Sarah J. Breier
CE723 – 1 Hospital Drive
University of Missouri at Columbia
Columbia MO 65212
(573) 882 2738
(573) 884 2664 FAX
breiermackies@missouri.edu
www.hmi.missouri.edu/ethics/
 
 
 
       DATE OF BIRTH:                           26 December 1967
 
QUALIFICATIONS:                      

2007                                        Fellowship in Physician Ethics and Professionalism
American Medical Association and Medical College of Wisconsin

2006                                        Legal Nurse Consultant Certification
                                                 University of Colorado - Denver

2002                                        Doctor of Philosophy (Medical Ethics)
                                                       School of Medicine
                                                       University of Tasmania, Australia
 
1997                                        Master of Nursing
                                                       University of Tasmania, Australia

1993                                        Bachelor of Nursing (Post Registration)
                                                       University of Tasmania, Australia

1992                                        NCLEX-RN
                                                       Austin, Texas, USA

1991                                        Accustomation Course for the Board of Nurse
                                                       Examiners for the State of Texas
Austin, Texas, USA

1990                                        Commission of Graduates of Foreign Nursing Schools Certificate Philadelphia, USA

1989                                        General Nursing Certificate (RN)
                                                       Launceston General Hospital
Tasmania, Australia
 
     
 AWARDS:
 
1998                                        Florence Nightingale Foundation Scholarship (1 year) - $4000 AUD

1999                                        Tasmania Research Scholarship, University of Tasmania, 
                                                School of Medicine (3years) - $51 000 AUD
 
CLINICAL PRACTICE/EMPLOYMENT:
 
November 2007 – present     Associate Director, MU Center for Health Ethics, University of 
Missouri - Columbia, Columbia, Missouri, USA

August 2004 – present          Assistant Professor of Clinical Nursing, Sinclair School of Nursing, University of Missouri- Columbia, Columbia, Missouri, USA;
Department Editor, Gastroenterology Nursing (Official Journal of the Society of Gastroenterology Nurses and Associates, Inc.)

March 2004 – June 2004      Instructor (NCLEX-RN), Kaplan Test Center, Ann Arbor, Michigan

Sept 2003 – June 2004          Clinical RN, Criticore Nursing Agency, Ann Arbor, Michigan

Dec 2002 – June 2003           Lecturer, School of Medicine, University of Tasmania, (Law & Ethics)

Feb 2002 – Nov 2002                 Lecturer, School of Medicine, University of Melbourne, (Health Ethics);
Clinical Registered Nurse, Cedar Court HealthSouth Rehabilitation Hospital, Melbourne, Australia

August 2001 – Nov 2001       Visiting Researcher, University of Texas at Arlington, School of Nursing, Arlington, Texas, USA;
Clinical Registered Nurse, Medical Center of Arlington, Physical Rehabilitation Unit, Arlington, Texas, USA.

Dec 2000 – Jan 2002             Clinical Tutor, School of Medicine, University of Tasmania, (Law & Ethics)

August 1999 – Oct 1999        Visiting Researcher, University of Texas at Arlington, School of Nursing / Southwestern Medical School, Parkland Memorial Hospital, Dallas, Texas, USA

Dec 1997 – May 2000          Clinical Nurse Specialist (Vascular Access/Clinical
Nutrition), Division of Medicine, Royal Hobart Hospital, Hobart, Australia; Clinical Tutor, School of Medicine / School of Nursing, University of Tasmania, Hobart, Australia
 
Oct 1995 – Dec 1997              Clinical Nurse Manager (Funded Projects), Department of Health and Human Services, Division of Hospitals and Ambulance, Launceston, Australia.
Feb 1994 - Oct 1995                          Lecturer, Tasmanian School of Nursing, University of Tasmania
Launceston, Tasmania, Australia; Clinical Teacher, Australian Maritime College, Launceston, Tasmania; Tutor in Health Studies , Center for Aboriginal Education, University of Tasmania, Launceston, Tasmania

January 1995                         Community Health Nurse Practitioner (locum), Nganampa Health Council, Pipylatjara/Kalka communities/Anangu Pitjantjatjara Lands, Central Australia

Dec 1993 – Jan 1994             Community Health Nurse Practitioner (locum), Nganampa Health Council, Iwantja Community/Anangu Pitjantjatjara Lands, Central Australia

April 1993 – Dec 1993           Registered Nurse, High Dependency Med/Surg Unit, St. Lukes Private Hospital, Launceston, Tasmania, Australia.

Oct 1991 – April 1993           Case Manager/RN Supervisor, Lifeway Home Health Care, Epic Health Group Inc., Austin, Texas, USA

Oct 1989 – Oct 1991              Registered Nurse, Department of Emergency Medicine, Launceston  General Hospital, Launceston, Tasmania, Australia

Aug 1986 – Aug 1989            Student Nurse (RN), Launceston General Hospital, Launceston, 
Tasmania, Australia. 
  
