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45What Can Feminist Epistemology Do for Surgery?Hypatia 29 (2): 404-421. 2014.Surgery is an important part of contemporary health care, but currently much of surgery lacks a strong evidence base. Uptake of evidence-based medicine (EBM) methods within surgical research and among practitioners has been slow compared with other areas of medicine. Although this is often viewed as arising from practical and cultural barriers, it also reflects a lack of epistemic fit between EBM research methods and surgical practice. In this paper we discuss some epistemic challenges in surger…Read more
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44Risk, Overdiagnosis and Ethical JustificationsHealth Care Analysis 27 (4): 231-248. 2019.Many healthcare practices expose people to risks of harmful outcomes. However, the major theories of moral philosophy struggle to assess whether, when and why it is ethically justifiable to expose individuals to risks, as opposed to actually harming them. Sven Ove Hansson has proposed an approach to the ethical assessment of risk imposition that encourages attention to factors including questions of justice in the distribution of advantage and risk, people’s acceptance or otherwise of risks, and…Read more
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44Evidence based medicine and justice: a framework for looking at the impact of EBM upon vulnerable or disadvantaged groupsJournal of Medical Ethics 30 (2): 141-145. 2004.This article examines the implicit promises of fairness in evidence based medicine , namely to avoid discrimination through objective processes, and to distribute effective treatments fairly. The relationship between EBM and vulnerable groups is examined. Several aspects of EBM are explored: the way evidence is created , and the way evidence is applied in clinical care and health policy. This analysis suggests that EBM turns our attention away from social and cultural factors that influence heal…Read more
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43Joint issues – conflicts of interest, the ASR hip and suggestions for managing surgical conflicts of interestBMC Medical Ethics 15 (1): 63. 2014.Financial and nonfinancial conflicts of interest in medicine and surgery are troubling because they have the capacity to skew decision making in ways that might be detrimental to patient care and well-being. The recent case of the Articular Surface Replacement (ASR) hip provides a vivid illustration of the harmful effects of conflicts of interest in surgery
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42Diagnosis, narrative identity, and asymptomatic diseaseTheoretical Medicine and Bioethics 38 (4): 307-321. 2017.An increasing number of patients receive diagnoses of disease without having any symptoms. These include diseases detected through screening programs, as incidental findings from unrelated investigations, or via routine checks of various biological variables like blood pressure or cholesterol. In this article, we draw on narrative identity theory to examine how the process of making sense of being diagnosed with asymptomatic disease can trigger certain overlooked forms of harm for patients. We s…Read more
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42BackgroundThere is a growing concern about artificial intelligence (AI) applications in healthcare that can disadvantage already under-represented and marginalised groups (eg, based on gender or race).ObjectivesOur objectives are to canvas the range of strategies stakeholders endorse in attempting to mitigate algorithmic bias, and to consider the ethical question of responsibility for algorithmic bias.MethodologyThe study involves in-depth, semistructured interviews with healthcare workers, scre…Read more
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42Confidentiality and the ethics of medical ethicsJournal of Medical Ethics 29 (4): 220-224. 2003.In this paper we consider the use of cases in medical ethics research and teaching. To date, there has been little discussion about the consent or confidentiality requirements that ought to govern the use of cases in these areas. This is in marked contrast to the requirements for consent to publish cases in clinical journals, or to use personal information in research. There are a number of reasons why it might be difficult to obtain consent to use cases in ethics. Many cases concern people who …Read more
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40Ethical issues raised by thyroid cancer overdiagnosis: A matter for public health?Bioethics 31 (8): 590-598. 2017.Current practices of identifying and treating small indolent thyroid cancers constitute an important but in some ways unusual form of overdiagnosis. Overdiagnosis refers to diagnoses that generally harm rather than benefit patients, primarily because the diagnosed condition is not a harmful form of disease. Patients who are overdiagnosed with thyroid cancer are harmed by the psycho-social impact of a cancer diagnosis, as well as treatment interventions such partial or total thyroidectomy, lifelo…Read more
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40Revisiting the equity debate in COVID-19: ICU is no panaceaJournal of Medical Ethics 46 (10): 641-645. 2020.Throughout March and April 2020, debate raged about how best to allocate limited intensive care unit resources in the face of a growing COVID-19 pandemic. The debate was dominated by utility-based arguments for saving the most lives or life-years. These arguments were tempered by equity-based concerns that triage based solely on prognosis would exacerbate existing health inequities, leaving disadvantaged patients worse off. Central to this debate was the assumption that ICU admission is a valuab…Read more
