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13Consent as a compositional act – a framework that provides clarity for the retention and use of dataPhilosophy, Ethics and Humanities in Medicine 19 (1): 1-10. 2024.Background Informed consent is one of the key principles of conducting research involving humans. When research participants give consent, they perform an act in which they utter, write or otherwise provide an authorisation to somebody to do something. This paper proposes a new understanding of the informed consent as a compositional act. This conceptualisation departs from a modular conceptualisation of informed consent procedures. Methods This paper is a conceptual analysis that explores what …Read more
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3The Undeserving Sick? An Evaluation of Patients’ Responsibility for Their Health ConditionCambridge Quarterly of Healthcare Ethics 29 (2): 175-191. 2020.The recent increased prevalence of diseases related to unhealthy lifestyles raises difficulties for healthcare insurance systems traditionally based on the principles of risk-management, solidarity, and selective altruism: since these diseases are, to some extent, predictable and avoidable, patients seem to bear some responsibility for their condition and may not deserve full access to social medical services. Here, we investigate with objective criteria to what extent it is warranted to hold pa…Read more
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1079Cómo tomar decisiones justas en el camino hacia la cobertura universal de saludPan-American Health Organization (PAHO). 2015.La cobertura universal de salud está en el centro de la acción actual para fortalecer los sistemas de salud y mejorar el nivel y la distribución de la salud y los servicios de salud. Este documento es el informe fi nal del Grupo Consultivo de la OMS sobre la Equidad y Cobertura Universal de Salud. Aquí se abordan los temas clave de la justicia (fairness) y la equidad que surgen en el camino hacia la cobertura universal de salud. Por lo tanto, el informe es pertinente para cada agente que infl uy…Read more
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1335Faire Des Choix Justes Pour Une Couverture Sanitaire UniverselleWorld Health Organization. 2015.This report from the WHO Consultative Group on Equity and Universal Health Coverage offers advice on how to make progress fairly towards universal health coverage.
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1535Making Fair Choices on the Path to Universal Health CoverageWorld Health Organisation. 2014.This report by the WHO Consultative Group on Equity and Universal Health Coverage addresses how countries can make fair progress towards the goal of universal coverage. It explains the relevant tradeoffs between different desirable ends and offers guidance on how to make these tradeoffs.
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7Fairness in Military Care: Might a Hybrid Concept of Equity Be the Answer?In Sheena M. Eagan & Daniel Messelken (eds.), Resource Scarcity in Austere Environments: An Ethical Examination of Triage and Medical Rules of Eligibility, Springer Verlag. pp. 155-171. 2023.Applying equity to health care is difficult and it is especially challenging when applied to cases that involve urgent military medicine care under resource scarcity. Part of the difficulty centers on the concept of equity itself. It is not clear what the best concept of equity applicable to medical care would be, or that there should be only one, or the same ones, across all levels of military health care. Despite the fact that equity is a key concern in health care, particularly in the age of …Read more
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42Should ethics consultants help clinicians face scarcity in their practice?Journal of Medical Ethics 34 (4): 241-246. 2008.In an international survey of rationing we have found that European physicians encounter scarcity-related ethical difficulties, and are dissatified with the resolution of many of these cases. Here we further examine survey results to explore whether ethics support services would be potentially useful in addressing scarcity related ethical dilemmas. Results indicate that while the type of help offered by ethics support services was considered helpful by physicians, they rarely referred difficulti…Read more
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50Ethical difficulties in clinical practice: experiences of European doctorsJournal of Medical Ethics 33 (1): 51-57. 2007.Background: Ethics support services are growing in Europe to help doctors in dealing with ethical difficulties. Currently, insufficient attention has been focused on the experiences of doctors who have faced ethical difficulties in these countries to provide an evidence base for the development of these services.Methods: A survey instrument was adapted to explore the types of ethical dilemma faced by European doctors, how they ranked the difficulty of these dilemmas, their satisfaction with the …Read more
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47Resolving the Conflict: Clarifying ‘Vulnerability’ in Health Care EthicsKennedy Institute of Ethics Journal 24 (1): 51-72. 2014.Vulnerability has been extensively discussed in medical research, but less so in health care. Thus, who the vulnerable in this domain are still remains an open question. One difficulty in their identification is due to the general criticism that vulnerability is not a property of only some, but rather of everyone. By presenting a philosophical analysis of the conditions of vulnerability ascription, we show that these seemingly irreconcilable understandings of vulnerability are not contradictory.…Read more
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23On vulnerability—analysis and applications of a many-faceted concept : IntroductionLes Ateliers de l'Éthique / the Ethics Forum 12 (2-3): 146-153. 2017.ANGELA MARTIN, SAMIA HURST
