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1Unduly iterative ethical review?Kennedy Institute of Ethics Journal 6 (2): 209-209. 1996.In lieu of an abstract, here is a brief excerpt of the content:“Unduly Iterative Ethical Review?”Franklin G. MillerMadam:Renée C. Fox and Nicholas A. Christakis have written a provocative article, “Perish and Publish: Non-Heart-Beating Organ Donation and Unduly Iterative Ethical Review” (KIEJ, December 1995). The language of their argument and some of the implicit assumptions on which it rests deserve critical scrutiny. They describe the articles presenting and commenting on the University of Pi…Read more
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70Death and legal fictionsJournal of Medical Ethics 37 (12): 719-722. 2011.Advances in life-saving technologies in the past few decades have challenged our traditional understandings of death. Traditionally, death was understood to occur when a person stops breathing, their heart stops beating and they are cold to the touch. Today, physicians determine death by relying on a diagnosis of ‘total brain failure’ or by waiting a short while after circulation stops. Evidence has emerged, however, that the conceptual bases for these approaches to determining death are fundame…Read more
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65Assessing research risks systematically: the net risks testJournal of Medical Ethics 33 (8): 481-486. 2007.Dual-track assessment directs research ethics committees to assess the risks of research interventions based on the unclear distinction between therapeutic and non-therapeutic interventions. The net risks test, in contrast, relies on the clinically familiar method of assessing the risks and benefits of interventions in comparison to the available alternatives and also focuses attention of the RECs on the central challenge of protecting research participants.Research guidelines around the world r…Read more
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58Decapitation and the definition of deathJournal of Medical Ethics 36 (10): 632-634. 2010.Although established in the law and current practice, the determination of death according to neurological criteria continues to be controversial. Some scholars have advocated return to the traditional circulatory and respiratory criteria for determining death because individuals diagnosed as ‘brain dead’ display an extensive range of integrated biological functioning with the aid of mechanical ventilation. Others have attempted to refute this stance by appealing to the analogy between decapitat…Read more
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42Duty to disclose what? Querying the putative obligation to return research results to participantsJournal of Medical Ethics 34 (3): 210-213. 2008.Many research ethics guidelines now oblige researchers to offer research participants the results of research in which they participated. This practice is intended to uphold respect for persons and ensure that participants are not treated as mere means to an end. Yet some scholars have begun to question a generalised duty to disclose research results, highlighting the potential harms arising from disclosure and questioning the ethical justification for a duty to disclose, especially with respect…Read more
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86The Dead Donor Rule: Can It Withstand Critical Scrutiny?Journal of Medicine and Philosophy 35 (3): 299-312. 2010.Transplantation of vital organs has been premised ethically and legally on "the dead donor rule" (DDR)—the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as "brain dead" and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for th…Read more
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30Clarifying the Nocebo Effect and Its Ethical ImplicationsAmerican Journal of Bioethics 12 (3): 30-31. 2012.The American Journal of Bioethics, Volume 12, Issue 3, Page 30-31, March 2012.
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7Striking the Right Balance in Research Ethics and RegulationAmerican Journal of Bioethics 10 (8): 65-65. 2010.This Article does not have an abstract
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46Principles of early stopping of randomized trials for efficacy: A critique of equipoise and an alternative nonexploitation ethical frameworkKennedy Institute of Ethics Journal 15 (2): 161-178. 2005.: Recent controversial decisions to terminate several large clinical trials have called attention to the need for developing a sound ethical framework to determine when trials should be stopped in light of emerging efficacy data. Currently, the fundamental rationale for stopping trials early is based on the principle that equipoise has been disturbed. We present an analysis of the ethical and practical problems with the "equipoise disturbed" position and describe an alternative ethical framework…Read more
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5Recruiting Research ParticipantsIn Ezekiel J. Emanuel (ed.), The Oxford textbook of clinical research ethics, Oxford University Press. pp. 397. 2008.
