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60The logos of the genome: Genomes as parts of organismsTheoretical Medicine and Bioethics 27 (6): 535-540. 2006.
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93Killing and Allowing to Die: Another LookJournal of Law, Medicine and Ethics 26 (1): 55-64. 1998.One of the most important questions in the debate over the morality of euthanasia and assisted suicide is whether an important distinction between killing patients and allowing them to die exists. The U.S. Supreme Court, in rejecting challenges to the constitutionality of laws prohibiting physician-assisted suicide, explicitly invoked this distinction, but did not explicate or defend it. The Second Circuit of the U.S. Court of Appeals had previously asserted, also without argument, that no meani…Read more
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193Death, Dignity, and the Theory of ValueEthical Perspectives 9 (2): 103-130. 2002.The word ‘dignity’ arises continuously in the debate over euthanasia and assisted suicide, both in Europe and in North America. Unlike the phrases ‘autonomy’ and ‘slippery slope’, ‘dignity’ is used by those on both sides of the question. For example, the organizations most prominently associated with the campaign that culminated in the recent legalization of euthanasia in Belgium are the Association pour la Droit de Mourir dans la Dignité and Recht op Waardig Sterven. Yet when Belgium passed its…Read more
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112Catholic Health Care: Not Dead YetThe National Catholic Bioethics Quarterly 1 (1): 41-50. 2001.
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324What is conscience and why is respect for it so important?Theoretical Medicine and Bioethics 29 (3): 135-149. 2008.The literature on conscience in medicine has paid little attention to what is meant by the word ‘conscience.’ This article distinguishes between retrospective and prospective conscience, distinguishes synderesis from conscience, and argues against intuitionist views of conscience. Conscience is defined as having two interrelated parts: (1) a commitment to morality itself; to acting and choosing morally according to the best of one’s ability, and (2) the activity of judging that an act one has do…Read more
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35Patients’ Perceptions of the Quality of Informed Consent for Common Medical ProceduresJournal of Clinical Ethics 5 (3): 189-194. 1994.
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53Futility and the varieties of medical judgmentTheoretical Medicine and Bioethics 18 (1-2): 63-78. 1997.Pellegrino has argued that end-of-life decisions should be based upon the physician's assessment of the effectiveness of the treatment and the patient's assessment of its benefits and burdens. This would seem to imply that conditions for medical futility could be met either if there were a judgment of ineffectiveness, or if the patient were in a state in which he or she were incapable of a subjective judgment of the benefits and burdens of the treatment. I argue that a theory of futility accordi…Read more
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38Death and dignity in Catholic Christian thoughtMedicine, Health Care and Philosophy 20 (4): 537-543. 2017.This article traces the history of the concept of dignity in Western thought, arguing that it became a formal Catholic theological concept only in the late nineteenth century. Three uses of the word are distinguished: intrinsic, attributed, and inflorescent dignity, of which, it is argued, the intrinsic conception is foundational. The moral norms associated with respect for intrinsic dignity are discussed briefly. The scriptural and theological bases for adopting the concept of dignity as a Chri…Read more
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67Patient expectations of benefit from phase I clinical trials: Linguistic considerations in diagnosing a therapeutic misconceptionTheoretical Medicine and Bioethics 24 (4): 329-344. 2003.The ethical treatment of cancer patientsparticipating in clinical trials requiresthat patients are well-informed about thepotential benefits and risks associated withparticipation. When patients enrolled in phaseI clinical trials report that their chance ofbenefit is very high, this is often taken as evidence of a failure of the informed consent process. We argue, however, that some simple themes from the philosophy of language may make such a conclusion less certain. First, the patient may rece…Read more
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56Terri Schiavo and the Roman Catholic Tradition of Forgoing Extraordinary Means of CareJournal of Law, Medicine and Ethics 33 (2): 359-362. 2005.Media coverage and statements by various Catholic spokespersons regarding the case of Terri Schiavo has generated enormous and deeply unfortunate confusion regarding Church teaching about the use of life-sustaining treatments. Two weeks ago, for example, I received a letter from the superior of a community of Missionary Sisters of Charity, who operate a hospice here in the United States The Missionary Sisters of Charity are the community founded by Mother Theresa, the 20th Century saint whose pr…Read more
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161Emergency contraception for women who have been raped: Must catholics test for ovulation, or is testing for pregnancy morally sufficient?Kennedy Institute of Ethics Journal 16 (4): 305-331. 2006.: On the grounds that rape is an act of violence, not a natural act of intercourse, Roman Catholic teaching traditionally has permitted women who have been raped to take steps to prevent pregnancy, while consistently prohibiting abortion even in the case of rape. Recent scientific evidence that emergency contraception (EC) works primarily by preventing ovulation, not by preventing implantation or by aborting implanted embryos, has led Church authorities to permit the use of EC drugs in the setti…Read more
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80Crossing the bridge: A time of transition for theoretical medicine and bioethicsTheoretical Medicine and Bioethics 23 (1): 5-7. 2002.
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108. Who Owns the Human Genome?In Daniel Monsour (ed.), Ethics & the New Genetics: An Integrated Approach, University of Toronto Press. pp. 123-133. 2007.
