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119Medical Futility: The Duty Not to TreatCambridge Quarterly of Healthcare Ethics 2 (2): 151. 1993.Partly because physicians can “never say never,” partly because of the seduction of modern technology, and partly out of misplaced fear of litigation, physicians have increasingly shown a tendency to undertake treatments that have no realistic expectation of success. For this reason, we have articulated common sense criteria for medical futility. If a treatment can be shown not to have worked in the last 100 cases, we propose that it be regarded as medically futile. Also, if the treatment fails …Read more
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28Selecting participants fairly for controlled human infection studiesBioethics 34 (8): 771-784. 2020.Controlled human infection (CHI) studies involve the deliberate exposure of healthy research participants to infectious agents to study early disease processes and evaluate interventions under controlled conditions with high efficiency. Although CHI studies expose participants to the risk of infection, they are designed to offer investigators unique advantages for studying the pathogenesis of infectious diseases and testing potential vaccines or treatments in humans. One of the central challenge…Read more
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39Healthcare as a CommonsCambridge Quarterly of Healthcare Ethics 4 (2): 207. 1995.In September 1994, theNew York Timescarried a front page article declaring healthcare reform dead in Congress. The obituary on healthcare followed a Congressional decision not to pursue the issue further in 1994. Although Congress and the President will likely revisit healthcare reform during 1995, the choices may be between various incremental steps, rather than substantive changes to bring about universal coverage.
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66Ethics Committees at Work: A Different Kind of “Prisoner's Dilemma”Cambridge Quarterly of Healthcare Ethics 4 (4): 530. 1995.A referral was made to our Cardiac Transplant Program for a patient who was in the New Jersey Prison System. The Medical Director of the New Jersey Department of Corrections called regarding a 39-year-old inmate who was being treated in a New Jersey hospital that has a unit for prisoners from a nearby cor- rectional facility. The referring physician described the patient to our Medical Director of heart transplantation as a “murderer” who had been incarcerated since 1987 and sentenced to prison …Read more
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94The Ethics of Human Gene Therapy, by LeRoy Walters and Julie Gage Palmer. New York: Oxford University Press, 1997. 209 pp (review)Cambridge Quarterly of Healthcare Ethics 6 (4): 494. 1997.
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90Caring for “Socially Undesirable” PatientsCambridge Quarterly of Healthcare Ethics 5 (4): 500. 1996.Mr. Bernard was a homeless man, aged 58. His medical history revealed alcohol abuse, seizure disorder, and two suicide attempts. Brought to the emergency room at a local hospital after being found “semi-comatose,” his respiratory distress led to his being intubated and placed on a ventilator. The healthcare team suspected the patient ingested antifreeze. Transferred from that hospital to the intensive care unit of the university hospital, his diagnosis was “high osmolar gap with high-anion gap m…Read more
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83Judging Medical Futility: An Ethical Analysis of Medical Power and ResponsibilityCambridge Quarterly of Healthcare Ethics 4 (1): 23. 1995.In situations where experience shows that a particular intervention will not benefit a patient, common sense seems to suggest that the intervention should not be used. Yet it is precisely in these situations that a peculiar ethic begins to operate, an ethic that Eddy calls “the criterion of potential benefit.” According to this ethic, “a treatment is appropriate if it might have some benefit.” Thus, the various maxims learned in medical school instruct physicians that “‘an error of commission is…Read more
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73Is the Treatment Beneficial, Experimental, or Futile?Cambridge Quarterly of Healthcare Ethics 5 (2): 248. 1996.D.T. a 35-year-old woman, was found to have breast cancer. At the time of mastectomy axillary lymph nodes were positive and the cancer was classified as adenocarcinoma, grade 4. The patient underwent conventional chemotherapy. When it became apparent the disease was metastatic, the patient's oncologist contacted a well-known cancer center regarding the possibility of treating the patient with high dose chemotherapy and autologous bone marrow transplantation. The patient's health insurance provid…Read more
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100You’ve got a friend in me: sociable robots for older adults in an age of global pandemicsEthics and Information Technology 23 (S1): 35-43. 2020.Social isolation and loneliness are ongoing threats to health made worse by the coronavirus disease 2019 pandemic. During the pandemic, half the globe's population have been placed under strict physical distancing orders and many long-term care facilities serving older adults went into lockdown mode, restricting access to all visitors, including family members. Before the pandemic emerged, a 2020 National Academy of Sciences, Engineering and Medicine report warned of the underappreciated adverse…Read more
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108Vaccine ethics: an ethical framework for global distribution of COVID-19 vaccinesJournal of Medical Ethics. forthcoming.This paper addresses the just distribution of vaccines against the SARS-CoV-2 virus and sets forth an ethical framework that prioritises frontline and essential workers, people at high risk of severe disease or death, and people at high risk of infection. Section I makes the case that vaccine distribution should occur at a global level in order to accelerate development and fair, efficient vaccine allocation. Section II puts forth ethical values to guide vaccine distribution including helping pe…Read more
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26What money can’t buy: an argument against paying people to get vaccinatedJournal of Medical Ethics 48 (6): 362-366. 2022.This paper considers the proposal to pay people to get vaccinated against the SARS-CoV-2 virus. The first section introduces arguments against the proposal, including less intrusive alternatives, unequal effects on populations and economic conditions that render payment more difficult to refuse. The second section considers arguments favouring payment, including arguments appealing to health equity, consistency, being worth the cost, respect for autonomy, good citizenship, the ends justifying th…Read more
