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58Editor's introduction: Theory and engagement in bioethicsTheoretical Medicine and Bioethics 22 (2): 65-68. 2001.
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66Clinical Equipoise: Foundational Requirement or Fundamental ErrorIn Bonnie Steinbock (ed.), The Oxford handbook of bioethics, Oxford University Press. 2007.Any view of equipoise faces perhaps the most radical and far-reaching objections from moral foundations. These objections hold that the equipoise requirement conflates the ethics of medical research and the ethics of clinical medicine. Once this conflation is recognized, this position holds, research can be given a new foundation on the imperative to avoid exploiting research participants. This article argues that what is novel in this critique is not as successful as its proponents claim and th…Read more
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37A Non-Paternalistic Model of Research Ethics and Oversight: Assessing the Benefits of Prospective ReviewJournal of Law, Medicine and Ethics 40 (4): 930-944. 2012.To judge from the rash of recent law review articles, it is a miracle that research with human subjects in the U.S. continues to draw breath under the asphyxiating heel of the rent-seeking, creativity-stifling, jack-booted bureaucrethics that is the current system of research ethics oversight and review. Institutional Review Boards, sometimes called Research Ethics Committees, have been accused of perpetrating “probably the most widespread violation of the First Amendment in our nation's history…Read more
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32Cutting surgical practice at the joints: Individuating and assessing surgical proceduresIn Ethical Guidelines for innovative surgery, University Publishing Group. pp. 19-52in Angelique M. Rietsma and Jonathan D. Moreno eds., Ethical Guidelines for Innovative Surgery. (Hagerstown, MD: University Publishing Group) 19-52. [PDF].
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128Amenable to reason: Aristotle's rhetoric and the moral psychology of practical ethicsKennedy Institute of Ethics Journal 10 (4): 287-305. 2000.: An Aristotelian conception of practical ethics can be derived from the account of practical reasoning that Aristotle articulates in his Rhetoric and this has important implications for the way we understand the nature and limits of practical ethics. An important feature of this conception of practical ethics is its responsiveness to the complex ways in which agents form and maintain moral commitments, and this has important implications for the debate concerning methods of ethics in applied et…Read more
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24Assessing the Moral Coherence and Moral Robustness of Social Systems: Proof of Concept for a Graphical Models ApproachScience and Engineering Ethics 22 (6): 1761-1779. 2016.This paper presents a proof of concept for a graphical models approach to assessing the moral coherence and moral robustness of systems of social interactions. “Moral coherence” refers to the degree to which the rights and duties of agents within a system are effectively respected when agents in the system comply with the rights and duties that are recognized as in force for the relevant context of interaction. “Moral robustness” refers to the degree to which a system of social interaction is co…Read more
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188Artificial Intelligence and Black‐Box Medical Decisions: Accuracy versus ExplainabilityHastings Center Report 49 (1): 15-21. 2019.Although decision‐making algorithms are not new to medicine, the availability of vast stores of medical data, gains in computing power, and breakthroughs in machine learning are accelerating the pace of their development, expanding the range of questions they can address, and increasing their predictive power. In many cases, however, the most powerful machine learning techniques purchase diagnostic or predictive accuracy at the expense of our ability to access “the knowledge within the machine.”…Read more
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68Adversaries at the Bedside: Advance Care Plans and Future WelfareBioethics 30 (8): 557-567. 2016.Advance care planning refers to the process of determining how one wants to be cared for in the event that one is no longer competent to make one's own medical decisions. Some have argued that advance care plans often fail to be normatively binding on caretakers because those plans do not reflect the interests of patients once they enter an incompetent state. In this article, we argue that when the core medical ethical principles of respect for patient autonomy, honest and adequate disclosure of…Read more
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23The Structure of Clinical Translation: Efficiency, Information, and EthicsHastings Center Report 45 (2): 27-39. 2015.The last two decades have witnessed a crescendo of allegations that clinical translation is rife with waste and inefficiency. Patient advocates argue that excessively demanding regulations delay access to life‐saving drugs, research funders claim that too much basic science languishes in academic laboratories, journal editors allege that biased reporting squanders public investment in biomedical research, and drug companies (and their critics) argue that far too much is expended in pharmaceutica…Read more
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29The decision to initiate invasive, first-in-human trials involving Parkinson’s disease presents a vexing ethical challenge. Such studies present significant surgical risks, and high degrees of uncertainty about intervention risks and biological effects. We argue that maintaining a favorable riskbenefit balance in such circumstances requires a higher than usual degree of confidence that protocols will lead to significant direct and/or social benefits. One critical way of promoting such confidence…Read more
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44Addressing ethical challenges in HIV prevention research with people who inject drugsJournal of Medical Ethics Recent Issues 44 (3): 149-158. 2018.Despite recent advances in HIV prevention and treatment, high HIV incidence persists among people who inject drugs. Difficult legal and political environments and lack of services for PWID likely contribute to high HIV incidence. Some advocates question whether any HIV prevention research is ethically justified in settings where healthcare system fails to provide basic services to PWID and where implementation of research findings is fraught with political barriers. Ethical challenges in researc…Read more
