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30Responses to Open Peer Commentaries on "Physicians' Silent Decisions: Because Patient Autonomy Doesn't Always Come First"American Journal of Bioethics 7 (7): 1-3. 2007.Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions—not all—are ethically justified by this standard. Justified s…Read more
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57Ethical dimensions of diagnosis: A case study and analysisTheoretical Medicine and Bioethics 2 (2): 129-143. 1987.A rational reconstruction of the role of moral values in diagnostic reasoning is undertaken. In the context of a case study it is shown how value and ethical considerations come into play in the complex course of making diagnostic and therapeutic decisions.
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33Physicians’ Professionally Responsible Power: A Core Concept of Clinical EthicsJournal of Medicine and Philosophy 41 (1): 1-9. 2016.The gathering of power unto themselves by physicians, a process supported by evidence-based practice, clinical guidelines, licensure, organizational culture, and other social factors, makes the ethics of power—the legitimation of physicians’ power—a core concept of clinical ethics. In the absence of legitimation, the physician’s power over patients becomes problematic, even predatory. As has occurred in previous issues of the Journal, the papers in the 2016 clinical ethics issue bear on the prof…Read more
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17Health Intuitions Inform Patient-Centered CareAmerican Journal of Bioethics 14 (6): 1-3. 2014.No abstract
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27A transcultural, preventive ethics approach to critical-care medicine: Restoring the critical care physician's power and authorityJournal of Medicine and Philosophy 23 (6). 1998.This article comments on the treatment of critical-care ethics in four preceding articles about critical-care medicine and its ethical challenges in mainland China, Hong Kong, Japan, and the Philippines. These articles show how cultural values can be in both synchrony and conflict in generating these ethical challenges and in the constraints that they place on the response of critical-care ethics to them. To prevent ethical conflict in critical care the author proposes a two-step approach to the…Read more
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74Philosophical challenges in teaching bioethics: The importance of professional medical ethics and its history for bioethicsJournal of Medicine and Philosophy 27 (4). 2002.The papers in this number of the Journal originated in a session sponsored by the American Philosophical Association's Committee on Philosophy and Medicine in 1999. The four papers and two commentaries identify and address philosophical challenges of how we should understand and teach bioethics in the liberal arts and health professions settings. In the course of introducing the six papers, this article explores themes these papers raise, especially the relationship among professional medical et…Read more
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31Trust, moral responsibility, the self, and well-ordered societies: The importance of basic philosophical concepts for clinical ethicsJournal of Medicine and Philosophy 27 (1). 2002.Although the work of clinical ethics is intensely practical, it employs and presumes philosophical concepts from the central branches of philosophy, including metaphysics, epistemology, ethics, and political philosophy. This essay introduces this issue in the Journal on clinical ethics by considering how the papers and book reviews included in it illuminate four such concepts: trust, moral responsibility, the self and well-ordered societies.
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28The Accidental BioethicistCambridge Quarterly of Healthcare Ethics 11 (4): 359-368. 2002.Albert Jonsen in The Birth of Bioethics notes that his career in bioethics began with a phone call to him from soon-to-be colleagues at the University of California at San Francisco Medical Center. Bioethics didn't begin with a bang but as an accident in the root sense—something that happened, not by necessity, but rather by chance. Indeed, the opening chapters of Jonsen's book chronicle a series of accidents that helped to create the field of bioethics. Principal among these was the fact that p…Read more
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25Medicine as a Profession: A Hypothetical Imperative in Clinical EthicsJournal of Medicine and Philosophy 40 (1): 1-7. 2015.
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20The abstract nature of anatomic construction and its advantages: Scientific medicine and human dignityAmerican Journal of Bioethics 7 (4). 2007.This Article does not have an abstract
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50Research to improve the health of pregnant and fetal patients presents ethical challenges to clinical investigators, institutional review boards, funding agencies, and data safety and monitoring boards. The Common Rule sets out requirements that such research must satisfy but no ethical framework to guide their application. We provide such an ethical framework, based on the ethical concept of the fetus as a patient. We offer criteria for innovation and for Phase I and II and then for Phase III c…Read more
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12Leibniz and Traditional PhilosophyStudia Leibnitiana 10 (2). 1978.In diesem Aufsatz zeige ich, wie Leibniz' spätere Philosophie auf seine frühen Arbeiten und auf die spätscholastische Philosophie, insbesondere den Nominalismus von Suarez, zurückgreift. Zunächst behaupte ich, daß Leibniz Suarez' Ontologie der Relationen ebenso wie seine Auffassung der Begriffe, des Besonderen und des Allgemeinen übernommen hat. Ich verwende die Ergebnisse dieser Untersuchung, um einige Hauptthemen der Leibnizschen Philosophie (die Theorie der Monaden und ihrer individuellen Beg…Read more
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24Prescribing viagra in an ethically responsible fashionJournal of Medicine and Philosophy 29 (6). 2004.Sildenafil citrate (Viagra) and other newly released pharmaceuticals that assist erectile dysfunction may be one of the most important categories of drugs released in the past decade. Sildenafil is distinctive because it creates a new therapeutic relationship not only between patient and physician, but also with sexual partner(s). Physicians must first evaluate the patient comprehensively, addressing not only erectile function and sexual performance, but overall physical and mental health. Since…Read more
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25Going against the grain: In praise of contrarian clinical ethicsJournal of Medicine and Philosophy 28 (1). 2003.Contrarian ways of thinking are generally good for the intellectual life and clinical ethics is no exception. This essay introduces the papers in the 2003 issue on clinical ethics of the Journal of Medicine and Philosophy , each of which goes against the grain in interesting and important ways. Considerations of identity predominate, in discussions of cloning, separation of conjoined twins, and the coming into existence of human beings. Whether viewing organ donation as admirable sacrifice is an…Read more
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59Patients with reduced agency: Conceptual, empirical, and ethical considerationsJournal of Medicine and Philosophy 9 (4): 329-332. 1984.
