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43Should Institutions Disclose the Names of Employees with Covid‐19?Hastings Center Report 50 (3): 25-27. 2020.Prestigious University is a large, private educational institution with a medical school, a university hospital, a law school, and graduate and undergraduate colleges all on a single campus. In the face of the Covid‐19 pandemic, students were told during spring break to return to campus only briefly to retrieve their belongings. Classes then went online. On March 23, 2020, the faculty, students, and staff were emailed the following by the university's director of infection control and public hea…Read more
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42Decision-making in patients with advanced cancer compared with amyotrophic lateral sclerosisJournal of Medical Ethics 34 (9): 664-668. 2008.Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months fo…Read more
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40Edmund 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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40The last low whispers of our dead: when is it ethically justifiable to render a patient unconscious until death?Theoretical Medicine and Bioethics 39 (3): 233-263. 2018.A number of practices at the end of life can causally contribute to diminished consciousness in dying patients. Despite overlapping meanings and a confusing plethora of names in the published literature, this article distinguishes three types of clinically and ethically distinct practices: double-effect sedation, parsimonious direct sedation, and sedation to unconsciousness and death. After exploring the concept of suffering, the value of consciousness, the philosophy of therapy, the ethical imp…Read more
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39Perceptions of control and unrealistic optimism in early-phase cancer trialsJournal of Medical Ethics 44 (2): 121-127. 2018.Purpose Recent research has found unrealistic optimism among patient-subjects in early-phase oncology trials. Our aim was to investigate the cognitive and motivational factors that evoke this bias in this context. We expected perceptions of control to be a strong correlate of unrealistic optimism. Methods A study of patient-subjects enrolled in early-phase oncology trials was conducted at two sites in the USA. Respondents completed questionnaires designed to assess unrealistic optimism and sever…Read more
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36Death 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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33Patients’ Perceptions of the Quality of Informed Consent for Common Medical ProceduresJournal of Clinical Ethics 5 (3): 189-194. 1994.
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31Sedation and care at the end of lifeTheoretical Medicine and Bioethics 39 (3): 171-180. 2018.This special issue of Theoretical Medicine and Bioethics takes up the question of palliative sedation as a source of potential concern or controversy among Christian clinicians and thinkers. Christianity affirms a duty to relieve unnecessary suffering yet also proscribes euthanasia. Accordingly, the question arises as to whether it is ever morally permissible to render dying patients unconscious in order to relieve their suffering. If so, under what conditions? Is this practice genuinely morally…Read more
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31Whole-brain death and integration: realigning the ontological concept with clinical diagnostic testsTheoretical Medicine and Bioethics 40 (5): 455-481. 2019.For decades, physicians, philosophers, theologians, lawyers, and the public considered brain death a settled issue. However, a series of recent cases in which individuals were declared brain dead yet physiologically maintained for prolonged periods of time has challenged the status quo. This signals a need for deeper reflection and reexamination of the underlying philosophical, scientific, and clinical issues at stake in defining death. In this paper, I consider four levels of philosophical inqu…Read more
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31Dear Dr. PeabodyPerspectives in Biology and Medicine 59 (4): 562-566. 2016.Francis W. Peabody, MDDepartment of MedicineBoston City Hospital and Harvard Medical SchoolBoston, MassachusettsMarch 19, 2017Dear Dr. Peabody,Thank you for giving us the opportunity to review your manuscript "The Care of the Patient." It has been carefully considered by the editors and two external reviewers. We regret to inform you that it cannot be considered further for publication in the Prestigious Journal of Medicine.Chief among our reasons is that it is overly long. Opinion pieces—especi…Read more
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30Physician-Assisted Suicide and Euthanasia: Theological and Ethical ResponsesChristian Bioethics 27 (3): 223-227. 2021.Euthanasia and rational suicide were acceptable practices in some quarters in antiquity. These practices all but disappeared as Hippocratic, Jewish, Christian, and Muslim beliefs took hold in Europe and the Near East. By the late nineteenth century, however, a political movement to legalize euthanasia and physician-assisted suicide (PAS) began in Europe and the United States. Initially, the path to legalization was filled with obstacles, especially in the United States. In the last few decades, …Read more
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29Catholic Health Care at the Edge of Ground ZeroThe National Catholic Bioethics Quarterly 2 (1): 15-16. 2002.
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29What's so special about medicine? A reply to de VilleTheoretical Medicine and Bioethics 14 (4): 379-380. 1993.