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39Vaccine passports and health disparities: a perilous journeyJournal of Medical Ethics 48 (12): 957-960. 2022.This paper raises health equity concerns about the use of passports for domestic and international travel to certify COVID-19 vaccination. Part I argues that for international travel, health equity objections undercut arguments defending vaccine passports, which are based on tholding people responsible, protecting global health, safeguarding individual liberty and continuing current practice. Part II entertains a proposal for a scaled down vaccine passport for domestic use in countries where vac…Read more
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24What do we owe the newly dead? An ethical analysis of findings from Japan's corpse hotels workersBioethics 33 (6): 691-698. 2019.While people are still alive, we owe them respect. Yet what, if anything, do we owe the newly dead? This question is an urgent practical concern for aged societies, because older people die at higher rates than any other age group. One novel way in which Japan, the frontrunner of aged societies, meets its need to accommodate high numbers of newly dead is itai hoteru or corpse hotels. Itai hoteru offer families a way to wait for space in over‐crowded crematoriums while affording an environment co…Read more
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26What’s yours is ours: waiving intellectual property protections for COVID-19 vaccinesJournal of Medical Ethics 47 (9): 595-598. 2021.This paper gives an ethical argument for temporarily waiving intellectual property protections for COVID-19 vaccines. It examines two proposals under discussion at the World Trade Organization : the India/South Africa proposal and the WTO Director General proposal. Section I explains the background leading up to the WTO debate. Section II rebuts ethical arguments for retaining current IP protections, which appeal to benefiting society by spurring innovation and protecting rightful ownership. It …Read more
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63United states and canadian approaches to justice in health care: A comparative analysis of health care systems and valuesTheoretical Medicine and Bioethics 15 (2). 1994.The purpose of this study is to compare and contrast the basic ethical values underpinning national health care policies in the United States and Canada. We use the framework of ethical theory to name and elaborate ethical values and to facilitate moral reflection about health care reform. Section one describes historical and contemporary social contract theories and clarifies the ethical values associated with them. Sections two and three show that health care debates and health care systems in…Read more
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40Health Care Systems: Moral Conflicts in European and American Public PolicyHastings Center Report 19 (6): 46. 1989.Book reviewed in this article: Medicine and Culture: Varieties of Treatment in the United States, England, West Germany, and France. By Lynn Payer. Health Care Systems: Moral Conflicts in European and American Public Policy. Edited by Hans‐Martin Sass and Robert U. Massey.
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59The Right Not to Be Born: Reinterpreting the Nonidentity ProblemAmerican Journal of Bioethics 12 (8). 2012.The American Journal of Bioethics, Volume 12, Issue 8, Page 34-35, August 2012
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15The Theory and Practice of ProfessionalismAmerican Journal of Bioethics 4 (2): 47-48. 2004.No abstract
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19Uncovering Cultural Bias in Ethics ConsultationAmerican Journal of Bioethics 1 (4): 49-50. 2001.
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25The time of one's life: views of aging and age group justiceHistory and Philosophy of the Life Sciences 43 (1): 1-14. 2021.This paper argues that we can see our lives as a snapshot happening now or as a moving picture extending across time. These dual ways of seeing our lives inform how we conceive of the problem of age group justice. A snapshot view sees age group justice as an interpersonal problem between distinct age groups. A moving picture view sees age group justice as a first-person problem of prudential choice. This paper explores these different ways of thinking about age group justice and illustrates them…Read more
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128Taking care of one's own: Justice and family caregivingTheoretical Medicine and Bioethics 23 (2): 117-133. 2002.This paper asks whether adult children have aduty of justice to act as caregivers for theirfrail, elderly parents. I begin (Sections I.and II.) by locating the historical reasons whyrelationships within families were not thoughtto raise issues of justice. I argue that thesereasons are misguided. The paper next presentsspecific examples showing the relevance ofjustice to family relationships. I point outthat in the United States today, the burden ofcaregiving for dependent parents fallsdisproport…Read more
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7Upstream Influences and Fair Subject SelectionAmerican Journal of Bioethics 20 (2): 22-24. 2020.Volume 20, Issue 2, February 2020, Page 22-24.
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65Towards a theory of age-group justiceJournal of Medicine and Philosophy 14 (6): 655-676. 1989.Norman Daniels' and Daniel Callahan's recent work attempts to develop and deepen theories of justice in order to accommodate intergenerational moral issues. Elsewhere, I have argued that Callahan's arguments furnish inadequate support for the age rationing policy he accepts. This essay therefore examines Daniel's account of age rationing, together with the complex theory of age-group justice that buttresses it. Sections one and two trace the main features of Daniels' prudential lifespan approach…Read more
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23The Ubiquity of CultureHastings Center Report 19 (6): 46-47. 1989.Book reviewed in this article: Medicine and Culture: Varieties of Treatment in the United States, England, West Germany, and France. By Lynn Payer. Health Care Systems: Moral Conflicts in European and American Public Policy. Edited by Hans‐Martin Sass and Robert U. Massey.
APA Western Division
Shatin, New Territories, Hong Kong
Areas of Specialization
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Applied Ethics |
Normative Ethics |
Social and Political Philosophy |
African/Africana Philosophy |
Asian Philosophy |
Philosophy of Computing and Information |