PROFESSIONAL PARTICIPATION PROFILE:
 
Professional Presentations & Attendance:

• Invited speaker, Post Acute Therapy & Care in the Home (PATCH) Conference, Sydney,

Australia, June 1996.

• Invited speaker, Intravenous Nursing Conference, Christchurch, New Zealand, March

1998.

• Invited speaker, Critical Care Association of Tasmania, Annual Seminar, Hobart,

September 1998.

• Invited speaker, Australian Bioethics Association Annual Conference, Hobart, Australia, 

October 1998.

• Invited speaker, 5th Annual Nursing Ethics Conference, University of Washington, USA

July 1999.

• Guest lecturer, Master of Science in Nursing Program, University of Texas at Arlington,

Texas, USA, July – October 1999.

• Invited speaker, Royal College of Nursing Australia International Nurses Day,

Tasmanian Chapter, May 2000.

• Invited speaker, The 1st Mater/Mercy National Nursing Conference, Balancing Care and

Cost, March 2001, Noosa, Queensland, Australia.

• Invited speaker, Health Ethics Futures: Multidisciplinary Conversations Conference, July

2001, Hamilton Island, Queensland, Australia.

• Invited speaker, 6th Australian Palliative Care Conference, September 2001, Hobart,

Tasmania, Australia.

• Invited speaker, Sigma Theta Tau Conference Series, September 22, 2005, Columbia,

Missouri, USA. 

• Invited speaker. 1st Annual MU Health Ethics Conference, October 2005, Columbia,

Missouri, USA.

• Invited speaker, Midwest Regional Conference on End-of-Life Care, November 2005,

Kansas City, Missouri, USA.

• Invited speaker, 17th Annual Gerontological Nursing Conference, December 2005,

Columbia, Missouri, USA.

• Invited speaker, Society of Gastroenterology Nurses and Associates, 33rd Annual

Conference, May 2006, San Antonio, Texas, USA.

• Invited Speaker, Annual MU Health Ethics Conference & Pellegrino Lectureship,

October 14-15, 2007, Columbia, Missouri, USA.

• Invited speaker, Society of Gastroenterology Nurses and Associates, 34th Annual

Education Meeting, May 2007, Baltimore, Maryland, USA.

• Invited speaker, Hospices of Central Iowa, Educational Meeting and Conference, July

2007, Des Moine, Iowa, USA.

• Invited speaker (panelist), Webster University “Resuscitating American Health Care Delivery: What are the Options? October, 2007, St. Louis, USA.

• Invited speaker, Hospices of Central Iowa,  November 2007 – February 2008,
• Invited speaker, St. Lukes Hospital Institute for Health Education, Ethics at the Bedside: Reality Check, April 2008, St Louis, USA.

• Invited speaker, American Cancer Society, Relay for Life Pep Rally, Columbia, Missouri, USA.

• Invited speaker, Kansas University Medical Center, “A Summit of Wizards: Practice, Payments & Policy for Midwest Advance Practice Nurses”, September, 2008, Kansas City, USA.

 
PUBLICATIONS:

• Breier, S.J.  “Uses of Total Parenteral Nutrition”, Drugs and Therapeutics Bulletin, Department of Health and Human Services, 1998; 2 (10): 2-4.

• Breier, S.J.  “To Feed or Not to Feed:  Ethical Dilemmas of Forgoing Artificial

Nutritional Support in the Advanced Cancer Patient”, Conference Proceedings, Australian Bioethics Association, October 1998.

• Breier, S.J. “Home Infusion Down Under: Consumer Perspectives”, Journal of

Intravenous Nursing, 1999; 22 (4): 187-193.

• Breier, S.J. “Recent Developments in the Care and Maintenance of Central Venous

Catheters”, Australian Society of Parenteral and Enteral Nutrition Newsletter, No.
2, June 1999.

• Breier, S.J. “Ethics and Total Parenteral Nutrition: Issues for Intravenous Nurse

Professionals”, Journal of Intravenous Nursing, 2000; 23 (1): 52-57.

• Mackie, S.B. “PEGs and Ethics”, Journal of Gastroenterology Nursing, 2001; 24 (3).

• Breier-Mackie, S.J.  “Patient Autonomy and Medical Paternity: Can Nurses Help Doctors

Listen to Patients?” Nursing Ethics, 2001; 8 (6): 510-521.

• Breier-Mackie, S.J., Newell, C.J. “Home TPN: An Ethical Decision-Making Dilemma”,

Australian Journal of Advanced Nursing, 2002; 19 (4): 27-32.

• Breier-Mackie, S.J. “Why Ethics and Gastroenterology Nursing?”. Ethics Connection

Column. Journal of Gastroenterology Nursing, 2005, 28 (3): 248-249.

