•  12
    In this chapter I consider the narrow and wider benefits of permitting assisted dying in the specific context of organ donation and transplantation. In addition to the commonly used arguments, there are two other neglected reasons for permitting assisted suicide and/or euthanasia: assisted dying enables those who do not wish to remain alive to prolong the lives of those who do, and also allows many more people to fulfill their wish to donate organs after death. In the first part of this chapter …Read more
  •  18
    Justice and the Fetus: Rawls, Children, and Abortion
    Cambridge Quarterly of Healthcare Ethics 20 (1): 93-101. 2011.
    In a footnote to the first edition of Political Liberalism, John Rawls introduced an example of how public reason could deal with controversial issues. He intended this example to show that his system of political liberalism could deal with such problems by considering only political values, without the introduction of comprehensive moral doctrines. Unfortunately, Rawls chose “the troubled question of abortion” as the issue that would illustrate this. In the case of abortion, Rawls argued, “the …Read more
  •  4
    Many families refuse to consent to donation from their deceased relatives or over-rule the consent given before death by the patient, but giving families more information about the potential recipients of organs could reduce refusal rates. In this paper, we analyse arguments for and against doing so, and conclude that this strategy should be attempted. While it would be impractical and possibly unethical to give details of actual potential recipients, generic, realistic information about the peo…Read more
  •  5
    Gatekeepers of Reward: a Pilot Study on the Ethics of Editing and Competing Evaluations of Value
    with Bart Penders
    Journal of Academic Ethics 16 (3): 211-223. 2018.
    The reward infrastructure in science centres on publication, in which journal editors play a key role. Reward distribution hinges on value assessments performed by editors, who draw from plural value systems to judge manuscripts. This conceptual paper examines the numerous biases and other factors that affect editorial decisions. Hybrid and often conflicting value systems contribute to an infrastructure in which editors manage reward through editorial review, commissioned commentaries and review…Read more
  •  4
    Division and discord in the Clinical Trials Regulation
    with David Townend
    Journal of Medical Ethics 42 (11): 729-732. 2016.
  •  7
    A Virtuous Death: Organ Donation and Eudaimonia
    Journal of Bioethical Inquiry 14 (3): 319-321. 2017.
  •  13
    The Relevance of Relevance in Research
    with Bernice Elger
    Swiss Medical Weekly. 2013.
    A new Swiss law requires that any research involving humans must aim to answer "a relevant research question". This paper explains the relevance of the relevance criterion in research, analyses the Swiss and British guidelines on relevance, and proposes a framework for researchers and REC members that enables a clearer conception of the role of relevance in research. We conclude that research must be either scientifically or societally beneficial in order to qualify as relevant, and RECs therefo…Read more
  •  2
    In June 2014, a paper reporting the results of a study into ‘emotional contagion’ on Facebook was published. This research has already attracted a great deal of criticism for problems surrounding informed consent. While most of this criticism is justified, other relevant consent issues have gone unremarked, and the study has several other ethical flaws which collectively indicate the need for better regulation of health and mood research using social networks.
  •  8
    Creating human organs in chimaera pigs: an ethical source of immunocompatible organs?
    with Wybo Dondorp, Niels Geijsen, and Guido de Wert
    Journal of Medical Ethics 41 (12): 970-974. 2015.
  •  253
    Lessons From the German Organ Scandal
    Journal of the Intensive Care Society 14 (3): 200-1. 2013.
    Doctors at four German hospitals have been suspended from their posts following internal investigations which alleged that they had been manipulating the organ transplant allocation system in order to help their patients get donor livers more quickly. It is alleged that doctors exaggerated the severity of their patients’ conditions so that they would be accorded higher priority for receiving organs, but there may also have been manipulation of medical records, deception of patients and potentia…Read more
  •  13
    Prioritising Healthcare Workers for Ebola Treatment: Treating Those at Greatest Risk to Confer Greatest Benefit
    with Priya Satalkar and Bernice E. Elger
    Developing World Bioethics 15 (2): 59-67. 2015.