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45Just care: should doctors give priority to patients of low socioeconomic status?Journal of Medical Ethics 35 (1): 7-11. 2009.Growing data on the socioeconomic determinants of health pose a challenge to analysis and application of fairness in health. In Just health: meeting health needs fairly, Norman Daniels argues for a change in the population end of our thinking about just health. What about clinical care? Given our knowledge of the importance of wealth, education or social status to health, is fairness in medicine served better by continuing to avoid considering our patients’ social status in setting clinical prio…Read more
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45Indecent Coverage? Protecting the Goals of Health Insurance from the Impact of Co-PaymentsCambridge Quarterly of Healthcare Ethics 15 (1): 107-113. 2006.As pressures increase to contain growing healthcare expenditures, there is currently a prominent rise in the shift of healthcare costs to patients in the form of deductibles, co-pays, and co-insurance. Rising co-payments are part of a larger picture of increasing overall out-of-pocket healthcare expenditures. From 1990 to 2000, per capita out-of-pocket payments for healthcare reached $707 in the United States, and doubled in several European countries with universal health insurance, reaching $3…Read more
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51Assisted Suicide is Compatible with Medical EthosAmerican Journal of Bioethics 11 (6). 2011.The American Journal of Bioethics, Volume 11, Issue 6, Page 55-57, June 2011
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17Design Bioethics, Not Only as a Research Tool but Also a Pedagogical ToolAmerican Journal of Bioethics 21 (6): 69-71. 2021.As highlighted by Pavarini et al., researchers in the field of bioethics have to remain critical and reflexive on the methodology and on the tools they use for their research purpose because...
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14How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience?BMC Medical Ethics 23 (1): 1-11. 2022.BackgroundImplicit prejudice can lead to disparities in treatment. The effects of specialty and experience on implicit obesity and mental illness prejudice had not been explored. The main objective was to examine how specializing in psychiatry/general medicine and years of experience moderated implicit obesity and mental illness prejudice among Swiss physicians. Secondary outcomes included examining the malleability of implicit bias via two video interventions and a condition of cognitive load, …Read more
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78Towards a Governance Framework for Brain DataNeuroethics 15 (2): 1-14. 2022.The increasing availability of brain data within and outside the biomedical field, combined with the application of artificial intelligence (AI) to brain data analysis, poses a challenge for ethics and governance. We identify distinctive ethical implications of brain data acquisition and processing, and outline a multi-level governance framework. This framework is aimed at maximizing the benefits of facilitated brain data collection and further processing for science and medicine whilst minimizi…Read more
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17Citizens' views on sharing their health data: the role of competence, reliability and pursuing the common goodBMC Medical Ethics 22 (1): 1-12. 2021.BackgroundIn this article, we address questions regarding how people consider what they do or do not consent to and the reasons why. This article presents the findings of a citizen forum study conducted by the University of Geneva in partnership with the Geneva University Hospitals to explore the opinions and concerns of members of the public regarding predictive oncology, genetic sequencing, and cancer. MethodsThis paper presents the results of a citizen forum that included 73 participants. A r…Read more
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58Fleshing Out VulnerabilityBioethics 29 (2): 98-107. 2013.In the literature on medical ethics, it is generally admitted that vulnerable persons or groups deserve special attention, care or protection. One can define vulnerable persons as those having a greater likelihood of being wronged – that is, of being denied adequate satisfaction of certain legitimate claims. The conjunction of these two points entails what we call the Special Protection Thesis. It asserts that persons with a greater likelihood of being denied adequate satisfaction of their legit…Read more
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21Continued Confinement of Those Most Vulnerable to COVID-19Kennedy Institute of Ethics Journal 30 (3): 401-418. 2020.Continued confinement of those most vulnerable to COVID-19—e.g., the elderly, those with chronic diseases and other risk factors—is presented as an uncontroversial measure when planning exit strategies from lockdown measures. Policies for deconfinement assume that these persons will remain confined even when others will not. This, however, could last quite a long time, and for some this could mean that they will remain in confinement for the rest of their lives.In a policy brief on ethical, lega…Read more
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27Inequalities in Health: Concepts, Measures, and Ethics (edited book)Oxford University Press. 2013.Which inequalities in longevity and health among individuals, groups, and nations are unfair? And what priority should health policy attach to narrowing them? These essays by philosophers, economists, epidemiologists, and physicians attempt to determine how health inequalities should be conceptualized, measured, ranked, and evaluated.