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39The Routledge Handbook of Feminist Bioethics (edited book)Routledge. 2022.The Routledge Handbook of Feminist Bioethics is an outstanding resource for anyone with an interest in feminist bioethics, with chapters covering topics from justice and power to the climate crisis. Comprising 42 chapters by emerging and established scholars, the volume is divided into six parts: Foundations of Feminist Bioethics Identity and Identifications Science, Technology and Research Health and Social Care Reproduction and Making Families Widening the Scope of Feminist Bioethics The volum…Read more
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36Device representatives in hospitals: are commercial imperatives driving clinical decision-making?Journal of Medical Ethics 44 (9): 589-592. 2018.Despite concerns about the relationships between health professionals and the medical device industry, the issue has received relatively little attention. Prevalence data are lacking; however, qualitative and survey research suggest device industry representatives, who are commonly present in clinical settings, play a key role in these relationships. Representatives, who are technical product specialists and not necessarily medically trained, may attend surgeries on a daily basis and be availabl…Read more
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35Vulnerability and BioethicsIn Catriona Mackenzie, Wendy Rogers & Susan Dodds (eds.), Vulnerability: New Essays in Ethics and Feminist Philosophy, Oup Usa. pp. 60. 2013.
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35Beneficence in general practice: an empirical investigationJournal of Medical Ethics 25 (5): 388-393. 1999.OBJECTIVES: To study and report the attitudes of patients and general practitioners (GPs) concerning the obligation of doctors to act for the good of their patients, and to provide a practical account of beneficence in general practice. DESIGN: Semi-structured interviews administered to GPs and patients. SETTING AND SAMPLE: Participants randomly recruited from an age and gender stratified list of GPs in a geographically defined region of South Australia. The sample comprised twenty-one general p…Read more
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34Bioethics and activism: A natural fit?Bioethics 33 (8): 881-889. 2019.Bioethics is a practically oriented discipline that developed to address pressing ethical issues arising from developments in the life sciences. Given this inherent practical bent, some form of advocacy or activism seems inherent to the nature of bioethics. However, there are potential tensions between being a bioethics activist, and academic ideals. In academic bioethics, scholarship involves reflection, rigour and the embrace of complexity and uncertainty. These values of scholarship seem to b…Read more
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34Against the use and publication of contemporary unethical research: the case of Chinese transplant researchJournal of Medical Ethics 46 (10): 678-684. 2020.Recent calls for retraction of a large body of Chinese transplant research and of Dr Jiankui He’s gene editing research has led to renewed interest in the question of publication, retraction and use of unethical biomedical research. In Part 1 of this paper, we briefly review the now well-established consequentialist and deontological arguments for and against the use of unethical research. We argue that, while there are potentially compelling justifications for use under some circumstances, thes…Read more
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34Understanding Corporate Responsibility: Culture and ComplicityAmerican Journal of Bioethics 11 (9): 18-20. 2011.The American Journal of Bioethics, Volume 11, Issue 9, Page 18-20, September 2011
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33Ethical and regulatory implications of the COVID-19 pandemic for the medical devices industry and its representativesBMC Medical Ethics 23 (1): 1-7. 2022.The development and deployment of medical devices, along with most areas of healthcare, has been significantly impacted by the COVID-19 pandemic. This has had variable ethical implications, two of which we will focus on here. First, medical device regulations have been rapidly amended to expedite approvals of devices ranging from face masks to ventilators. Although some regulators have issued cessation dates, there is inadequate discussion of triggers for exiting these crisis standards, and evid…Read more
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32Hips, Knees, and Hernia Mesh: When Does Gender Matter in Surgery?International Journal of Feminist Approaches to Bioethics 10 (1): 148-174. 2017.This paper draws attention to gendered dimensions of surgical device failure, focusing on two case studies—hernia repair mesh for pelvic organ prolapse, and metal-on-metal hip implants. We explore possible reasons for higher rates of harms to women, including systematic biases in health research and device regulation. Given that these factors are readily identifiable, we look to feminist scholarship to understand what might maintain them, including the role of cultural factors within surgery, su…Read more
