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271Clarifying how to deploy the public interest criterion in consent waivers for health data and tissue researchBMC Medical Ethics 21 (1): 1-10. 2020.Background Several jurisdictions, including Singapore, Australia, New Zealand and most recently Ireland, have a public interest or public good criterion for granting waivers of consent in biomedical research using secondary health data or tissue. However, the concept of the public interest is not well defined in this context, which creates difficulties for institutions, institutional review boards and regulators trying to implement the criterion. Main text This paper clarifies how the public int…Read more
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258Context is Needed When Assessing Fair Subject SelectionAmerican Journal of Bioethics 20 (2): 20-22. 2020.Volume 20, Issue 2, February 2020, Page 20-22.
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573An Ethics Framework for Big Data in Health and ResearchAsian Bioethics Review 11 (3): 227-254. 2019.Ethical decision-making frameworks assist in identifying the issues at stake in a particular setting and thinking through, in a methodical manner, the ethical issues that require consideration as well as the values that need to be considered and promoted. Decisions made about the use, sharing, and re-use of big data are complex and laden with values. This paper sets out an Ethics Framework for Big Data in Health and Research developed by a working group convened by the Science, Health and Policy…Read more
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303Precision Medicine and Big Data: The Application of an Ethics Framework for Big Data in Health and ResearchAsian Bioethics Review 11 (3): 275-288. 2019.As opposed to a ‘one size fits all’ approach, precision medicine uses relevant biological, medical, behavioural and environmental information about a person to further personalize their healthcare. This could mean better prediction of someone’s disease risk and more effective diagnosis and treatment if they have a condition. Big data allows for far more precision and tailoring than was ever before possible by linking together diverse datasets to reveal hitherto-unknown correlations and causal pa…Read more
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305What is the sufficientarian precautionary principle?Bioethics 33 (9): 1083-1084. 2019.In their recent article, Koplin, Gyngell and Savulescu (2019) assess the viability of the precautionary principle as a decision-making tool to determine whether and under what circumstances germline gene editing should proceed. While their survey of different forms of the precautionary principle is illuminating, the most novel contribution is a new account of the precautionary principle, what they dub the Sufficientarian Precautionary Principle (SPP). SPP is meant to avoid several problems with…Read more
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404Toward Realism About Genetic EnhancementAmerican Journal of Bioethics 19 (7): 28-30. 2019.Volume 19, Issue 7, July 2019, Page 28-30.
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400The need for donor consent in mitochondrial replacementJournal of Medical Ethics 44 (12): 825-829. 2018.Mitochondrial replacement therapy requires oocytes of women whose mitochondrial DNA will be transmitted to resultant children. These techniques are scientifically, ethically and socially controversial; it is likely that some women who donate their oocytes for general in vitro fertilisation usage would nevertheless oppose their genetic material being used in MRT. The possibility of oocytes being used in MRT is therefore relevant to oocyte donation and should be included in the consent process whe…Read more
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38Making Mistakes About One's “True” SelfAmerican Journal of Bioethics Neuroscience 1 (3): 8-9. 2010.
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31What Is the Goal of Moral Engineering?American Journal of Bioethics Neuroscience 2 (4): 10-11. 2011.
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450Presenters or Patients? A Crucial Distinction in Individual Health AssessmentsAsian Bioethics Review 10 (1): 67-73. 2018.Individual health assessments (IHAs) for asymptomatic individuals provide a challenge to traditional distinctions between patient care and non-medical practice. They may involve undue radiation exposure, lead to false positives, and involve high out-of-pocket costs for recipients. A recent paper (Journal of the American College of Radiology 13(12): 1447–1457.e1, 2016) has criticised the use of IHAs and argued that recipients should be classified as ‘presenters’, not ‘patients’, to distinguish it…Read more
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664Autonomy and EnhancementNeuroethics 7 (2): 123-136. 2013.Some have objected to human enhancement on the grounds that it violates the autonomy of the enhanced. These objections, however, overlook the interesting possibility that autonomy itself could be enhanced. How, exactly, to enhance autonomy is a difficult problem due to the numerous and diverse accounts of autonomy in the literature. Existing accounts of autonomy enhancement rely on narrow and controversial conceptions of autonomy. However, we identify one feature of autonomy common to many mains…Read more
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568The Ethics of Producing In Vitro MeatJournal of Applied Philosophy 31 (2): 188-202. 2014.The prospect of consumable meat produced in a laboratory setting without the need to raise and slaughter animals is both realistic and exciting. Not only could such in vitro meat become popular due to potential cost savings, but it also avoids many of the ethical and environmental problems with traditional meat productions. However, as with any new technology, in vitro meat is likely to face some detractors. We examine in detail three potential objections: 1) in vitro meat is disrespectful, eith…Read more
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566Double trouble: Should double embryo transfer be banned?Theoretical Medicine and Bioethics 36 (2): 121-139. 2015.What role should legislation or policy play in avoiding the complications of in-vitro fertilization? In this article, we focus on single versus double embryo transfer, and assess three arguments in favour of mandatory single embryo transfer: risks to the mother, risks to resultant children, and costs to society. We highlight significant ethical concerns about each of these. Reproductive autonomy and non-paternalism are strong enough to outweigh the health concerns for the woman. Complications du…Read more
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412Procedural Moral EnhancementNeuroethics 12 (1): 73-84. 2016.While philosophers are often concerned with the conditions for moral knowledge or justification, in practice something arguably less demanding is just as, if not more, important – reliably making correct moral judgments. Judges and juries should hand down fair sentences, government officials should decide on just laws, members of ethics committees should make sound recommendations, and so on. We want such agents, more often than not and as often as possible, to make the right decisions. The purp…Read more
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51The Right to Know: A Revised Standard for Reporting Incidental FindingsHastings Center Report 48 (2): 22-32. 2018.The “best-medical-interests” standard for reporting findings does not go far enough. Research subjects have a right to know about any comprehensible piece of information about them that is generated by research in which they are participating. An even broader standard may sometimes be appropriate: if subjects agree to accept information that they may not understand, then all information may be disclosed.
