal of Nursing Law 7,1: 41-53.
Cook, A. & Hoas, H. (2000). Where the rubber hits the road. Healthcare Ethics Committee Forum, 12 (4):331-340
Cook, A, Hoas, H., & Joyner, J. (2001). No secrets on Main Street.American Journal of Nursing, 101(8): 67-71.
Cook, A., & Hoas, H. (2001). Voices from the margins: A context for developing bioethics-related resources in rural areas. American Journal of Bioethics 1 (3) 1-20.
Cook, A., Hoas, H. & Guttmannova, K. (2002). Ethical Issues Faced by Rural Physicians.
Cook, A & Hoas, H. (2002). Irreconcilable differences: Seeking boundaries for privacy and technology. American Journal of Bioethics 2 (2). http://bioethics.net
Cook, A. (2002). Is our healthcare good enough? Rural Nurse Connection, Summer. P:1-2.
Cook, A. Hoas, H. & Grayson, C. (2003). Asking for organs: Different needs and different values. Journal of Clinical Ethics 14 (1/2): 37- 48.
Cook, A., Hoas, H. & Guttmannova, K. (2003). Not by technology alone: Optimizing a process for patient safety. Biomedical Instrumentation and Technology, 37(2):128-13-130.