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5On What Grounds? A Pilot Study of References Used in Clinical Ethics Consultation and EducationHEC Forum 1-19. forthcoming.In accordance with standards published by the American Society for Bioethics and Humanities (ASBH), ethics consultants are expected to provide recommendations that align with scholarly literature, professional society statements, law, and policy. However, there are no studies to date that characterize the specific references that ethics consultants and educators use to inform their work. To address this gap, a convenience sample of clinical ethics consultants and educators was surveyed online th…Read more
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22Conscientious Objection to Aggressive Interventions for Patients in a Vegetative StateAmerican Journal of Bioethics 1-12. forthcoming.Some physicians refuse to perform life-sustaining interventions, such as tracheostomy, on patients who are very likely to remain permanently unconscious. To explain their refusal, these clinicians often invoke the language of “futility”, but this can be inaccurate and can mask problematic forms of clinical power. This paper explores whether such refusals should instead be framed as conscientious objections. We contend that the refusal to provide interventions for patients very likely to remain p…Read more
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13It’s Worth What You Can Sell It for: A Survey of Employment and Compensation Models for Clinical EthicistsHEC Forum 1-16. forthcoming.This article reports results of a survey about employment and compensation models for clinical ethics consultants working in the United States and discusses the relevance of these results for the professionalization of clinical ethics. This project uses self-reported data from healthcare ethics consultants to estimate compensation across different employment models. The average full-time annualized salary of respondents with a clinical doctorate is $188,310.08 (SD=$88,556.67), $146,134.85 (SD=$5…Read more
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33The Right to Be ChildfreeNarrative Inquiry in Bioethics 13 (1): 59-64. 2023.Abstract:In this manuscript, we start with a real life account of an Ob/Gyn experience with a young patient from the childfree movement requesting permanent sterilization. A narrative ethics approach invites the reader to experience the encounter in an immersive way for this growing issue. This approach allows readers to reflect on their reaction to the patient and consider how that can affect other patient encounters. Additionally, it explores the stigma these young patients encounter making a …Read more
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10Non-Roman Catholic Physicians Should Be Permitted to Write Prescriptions for Birth Control in Roman Catholic InstitutionsJournal of Clinical Ethics 32 (3): 265-270. 2021.The legal and ethical asymmetry between honoring positive claims of conscience versus negative claims of conscience was recently analyzed by several articles in this journal. The first author of this article (ALB) identified unique but defeasible reasons against honoring positive claims of conscience, such as the greater threat they post to institutional values and institutional resources than negative claims of conscience. However, ALB wrote, when these reasons can be overcome, positive claims …Read more
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6An Argument for Standardized Ethical Directives for Secular Healthcare ServicesJournal of Clinical Ethics 33 (3): 175-188. 2022.We argue that the American Society for Bioethics and Humanities has endorsed a facilitation approach to clinical ethics consultation that asserts that bioethicists can offer moral recommendations that are well-grounded in bioethical consensus. We claim that the closest thing the field currently has to a citable, nationally endorsed bioethical consensus are the 22 Core References used to construct the questions for the Healthcare Ethics Consultant-Certified (HEC-C) exam. We acknowledge that the C…Read more
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6Responding to Fiester’s Critique of a Bioethical Consensus ProjectJournal of Clinical Ethics 33 (3): 198-201. 2022.We respond to Autumn Fiester’s critique that our proposed bioethical consensus project amounts to “ethical hegemony,” and evaluate her claim that ethicists should restrict themselves to “mere process” recommendations. We argue that content recommendations are an inescapable aspect of clinical ethics consultation, and our primary concern is that, without standardization of bioethical consensus, our field will vacillate among appeals to the disparate claims in the 22 “Core References,” unsustainab…Read more
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9Should Positive Claims of Conscience Receive the Same Protection as Negative Claims of Conscience? Clarifying the Asymmetry DebateJournal of Clinical Ethics 31 (2): 136-142. 2020.In the debate over clinicians’ conscience, there is a greater ethical, legal, and scholarly focus on negative, rather than positive, claims of conscience. This asymmetry produces a seemingly unjustified double standard with respect to clinicians’ conscience under the law. For example, a Roman Catholic physician working at a secular institution may refuse to provide physician-aid-in-dying on the basis of conscience, but a secular physician working at a Roman Catholic institution may not insist on…Read more
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16Defending, Improving, Expanding, and Applying a Moral-Metaphysical Proceduralism for Secular Clinical EthicsAmerican Journal of Bioethics 21 (7): 6-9. 2021.A paradox has always lingered at the heart of secular clinical ethics: How are ethicists to provide moral guidance in a pluralistic society? I want to thank all the commentary authors for being suc...