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32Strengthening the ethical assessment of placebo-controlled surgical trials: three proposalsBMC Medical Ethics 15 (1): 78. 2014.Placebo-controlled surgical trials can provide important information about the efficacy of surgical interventions. However, they are ethically contentious as placebo surgery entails the risk of harms to recipients, such as pain, scarring or anaesthetic misadventure. This has led to claims that placebo-controlled surgical trials are inherently unethical. On the other hand, without placebo-controlled surgical trials, it may be impossible to know whether an apparent benefit from surgery is due to t…Read more
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31Potential Conflict of Interest and Bias in the RACGP’s Smoking Cessation Guidelines: Are GPs Provided with the Best Advice on Smoking Cessation for their Patients?Public Health Ethics 8 (3): 319-331. 2015.Patient visits are an important opportunity for general practitioners to discuss the risks of smoking and cessation strategies. In Australia, the guidelines on cessation published by the Royal Australian College of General Practitioners represent a key resource for GPs in this regard. The predominant message of the Guidelines is that pharmacotherapy should be recommended as first-line therapy for smokers expressing an interest in quitting. This, however, ignores established evidence about the su…Read more
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30Smoke and mirrors: unanswered questions and misleading statements obscure the truth about organ sources in ChinaJournal of Medical Ethics 42 (8): 552-553. 2016.
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29Casting the net too wide on overdiagnosis: benefits, burdens and non-harmful diseaseJournal of Medical Ethics 42 (11): 717-719. 2016.
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29Bioethics, Volume 35, Issue 7, Page 623-633, September 2021.
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29Details Matter—Definitions and Context Can’t Be Glossed Over When Managing InnovationAmerican Journal of Bioethics 19 (6): 28-29. 2019.Volume 19, Issue 6, June 2019, Page 28-29.
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28IntroductionInternational Journal of Feminist Approaches to Bioethics 5 (2): 1-10. 2012.Our motivation for proposing a special issue of IJFAB on vulnerability is twofold. First, there is growing interest in the concept of vulnerability within both bioethics and feminist theory. Reflecting this interest, this special issue provides a forum for exploring the relevance for bioethics of feminist perspectives on vulnerability. Second, despite growing recognition within bioethics of the moral significance of vulnerability, the concept remains under-theorized in bioethical (and wider phil…Read more
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26Practical ethics for general practiceOxford University Press. 2004.The aim of this book is to provide an accessible account of ethics in general practice, addressing concerns identified by practitioners. It contains many examples and allows the reader to gain practical insights into how to identify and analyze the ethical issues they encounter in everyday general practice.
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26Virtue ethics and public health: A practice-based analysisMonash Bioethics Review 23 (1): 10-21. 2004.Public health plays an important, albeit often unnoticed, role in protecting and promoting the health of populations. The activities of public health are complex, performed by multiple professionals, and range from the innocuous to the intrusive. Ethical analyses in public health reflect some of this complexity and fragmentation, with no one approach able to capture the full range of ethical considerations raised by public health activities. There are however, good reasons why we should pursue s…Read more
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25Testing relationships: ethical arguments for screening for type 2 diabetes mellitus with HbA1CJournal of Medical Ethics 38 (3): 180-183. 2012.Since the 1990s, glycated haemoglobin (HbA1C) has been the gold standard for monitoring glycaemic control in people diagnosed as having either type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM). Discussions are underway about diagnosing diabetes mellitus on the basis of HbA1C titres and using HbA1C tests to screen for T2DM. These discussions have focused on the relative benefits for individual patients, with some attention directed towards reduced costs to healthcare systems and …Read more
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25Whistle-blowing in the medical curriculum: A response to FaunceMonash Bioethics Review 24 (1): 50-58. 2005.We agree with Faunce’s proposal that academic legitimacy is important in ensuring that whistle-blowing is included in medical curricula. We disagree, however, with the assertion that this is best achieved by means of an over-arching theoretical foundation for health care whistle-blowing of the kind suggested by Faunce. We propose that systematic theoretical justification is neither the sole nor the main determinant of academic legitimacy when it comes to matters for inclusion in medical school c…Read more
Sydney, New South Wales, Australia
Areas of Specialization
Applied Ethics |
Areas of Interest
Applied Ethics |