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37Placebo Effects and the Ethics of Therapeutic Communication: A Pragmatic PerspectiveKennedy Institute of Ethics Journal 26 (1): 79-103. 2016.Doctor–patient communication is a crucial component in any therapeutic encounter. Physicians use words to formulate diagnoses and prognoses, to disclose the risks and benefits of medical interventions, and to explain why, how, and when a therapy will be administered to a patient. Likewise, patients communicate to describe their symptoms, to make sense of their conditions, to report side effects, to explore other therapeutic options, and to share their feelings. Throughout the history of medicine…Read more
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182Misconceptions about coercion and undue influence: Reflections on the views of irb membersBioethics 27 (9): 500-507. 2012.Payment to recruit research subjects is a common practice but raises ethical concerns relating to the potential for coercion or undue influence. We conducted the first national study of IRB members and human subjects protection professionals to explore attitudes as to whether and why payment of research participants constitutes coercion or undue influence. Upon critical evaluation of the cogency of ethical concerns regarding payment, as reflected in our survey results, we found expansive or inco…Read more
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50Professional Integrity and Physician‐Assisted DeathHastings Center Report 25 (3): 8-17. 1995.The practice of voluntary physician‐assisted death as a last resort is compatible with doctors' duties to practice competently, to avoid harming patients unduly, to refrain from medical fraud, and to preserve patients' trust. It therefore does not violate physicians' professional integrity.
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81The internal morality of medicine: An introductionJournal of Medicine and Philosophy 26 (6). 2001.This Article does not have an abstract
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73When and Why Is Research without Consent Permissible?Hastings Center Report 46 (2): 35-43. 2016.The view that research with competent adults requires valid consent to be ethical perhaps finds its clearest expression in the Nuremberg Code, whose famous first principle asserts that “the voluntary consent of the human subject is absolutely essential.” In a similar vein, the United Nations International Covenant on Civil and Political Rights states that “no one shall be subjected without his free consent to medical or scientific experimentation.” Yet although some formulations of the consent p…Read more
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6Editors' IntroductionPerspectives in Biology and Medicine 59 (1): 1-1. 2016.On June 16, 1966, the New England Journal of Medicine published “Ethics and Clinical Research” by Henry K. Beecher. Beecher’s account of 22 examples of unethical contemporary clinical research shook up the medical profession and helped pave the way for U.S. federal regulation of research involving human subjects. Five decades later, in this issue of Perspectives in Biology and Medicine, we pay tribute to the lasting significance of this whistle-blowing article and to the remarkable contributions…Read more
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44Treatment-resistant depression and physician-assisted deathJournal of Medical Ethics 41 (11): 885-886. 2015.
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41Symposium on equipoise and the ethics of clinical trialsJournal of Medicine and Philosophy 32 (2). 2007.This Article does not have an abstract
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47The internal morality of medicine: Explication and application to managed careJournal of Medicine and Philosophy 23 (4). 1998.Some ethical issues facing contemporary medicine cannot be fully understood without addressing medicine's internal morality. Medicine as a profession is characterized by certain moral goals and morally acceptable means for achieving those goals. The list of appropriate goals and means allows some medical actions to be classified as clear violations of the internal morality, and others as borderline or controversial cases. Replies are available for common objections, including the superfluity of …Read more
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32An apology for socratic bioethicsAmerican Journal of Bioethics 8 (7). 2008.Bioethics is a hybrid discipline. As a theoretical enterprise it stands for untrammeled inquiry and argument. Yet it aims to influence medical practice and policy. In this article we explore tensions between these two dimensions of bioethics and examine the merits and perils of a “Socratic” approach to bioethics that challenges “the conventional wisdom.”.
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163Research Ethics and Misguided Moral IntuitionJournal of Law, Medicine and Ethics 32 (1): 111-116. 2004.The term therapeutic misconception was coined by Paul Appelbaum and his colleagues to describe the tendency of patients enrolled in clinical trials to confuse research participation with the personal clinical attention characteristic of medical care. It has not been recognized that an analogous therapeutic misconception pervades ethical thinking about clinical research with patient-subjects. Investigators and bioethicists often judge the ethics of clinical research based on ethical standards app…Read more
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62Nudging, Autonomy, and Valid Consent: Context MattersAmerican Journal of Bioethics 13 (6): 12-13. 2013.No abstract
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36The Ethics of Continued Life‐Sustaining Treatment for those Diagnosed as Brain‐deadBioethics 30 (3): 151-158. 2015.Given the long-standing controversy about whether the brain-dead should be considered alive in an irreversible coma or dead despite displaying apparent signs of life, the ethical and policy issues posed when family members insist on continued treatment are not as simple as commentators have claimed. In this article, we consider the kind of policy that should be adopted to manage a family's insistence that their brain-dead loved one continues to receive supportive care. We argue that while it wou…Read more
Areas of Interest
Applied Ethics |