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519How 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
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503When Should Genome Researchers Disclose Misattributed Pahentage?Hastings Center Report 45 (4): 28-36. 2015.Research studies increasingly use genomic sequencing to draw inferences based on comparisons between the genetic data of a set of purportedly related individuals. As use of this method progresses, it will become much more common to discover that the assumed biological relationships between the individuals are mistaken. Consequently, researchers will have to grapple with decisions about whether to return incidental findings of misattributed parentage on a much larger scale than ever before. In th…Read more
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495International Clinical Research and Justice in the Belmont ReportPerspectives in Biology and Medicine 63 (2): 374-388. 2020.The Belmont Report was written by a US Commission charged by the US Congress to advise on research supported by the US government. Its focus was understandably domestic. In the 40 years since its publication, clinical research has become increasingly international. Many clinical trials have sites in multiple countries, and many of the host countries are relatively impoverished. Such research raises some distinctive ethical issues. This paper outlines some of the key ethical challenges that have …Read more
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483Valuing StillbirthsBioethics 29 (6): 413-423. 2014.Estimates of the burden of disease assess the mortality and morbidity that affect a population by producing summary measures of health such as quality-adjusted life years and disability-adjusted life years. These measures typically do not include stillbirths among the negative health outcomes they count. Priority-setting decisions that rely on these measures are therefore likely to place little value on preventing the more than three million stillbirths that occur annually worldwide. In contrast…Read more
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455Transmitting Cholera to HaitiIn Drue H. Barrett, Gail Bolan, Angus Dawson, Leonard Ortmann, Andreas Reis & Carla Saenz (eds.), Public Health Ethics: Cases Spanning the Globe, Springer. pp. 270-74. 2016.
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448COVID-19 vaccine trial ethics once we have efficacious vaccinesScience 370 (6522): 1277-1279. 2020.Some placebo-controlled trials can continue ethically after a candidate vaccine is found to be safe and efficacious
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391A Third Way: Ethics Guidance as Evidence-Informed Provisional RulesAmerican Journal of Bioethics 10 (6): 20-22. 2010.
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386Sharing the benefits of research fairly: two approachesJournal of Medical Ethics 38 (4): 219-223. 2012.Research projects sponsored by rich countries or companies and carried out in developing countries are often described as exploitative. One important debate about the prevention of exploitation in research centres on whether and how clinical research in developing countries should be responsive to local health problems. This paper analyses the responsiveness debate and draws out more general lessons for how policy makers can prevent exploitation in various research contexts. There are two indepe…Read more
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381A Biological Alternative to Moral ExplanationsSouthern Journal of Philosophy 46 (3): 385-407. 2008.Some moral realists claim that moral facts are a species of natural fact, amenable to scientific investigation. They argue that these moral facts are needed in the best explanations of certain phenomena and that this is evidence that they are real. In this paper I present part of a biological account of the function of morality. The account allows the identification of a plausible natural kind that could play the explanatory role that a moral kind would play in naturalist realist theories. It is…Read more
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380Preventing Sin: The Ethics of Vaccines Against SmokingHastings Center Report 43 (3): 23-33. 2013.Advances in immunotherapy pave the way for vaccines that target not only infections, but also unhealthy behaviors such as smoking. A nicotine vaccine that eliminates the pleasure associated with smoking could potentially be used to prevent children from adopting this addictive and dangerous behavior. This paper offers an ethical analysis of such vaccines. We argue that it would be permissible for parents to give their child a nicotine vaccine if the following conditions are met: (1) the vaccine …Read more
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378Health Research Priority Setting: Do Grant Review Processes Reflect Ethical Principles?Global Public Health. forthcoming.Most public and non-profit organisations that fund health research provide the majority of their funding in the form of grants. The calls for grant applications are often untargeted, such that a wide variety of applications may compete for the same funding. The grant review process therefore plays a critical role in determining how limited research resources are allocated. Despite this, little attention has been paid to whether grant review criteria align with widely endorsed ethical criteria fo…Read more
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377Comparing 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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369The Ethics of Transactions in an Unjust WorldIn K. Zeiler & E. Malmqvist (eds.), Bioethics and Border Crossing: Perspectives on Giving, Selling and Sharing Bodies, Routledge: Oxon. pp. 185-196. 2016.In this paper I examine the ethics of benefit-sharing agreements between victims and beneficiaries of injustice in the context of trans-national bodily giving, selling, and sharing. Some obligations are the same no matter who the parties to a transaction are. Prohibitions on threats, fraud and harm apply universally and their application to transactions in unjust contexts is not disputed. I identify three sources of obligations that are affected by unjust background conditions. First, power disp…Read more
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359Streamlining 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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350How not to count the health benefits of family planningJournal of Medical Ethics 1 1-4. 2021.Several influential organisations have attempted to quantify the costs and benefits of expanding access to interventions-like contraceptives-that are expected to decrease the number of pregnancies. Such health economic evaluations can be invaluable to those making decisions about how to allocate scarce resources for health. Yet how the benefits should be measured depends on controversial value judgments. One such value judgment is found in recent analyses from the Disease Control Priority Networ…Read more
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340Response to Open Peer Commentaries on “Informed Consent: What Must Be Disclosed and What Must Be Understood?”American Journal of Bioethics 21 (7): 1-5. 2021.In “Informed Consent: What Must be Disclosed and What Must be Understood?”, we reject a dogma at the heart of research ethics. We demonstrate that the constitutive claim...
