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23The “Reasonable Subject Standard” as an Alternative to the “Best Interest Standard”American Journal of Bioethics 18 (8): 66-67. 2018.
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28Disclosure and Consent to Medical Research ParticipationJournal of Moral Philosophy 12 (2): 195-219. 2015.Most regulations and guidelines require that potential research participants be told a great deal of information during the consent process. Many of these documents, and most of the scholars who consider the consent process, assume that all this information must be disclosed because it must all be understood. However, a wide range of studies surveying apparently competent participants in clinical trials around the world show that many do not understand key aspects of what they have been told. Th…Read more
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25Disease Prevalence and the Magnitude of Research BenefitsAmerican Journal of Bioethics 18 (4): 73-74. 2018.
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1091Understanding, Communication, and ConsentErgo: An Open Access Journal of Philosophy 5 45-68. 2018.Misconceived Consent: Miguel has stage IV lung cancer. He has nearly exhausted his treatment options when his oncologist, Dr. Llewellyn, tells him about an experimental vaccine trial that may boost his immune response to kill cancer cells. Dr. Llewellyn provides Miguel with a consent form that explains why the study is being conducted, what procedures he will undergo, what the various risks and benefits are, alternative sources of treatment, and so forth. She even sits down with him, carefully t…Read more
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565The Duty to Rescue and Randomized Controlled Trials Involving Serious DiseasesJournal of Moral Philosophy 15 (3): 298-323. 2018.During the recent Ebola epidemic, some commentators and stakeholders argued that it would be unethical to carry out a study that withheld a potential treatment from affected individuals with such a serious, untreatable disease. As a result, the initial trials of experimental treatments did not have control arms, despite important scientific reasons for their inclusion. In this paper, we consider whether the duty to rescue entails that it would be unethical to withhold an experimental treatment f…Read more
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32The Moral Foundations of ParenthoodOxford University Press. 2017.In this book, Joseph Millum explains how parental rights and responsibilities are acquired, what they consist in, and how parents should go about making decisions on behalf of their children. In doing so, he provides a set of frameworks to help solve pressing ethical dilemmas relating to parents and children.
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3938Lies, Control, and Consent: A Response to Dougherty and MansonEthics 128 (2): 446-461. 2018.Tom Dougherty argues that culpably deceiving another person into sex is seriously wrong no matter what the content about which she is deceived. We argue that his explanation of why deception invalidates consent has extremely implausible implications. Though we reject Dougherty’s explanation, we defend his verdict about deception and consent to sex. We argue that he goes awry by conflating the disclosure requirement for consent and the understanding requirement. When these are distinguished, we c…Read more
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27The limits of research institutions in setting research prioritiesJournal of Medical Ethics 43 (12): 810-811. 2017.In When Clinical Trials Compete: Prioritizing Study Recruitment, Gelinas et al tackle an important issue—study non-completion—and draw conclusions with which we largely agree. Most importantly, we accept that setting priorities among competing research studies is necessary and should be informed by ethical analysis. We disagree with the conclusion of Gelinas et al that this priority setting should take place at the level of the individual research institution. At a minimum, they should consider …Read more
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1462How to allocate scarce health resources without discriminating against people with disabilitiesEconomics and Philosophy 33 (2): 161-186. 2017.One widely used method for allocating health care resources involves the use of cost-effectiveness analysis (CEA) to rank treatments in terms of quality-adjusted life-years (QALYs) gained. CEA has been criticized for discriminating against people with disabilities by valuing their lives less than those of non-disabled people. Avoiding discrimination seems to lead to the ’QALY trap’: we cannot value saving lives equally and still value raising quality of life. This paper reviews existing response…Read more
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19Global Justice and Bioethics (edited book)Oxford University Press. 2012.This book presents a collection of original essays by leading thinkers in political theory, philosophy, and bioethics on key issues concerning global justice and bioethics. It is the first collection to comprehensively address these pressing theoretical and practical questions about international distributive justice, humans rights, health care and medical research.
