About

Mara Buchbinder is a medical anthropologist specializing in the culture of medicine in the United States. Her recent work explores how patients, families, and healthcare providers navigate social and ethical challenges raised by new developments in medical technology, public health policy, and law. She has a particular interest in the role of language in medicine and in the relationships among patients, families, and clinicians in managing illness and healthcare. As a Professor in UNC’s Department of Social Medicine and core faculty in the Center for Bioethics, Mara Buchbinder is strongly committed to interdisciplinary inquiry in the medical humanities, bioethics, and socio-legal studies.

Research topics

• Political Science
• Sociology
• Law
• Engineering ethics
• Family medicine
• Psychotherapist
• Medicine
• Social psychology
• Psychology

Selected publications

• Culture and control in end‐of‐life planning

  UNC Libraries · 2026-04-14

  articleOpen accessSenior author

  Sister Rita, a Franciscan nun, lived an active life of service, working first as a teacher and later in hospital-based pastoral care until she retired in her early 80s to the Sisters of the Sacred Heart convent, an apostolic order in the Midwestern United States. Even then, she continued to live independently and provide pastoral care to her older peers. She was physically active until her last year, and only began to slow down and show signs of cognitive impairment about a year before she died at 96.

  PublisherDOI

• Appreciating Language in Bioethics: From Theory to Practice

  The American Journal of Bioethics · 2025-04-03 · 1 citations

  letterOpen access1st authorCorresponding

  As someone with longstanding interests not only in what is said in clinical interactions but also in what is left unsaid, I read the target essay by Clapp and colleagues (2025) with great enthusiasm. I concur with the authors that linguistic theory has been underappreciated in bioethics. Their essay offers two valuable contributions to the bioethics literature that should render it an instant classic: a helpful primer in linguistic theory for the uninitiated, and an application of that theory toward an incisive critique of dominant approaches to decision-making.

  PublisherOA PDFDOI

• “I still feel so lost”: experiences of women receiving SANE care during the year after sexual assault

  UNC Libraries · 2025-01-10

  articleOpen access

  OBJECTIVE: Emergency caregivers provide initial care to women sexual assault (SA) survivors. An improved understanding of the issues facing this population can aide emergency care practitioners in providing high quality care. The goal of this study was to share the experiences of women SA survivors with the emergency care practitioners that care for them. METHODS: English-speaking adult women (n = 706) who received SA Nurse Examiner (SANE) evaluation within 72 hours of SA at 1 of 13 geographically distributed sites were enrolled in a prospective, longitudinal multi-site observational study. We qualitatively analyzed responses to the open-ended question: "What do you think is most important for researchers to understand about your experience since the assault?" asked 1 week, 6 weeks, 6 months, and 1 year after enrollment. RESULTS: Themes from responses (n = 1434) from 590 women (84% of study sample) fell into 12 broad categories: daily life, justice, medical, and social services, mental health, physical health, prior trauma, recovery, romantic relationships, safety, self, shame, and social interactions. Responses demonstrated that the assault permeates many aspects of assault survivors' daily lives. CONCLUSIONS: Qualitative analyses of open-ended responses from a large cohort of women SA survivors receiving SANE care highlight the challenges for survivors and can increase understanding among the emergency care practitioners who care for them. The authors propose a brief acronym to help emergency care practitioners recall important messages for SA survivors.

  PublisherDOI

• Supporting OB-GYNs in Abortion-Restrictive States: A Playbook for Institutions

  Obstetric Anesthesia Digest · 2025-05-24

  articleSenior author

  ( JAMA . 2024;332(8):613–614. doi: 10.1001/jama.2024.10270) The Supreme Court decision in Dobbs v. Jackson Women’s Health Organization has thrown abortion legislation throughout the nation into disarray, with each state imposing its own unique laws. In states with near-total abortion bans, obstetrician-gynecologists (OB-GYNs) are now faced with decisions between legal ramifications and providing patients with the accepted standards of care. Many OB-GYNs have left states with such bans due to stress associated with these weighty decisions, which has reduced the availability of women’s health care in some areas of the nation and may impact morbidity and mortality. This article is an opinion piece focusing on the personal and professional effects of state abortion bans on OB-GYNs as of March 2023, focusing on institutional support and recommendations to both support and retain OB-GYNs.