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24First-in-human clinical trials represent a critical juncture in the translation of laboratory discoveries. However, because they involve the greatest degree of uncertainty at any point in the drug development process, their initiation is beset by a series of nettlesome ethical questions [1]: has clinical promise been sufficiently demonstrated in animals? Should trial access be restricted to patients with refractory disease? Should trials be viewed as therapeutic? Have researchers adequately mini…Read more
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50Bringing science and advocacy together to address health needs of people who inject drugsJournal of Medical Ethics Recent Issues 44 (3): 165-166. 2018.In crafting our paper on addressing the ethical challenges in HIV prevention research with people who inject drugs, 1 we had hoped to stimulate further discussion and deliberation about the topic. We are pleased that three commentaries on our paper have begun this process. 2 3 4 The commentaries rightly bring up important issues relating to community engagement and problems in translating research into practice in the fraught environments in which PWID face multiple risks. These risks include ac…Read more
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25Equipoise and the Criteria for Reasonable ActionJournal of Law, Medicine and Ethics 34 (2): 441-450. 2006.Critics of clinical equipoise have long argued that it represents an overly permissive, and therefore morally unacceptable, mechanism for resolving the tensions inherent in clinical research. In particular, the equipoise requirement is often attacked on the grounds that it is not sufficiently responsive to the interests of individual patients. In this paper, we outline a view of equipoise that not only withstands a stronger version of this objection, which was recently articulated by Deborah Hel…Read more
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44Bringing science and advocacy together to address health needs of people who inject drugsJournal of Medical Ethics 44 (3): 165-166. 2018.In crafting our paper on addressing the ethical challenges in HIV prevention research with people who inject drugs,1 we had hoped to stimulate further discussion and deliberation about the topic. We are pleased that three commentaries on our paper have begun this process.2 3 4 The commentaries rightly bring up important issues relating to community engagement and problems in translating research into practice in the fraught environments in which PWID face multiple risks. These risks include acqu…Read more
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26Dignity and the Value of Rejecting Profitable but Insulting OffersMind 124 (494): 409-448. 2015.In this paper we distinguish two competing conceptions of dignity, one recognizably Hobbesian and one recognizably Kantian. We provide a formal model of how decision-makers committed to these conceptions of dignity might reason when engaged in an economic transaction that is not inherently insulting, but in which it is possible for the dignity of the agent to be called into question. This is a modified version of the ultimatum game. We then use this model to illustrate ways in which the Kantian …Read more
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108The Place of Philosophy in Bioethics TodayAmerican Journal of Bioethics 22 (12): 10-21. 2021.In some views, philosophy’s glory days in bioethics are over. While philosophers were especially important in the early days of the field, so the argument goes, the majority of the work in bioethics today involves the “simple” application of existing philosophical principles or concepts, as well as empirical work in bioethics. Here, we address this view head on and ask: What is the role of philosophy in bioethics today? This paper has three specific aims: (1) to respond to skeptics and make the …Read more
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57Addressing ethical challenges in HIV prevention research with people who inject drugsJournal of Medical Ethics 44 (3): 149-158. 2018.Despite recent advances in HIV prevention and treatment, high HIV incidence persists among people who inject drugs. Difficult legal and political environments and lack of services for PWID likely contribute to high HIV incidence. Some advocates question whether any HIV prevention research is ethically justified in settings where healthcare system fails to provide basic services to PWID and where implementation of research findings is fraught with political barriers. Ethical challenges in researc…Read more
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16Solitary death and new lifestyles during and after COVID-19: wearable devices and public health ethicsBMC Medical Ethics 22 (1): 1-10. 2021.BackgroundSolitary death (kodokushi) has recently become recognized as a social issue in Japan. The social isolation of older people leads to death without dignity. With the outbreak of COVID-19, efforts to eliminate solitary death need to be adjusted in line with changes in lifestyle and accompanying changes in social structure. Health monitoring services that utilize wearable devices may contribute to this end. Our goals are to outline how wearable devices might be used to (1) detect emergency…Read more
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39Ethical Considerations in the Conduct of Electronic Surveillance ResearchJournal of Law, Medicine and Ethics 34 (3): 611-619. 2006.The extant clinical literature indicates profound problems in the assessment, monitoring, and documentation of care in long-term care facilities. The lack of adequate resources to accommodate higher staff-to-resident ratios adds additional urgency to the goal of identifying more costeffective mechanisms to provide care oversight. The ever expanding array of electronic monitoring technologies in the clinical research arena demands a conceptual and pragmatic framework for the resolution of ethical…Read more
Areas of Specialization
Ethics of Artificial Intelligence, Misc |
Value Theory |
Biomedical Ethics |
Applied Ethics |
Normative Ethics |
Areas of Interest
Value Theory |
Biomedical Ethics |
Applied Ethics |
Normative Ethics |