•  19
    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.
  •  19
    How Medical Tourism Enables Preferential Access to Care: Four Patterns from the Canadian Context
    with Rory Johnston, Valorie A. Crooks, Jeff Morgan, and Krystyna Adams
    Health 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
  •  16
    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
  •  32
    Relative Versus Absolute Standards for Everyday Risk in Adolescent HIV Prevention Trials: Expanding the Debate
    with Cari L. Miller and Glenda Gray
    American 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
  •  165
    Needs Exploitation
    Ethical 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
  •  57
    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
  •  80
    Beyond sun, sand, and stitches: Assigning responsibility for the Harms of medical tourism
    with Valorie Crooks, Rory Johnston, and Paul Kingsbury
    Bioethics 27 (5): 233-242. 2013.
    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
  •  9
    Canadian research ethics board members’ attitudes toward benefits from clinical trials
    with Kori Cook and John Calvert
    BMC 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
  •  62
    The 'patient's physician one-step removed': the evolving roles of medical tourism facilitators
    with V. A. Crooks, K. Adams, P. Kingsbury, and R. Johnston
    Journal 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
  •  49
    Issues and Challenges in Research on the Ethics of Medical Tourism: Reflections from a Conference (review)
    with Valorie Crooks and Leigh Turner
    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
  •  46
    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