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Roxanne Kirsch

Title: Staff Physician, Cardiac Critical Care Unit, Department of Critical Care Medicine
Designations: MD, MBE, FRCPC, FAAP
Alternate Contact Name: Kathy Boyko
Alternate Phone: 416-813-6860
Alternate Email:
U of T Positions: Assistant Professor, Department of Paediatrics

Hospital Positions

Clinical Associate, Bioethics Department

Associate Chief, Equity, Diversity, Inclusion, Wellness and Faculty Development for Perioperative Services

Wellness Director, Critical Care Residency 

Research Positions

Project Investigator


Dr. Roxanne Kirsch joined The Hospital for Sick Children in 2016 in the Department of Critical Care Medicine, Division of Cardiac Critical Care, and in the Department of Bioethics. Kirsch was previously on faculty at Children’s Hospital of Philadelphia (CHOP) 2009-2016 as a Cardiac Intensivist. She completed a Masters degree in Biomedical Ethics at the University of Pennsylvania in 2016.

Her academic work focuses on the ethical and social challenges of stopping advanced therapies, end of life care, and use of non-beneficial ICU therapies in terminal illness, and in the development of frameworks for resource allocation. Her interests include improving patient care delivery by enhancing health care workers’ facility in understanding and dealing with the ethical issues intendant to paediatric critical care and cardiology.


Research involves the application of clinical ethics to develop conceptual frameworks, operations frameworks, decision making support, communications support, and bioethics education for clinicians to improve patient care and ethical facility among care providers. Key projects include ethical considerations for: discontinuation of ECMO or ventricular assist device support, offering intensive care therapies, innovational care and institutional resource allocation.

Education and experience

  • 1998: BA, University of Saskatchewan, Saskatoon, SK (Magna cum Laude, History)
  • 2002: MD, University of Saskatchewan, Saskatoon, SK (Great Distinction)
  • 2002–2006: Resident in Pediatrics, Alberta Children’s Hospital, Calgary, AB
  • 2004–2005: Chief Resident, Pediatrics, Alberta Children’s Hospital, Calgary, AB
  • 2005: Registrar in Pediatrics, Mater Children’s Hospital, Brisbane, QLD, Australia
  • 2006–2008: Fellow in Pediatric Critical Care, Stollery Children’s Hospital, Edmonton
  • 2007–2008: Chief Fellow, Pediatric Critical Care, Stollery Children’s Hospital, Edmonton, AB
  • 2008–2009: Clinical Fellow, Pediatric Cardiac Critical Care, The Children’s Hospital of Philadelphia, PA
  • 2016: MBE, Masters of Bioethics, with certificate in Bioethics Mediation, University of Pennsylvania, Philadelphia, PA



  1. Di Nardo M, Dalle Ore A, Testa G, Annich G, Piervincenzi E, Zampini G, Bottari G, Cecchetti C, Amodeo A, Lorusso R, Del Sorbo L, Kirsch R. Principlism and Personalism. Comparing Two Ethical Models Applied Clinically in Neonates Undergoing Extracorporeal Membrane Oxygenation Support. Frontiers in Pediatrics; 2019:7:312. Senior Author.
    PMID: 31417882. PMCID: PMC6682695. DOI: 10.3389/fped.2019.00312
  2. Kirsch RE, Balit CR, Carnevale FA, Latour JM, Larcher V. Ethical, Cultural, Social, and Individual Considerations Prior to Transition to Limitation or Withdrawal of Life-Sustaining Therapies. Pediatric Critical Care Medicine; 2018:19(8):S10-S18. Principal Author.
    PMID: 30080802; DOI: 10.1097/PCC.0000000000001488
  3. Kirsch R, Munson D. Ethical and end of life considerations for neonates requiring ECMO support. Seminars in Perinatology; 2018:42(2): 129-137. Principal Author. PMID: 29331209. DOI: 10.1053/j.semperi.2017.12.009.
  4. Kirsch RE, Coronado J, Roeleveld PP, Tweddell J, Mott AM, Roth SJ. The Burdens of Offering: Ethical and Practical Considerations. World Journal for Pediatric and Congenital Heart Surgery; 2017;8(6):715-720. Principal Author. PMID: 29187107. DOI: 10.1177/2150135117733940
  5. Tomasi J, Warren C, Kolodzey L, Pinkney S, Guerguerian AM, Kirsch R, Hubbert J, Sperling C, Sutton P, Laussen P, Trbovich P. Convergent parallel mixed-methods study to understand information exchange in paediatric critical care and inform the development of safety enhancing interventions: a protocol study. BMJ Open; 2018:8:e023691. Co-author.
    PMID: 30173162; PMCID: PMC6120652; DOI: 10.1136/bmjopen-2018-023691

2019/3 - 2022/3 Utilizing high resolution physiological data and artificial intelligence to develop a pediatric cardiac arrest prediction tool for integration into bedside clinical practice, Operating Grant 

Funding Sources: Canadian Institutes of Health Research (CIHR) 
Natural Sciences and Engineering Research Council of Canada (NSERC partnered) 
Total Funding - 600,000 (Canadian dollar) 
Portion of Funding Received - 200,000 (Canadian dollar) 
Co-investigators: Michael-Alice Moga; Michael Brudno; Mjaye Mazwi; Roxanne Kirsch 
Collaborators: Alison Paprica; Anusha Jegatheeswaran; Evan Butler; James Drake; Judy Van Clief; Marzyeh Ghassemi; Michael Salter; Patricia Trbovich 
Principal Knowledge User: Azadeh Assadi 
Principal Investigator: Anna Goldenberg; Peter Laussen 

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