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15Capacities to Refuse Treatment: A ReplyAmerican Journal of Bioethics 24 (3): 15-19. 2023.The three of us work as academics and clinical ethicists. In our clinical ethics work, we often encounter patients who lack decision-making capacity, but who nonetheless have strong preferences abo...
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23Mapping the Moral Terrain of Clinical DeceptionHastings Center Report 53 (1): 17-25. 2023.Legal precedent, professional‐society statements, and even many medical ethicists agree that some situations may call for a clinician to engage in an act of lying or nonlying deception of a patient or patient's family member. Still, the moral terrain of clinical deception is largely uncharted, and when it comes to practical guidance for clinicians, many might think that ethicists offer nothing more than the rule never to deceive. This guidance is insufficient to meet the real‐world demands of cl…Read more
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While many Catholic hospitals permit the prescription of the emergency contraception drug levonorgestrel for rape victims, some continue to prohibit this practice as a matter of institutional conscience. While the standard approach to this issue has been to offer an argument that levonorgestrel either is or is not morally permissible, we have taken a different tack. We begin by briefly describing and acknowledging that reasonable disagreement exists on this question (part one), and then arguing …Read more
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Conscientious objection and LGBTQ discrimination in the United StatesJournal of Public Health Policy 42 (2). 2021.Given recent legal developments in the United States, now is a critical time to draw attention to how ‘conscientious objection’ is sometimes used by health care providers to discriminate against the LGBTQ community. We review legal developments from 2019 and present several cases where health care providers used conscientious objection in ways that discriminate against the LGBTQ community, resulting in damaged trust by this underserved population. We then discuss two important conceptual points …Read more
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Non-Roman Catholic Physicians Should Be Permitted to Write Prescriptions for Birth Control in Roman Catholic InstitutionsJournal of Clinical Ethics 32 (3). 2021.The legal and ethical asymmetry between honoring positive claims of conscience versus negative claims of conscience was recently analyzed by several articles in this journal. The first author of this article (ALB) identified unique but defeasible reasons against honoring positive claims of conscience, such as the greater threat they post to institutional values and institutional resources than negative claims of conscience. However, ALB wrote, when these reasons can be overcome, positive claims …Read more
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12Locked InHastings Center Report 52 (6): 4-5. 2022.Tiffany was seventeen when injury to her brain stem put her in the intensive care unit on life‐sustaining treatment and in a permanently locked‐in state—fully conscious but able to control no bodily movements other than her eye movements. As a clinical ethicist at the hospital, I was consulted by her neurologist, who had established a blink‐once‐for‐yes, twice‐for‐no system of communication so that Tiffany could respond to questions. Her mother wanted Tiffany to continue receiving treatment that…Read more
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16Philosophical Failure and the Reasonability View of Conscientious Objection: Can Reason Adjudicate Metaphysical or Religious Claims?Journal of Medicine and Philosophy 48 (1): 12-20. 2023.Robert Card has proposed a reasonability view of conscientious objection that asks providers to state the reasons for their objection for evaluation and approval by a review board. Jason Marsh has challenged Card to provide explicit criteria for what makes a conscientious objection reasonable, which he claims will be too difficult a task given that such objections often involve contentious metaphysical or religious claims. Card has responded by outlining standards by which a conscientious object…Read more
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24Putting the Asymmetry Debate in Its PlaceAmerican Journal of Bioethics 21 (8): 68-69. 2021.The target article by Kyle Fritz draws attention to the asymmetry debate, an under-analyzed issue within the broader debate over the proper role of physician conscience in healthcare. The as...
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21Neuroethics and the Naturalistic FallacyAmerican Journal of Bioethics Neuroscience 10 (3): 124-126. 2019.
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22Credentialing Ethics ExpertiseAmerican Journal of Bioethics 20 (3): 50-52. 2020.Volume 20, Issue 3, March 2020, Page 50-52.