    The Ebola epidemic in Western Africa has highlighted issues related to weak health systems, the politics of drug and vaccine development and the need for transparent and ethical criteria for use of scarce local and global resources during public health emergency. In this paper we explore two key themes. First, we argue that independent of any use of experimental drugs or vaccine interventions, simultaneous implementation of proven public health principles, community engagement and culturally sen…Read more
  •  2
    Evidence-Based Persuasion: An Ethical Imperative
    with Bernice Elger
    Journal of the American Medical Association 309 (16): 1689-90. 2013.
    The primacy in modern medical ethics of the principle of respect for autonomy has led to the widespread assumption that it is unethical to change someone’s beliefs, because doing so would constitute coercion or paternalism., In this Viewpoint we suggest that persuasion is not necessarily paternalistic and is an essential component of modern medical practice.
  •  4
    Using non-human primates to benefit humans: research and organ transplantation—response to César Palacios-González
    with Wybo Dondorp and Guido de Wert
    Medicine, Health Care and Philosophy 19 (2): 227-228. 2016.
  •  1
    The Trojan Citation and the “Accidental” Plagiarist
    Journal of Bioethical Inquiry 13 (1): 7-9. 2016.
  •  1
    Cryoethics
    In Hugh LaFollette (ed.), The International Encyclopedia of Ethics, Wiley-blackwell. 2013.
    Cryoethics is a new theme within bioethics (see bioethics) concerned with the ethics of cryonic storage. Cryonics, which is also erroneously referred to as “cryogenic” technology, offers people the option of having their bodies or brain-stems preserved at very low temperatures after death in order to be revived at some point in the future when technology is sufficiently advanced to enable reanimation, and possibly immortality. The main issues in cryoethics center around whether it is ethical to …Read more
  •  29
    This paper examines the legal justification for water fluoridation (WF) in the United Kingdom. While current legislation clearly permits WF, there is a degree of obfuscation concerning whether the practice amounts to medication, and were it to be acknowledged that fluoridated water constitutes a medicine, the legality of the practice would not be so obvious. It is concluded that an accurate and honest interpretation of the law would result in the conclusion that fluoridation does constitute medi…Read more
  •  20
    Prescribing placebos ethically: the appeal of negatively informed consent
    Journal of Medical Ethics 35 (2): 97-99. 2009.
    Kihlbom has recently argued that a system of seeking negatively informed consent might be preferable in some cases to the ubiquitous informed consent model. Although this theory is perhaps not powerful enough to supplant informed consent in most settings, it lends strength to Evans’ and Hungin’s proposal that it can be ethical to prescribe placebos rather than "active" drugs. This paper presents an argument for using negatively informed consent for the specific purpose of authorising the use of …Read more
  •  5
    This article highlights the often overlooked fact that doctors who respect a bereaved family's veto of a deceased patient's organ donation are complicit in the deaths of those who would have benefited from the organs in question. Respecting the veto violates the dying wish of the patient, is against the spirit of the law and contributes to the deaths of other patients.
  •  1
    In recent years there have been many revelations about ghost authors, who contribute to publications but are not credited, and guest authors, who do not contribute but are credited. Most medical and many other journals adhere to the authorship standards set by the International Committee of Medical Journal Editors (ICMJE), which were designed in part to combat the phenomena of ghost and guest authorship. However, the current criteria set for authorship by the ICMJE have their own problems. This …Read more
  •  6
    Continuous consent and dignity in dentistry
    British Dental Journal 203 (11): 569-571. 2007.