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60Moral Status, Justice, and the Common Morality: Challenges for the Principlist Account of Moral ChangeKennedy Institute of Ethics Journal 23 (3): 275-296. 2013.The idea that ethics can be derived from a common morality, while controversial, has become very influential in biomedical ethics. Although the concept is employed by several theories, it has most prominently been given a central role in principlism, an ethical theory endorsed by Tom Beauchamp and James Childress in Principles of Biomedical Ethics (2009).1 This text has become a cornerstone of medical ethics education, an achievement that has been commended by critics and supporters alike. It ar…Read more
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106“Reinventing” the rule of double effectIn Bonnie Steinbock (ed.), The Oxford handbook of bioethics, Oxford University Press. pp. 114--49. 2007.The Rule of Double Effect has played an important role in bioethics, especially during the last fifty years. Its major application in bioethics has been in providing physicians who are opposed to euthanasia with a moral justification for using opioid analgesics in treating the pain of patients whose death might thereby be hastened. It has also prominently been applied to certain obstetric cases. The scope of application of double effect is actually much broader than medical ethics, extending to …Read more
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102Diseases and natural kindsTheoretical Medicine and Bioethics 26 (6): 487-513. 2005.David Thomasma called for the development of a medical ethics based squarely on the philosophy of medicine. He recognized, however, that widespread anti-essentialism presented a significant barrier to such an approach. The aim of this article is to introduce a theory that challenges these anti-essentialist objections. The notion of natural kinds presents a modest form of essentialism that can serve as the basis for a foundationalist philosophy of medicine. The notion of a natural kind is neither…Read more
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75The varieties of human dignity: a logical and conceptual analysisMedicine, Health Care and Philosophy 16 (4): 937-944. 2013.The word ‘dignity’ is used in a variety of ways in bioethics, and this ambiguity has led some to argue that the term must be expunged from the bioethical lexicon. Such a judgment is far too hasty, however. In this article, the various uses of the word are classified into three serviceable categories: intrinsic, attributed, and inflorescent dignity. It is then demonstrated that, logically and linguistically, the attributed and inflorescent meanings of the word presuppose the intrinsic meaning. Th…Read more
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27Macklin, Ruth. Against Relativism: Cultural Diversity and the Search for Ethical Universals in MedicineThe National Catholic Bioethics Quarterly 1 (3): 467-469. 2001.
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41Edmund Pellegrino's Philosophy and Ethics of Medicine: An OverviewKennedy Institute of Ethics Journal 24 (2): 105-112. 2014.Pellegrino was there at the beginning of the field. In the 1950s and 60s, before there was a Kennedy Institute of Ethics or a Hastings Center; before the word ‘bioethics’ itself was coined, Pellegrino was writing articles such as "Ethical Considerations in the Practice of Medicine and Nursing," published in 1964. He was among those who started the Society for Health and Human Values—a precursor organization to the American Society for Bioethics and Humanities. He was the founding editor of the J…Read more
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48What's so special about medicine?Theoretical Medicine and Bioethics 14 (1): 379-380. 1993.Health care has increasingly come to be understood as a commodity. The ethical implications of such an understanding are significant. The author argues that health care is not a commodity because health care (1) is non-proprietary, (2) serves the needs of persons who, as patients, are uniquely vulnerable, (3) essentially involves a special human relationship which ought not be bought or sold, (4) helps to define what is meant by necessity and cannot be considered a commodity when subjected to ri…Read more
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20Bioethics, Conflicts of Interest, the Limits of TransparencyHastings Center Report 33 (4): 40-43. 2003.The movement in bioethics toward disclosure of financial conflicts of interest is well and good, most of the time. But in some cases, disclosure is not only unnecessary but destructive. When bioethicists advance arguments whose premises and logical moves are open to scrutiny, disclosure—far from clearing the air of bias—introduces bias.
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528Speaking of the value of lifeKennedy Institute of Ethics Journal 21 (2): 181-199. 2011.The notion of the value of life is often invoked in discussions regarding medical care for the sick and the dying. This theme has figured in arguments about medical ethics for decades, but many of the phrases associated with this concept have received little serious scrutiny. It is true that some philosophers have declared a few commonly used phrases such as “the sanctity of life,” “the infinite value of life,” and “the value of life itself” to be unclear at best or misguided at worst. Their has…Read more
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26Jonas, Hans. The Phenomenon of Life: Toward a Philosophical Biology (review)Review of Metaphysics 55 (4): 863-865. 2002.
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104Deliberative democracy and stem cell research in new York state: The good, the bad, and the uglyKennedy Institute of Ethics Journal 19 (1). 2009.Many states in the U.S. have adopted policies regarding human embryonic stem cell (hESC) research in the last few years. Some have arrived at these policies through legislative debate, some by referendum, and some by executive order. New York has chosen a unique structure for addressing policy decisions regarding this morally controversial issue by creating the Empire State Stem Cell Board with two Committees—an Ethics Committee and a Funding Committee. This essay explores the pros and cons of v…Read more
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Applied Ethics |
Normative Ethics |
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Normative Ethics |