• Breier-Mackie, S.J. “PEGs and Ethics Revisited: A Timely Reflection in the Wake of the

Terri Schiavo Case”, Journal of Gastroenterology Nursing, 2005; 28 (4): 292-7.

• Breier-Mackie, S.J. “Ethics and Endoscopy”, Ethics Connection Column. Journal of

Gastroenterology Nursing, 2005, 28 (6): 514-515.
 

• Breier-Mackie, S.J. “Who is the Clinical Ethicist”, Journal of Gastrenterology Nursing,

2005, 29 (1): 182-3.

• Breier-Mackie, S.J. “Medical Ethics and Nursing Ethics: Is There really Any

Difference?”, Journal of Gastroenterology Nursing, 2006, 29 (2): 70-2.

• Breier-Mackie, S.J. Ethics, Artificial Nutrition and Anorexia Nervosa, Practical

Bioethics, 2006.

• Breier-Mackie, S.J. Percutaneous Feeding Tube Placement and Severe Anorexia

Nervosa, Journal of Gastroenterology Nursing, 2006, 29 (5).  

• Breier-Mackie, S.J. Cultural Competence and Patient Advocacy: The New Challenge for

Nurses. Journal of Gastroenterology Nursing, 2007, 30 (2): 120-2.

• Breier-Mackie, S.J., Fleming, D.A. The Science and Ethics of Feeding Tubes, Missouri

Medicine, 2007; 104(3): 191-5. 

• Breier-Mackie, S.J., What’s Your Contribution to the Clinical Ethics Process? Nursing
              Management, 2008: February; 35-43.

 
BOOK REVIEWS:

Journal of Nursing Ethics, 2000; 7(2) – Mattingly, C.  1998:  Healing Dramas and Clinical Plots:
The Narrative and Structure of Experience. Cambridge; Cambridge University Press, ISBN 0 521 63994 8. 
 
Editorial Acknowledgements:

• 1998 Australian Bioethics Association Conference Proceedings

• Newell, C.  Biomedicine, Genetics and Disability: Reflections on Nursing and a

Philosophy of Holism, Nursing Ethics, 2000; 7 (3): 227-236.

 
GRANT FUNDED PROJECTS:

Position: Grant Writer and Project Administrator, Medicare Incentive Projects, Department of Health and Human Services, Hospitals & Ambulance Division, Launceston Australia, 1995 – 1997.

• Perioperative Assessment Project

1996 - $84 550  AUD
1997 - $183, 730  AUD

•  
• Bed Allocations Project

1997 - $41, 500  AUD

•  
• Hospital in the Home Project

• High Risk Anaesthetic Assessment Clinic Project

1996 - $47, 498  AUD
1997 – $72, 920  AUD

• Extended Paediatric Care Program

• Wound Management Clinic

 $1997 – 12, 374  AUD

 WORKS IN PROGRESS:

• “Food for Thought: Ethics & Artificial Nutritional Support”, PhD Dissertation abridged article

for submission to the Journal of Clinical Ethics, Fall 2007.

• “ Cancer in Pregnancy: A Narrative Ethics Analysis”, Grant application and proposal for 

submission to the Lance Armstrong Foundation, in collaboration with Dr. Elyce Cardonick, High Risk Fetal Maternal Medicine Physician, New Jersey, 2007.

• “Ethics Consult Service Evaluation – University of Missouri at Columbia”, evaluation article for

The Journal of Clinical Ethics, in collaboration with Drs. Fleming and Bondeson, and Ms Kristin Johnson RN, Fall 2007

• “Would the Professional Clinical Ethicist Please Stand Up”, article for submission to Nursing

Ethics, Fall 2007.

• “Clinical Ethics for Nurses”, long term work in progress for a case based text, anticipated

completion 2008/9.
 
MEMBERSHIP OF PROFESSIONAL ORGANIZATIONS:

• Nurses Board of Tasmania since October 1989
• Australian Nurses Federation since October 1989
• Licensed RN State of Texas since 1992
• Australian Home and Outpatient Intravenous Therapy Association since April 1995
• Royal College of Nursing Australia since June 1998
• Intravenous Nurses Society (USA) since June 1998
• Australian Bioethics Association since October 1998
• Ethics Society (Royal College of Nursing) since January 2000
• Law Society (Royal College of Nursing) since January 2000
• Licensed RN State of Michigan since 2002
• Licensed RN State of Missouri since August 2004
• Oncology Nurses Association since June 2005
• American Society Bioethics and Humanities since January 2005

 
ACADEMIC ACTIVITIES 2006/2007:

• Course Coordinator N4200 Nursing Law and Ethics (RN to BSN option, baccalaureate and 

accelerated programs)