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603Post‐Trial Access to Antiretrovirals: Who Owes What to Whom?Bioethics 25 (3): 145-154. 2011.ABSTRACT Many recent articles argue that participants who seroconvert during HIV prevention trials deserve treatment when they develop AIDS, and there is a general consensus that the participants in HIV/aids treatment trials should have continuing post‐trial access. As a result, the primary concern of many ethicists and activists has shifted from justifying an obligation to treat trial participants, to working out mechanisms through which treatment could be provided. In this paper I argue that t…Read more
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764Informed consent to HIV cure researchJournal of Medical Ethics 43 (2): 108-113. 2017.Trials with highly unfavourable risk–benefit ratios for participants, like HIV cure trials, raise questions about the quality of the consent of research participants. Why, it may be asked, would a person with HIV who is doing well on antiretroviral therapy be willing to jeopardise his health by enrolling in such a trial? We distinguish three concerns: first, how information is communicated to potential participants; second, participants’ motivations for enrolling in potentially high risk researc…Read more
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883The tortured patient: a medical dilemmaHastings Center Report 41 (3): 38-47. 2011.Torture is unethical and usually counterproductive. It is prohibited by international and national laws. Yet it persists: according to Amnesty International, torture is widespread in more than a third of countries. Physicians and other medical professionals are frequently asked to assist with torture. Medical complicity in torture, like other forms of involvement, is prohibited both by international law and by codes of professional ethics. However, when the victims of torture are also patients i…Read more
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523The Ethics of Placebo-controlled Trials: Methodological JustificationsContemporary Clinical Trials 36 (2): 510-14. 2013.The use of placebo controls in clinical trials remains controversial. Ethical analysis and international ethical guidance permit the use of placebo controls in randomized trials when scientifically indicated in four cases: (1) when there is no proven effective treatment for the condition under study; (2) when withholding treatment poses negligible risks to participants; (3) when there are compelling methodological reasons for using placebo, and withholding treatment does not pose a risk of serio…Read more
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694The Foundation of the Child's Right to an Open FutureJournal of Social Philosophy 45 (4): 522-538. 2014.It is common to cite the child’s “right to an open future” in discussions of how parents and the state may and should treat children. However, the right to an open future can only be useful in these discussions if we have some method for deriving the content of the right. In the paper in which he introduces the right to an open future Joel Feinberg seems to provide such a method: he derives the right from the content of adult autonomy rights. In this paper I argue that his argument fails. If it …Read more
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616Introduction: International Research Ethics EducationJournal of Empirical Research on Human Research Ethics: An International Journal 9 (2): 1-2. 2014.NIH's fogarty international Center has provided grants for the development of training programs in international research ethics for low- and middle-income (LMIC) professionals since 2000. Drawing on 12 years of research ethics training experience, a group of Fogarty grantees, trainees, and other ethics experts sought to map the current capacity and need for research ethics in LMICs, analyze the lessons learned about teaching bioethics, and chart a way forward for research ethics training in a r…Read more
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381Comparing the Understanding of Subjects receiving a Candidate Malaria Vaccine in the United States and MaliAmerican Journal of Tropical Medicine and Hygiene 83 (4): 868-72. 2010.Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participant…Read more
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840How do we acquire parental responsibilities?Social Theory and Practice 34 (1): 71-93. 2008.It is commonly believed that parents have special duties toward their children—weightier duties than they owe other children. How these duties are acquired, however, is not well understood. This is problematic when claims about parental responsibilities are challenged; for example, when people deny that they are morally responsible for their biological offspring. In this paper I present a theory of the origins of parental responsibilities that can resolve such cases of disputed moral parenthood.
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629Manipulation in the Enrollment of Research ParticipantsHastings Center Report 43 (2): 38-47. 2013.In this paper we analyze the non-coercive ways in which researchers can use knowledge about the decision-making tendencies of potential participants in order to motivate them to consent to research enrollment. We identify which modes of influence preserve respect for participants’ autonomy and which disrespect autonomy, and apply the umbrella term of manipulation to the latter. We then apply our analysis to a series of cases adapted from the experiences of clinical researchers in order to develo…Read more
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9Disclosure and Consent to Medical Research ParticipationJournal of Moral Philosophy 11 (4). 2014.Most regulations and guidelines require that potential research participants be told a great deal of information during the consent process. Many of these documents, and most of the scholars who consider the consent process, assume that all this information must be disclosed because it must all be understood. However, a wide range of studies surveying apparently competent participants in clinical trials around the world show that many do not understand key aspects of what they have been told. Th…Read more
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361Streamlining Ethical ReviewAnnals of Internal Medicine 153 (10): 655-72. 2010.The U.S. review system for human subjects research has been widely criticized in recent years for requirements that delay research without improving human subjects protections. Any major reformulation of regulations may take some time to implement. In the meantime, current regulations often allow for streamlined ethics review without jeopardizing—and possibly improving—protections for research participants. We discuss underutilized options, including research that need not be classified as “hum…Read more
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18Norvin Richards , The Ethics of Parenthood . Reviewed byPhilosophy in Review 32 (2): 130-132. 2012.
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2057Global Bioethics and Political TheoryIn J. Millum & E. J. Millum (eds.), Global Justice and bioethics, Oxford University Press. pp. 17-42. 2012.Most bioethicists who address questions to which global justice matters have not considered the significance of the disputes over the correct theory of global justice. Consequently, the significance of the differences between theories of global justice for bioethics has been obscured. In this paper, I consider when and how these differences are important. I argue that certain bioethical problems can be resolved without addressing disagreements about global justice. People with very different vie…Read more
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338Are pharmaceutical patents protected by human rights?Journal of Medical Ethics 34 (11). 2008.The International Bill of Rights enshrines a right to health, which includes a right to access essential medicines. This right frequently appears to conflict with the intellectual property regime that governs pharmaceutical patents. However, there is also a human right that protects creative works, including scientific productions. Does this right support intellectual property protections, even when they may negatively affect health? This article examines the recent attempt by the Committee on E…Read more
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William F. Harms, Information and Meaning in Evolutionary ProcessesPhilosophy in Review 26 (3): 185. 2006.
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647International Research Ethics EducationJournal of the American Medical Association 313 (5): 461-62. 2015.This paper assesses the state of research ethics in low- and middle-income countries and the achievements of the Fogarty International Center's bioethics training program since 2000. The vision of FIC for the next decade of research ethics education is encapsulated in four proposed goals: (1) Ensure sufficient expertise in ethics review by having someone with long-term training on every high-workload REC; (2) Develop LMIC capacity to conduct original research on critical ethical issues by suppor…Read more
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532How Do We Acquire Parental Rights?Social Theory and Practice 36 (1): 112-132. 2010.In this paper I develop a theory of the acquisition of parental rights. According to this investment theory, parental rights are generated by the performance of parental work. Thus, those who successfully parent a child have the right to continue to do so, and to exclude others from so doing. The account derives from a more general principle of desert that applies outside the domain of parenthood. It also has some interesting implications for the attribution of moral parenthood. In particular, i…Read more
Areas of Specialization
Applied Ethics |
Normative Ethics |
Social and Political Philosophy |
Biomedical Ethics |
Political Ethics |