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45Two dogmas of research ethics and the integrative approach to human-subjects researchJournal of Medicine and Philosophy 32 (2). 2007.This article argues that lingering uncertainty about the normative foundations of research ethics is perpetuated by two unfounded dogmas of research ethics. The first dogma is that clinical research, as a social activity, is an inherently utilitarian endeavor. The second dogma is that an acceptable framework for research ethics must impose constraints on this endeavor whose moral force is grounded in role-related obligations of either physicians or researchers. This article argues that these dog…Read more
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66Social value, clinical equipoise, and research in a public health emergencyBioethics 33 (3): 326-334. 2018.The 2016 CIOMS International ethical guidelines for health‐related research involving humans states that ‘health‐related research should form an integral part of disaster response’ and that, ‘widespread emergency use [of unproven interventions] with inadequate data collection about patient outcomes must therefore be avoided’ (Guideline 20). This position is defended against two lines of criticism that emerged during the 2014 Ebola outbreak. One holds that desperately ill patients have a moral ri…Read more
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79The ambiguity and the exigency: Clarifying 'standard of care' arguments in international researchJournal of Medicine and Philosophy 25 (4). 2000.This paper examines the concept of a 'standard of care' as it has been used in recent arguments over the ethics of international human-subjects research. It argues that this concept is ambiguous along two different axes, with the result that there are at least four possible standard of care arguments that have not always been clearly distinguished. As a result, it has been difficult to assess the implications of opposing standard of care arguments, to recognize important differences in their sup…Read more
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40There is near universal agreement within the scientific and ethics communities that a necessary condition for the moral permissibility of cross-national, collaborative research is that it be responsive to the health needs of the host community. It has proven difficult, however, to leverage or capitalize on this consensus in order to resolve lingering disputes about the ethics of international medical research. This is largely because different sides in these debates have sometimes provided differe…Read more
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24Self-Defeating Codes of Medical Ethics and How to Fix Them: Failures in COVID-19 Response and BeyondAmerican Journal of Bioethics 21 (1): 4-13. 2021.Statements of the core ethical and professional responsibilities of medical professionals are incomplete in ways that threaten fundamental goals of medicine. First, in the absence of explicit guida...
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112Sham Surgery and Genuine Standards of Care: Can the Two be Reconciled?American Journal of Bioethics 3 (4): 61-64. 2003.
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43Recent debates over the use of sham surgery as a control for studies of fetal tissue transplantation for Parkinson’s disease have focused primarily on rival interpretations of the US federal regulations governing human-subjects research. Using the core ethical and methodological considerations that underwrite the equipoise requirement, we nd strong prima facie reasons against using sham surgery as a control in studies of cellular-based therapies for Parkinson’s disease and more broadly in clinic…Read more
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63Research at the Auction Block: Problems for the Fair Benefits Approach to International ResearchHastings Center Report 40 (4): 34-45. 2010.The “fair benefits” approach to international research is designed to produce results that all can agree are fair without taking a stand on divisive questions of justice. But its appealing veneer of collaboration masks ambiguities at both a conceptual and an operational level. An attempt to put it into practice would look a lot like an auction, leaving little reason to think the outcomes will satisfy even minimal conditions of fairness.
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Offshoring Science: The Promise and Perils of the Globalization of Clinical TrialsIRB: Ethics & Human Research 33 (1): 18-20. 2011.Research ethics is often said to have been born of scandal. Whether or not this is true of the field in general, it does seem to be the case for much of the literature on the ethics of international research. But in When Experiments Travel: Clinical Trials and the Global Search for Human Subjects, the anthropologist Adriana Petryna sets out to portray not scandal, but the routine offshoring of clinical trials. Through gripping interviews and detailed case studies, she follows the lifecycle of in…Read more
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24Before participants can be enrolled in a clinical trial, an institutional review board must determine that the risks that the research poses to participants are ‘reasonable.’ This paper examines the two dominant frameworks for assessing research risks and argues that each approach suffers from significant shortcomings. It then considers what issues must be addressed in order to construct a framework for risk assessment that is grounded in a compelling normative foundation and might provide more …Read more
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34Learning health systems, clinical equipoise and the ethics of response adaptive randomisationJournal of Medical Ethics 44 (6): 409-415. 2018.To give substance to the rhetoric of ‘learning health systems’, a variety of novel trial designs are being explored to more seamlessly integrate research with medical practice, reduce study duration and reduce the number of participants allocated to ineffective interventions. Many of these designs rely on response adaptive randomisation. However, critics charge that RAR is unethical on the grounds that it violates the principle of equipoise. In this paper, I reconstruct critiques of RAR as holdi…Read more
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25Justice in the Application of Science: Beyond Fair BenefitsAmerican Journal of Bioethics 10 (6): 54-56. 2010.There are now at least two different views that fall under the heading of the “fair benefits” approach (FBA) to international research. These views share a number of important commitments, such as...