• Adjunct Faculty, Center for Health Ethics
• Committee Member, Hospital Clinical Ethics Committee
• Clinical Ethicist, Ethics Consult Service, University Hospital
• Guest Faculty, HMI Health Ethics Elective
• ‘Nursing Ethics’  March 2006
• ‘Tube Feeding Facts’  April 2006
• ‘Healthcare Systems, Professional Relationships, and Teams’, March 2006
• Moderator – National Hospice Program End-of-Life Seminar, April 2006.
• Department Editor / Columnist, Journal of Gastroenterology Nursing
• Committee Member / Assistant Supervisor, Masters of Psychology Student (K.Daly)
• Guest lecturer/facilitator – ethics teaching VA Hospital (Center for Health Ethics)

January 2006 – ‘Nursing vs Medical Ethics’

• Committee Member/ Presenter/Panelist, MU Health Ethics Conference and Annual 

 Pellegrino Lectureship, (Center for Health Ethics) October 2006

• Nominated member – Patient Centered Care Innovation Group (PCCIG), MU Health Care
• Co-planner and facilitator, Perez Mesa Lectureship, April 2006
• Invited presenter, Society of Gastroenterolgy Nurses and Associates Annual Educational 

 Meeting and Conference, San Antonio, Texas, May 2006

• Reviewer, Journal of Nursing Ethics as of June 2006
• Participant, MU Campus Writing Program, August 2006
• Presenter, MU Ethics Grand Rounds, September 2006
• Nominated member, Educational Technologies Advisory Board, U of MO-Columbia
• Invited presenter and workshop facilitator, Society of Gastroenterology Nurses and 
• Associates, Annual Educational meeting and conference, Baltimore MD, May 2007.
• Junior Investigator – RAND Project (A joint project of RAND Health and the John A 

Hartford Foundation)

• Center Fellow, MU Interdisciplinary Center of Aging

 
 
COMMUNITY INVOLVEMENT/PARTICIPATION:

• Advocate and Support Person – Pregnant With Cancer Network (www.prenantwithcancer.org )
• Advocate and Volunteer – Lance Armstrong Foundation (www.laf.org )
• Executive Board Member  – Columbia Multisport Club
• Ellis Fischel Cancer Center Conference (Sept 07) “Cancer & Exercise”
• American Cancer Society (Dec 07) “Cancer & Exercise”

 
PROFESSIONAL INTERESTS:

• Health Ethics (clinical ethics consultation, teaching, research)
• Medical Humanities ~ Narrative Ethics Research
• Nursing Jurisprudence & Legal Nurse Consulting
• Clinical Nutrition
• Cancer in Pregnancy

 
PERSONAL INTERESTS:

• Jogging and biking the Katy Trail
• Triathlon
• Family Recreation
• 20th Century History 

 
SHORT TERM CAREER GOALS:

• To apply both my clinical and academic training in an acute care setting and a center for clinical ethics in a medical academic institution and to gain valuable experience in clinical ethics, research and education;

• To complete both my post-doctoral fellowship program in physician ethics and professionalism;

• To augment my training in legal nurse consulting with collaborative projects with both General Counsel and outside law firms; 

• To engage in a consistent collaborative scholarly activities with fellow CHE and HMI faculty, including the development of continuing education opportunities and graduate certification within health care ethics;

• To formalize and coordinate weekly clinical ethics rounds and reviews within University Hospital with a view to expand to other MU Health Care campuses;
  
• To simultaneously engage in a rewarding professional opportunities and most importantly – be there for my children.

LONG TERM CAREER GOALS:

• To be a recognized authority on clinical ethics and nursing jurisprudence in acute health care – internationally!

• To keep working at the ‘coal face’ and not to become detached from the clinical realities of health care.  

 
PERSONAL ACHIEVEMENTS:

• Selected to represent Australia at the 1991, 1992 and 1996 World Triathlon Championships
• 1991 Tasmanian Long Course Triathlon Champion
• Winner of Tasmania Triathlon Point Score Series
• Official finisher 1995 Australian Ironman Triathlon
• 1996 Silver Medal – Tasmanian State Marathon Championships
• Official finisher 1996 Cradle Mountain Ultra Marathon, Australia
• Cancer Survivor & Inaugural Survivor Summit Participant ~ Lance Armstrong Foundation 2006
• Selected in TeamUSA for World Championships – long distance triathlon, November 2006
• Winner, Athena Division 2006 USA Triathlon Club Championships, Las Vegas, October 2006
• Masters Champion 2007 Ultramax Triathlon, St Louis, June 2007

 
Professional Referees:
Ms. Patti Wright
Fiscal Operations & Administrative Manager
MU Sinclair School of Nursing
University of Missouri-Columbia
Work  573-882-0756
wrightpa@missouri.edu
 
Dr. David Fleming, 
Professor of Medicine, & Director of the MU Center for Health Ethics
University of Missouri-Columbia
Work 573-882-2738
flemingd@health.missouri.edu