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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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31An 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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165Research 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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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
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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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84The internal morality of medicine: An evolutionary perspectiveJournal of Medicine and Philosophy 26 (6). 2001.A basic question of medical ethics is whether the norms governing medical practice should be understood as the application of principles and rules of the common morality to medicine or whether some of these norms are internal or proper to medicine. In this article we describe and defend an evolutionary perspective on the internal morality of medicine that is defined in terms of the goals of clinical medicine and a set of duties that constrain medical practice in pursuit of these goals. This pers…Read more
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87The Good Death, Virtue, and Physician-Assisted Death: An Examination of the Hospice Way of DeathCambridge Quarterly of Healthcare Ethics 4 (1): 92. 1995.The problem of physician-assisted death, assisted suicide and active euthanasia, has been debated predominantly in the ethically familiar vocabulary of rights, duties, and consequences. Patient autonomy and the right to die with dignity vie with the duty of physicians to heal, but not to kill, and the specter of “the slippery slope” from voluntary euthanasia as a last resort for patients suffering from terminal illness to PAD on demand and mercy killing of “hopeless” incompetent patients. Anothe…Read more
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118Facing up to paternalism in research ethicsHastings Center Report 37 (3): 24-34. 2007.: Bioethicists have failed to understand the pervasively paternalistic character of research ethics. Not only is the overall structure of research review and regulation paternalistic in some sense; even the way informed consent is sought may imply paternalism. Paternalism has limits, however. Getting clear on the paternalism of research ethics may mean some kinds of prohibited research should be reassessed
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37Money and Distorted Ethical Judgments about Research: Ethical Assessment of the TeGenero TGN1412 Trial (review)American Journal of Bioethics 7 (2): 76-81. 2007.The recent TeGenero phase I trial of a novel monoclonal antibody in healthy volunteers produced a drastic inflammatory reaction in participants receiving the experimental agent. Commentators on the ethics of the research have focused considerable attention on the role of financial considerations: the for-profit status of the biotechnology company and Contract Research Organization responsible respectively for sponsoring and conducting the trial and the amount of monetary compensation to particip…Read more
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18The case for a Code of Ethics for Bioethicists: Some Reasons for SkepticismAmerican Journal of Bioethics 5 (5): 50-52. 2005.1. The opinions expressed are those of the author and do not necessarily reflect the position or policy of the National Institutes of Health, the Public Health Service, or the Department of Health and Human Services
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34By Author BAGHERI, Alireza. Criticism of “BrainKennedy Institute of Ethics Journal 13 (4): 407-09. 2003.
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27A Response to Commentators on "Sham Surgery: An Ethical Analysis"American Journal of Bioethics 3 (4): 36-36. 2003.
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69Rethinking the Ethics of Vital Organ DonationsHastings Center Report 38 (6): 38-46. 2008.Accepted medical practice already violates the dead donor rule. Explicitly jettisoning the rule—allowing vital organs to be extracted, under certain conditions, from living patients—is a radical change only at the conceptual level. But it would expand the pools of eligible organ donors.
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16The ethics of peer review in bioethicsJournal of Medical Ethics 40 (10): 697-701. 2014.A good deal has been written on the ethics of peer review, especially in the scientific and medical literatures. In contrast, we are unaware of any articles on the ethics of peer review in bioethics. Recognising this gap, we evaluate the extant proposals regarding ethical standards for peer review in general and consider how they apply to bioethics. We argue that scholars have an obligation to perform peer review based on the extent to which they personally benefit from the peer review process. …Read more
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40A Normative Justification for Distinguishing the Ethics of Clinical Research from the Ethics of Medical CareJournal of Law, Medicine and Ethics 33 (Fall 2005): 566-74. 2005.In the research ethics literature, there is strong disagreement about the ethical acceptability of placebo-controlled trials, particularly when a tested therapy aims to alleviate a condition for which standard treatment exists. Recently, this disagreement has given rise to debate over the moral appropriateness of the principle of clinical equipoise for medical research. Underlying these debates are two fundamentally different visions of the moral obligations that investigators owe their subjects…Read more
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Psychiatric researchIn Sidney Bloch & Stephen A. Green (eds.), Psychiatric ethics, Oxford University Press. 1981.