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105Including patients in resuscitation decisions in Switzerland: from doing more to doing betterJournal of Medical Ethics 39 (3): 158-165. 2013.Background Decisions regarding Cardio-Pulmonary Resuscitation (CPR) and Do Not Attempt Resuscitation (DNAR) orders remain demanding, as does including patients in the process. Objectives To explore physicians’ justification for CPR/DNAR orders and decisions regarding patient inclusion, as well as their reports of how they initiated discussions with patients. Methods We administered a face-to-face survey to residents in charge of 206 patients including DNAR and CPR orders, with or without patient…Read more
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113Measuring the Global Burden of Disease: Philosophical Dimensions (edited book)Oup Usa. 2020.The Global Burden of Disease Study is one of the largest-scale research collaborations in global health, producing critical data for researchers, policy-makers, and health workers about more than 350 diseases, injuries, and risk factors. Such an undertaking is, of course, extremely complex from an empirical perspective. But it also raises complex ethical and philosophical questions. In this volume, a group of leading philosophers, economists, epidemiologists, and policy scholars identify and dis…Read more
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18Vulnerability identified in clinical practice: a qualitative analysisBMC Medical Ethics 20 (1): 1-10. 2019.Background Although it is the moral duty of physicians to protect vulnerable patients, there are no data on how vulnerability is perceived in clinical practice. This study explores how physicians classify someone as “vulnerable”. Method Thirty-three physicians were initially questioned about resource allocation problems in their work. The results of these interviews were examined with qualitative study software to identify characteristics associated with vulnerability in patients. Data were conc…Read more
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701Background Implicit biases are present in the general population and among professionals in various domains, where they can lead to discrimination. Many interventions are used to reduce implicit bias. However, uncertainties remain as to their effectiveness. Methods We conducted a systematic review by searching ERIC, PUBMED and PSYCHINFO for peer-reviewed studies conducted on adults between May 2005 and April 2015, testing interventions designed to reduce implicit bias, with results measured usin…Read more
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10A qualitative study on existential suffering and assisted suicide in SwitzerlandMost Recent Articles: Bmc Medical Ethics. forthcoming.In Switzerland, people can be granted access to assisted suicide on condition that the person whose wish is to die performs the fatal act, that he has his decisional capacity and that the assisting person...
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27A qualitative study on existential suffering and assisted suicide in SwitzerlandBMC Medical Ethics 20 (1): 34. 2019.In Switzerland, people can be granted access to assisted suicide on condition that the person whose wish is to die performs the fatal act, that he has his decisional capacity and that the assisting person’s conduct is not selfishly motivated. No restrictions relating to the ground of suffering are mentioned in the act. Existential suffering as a reason for wanting to die, however, gives raise to controversial issues. Moreover, existential suffering lacks definition and no consensus exists on how…Read more
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36Informed Consent and the Disclosure of Clinical Results to Research ParticipantsAmerican Journal of Bioethics 17 (7): 58-60. 2017.
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18Ethical Criteria for Human Trials of Stem-Cell-Derived Dopaminergic Neurons in Parkinson's DiseaseAmerican Journal of Bioethics Neuroscience 6 (1): 52-60. 2015.
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14Clinically Driven Safety BenchmarksAmerican Journal of Bioethics Neuroscience 3 (2): 22-23. 2012.
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25From Ritalin to Malignant Teaching—The Fuzzy Borders of NeuroenhancementAmerican Journal of Bioethics Neuroscience 1 (1): 31-33. 2010.