    Despite the heavy emphasis on consent in the ethical code of the General Dental Council (GDC), it is often overlooked that communication difficulties between patient and dentist can cause problems in maintaining genuine consent during interventions. Inconsistencies in the GDC's Standards for dental professionals and Principles of patient consent guidelines are examined in this article, and it is concluded that more emphasis must be placed on continuous consent as an ongoing process essential to …Read more
  •  1
    Hematopoietic stem cell transplantation is a widely accepted practice in the United Kingdom (UK). The relatively liberal UK law permits donation both within families and from strangers, and even allows the creation of “saviour siblings” who are brought into being with the specific intent of having them donate stem cells to save other members of their family. This chapter describes the regulation of HSCT in the UK and highlights some ethical issues related to discrimination against some categorie…Read more
  •  9
    Autonomy and Fear of Synthetic Biology: How Can Patients’ Autonomy Be Enhanced in the Field of Synthetic Biology? A Qualitative Study with Stable Patients
    with Milenko Rakic, Isabelle Wienand, Rebecca Nast, and Bernice S. Elger
    Science and Engineering Ethics 23 (2): 375-388. 2017.
    We analyzed stable patients’ views regarding synthetic biology in general, the medical application of synthetic biology, and their potential participation in trials of synthetic biology in particular. The aim of the study was to find out whether patients’ views and preferences change after receiving more detailed information about synthetic biology and its clinical applications. The qualitative study was carried out with a purposive sample of 36 stable patients, who suffered from diabetes or gou…Read more
  •  11
    Evidence and Ethics in Occupational Therapy
    with Justine Shaw
    British Journal of Occupational Therapy 74 (5): 254-256. 2011.
    Reagon, Bellin and Boniface argue that traditional models of evidence-based practice focus too much on randomised controlled trials and neglect 'the multiple truths of occupational therapy'. This opinion piece points out several flaws in their argument, and suggests that it is unethical to rely on weaker evidence sources when higher quality evidence exists. Ironically, the evidence that they provide to support their argument regarding different types of evidence is itself very weak.
  •  12
    The Vulnerability of the Individual Benefit Argument
    with Domnita O. Badarau and Rebecca L. Nast
    American Journal of Bioethics 14 (12): 17-18. 2014.
  •  10
    The body as unwarranted life support: a new perspective on euthanasia
    Journal of Medical Ethics 33 (9): 519-521. 2007.
    It is widely accepted in clinical ethics that removing a patient from a ventilator at the patient’s request is ethically permissible. This constitutes voluntary passive euthanasia. However, voluntary active euthanasia, such as giving a patient a lethal overdose with the intention of ending that patient’s life, is ethically proscribed, as is assisted suicide, such as providing a patient with lethal pills or a lethal infusion. Proponents of voluntary active euthanasia and assisted suicide have arg…Read more
  •  6
    The representation of women as authors, reviewers, editors-in-Chief, and editorial board members at six general medical journals in 2010 and 2011.
    with Thomas Erren, Juliane Groß, and Barbara Selle
    JAMA Internal Medicine 174 (4): 633. 2014.
    Although more women continue to enter the medical profession, disparities between the sexes in academic medicine persist. This “gender gap” has implications for academic advancement. In 2006, Jagsi and colleagues reported that, although the proportion of women among first and last authors in the United States had significantly increased since 1970, women still represented a minority of the authors of original research and guest editorials in six prominent medical journals.1 In a related 2008 stu…Read more
  •  3
    Institutional review boards (IRBs) have a reputation for impeding research. This reputation is understandable inasmuch as many studies are poorly designed, exploit participants, or do not ask a relevant question , and it is entirely proper that IRBs should reject such proposals. However, IRBs also frequently reject or tamper with perfectly sound and relevant studies in the name of protecting participants from harm, in accordance with the widely accepted message that “clinical research is justifi…Read more
  •  1
    Genetic Morality
    Peter Lang. 2006.
    This book will attempt to show that these and other problems are ultimately resolvable, given careful and unbiased application of established ethical principles ...
  •  3
    Crocodile tiers
    Journal of Medical Ethics 34 (8): 575. 2008.
    It is clearly unethical for the NHS to tell people that they will die sooner unless they pay for private treatment, and then to tell them that if they pay for private treatment they will have to pay the NHS for its insufficient service. This is all the more true if people in other parts of the country are receiving all the drugs they need for the same condition on the NHS. Patients who discover that the NHS care that they have paid for will not keep them alive should be able to supplement their …Read more