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25To cite this Article: , 'Two Dogmas of Research Ethics and the Integrative Approach to Human-Subjects Research', Journal of Medicine and Philosophy, 32:2, 99 - 116 To link to this article: DOI: 10.1080/03605310701255727 URL: http://dx.doi.org/10.1080/03605310701255727..
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163Moral Knowledge and the Acquisition of Virtue in Aristotle's "Nicomachean" and "Eudemian Ethics"Review of Metaphysics 54 (3). 2001.IN BOTH THE EUDEMIAN ETHICS AND THE NICOMACHEAN ETHICS, Aristotle says that the aim of ethical inquiry is a practical one; we want to know what virtue is so that we may become good ourselves and thereby do well and be happy. By classifying ethical inquiry as a practical endeavor, Aristotle is rejecting a view that he attributes to Socrates according to which ethics is a kind of theoretical science. In theoretical sciences, such as geometry or astronomy, the knowledge of a particular subject matt…Read more
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10An 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 ethi…Read more
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21Justice and the Human Development Approach to International ResearchHastings Center Report 35 (1): 24. 2005.The debate over when medical research may be performed in developing countries has steered clear of the broad issues of social justice in favor of what seem more tractable, practical issues. A better approach will reframe the question of justice in international research in a way that makes explicit the links between medical research, the social determinants of health, and global justice.
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86Justice and the human development approach to international researchHastings Center Report 35 (1): 24-37. 2005.: The debate over when medical research may be performed in developing countries has steered clear of the broad issues of social justice in favor of what seem more tractable, practical issues. A better approach will reframe the question of justice in international research in a way that makes explicit the links between medical research, the social determinants of health, and global justice
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17Within international development [1], public health [2], and clinical medicine [3]–[5], there is increasing interest in determining whether cash payments or other economic incentives can be used to influence the choices and behavior of individuals and groups in order to promote desired health goals. However, a number of complex issues affect the review and approval by research ethics committees of research studying the effectiveness of using financial incentives to promote desired health goals. …Read more
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17Embryos, Stem Cells, and the "Strategic" Element of Public Moral ReasoningAmerican Journal of Bioethics 2 (1): 56-57. 2002.
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14Freedom From Subjection to the Will of Others: Study Payments, Labor, and Moral EqualityAmerican Journal of Bioethics 19 (9): 32-34. 2019.Volume 19, Issue 9, September 2019, Page 32-34.
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40Groundhog Day for Medical Artificial IntelligenceHastings Center Report 48 (3). 2018.Following a boom in investment and overinflated expectations in the 1980s, artificial intelligence entered a period of retrenchment known as the “AI winter.” With advances in the field of machine learning and the availability of large datasets for training various types of artificial neural networks, AI is in another cycle of halcyon days. Although medicine is particularly recalcitrant to change, applications of AI in health care have professionals in fields like radiology worried about the futu…Read more
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48Does Research Ethics Rest on a Mistake? The Common Good, Reasonable Risk and Social JusticeAmerican Journal of Bioethics 5 (1). 2005.This Article does not have an abstract
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58Equipose and international human-subjects researchBioethics 15 (4). 2001.This paper examines the role of equipoise in evaluating international research. It distinguishes two possible formulations of the equipoise requirement that license very different evaluations of international research proposals. The interpretation that adopts a narrow criterion of similarity between clinical contexts has played an important role in one recent controversy, but it suffers from a number of problems. An alternative interpretation that adopts a broader criterion of similarity does a …Read more
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58Editor's introduction: Theory and engagement in bioethicsTheoretical Medicine and Bioethics 22 (2): 65-68. 2001.
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27Clinical Trial Portfolios: A Critical Oversight in Human Research Ethics, Drug Regulation, and PolicyHastings Center Report 49 (4): 31-41. 2019.Regulators rely on clinical trials for drug approval and labeling decisions. Health systems and clinicians rely on the evidence from trials to determine treatment, and patients rely on it to decide which courses of care to undertake. Many of these stakeholders presume that the careful review of individual studies is enough to address the ethical and scientific questions that arise in clinical trials. In what follows, however, we demonstrate that explicit consideration of trial portfolios—series …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 |