  PublisherDOI

• Impact of post-Dobbs abortion restrictions on maternal-fetal medicine physicians in the Southeast: a qualitative study

  UNC Libraries · 2025-05-20

  articleOpen access1st authorCorresponding
  PublisherDOI

• Moral Stress and Moral Distress: Confronting Challenges in Healthcare Systems under Pressure

  UNC Libraries · 2025-07-26

  articleOpen access

  Stresses on healthcare systems and moral distress among clinicians are urgent, intertwined bioethical problems in contemporary healthcare. Yet conceptualizations of moral distress in bioethical inquiry often overlook a range of routine threats to professional integrity in healthcare work. Using examples from our research on frontline physicians working during the COVID-19 pandemic, this article clarifies conceptual distinctions between <em>moral distress</em>, <em>moral injury</em>, and <em>moral stress</em> and illustrates how these concepts operate together in healthcare work. Drawing from the philosophy of healthcare, we explain how moral stress results from the normal operations of overstressed systems; unlike moral distress and moral injury, it may not involve a sense of powerlessness concerning patient care. The analysis of moral stress directs attention beyond the individual, to stress-generating systemic factors. We conclude by reflecting on how and why this conceptual clarity matters for improving clinicians' professional wellbeing, and offer preliminary pathways for intervention.

  PublisherDOI

• Who’s Deciding? A Study of Patient-Surgeon Discussions About Contralateral Prophylactic Mastectomy

  The American Surgeon · 2025-09-19

  article

  BackgroundDespite rising rates of contralateral prophylactic mastectomy (CPM), little is known about how surgeons and patients communicate about the procedure. This study is among the first to use real-time audio recordings of CPM discussions, link conversations to treatment choice, and include multiple institutions. We assessed surgeon-patient discussions, focusing on how often CPM was addressed, who initiated it, and how decisions were made.MethodsWe recruited surgeons and patients from three academic centers and audio-recorded the first surgical consultation for patients with (1) early-stage unilateral breast cancer or ductal carcinoma in situ and (2) no strong family history or BRCA mutation. Transcripts were analyzed using an inductive, qualitative approach to generate themes and detect patterns.ResultsTwenty-seven patients and eight surgeons participated. In 14 cases, neither patient nor surgeon mentioned CPM. In the remaining 13, surgeons initiated the topic in 10, typically while introducing surgical options. Of the four patients who received CPM, each had a strong initial preference for CPM and was undeterred by the surgeon's cautionary statements against it. When patients lacked strong preferences for CPM, they generally followed surgeon recommendations to forego CPM or to delay the decision until tests (eg, genetics and MRI) were complete.DiscussionSurgeons, not patients, most commonly initiated CPM discussions. Initial patient preference strongly influenced surgical decisions. Surgeon recommendations to wait for additional information shaped decision making only when patients were initially undecided. Future research should explore how patients form preferences prior to consultation and how best to address them during clinical conversations.

  PublisherDOI

• Semantics Matter: Maternal–Fetal Medicine Physician Perspectives on Defining Abortion Care in the Post- <i>Dobbs</i> Southeast