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415The Obligation to Participate in Biomedical ResearchJournal of the American Medical Association 302 (1): 67-72. 2009.The current prevailing view is that participation in biomedical research is above and beyond the call of duty. While some commentators have offered reasons against this, we propose a novel public goods argument for an obligation to participate in biomedical research. Biomedical knowledge is a public good, available to any individual even if that individual does not contribute to it. Participation in research is a critical way to support an important public good. Consequently, all have a duty to …Read more
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171The importance of rationalityHastings Center Report 43 (1): 3. 2013.Michael Hauskeller (“Reflections from a Troubled Stream: Giubliani and Minerva on ‘After-Birth Abortion’) has recently suggested that we should resist rationalist tendencies in moral discourse: “[I]s not all morality ultimately irrational? Even the most strongly held moral convictions can be shown to lack a rational basis.” (Hauskeller 2012, p. 18) Hauskeller was responding to Alberto Giubliani and Francesca Minverva’s (2012) recent defense of the permissibility of killing infants, but his ant…Read more
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369Code-consistent ethics review: defence of a hybrid accountJournal of Medical Ethics 44 (7): 494-495. 2018.It is generally unquestioned that human subjects research review boards should assess the ethical acceptability of protocols. It says so right on the tin, after all: they are explicitly called research ethics committees in the UK. But it is precisely those sorts of unchallenged assumptions that should, from time to time, be assessed and critiqued, in case they are in fact unfounded. John Stuart Mill's objection to suppressers of dissent is instructive here: “If the opinion is right, they are dep…Read more
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313Genetic Affinity and the Right to ‘Three-parent IVF’Journal of Assisted Reproduction and Genetics 34 (12): 1577-1580. 2017.With the recent report of a live birth after use of Mitochondrial replacement therapy, sometimes called ‘Three-parent IVF’, the clinical application of the technique is fast becoming a reality. While the United Kingdom allows the procedure under regulatory scrutiny, it remains effectively outlawed in many other countries. We argue that such prohibitions may violate individuals’ procreative rights, grounded in individuals’ interest in genetic affinity. The interest in genetic affinity was recen…Read more
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812Consent and the ethical duty to participate in health data researchJournal of Medical Ethics 44 (6): 392-396. 2018.The predominant view is that a study using health data is observational research and should require individual consent unless it can be shown that gaining consent is impractical. But recent arguments have been made that citizens have an ethical obligation to share their health information for research purposes. In our view, this obligation is sufficient ground to expand the circumstances where secondary use research with identifiable health information is permitted without explicit subject conse…Read more
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71Why Adopt a Maximin Theory of Exploitation?American Journal of Bioethics 10 (6): 38-39. 2010.Angela Ballantyne (2010) argues that international research is exploitative when the transactions between researchers and participants who lack basic goods do not provide participants with the maxi...
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45Reevaluating the Right to Withdraw From Research Without PenaltyAmerican Journal of Bioethics 11 (4): 14-16. 2011.In “Assessing the Remedy: The Case for Contracts in Clinical Trials,” Sarah Edwards (2011) proposes that research participants acquire contractual obligations to investigators, thus opening the doo...
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5942The Right to Withdraw from ResearchKennedy Institute of Ethics Journal 20 (4): 329-352. 2010.The right to withdraw from participation in research is recognized in virtually all national and international guidelines for research on human subjects. It is therefore surprising that there has been little justification for that right in the literature. We argue that the right to withdraw should protect research participants from information imbalance, inability to hedge, inherent uncertainty, and untoward bodily invasion, and it serves to bolster public trust in the research enterprise. Altho…Read more
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1183Direct vs. Indirect Moral EnhancementKennedy Institute of Ethics Journal 25 (3): 261-289. 2015.Moral enhancement is an ostensibly laudable project. Who wouldn’t want people to become more moral? Still, the project’s approach is crucial. We can distinguish between two approaches for moral enhancement: direct and indirect. Direct moral enhancements aim at bringing about particular ideas, motives or behaviors. Indirect moral enhancements, by contrast, aim at making people more reliably produce the morally correct ideas, motives or behaviors without committing to the content of those ideas, m…Read more
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National University of SingaporeCentre for Biomedical Ethics, Yong Loo Lin School of MedicineAssistant Professor
Singapore, Singapore
Areas of Specialization
Applied Ethics |
Biomedical Ethics |
Ethics and Science |