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94What makes placebo-controlled trials unethical?American Journal of Bioethics 2 (2). 2002.The leading ethical position on placebo-controlled clinical trials is that whenever proven effective treatment exists for a given condition, it is unethical to test a new treatment for that condition against placebo. Invoking the principle of clinical equipoise, opponents of placebo-controlled trials in the face of proven effective treatment argue that they (1) violate the therapeutic obligation of physicians to offer optimal medical care and (2) lack both scientific and clinical merit. We conte…Read more
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78Bench to bedside: Mapping the moral terrain of clinical researchHastings Center Report 38 (2): 30-42. 2008.: Medical research is widely thought to have a fundamentally therapeutic orientation, in spite of the fact that clinical research is thought to be ethically distinct from medical care. We need an entirely new conception of clinical research ethics—one that looks to science instead of the doctor-patient relationship.
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37Incidental Findings in Human Subjects Research: What Do Investigators Owe Research Participants?Journal of Law, Medicine and Ethics 36 (2): 271-279. 2008.The use of brain imaging technology as a common tool of research has spawned concern and debate over how investigators should respond to incidental fndings discovered in the course of research. In this article, we argue that investigators have an obligation to respond to incidental fndings in view of their entering into a professional relationship with research participants in which they are granted privileged access to private information with potential relevance to participants' health. We dis…Read more
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190Cosmetic Surgery and the Internal Morality of MedicineCambridge Quarterly of Healthcare Ethics 9 (3): 353-364. 2000.Cosmetic surgery is a fast-growing medical practice. In 1997 surgeons in the United States performed the four most common cosmetic procedures443,728 times, an increase of 150% over the comparable total for 1992. Estimated total expenditures for cosmetic surgery range from $1 to $2 billion. As managed care cuts into physicians' income and autonomy, cosmetic surgery, which is not covered by health insurance, offers a financially attractive medical specialty
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34Enhancement technologies and professional integrityAmerican Journal of Bioethics 5 (3). 2005.*The opinions expressed are the views of the author and do not necessarily reflect the policy of the National Institutes of Health, the Public Health Service, or the U.S. Department of Health and Human Services
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49The ethics of placebo-controlled trialsIn Ezekiel J. Emanuel (ed.), The Oxford textbook of clinical research ethics, Oxford University Press. pp. 261. 2008.
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43Can Physician-Assisted Suicide Be Regulated Effectively?Journal of Law, Medicine and Ethics 24 (3): 225-232. 1996.With breathtalung speed, traditional criminal prohibitions against assisted suicide have been declared unconstitutional in twelve states, including California and New York. This poses great promise and great peril. The promise is that competent terminally ill patients, as a compassionate measure of last resort, will have the option of putting an end to their suffering by physician-assisted suicide. More sigmficant, legally permitting this controversial option may be a catalyst for doctors, healt…Read more
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17Sham Surgery: An Ethical AnalysisAmerican Journal of Bioethics 3 (4): 41-48. 2003.Surgical clinical trials have seldom used a "sham" or placebo surgical procedure as a control, owing to ethical concerns. Recently, several ethical commentators have argued that sham surgery is either inherently or presumptively unethical. In this article I contend that these arguments are mistaken and that there are no sound ethical reasons for an absolute prohibition of sham surgery in clinical trials. Reflecting on three cases of sham surgery, especially on the recently reported results of a …Read more
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61A Critique of Clinical Equipoise: Therapeutic Misconception in the Ethics of Clinical TrialsHastings Center Report 33 (3): 19-28. 2003.A predominant ethical view holds that physician‐investigators should conduct their research with therapeutic intent. And since a physician offering a therapy wouldn't prescribe second‐rate treatments, the experimental intervention and the best proven therapy should appear equally effective. "Clinical equipoise" is necessary. But this perspective is flawed. The ethics of research and of therapy are fundamentally different, and clinical equipoise should be abandoned.
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52Research on Medical Records Without Informed ConsentJournal of Law, Medicine and Ethics 36 (3): 560-566. 2008.Observational research involving access to personally identifiable data in medical records has often been conducted without informed consent, owing to practical barriers to soliciting consent and concerns about selection bias. Nevertheless, medical records research without informed consent appears to conflict with basic ethical norms relating to clinical research and personal privacy. This article analyzes the scope of these norms and provides an ethical justification for research using personal…Read more
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50Death, Dying, and Organ Donation: Reconstructing Medical Ethics at the End of LifeOxford University Press. 2011.This book challenges fundamental doctrines of established medical ethics. It is argued that the routine practice of stopping life support technology causes the death of patients and that donors of vital organs (hearts, liver, lungs, and both kidneys) are not really dead at the time that their organs are removed for life-saving transplantation. Although these practices are ethically legitimate, they are not compatible with traditional medical ethics: they conflict with the norms that doctors must…Read more
Areas of Interest
Applied Ethics |