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29Unrealistic optimism in early-phase oncology trialsIRB: Ethics & Human Research 33 (1): 1. 2011.Unrealistic optimism is a bias that leads people to believe, with respect to a specific event or hazard, that they are more likely to experience positive outcomes and/or less likely to experience negative outcomes than similar others. The phenomenon has been seen in a range of health-related contexts—including when prospective participants are presented with the risks and benefits of participating in a clinical trial. In order to test for the prevalence of unrealistic optimism among participants…Read more
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28Researchers' preferences and attitudes on ethical aspects of genomics research: a comparative study between the USA and SpainJournal of Medical Ethics 35 (4): 251-257. 2009.Introduction: The use of human samples in genomic research has increased ethical debate about informed consent (IC) requirements and the information that subjects should receive regarding the results of the research. However, there are no quantitative data regarding researchers’ attitudes about these issues. Methods: We present the results of a survey of 104 US and 100 Spanish researchers who had published genomic epidemiology studies in 61 journals during 2006. Results: Researchers preferred a …Read more
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27Why the Common-Sense Distinction between Killing and Allowing-to-Die Is So Easy to Grasp but So Hard to ExplainCambridge Quarterly of Healthcare Ethics 28 (2): 353-358. 2019.
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26Macklin, 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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26Jonas, Hans. The Phenomenon of Life: Toward a Philosophical Biology (review)Review of Metaphysics 55 (4): 863-865. 2002.
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26Do the Bishops Have It Right On Health Care Reform?Christian Bioethics 2 (3): 309-325. 1996.The National Conference of Catholic Bishops has argued for significant government involvement in health care in order to assure respect for what they regard as the right to health care. Critics charge that the bishops are wrong because health care is not a right. In this article, it is argued that these critics are correct in their claim that health care is not a right. However, it is also argued that the premise that health care is not a right does not imply that the market is the most equitabl…Read more
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25Life‐Years & Rationing in the Covid‐19 Pandemic: A Critical AnalysisHastings Center Report 51 (5): 18-29. 2021.Hastings Center Report, Volume 51, Issue 5, Page 18-29, September‐October 2021.
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24Context and scale: Distinctions for improving debates about physician “rationing”Philosophy, Ethics, and Humanities in Medicine 2017 12:1 12 (1): 5. 2017.Important discussions about limiting care based on professional judgment often devolve into heated debates over the place of physicians in bedside rationing. Politics, loaded rhetoric, and ideological caricature from both sides of the rationing debate obscure precise points of disagreement and consensus, and hinder critical dialogue around the obligations and boundaries of professional practice. We propose a way forward by reframing the rationing conversation, distinguishing between the scale of…Read more
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24Ethical Principles, Process, and the Work of Bioethics CommissionsHastings Center Report 47 (S1): 50-53. 2017.Shortly after the Presidential Commission for the Study of Bioethical Issues was constituted in 2010 and days before the commission members were to join a conference call to discuss possible topics for their deliberation, Craig Venter held a press conference announcing that his lab had created a synthetic chromosome for a species of mycoplasma and had inserted this genetic material into organisms of another species of mycoplasma (the genes of which had been deactivated), transforming the host sp…Read more
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24Unlike Diamonds, Defibrillators Aren’t Forever: Why It Is Sometimes Ethical to Deactivate Cardiac Implantable Electrical DevicesCambridge Quarterly of Healthcare Ethics 28 (2): 338-346. 2019.
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23Physicians' confidence in discussing do not resuscitate orders with patients and surrogatesJournal of Medical Ethics 34 (2): 96-101. 2008.Purpose: Physicians are often reluctant to discuss “Do Not Resuscitate” orders with patients. Although perceived self-efficacy is a known prerequisite for behavioural change, little is understood about the confidence of physicians regarding DNR discussions.Subjects and methods: A survey of 217 internal medicine attendings and 132 housestaff at two teaching hospitals about their attitudes and confidence regarding DNR discussions.Results: Participants were significantly less confident about their …Read more
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23Context and scale: Distinctions for improving debates about physician “rationing”Philosophy, Ethics, and Humanities in Medicine 12 5. 2017.Important discussions about limiting care based on professional judgment often devolve into heated debates over the place of physicians in bedside rationing. Politics, loaded rhetoric, and ideological caricature from both sides of the rationing debate obscure precise points of disagreement and consensus, and hinder critical dialogue around the obligations and boundaries of professional practice. We propose a way forward by reframing the rationing conversation, distinguishing between the scale of…Read more
Chicago, Illinois, United States of America
Areas of Specialization
Applied Ethics |
Normative Ethics |
Areas of Interest
Applied Ethics |
Normative Ethics |