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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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44Principles 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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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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5Recruiting Research ParticipantsIn Ezekiel J. Emanuel (ed.), The Oxford textbook of clinical research ethics, Oxford University Press. pp. 397. 2008.
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34Placebo 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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47Professional 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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174Misconceptions 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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65When 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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42Treatment-resistant depression and physician-assisted deathJournal of Medical Ethics 41 (11): 885-886. 2015.
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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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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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44The 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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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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30An 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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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
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83The 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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13The 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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34Money 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
Areas of Interest
Applied Ethics |