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70A Philosophical Taxonomy of Ethically Significant Moral Distress: Figure 1Journal of Medicine and Philosophy 40 (1): 102-120. 2015.Moral distress is one of the core topics of clinical ethics. Although there is a large and growing empirical literature on the psychological aspects of moral distress, scholars, and empirical investigators of moral distress have recently called for greater conceptual clarity. To meet this recognized need, we provide a philosophical taxonomy of the categories of what we call ethically significant moral distress: the judgment that one is not able, to differing degrees, to act on one’s moral knowle…Read more
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19Cosmetic Genetics and Virtue-Based Restraints on AutonomyAmerican Journal of Bioethics 10 (4): 71-72. 2010.
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4Power, Integrity, And Trust In The Managed Practice Of Medicine: Lessons From The History Of Medical EthicsSocial Philosophy and Policy 19 (2): 180-211. 2002.Bioethics as a field began some years before it was finally named in the early 1970s. In many ways, bioethics originated in response to urgent matters of the moment, including the controversy over disconnecting Karen Quinlan's respirator, the egregious paternalism of Donald Cowart's doctors in the famous “Dax” case, the abuse of research subjects in the notorious Tuskegee Syphilis Study, and the need to devise an intellectual framework for the development of federal regulations to protect human …Read more
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46Taking the history of medical ethics seriously in teaching medical professionalismAmerican Journal of Bioethics 4 (2). 2004.This Article does not have an abstract
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59A critical analysis of the concept and discourse of 'unborn child'American Journal of Bioethics 8 (7). 2008.Despite its prominence in the abortion debate and in public policy, the discourse of 'unborn patient' has not been subjected to critical scrutiny. We provide a critical analysis in three steps. First, we distinguish between the descriptive and normative meanings of 'unborn child.' There is a long history of the descriptive use of 'unborn child.' Second, we argue that the concept of an unborn child has normative content but that this content does not do the work that opponents of abortion want it…Read more
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9The ethical concept of medicine as a profession: its origins in modern medical ethics and implications for physiciansAdvances in Bioethics 10 17-27. 2006.
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13John Gregory's Writings on Medical Ethics and Philosophy of MedicineSpringer Verlag. 1998.This volume reprints in a scholar's edition the first English-language texts on bioethics, John Gregory's (1724-1773) Observations on the Duties and Offices of a Physician and on the Method of Prosecuting Enquiries in Philosophy (London, 1770) and Lectures on the Duties and Qualifications of a Physician (London, 1772). Five previously unpublished manuscripts of Gregory's lectures are also included. An introduction places Gregory's medical ethics and philosophy of medicine in their eighteenth-cen…Read more
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16Response to Commentaries on “A Critical Analysis of the Concept and Discourse of 'Unborn Child'”American Journal of Bioethics 8 (7): 4-6. 2008.Despite its prominence in the abortion debate and in public policy, the discourse of ‘unborn patient’ has not been subjected to critical scrutiny. We provide a critical analysis in three steps. First, we distinguish between the descriptive and normative meanings of ‘unborn child.’ There is a long history of the descriptive use of ‘unborn child.’ Second, we argue that the concept of an unborn child has normative content but that this content does not do the work that opponents of abortion want it…Read more
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30Justified Limits on Refusing InterventionHastings Center Report 21 (2): 12-18. 1991.Physicians may justifiably limit patients' refusals of medical interventions when the refusal is based on a negative right to noninterference coupled with a request for an unreasonable alternative.
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48Placing and Evaluating Unproven Interventions Within a Clinical Ethical Taxonomy of Treatments for Ebola Virus DiseaseAmerican Journal of Bioethics 15 (4): 50-53. 2015.
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42Philosophical Provocation: The Lifeblood of Clinical EthicsJournal of Medicine and Philosophy 42 (1): 1-6. 2017.The daily work of the clinical ethics teacher and clinical ethics consultant falls into the routine of classifying clinical cases by ethical type and proposing ethically justified alternatives for the professionally responsible management of a specific type of case. Settling too far into this routine creates the risk of philosophical inertia, which is not good either for the clinical ethicist or for the field of clinical ethics. The antidote to this philosophical inertia and resultant blinkered …Read more
Houston, Texas, United States of America
Areas of Specialization
Applied Ethics |
17th/18th Century Philosophy |
Areas of Interest
Applied Ethics |
17th/18th Century Philosophy |