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334Setting priorities fairly in response to Covid-19: identifying overlapping consensus and reasonable disagreementJournal of Law and the Biosciences 1 (1). 2020.Proposals for allocating scarce lifesaving resources in the face of the Covid-19 pandemic have aligned in some ways and conflicted in others. This paper attempts a kind of priority setting in addressing these conflicts. In the first part, we identify points on which we do not believe that reasonable people should differ—even if they do. These are (i) the inadequacy of traditional clinical ethics to address priority-setting in a pandemic; (ii) the relevance of saving lives; (iii) the flaws of fir…Read more
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332Are 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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331The Global Forum for Bioethics in Research: Past present and futureSouth African Journal of Bioethics and Law 7 (1): 5. 2014.The Global Forum on Bioethics in Research (GFBR) served as a global platform for debate on ethical issues in international health research between 1999 and 2008, bringing together research ethics experts, researchers, policy makers and community members from developing and developed countries. In total, nine GFBR meetings were held on six continents. Work is currently underway to revive the GFBR. This paper describes the purpose and history of the GFBR and presents key elements for its reinstate…Read more
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319Introduction: Global Justice and BioethicsIn J. Millum & E. J. Emanuel (eds.), Global Justice and Bioethics, Oxford University Press. pp. 1-14. 2012.This introduction begins with two simple case studies that reveal a background of socio-economic complexities that hinder development. The availability of healthcare and the issue of cross-border justice are the key points to be addressed in this study. The chapters consider philosophy, economics, and bioethics in order to provide a global perspective. Two theories come into play in this book—the ideal and non-ideal—which offer insight on why and how things are done.
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306Allocation of scarce biospecimens for use in researchJournal of Medical Ethics 47 (11): 740-743. 2021.Hundreds of millions of rare biospecimens are stored in laboratories and biobanks around the world. Often, the researchers who possess these specimens do not plan to use them, while other researchers limit the scope of their work because they cannot acquire biospecimens that meet their needs. This situation raises an important and underexplored question: how should scientists allocate biospecimens that they do not intend to use? We argue that allocators should aim to maximise the social value of…Read more
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292Response to Open Peer Commentaries on “Health Research Priority Setting: The Duties of Individual Funders”American Journal of Bioethics 19 (1). 2019.We respond to open peer commentaries on our target article, "Health Research Priority Setting: The Duties of Individual Funders"
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291Emergency care research ethics in low- and middle-income countriesBMJ Global Health 4. 2019.A large proportion of the total global burden of disease is caused by emergency medical conditions. Emergency care research is essential to improving emergency medicine but this research can raise some distinctive ethical challenges, especially with regard to (1) standard of care and risk–benefit assessment; (2) blurring of the roles of clinician and researcher; (3) enrolment of populations with intersecting vulnerabilities; (4) fair participant selection; (5) quality of consent; and (6) communi…Read more
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285Response to Open Peer Commentaries on “How Payment for Research Participation Can Be Coercive”American Journal of Bioethics 20 (8). 2020.Volume 20, Issue 8, August 2020, Page W8-W11.
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264Stillbirth should be given greater priority on the global health agendaBritish Medical Journal 351. 2015.Stillbirths are largely excluded from international measures of mortality and morbidity. Zeshan Qureshi and colleagues argue that stillbirth should be higher on the global health agenda.
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262Canada’s new ethical guidelines for research with humans: A critique and comparison with the United StatesCanadian Medical Association Journal 184 657-61. 2012.Canada’s Tri-Council Policy Statement: Ethical conduct for research involving humans, first published in 1998, has recently been updated.1 The US Department of Health and Human Services has just issued an Advance Notice of Proposed Rulemaking that would substantially change the 20-year-old Common Rule governing most federally funded research involving human participants.2 A comparison of the two countries’ systems for protecting human research participants is therefore timely. This analysis situ…Read more
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257How to Identify Priority Questions for Bioethics ResearchAmerican Journal of Bioethics 22 (1): 17-18. 2022.The organizations that fund bioethics research receive many more eligible grant applications than they can support. Academic positions that support bioethics research are likewise scarce. As a resu...
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256Should health research funding be proportional to the burden of disease?Politics, Philosophy and Economics 22 (1): 76-99. 2023.Public funders of health research have been widely criticized on the grounds that their allocations of funding for disease-specific research do not reflect the relative burdens imposed by different diseases. For example, the US National Institutes of Health spends a much greater fraction of its budget on HIV/aids research and a much smaller fraction on migraine research than their relative contribution to the US burden of disease would suggest. Implicit in this criticism is a normative claim: In…Read more
Areas of Specialization
Applied Ethics |
Normative Ethics |
Social and Political Philosophy |
Biomedical Ethics |
Political Ethics |