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672Exploitation and Sweatshop Labor: Perspectives and IssuesBusiness Ethics Quarterly 20 (2): 187-213. 2010.In this review, I survey theoretical accounts of exploitation in business, chiefly through the example of low wage or sweatshop labor. This labor is associated with wages that fall below a living wage standard and include long working hours. Labor of this kind is often described as self-evidently exploitative and immoral (Van Natta 1995). But for those who defend sweatshop labor as the first rung on a ladder toward greater economic development, the charge that sweatshop labor is self-evidently e…Read more
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29Attitudes toward Post‐Trial Access to Medical Interventions: A Review of Academic Literature, Legislation, and International Guidelines (review)Developing World Bioethics 16 (2): 70-79. 2015.There is currently no international consensus around post-trial obligations toward research participants, community members, and host countries. This literature review investigates arguments and attitudes toward post-trial access. The literature review found that academic discussions focused on the rights of research participants, but offered few practical recommendations for addressing or improving current practices. Similarly, there are few regulations or legislation pertaining to post-trial a…Read more
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29Response to open Peer commentaries on “Is Health Worker Migration a Case of Poaching?”American Journal of Bioethics 9 (3). 2009.I would like to thank all of the respondents to my article both for their expansions on the theme of health worker migration and for their criticisms of my argument against the use of the term ’poaching’ in the context of international health worker migration. In this response, I will clarify my argument in light of the worries raised primarily by Tache and Schillinger and Ari Zivotofsky and Naomi Zivotofsky.
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30How Medical Tourism Enables Preferential Access to Care: Four Patterns from the Canadian ContextHealth Care Analysis 25 (2): 138-150. 2017.Medical tourism is the practice of traveling across international borders with the intention of accessing medical care, paid for out-of-pocket. This practice has implications for preferential access to medical care for Canadians both through inbound and outbound medical tourism. In this paper, we identify four patterns of medical tourism with implications for preferential access to care by Canadians: Inbound medical tourism to Canada’s public hospitals; Inbound medical tourism to a First Nations…Read more
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26Can We Care for Aging Persons without Worsening Global Inequities? The Case of Long-Term Care Worker Migration from the Anglophone CaribbeanPublic Health Ethics 10 (3). 2017.The international migration of health workers, including long-term care workers for aging populations, contributes to a shortage of these workers in many parts of the world. In the Anglophone Caribbean, LCW shortages and the migration of nurses to take on LCW positions abroad threaten the health of local populations and widen global inequities in health. Many responses have been proposed to address the international migration of health workers generally, including making it more difficult for th…Read more
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48Relative Versus Absolute Standards for Everyday Risk in Adolescent HIV Prevention Trials: Expanding the DebateAmerican Journal of Bioethics 11 (6). 2011.The concept of minimal risk has been used to regulate and limit participation by adolescents in clinical trials. It can be understood as setting an absolute standard of what risks are considered minimal or it can be interpreted as relative to the actual risks faced by members of the host community for the trial. While commentators have almost universally opposed a relative interpretation of the environmental risks faced by potential adolescent trial participants, we argue that the ethical concer…Read more
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215Needs ExploitationEthical Theory and Moral Practice 11 (4): 389-405. 2008.Sweatshop labor is often cited as an example of the worst and most pervasive form of exploitation today, yet understanding what is meant by the charge has proven surprisingly difficult for philosophers. I develop an account of what I call “Needs Exploitation,” grounded in a specification of the duty of beneficence. In the case of sweatshop labor, I argue that employers face a duty to extend to employees a wage sufficient to meet their basic needs. This duty is limited by the degree of the employ…Read more
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71Exploitations and their complications: The necessity of identifying the multiple forms of exploitation in pharmaceutical trialsBioethics 26 (5): 251-258. 2012.Human subject trials of pharmaceuticals in low and middle income countries have been associated with the moral wrong of exploitation on two grounds. First, these trials may include a placebo control arm even when proven treatments for a condition are in use in other parts of the world. Second, the trial researchers or sponsors may fail to make a successful treatment developed through the trial available to either the trial participants or the host community following the trial.Many commentators …Read more