  Journal of Women s Health · 2025-06-01 · 1 citations

  article

  This study examines how maternal-fetal medicine (MFM) physicians in the Southeastern United States define abortion care in the context of legal restrictions following the U.S. Supreme Court decision in Dobbs v. Jackson Women’s Health Organization . We conducted qualitative, semistructured interviews with 35 MFM physicians in 10 Southeastern states between February and June 2023. We analyzed interviews using a descriptive qualitative approach and identified emergent themes through inductive coding. This analysis explores the emergent theme that increased legal penalties in state abortion restrictions post- Dobbs prompted many MFMs to more closely examine the definition of abortion care and its potential impact on patient care. Whether participants believed a given scenario involved abortion care differed among participants and depended on situational factors such as intended fetal status at the time of delivery, gestational duration, and type of intervention. Regardless of participants’ personal convictions, many expressed uncertainty over the legal definition of abortion. With little legal clarity and significant potential consequences, provider willingness to uphold the standard of care depended on their level of risk tolerance, leading to discrepancies in care. These findings demonstrate that provider definitions of abortion are nuanced and varied in ways that cannot be adequately captured in legal language. While individual conceptualizations of abortion are irrelevant to medical best practices, abortion restrictions position providers and institutions as gatekeepers of access to essential medical care based on how they define abortion. Fearing legal repercussions, providers may feel compelled to limit care beyond the scope of the law, resulting in delayed, denied, or inappropriate care and violation of patient rights to informed consent and bodily autonomy.

  PublisherDOI

• The Inevitable Vagueness of Medical Exceptions to Abortion Bans

  SSRN Electronic Journal · 2025-01-01 · 1 citations

  preprintOpen access
  PublisherDOI

• Organizational Resilience in Healthcare: A Scoping Review

  Journal of Healthcare Management · 2025-05-01 · 6 citations

  reviewOpen access

  GOAL: Healthcare organizations have always faced challenges, yet the past decade has been particularly difficult due to workforce shortages, the COVID-19 pandemic, and economic demands, all of which can impact quality of care. While some healthcare organizations have demonstrated the ability to adapt to such stressors-which has been termed "organizational resilience"-others have not. Most of the research on resilience in healthcare has been on individual clinicians; less is known about how extra-individual groups such as teams, units, and systems develop resilience. Understanding what organizational resilience is, how to measure it, and how healthcare organizations can develop it is essential to responding effectively to future acute and chronic stressors in the healthcare industry. The purpose of this scoping review is to synthesize how organizational resilience is defined and measured in the current healthcare literature and to inform future interventions to improve organizational resilience. METHODS: We searched PubMed and Scopus databases for articles mentioning organizational resilience in healthcare. Eligible sources were those published in English through December 2023 in any format, and that described or measured organizational resilience in healthcare. Titles and abstracts were screened, and information was extracted from eligible articles. PRINCIPAL FINDINGS: We screened 243 articles and included 97 in our review. Across these studies, organizational resilience was described as a healthcare system's ability to continue functioning and meet its objectives when exposed to stressful stimuli. Reactive and proactive strategies, as well as reflection, were identified as key components of organizational resilience. Four measures of organizational resilience were developed for use in healthcare, but only two have been validated. PRACTICAL APPLICATIONS: Future studies should focus on validating and comparing existing measures of organizational resilience and using them to investigate how organizational resilience may impact quality of care and clinician well-being, allowing the field to move beyond the focus on individual clinician resilience.

  PublisherDOI

Recent grants

• Sociocultural Consequences of Legal Innovation: An Anthropological Analysis

  NSF · $150k · 2016–2019

Frequent coauthors

• David L. Rosen

  University of North Carolina at Chapel Hill

  147 shared

• Tom Weisner

  University of California, Berkeley

  125 shared

• Rachael Stryker

  125 shared

• Myra Bluebond‐Langner

  University College London

  125 shared

• Abby Hardgrove

  Rutgers, The State University of New Jersey

  100 shared

• Jill E. Korbin

  100 shared

• David F. Lancy

  100 shared

• Meghan C. Halley

  100 shared

Education

• Ph.D., Anthropology

  UCLA

  2010

• M.A., Anthropology

  Case Western

  2005

• B.A., Psychological and Brain Sciences

  Dartmouth College

  2002

Awards & honors

• Greenwall Faculty Scholars Award (2015-2018)
• Phillip and Ruth Hettleman Prize for Artistic and Scholarly…