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Should Positive Claims of Conscience Receive the Same Protection as Negative Claims of Conscience? Clarifying the Asymmetry DebateJournal of Clinical Ethics 31 (2). 2020.In the debate over clinicians’ conscience, there is a greater ethical, legal, and scholarly focus on negative, rather than positive, claims of conscience. This asymmetry produces a seemingly unjustified double standard with respect to clinicians’ conscience under the law. For example, a Roman Catholic physician working at a secular institution may refuse to provide physician-aid-in-dying on the basis of conscience, but a secular physician working at a Roman Catholic institution may not insist on…Read more
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38Three Kinds of Decision-Making Capacity for Refusing Medical InterventionsAmerican Journal of Bioethics 22 (11): 73-83. 2021.According to a standard account of patient decision-making capacity, patients can provide ethically valid consent or refusal only if they are able to understand and appreciate their medical c...
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34Secular Clinical Ethicists Should Not Be Neutral Toward All Religious Beliefs: An Argument for a Moral-Metaphysical ProceduralismAmerican Journal of Bioethics 21 (6): 5-16. 2021.Moral pluralism poses a foundational problem for secular clinical ethics: How can ethical dilemmas be resolved in a context where there is disagreement not only on particular cases, but further, on...
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10Fostering medical staff reflection on the technological alienation of parents in the NICUClinical Ethics 17 (4): 449-451. 2022.We describe a case of parents refusing a tracheostomy for an otherwise healthy newborn. The refusal was not honored because permitting the refusal would have violated state law, which required a child to have a qualifying condition (e.g. a terminal diagnosis, permanent unconsciousness, incurable condition with severe suffering) to remove or withhold life-sustaining treatment. However, this case strained the relationship between the parents and medical staff, who worried about sending the newborn…Read more
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508Are conscientious objectors morally obligated to refer?Journal of Medical Ethics 48 (8): 547-550. 2022.In this paper, we argue that providers who conscientiously refuse to provide legal and professionally accepted medical care are not always morally required to refer their patients to willing providers. Indeed, we will argue that refusing to refer is morally admirable in certain instances. In making the case, we show that belief in a sweeping moral duty to refer depends on an implicit assumption that the procedures sanctioned by legal and professional norms are ethically permissible. Focusing on …Read more
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23Burying the basilisk of bioethics: What can be resolved, dissolved, and refocused in the ethics expertise debateBioethics 37 (6): 515-522. 2023.Since the inception of bioethics, some theorists have denied that clinical ethicists have ethics expertise, understood as the ability to give justified moral recommendations in patient cases. These denials have caused considerable alarm, leading some to argue that the entire discipline needs to be fundamentally reconsidered. Although this debate has been a source of academic attention for decades, these challenges to ethics expertise can now be either resolved by showing they are based on an unt…Read more
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21The many metaphysical commitments of secular clinical ethics: Expanding the argument for a moral–metaphysical proceduralismBioethics 36 (7): 783-793. 2022.Bioethics, Volume 36, Issue 7, Page 783-793, September 2022.
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19Defending secular clinical ethics expertise from an Engelhardt-inspired sense of theoretical crisisTheoretical Medicine and Bioethics 43 (1): 47-66. 2022.The national standards for clinical ethics consultation set forth by the American Society for Bioethics and Humanities endorse an “ethics facilitation” approach, which characterizes the role of the ethicist as one skilled at facilitating consensus within the range of ethically acceptable options. To determine the range of ethically acceptable options, ASBH recommends the standard model of decision-making, which is grounded in the values of autonomy, beneficence, nonmaleficence, and justice. H. T…Read more
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397Two internal critiques for theists who oppose moral enhancement on a process virtue basisBioethics 36 (4): 367-373. 2021.Bioethics, Volume 36, Issue 4, Page 367-373, May 2022.
Abram Brummett
Oakland University William Beaumont School of Medicine
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Oakland University William Beaumont School of MedicineAssistant Professor
Saint Louis University
PhD, 2019
Areas of Specialization
Medical Ethics |
Neuroethics |
Reproductive Ethics |
Areas of Interest
Philosophy, Misc |
Value Theory |
Metaphysics and Epistemology |
Medical Ethics |
Neuroethics |