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92Beyond sun, sand, and stitches: Assigning responsibility for the Harms of medical tourismBioethics 27 (5): 233-242. 2012.Medical tourism (MT) can be conceptualized as the intentional pursuit of non-emergency surgical interventions by patients outside their nation of residence. Despite increasing popular interest in MT, the ethical issues associated with the practice have thus far been under-examined. MT has been associated with a range of both positive and negative effects for medical tourists' home and host countries, and for the medical tourists themselves. Absent from previous explorations of MT is a clear argu…Read more
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23Canadian research ethics board members’ attitudes toward benefits from clinical trialsBMC Medical Ethics 16 (1): 1-7. 2015.BackgroundWhile ethicists have for many years called for human subject trial participants and, in some cases, local community members to benefit from participation in pharmaceutical and other intervention-based therapies, little is known about how these discussions are impacting the practice of research ethics boards that grant ethical approval to many of these studies.MethodsTelephone interviews were conducted with 23 REB members from across Canada, a major funder country for human subject rese…Read more
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78The 'patient's physician one-step removed': the evolving roles of medical tourism facilitatorsJournal of Medical Ethics 37 (9): 530-534. 2011.Background: Medical tourism involves patients travelling internationally to receive medical services. This practice raises a range of ethical issues, including potential harms to the patient's home and destination country and risks to the patient's own health. Medical tourists often engage the services of a facilitator who may book travel and accommodation and link the patient with a hospital abroad. Facilitators have the potential to exacerbate or mitigate the ethical concerns associated with m…Read more
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64Issues and Challenges in Research on the Ethics of Medical Tourism: Reflections from a Conference (review)Journal of Bioethical Inquiry 8 (1): 3-6. 2011.The authors co-organized (Snyder and Crooks) and gave a keynote presentation at (Turner) a conference on ethical issues in medical tourism. Medical tourism involves travel across international borders with the intention of receiving medical care. This care is typically paid for out-of-pocket and is motivated by an interest in cost savings and/or avoiding wait times for care in the patient’s home country. This practice raises numerous ethical concerns, including potentially exacerbating health in…Read more
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60“Do your homework…and then hope for the best”: the challenges that medical tourism poses to Canadian family physicians’ support of patients’ informed decision-making (review)BMC Medical Ethics 14 (1): 37. 2013.Medical tourism—the practice where patients travel internationally to privately access medical care—may limit patients’ regular physicians’ abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors’ typical involvement in patients’ informed decision-making is challenged when their patients engage in medical tourism
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37“It Was the Best Decision of My Life”: a thematic content analysis of former medical tourists’ patient testimonialsBMC Medical Ethics 16 (1): 8. 2015.Medical tourism is international travel with the intention of receiving medical care. Medical tourists travel for many reasons, including cost savings, limited domestic access to specific treatments, and interest in accessing unproven interventions. Medical tourism poses new health and safety risks to patients, including dangers associated with travel following surgery, difficulty assessing the quality of care abroad, and complications in continuity of care. Online resources are important to the…Read more
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84Easy Rescues and Organ TransplantationHEC Forum 21 (1): 27-53. 2009.Many people in desperate need of an organ will die on waiting lists for transplantation or face increased morbidity because of their wait. This circumstance is particularly troubling since many viable organs for transplantation go unused when individuals fail to participate in their local organ donation system. In this paper, I consider whether participating in organ transplantation should be considered a form of a rescue of others from the great harms caused by a shortage in transplantable orga…Read more
Burnaby, British Columbia, Canada
Areas of Specialization
Applied Ethics |
Applied Ethics, Miscellaneous |
Biomedical Ethics |
Areas of Interest
Social and Political Philosophy |
Business Ethics |