-
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
-
69Death 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
-
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
-
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
-
43Duty 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
-
85The 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
-
115Clinical equipoise and the incoherence of research ethicsJournal of Medicine and Philosophy 32 (2). 2007.The doctrine of clinical equipoise is appealing because it appears to permit physicians to maintain their therapeutic obligation to offer optimal medical care to patients while conducting randomized controlled trials (RCTs). The appearance, however, is deceptive. In this article we argue that clinical equipoise is defective and incoherent in multiple ways. First, it conflates the sound methodological principle that RCTs should begin with an honest null hypothesis with the questionable ethical no…Read more
-
85The clinician-investigator: Unavoidable but manageable tensionKennedy Institute of Ethics Journal 13 (4): 329-346. 2003.: The "difference position" holds that clinical research and therapeutic medical practice are sufficiently distinct activities to require different ethical rules and principles. The "similarity position" holds instead that clinical investigators ought to be bound by the same fundamental principles that govern therapeutic medicine—specifically, a duty to provide the optimal therapeutic benefit to each patient or subject. Some defenders of the similarity position defend it because of the overlap b…Read more
-
56Paul Litton and Franklin G. Miller Reply to Madeline M. MottaJournal of Law, Medicine and Ethics 33 (4): 635-635. 2005.
-
155Moral fictions and medical ethicsBioethics 24 (9): 453-460. 2009.Conventional medical ethics and the law draw a bright line distinguishing the permitted practice of withdrawing life-sustaining treatment from the forbidden practice of active euthanasia by means of a lethal injection. When clinicians justifiably withdraw life-sustaining treatment, they allow patients to die but do not cause, intend, or have moral responsibility for, the patient's death. In contrast, physicians unjustifiably kill patients whenever they intentionally administer a lethal dose of m…Read more
-
19Forgoing Debriefing in Deceptive Research: Is It Ever Ethical?Ethics and Behavior 23 (2): 98-116. 2013.The use of deception in research is generally permitted so long as participants are debriefed at the conclusion of their participation. Several authoritative research ethics guidelines allow investigators to omit debriefing under certain circumstances, however. Here we examine various justifications for forgoing debriefing in deceptive research, including concerns about subject pool contamination, the risk that revealing the deception will be harmful or distressing to participants, and issues of…Read more
-
13Letters: "Unduly 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
-
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.
-
7Striking the Right Balance in Research Ethics and RegulationAmerican Journal of Bioethics 10 (8): 65-65. 2010.This Article does not have an abstract
-
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
-
5Recruiting Research ParticipantsIn Ezekiel J. Emanuel (ed.), The Oxford textbook of clinical research ethics, Oxford University Press. pp. 397. 2008.
-
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
-
180Misconceptions 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
-
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.
-
81The internal morality of medicine: An introductionJournal of Medicine and Philosophy 26 (6). 2001.This Article does not have an abstract
-
72When 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
Areas of Interest
Applied Ethics |