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461Are 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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446Two 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.
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44The 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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42Reaching Across The ‘Deepest Divide’: Moral Acquaintanceship, Religion, And BioethicsHeythrop Journal 61 (4): 677-688. 2020.The Heythrop Journal, EarlyView.
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39Whose harm? Which metaphysic?Theoretical Medicine and Bioethics 40 (1): 43-61. 2019.Douglas Diekema has argued that it is not the best interest standard, but the harm principle that serves as the moral basis for ethicists, clinicians, and the courts to trigger state intervention to limit parental authority in the clinic. Diekema claims the harm principle is especially effective in justifying state intervention in cases of religiously motivated medical neglect in pediatrics involving Jehovah’s Witnesses and Christian Scientists. I argue that Diekema has not articulated a harm pr…Read more
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38Taxonomizing Views of Clinical Ethics ExpertiseAmerican Journal of Bioethics 19 (11): 50-61. 2019.Our aim in this article is to bring some clarity to the clinical ethics expertise debate by critiquing and replacing the taxonomy offered by the Core Competencies report. The orienting question for our taxonomy is: Can clinical ethicists offer justified, normative recommendations for active patient cases? Views that answer “no” are characterized as a “negative” view of clinical ethics expertise and are further differentiated based on (a) why they think ethicists cannot give justified normative r…Read more
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34Three 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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29Secular 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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28When conscientious objection runs amok: A physician refusing HIV preventative to a bisexual patientClinical Ethics 16 (2): 151-154. 2021.This paper reports of a case where a physician conscientiously objected to prescribing PrEP to a bisexual patient so as not to “enable immoral sexual behavior.” The case represents an instance of conscience creep, a phenomenon whereby clinicians invoke conscientious objection in sometimes objectionable ways that extend beyond the traditional contexts of abortion, sterilization, or physician aid in dying. This essay uses a reasonability view of conscientious objection to argue that the above case…Read more
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23One of the most significant and persistent debates in secular clinical ethics is the question of ethics expertise, which asks whether ethicists can make justified moral recommendations in active patient cases. A critical point of contention in the ethics expertise debate is whether there is, in fact, a bioethical consensus upon which secular ethicists can ground their recommendations and whether there is, in principle, a way of justifying such a consensus in a morally pluralistic context. In a s…Read more
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20Putting 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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20We have nothing left to buryHastings Center Report 52 (1): 12-14. 2022.Hastings Center Report, Volume 52, Issue 1, Page 12-14, January/February 2022.
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20Mapping 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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20The Quasi-religious Nature of Clinical Ethics ConsultationHEC Forum 32 (3): 199-209. 2020.What is the proper role of a clinical ethics consultant’s religious beliefs in forming recommendations for clinical ethics consultation? Where Janet Malek has argued that religious belief should have no influence on the formation of a CEC’s recommendations, Clint Parker has argued a CEC should freely appeal to all their background beliefs, including religious beliefs, in formulating their recommendations. In this paper, I critique both their views by arguing the position envisioned by Malek puts…Read more
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19Response to Open Peer Commentaries “Taxonomizing Views of Clinical Ethics Expertise”American Journal of Bioethics 20 (1). 2020.
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19Dementia, beauty, and play: A way of seeing and being with the wearisome patientClinical Ethics 17 (1): 87-89. 2022.We describe a case of an elderly patient suffering from advanced dementia whose chronic confusion has become a source of frustration for her caregivers. Mrs. M experiences a touching interaction with a new nurse who takes a different approach with her. We describe this interaction and elaborate upon it by drawing from Catholic social teaching and the philosophy of play. Cases like these do not involve dramatic or esoteric ethical problematics, but rather the sort of dilemma born of the everyday …Read more
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18Conscience claims, metaphysics, and avoiding an LGBT eugenicBioethics 32 (5): 272-280. 2018.Novel assisted reproductive technologies (ART) are poised to present our society with strange new ethical questions, such as whether lesbian, gay, bisexual, and transgender (LGBT) couples should be allowed to produce children biologically related to both parents, or whether trans‐women who want to experience childbirth should be allowed to receive uterine transplants. Clinicians opposed to offering such technologies to LGBT couples on moral grounds are likely to seek legal shelter through the co…Read more
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18This case raises the difficult question of how to respond to patients who appear to lack decision-making capacity, yet retain limited communication that allows them to state a preference for life-sustaining treatment that conflicts with the choice of their surrogate. I argue that the patient’s preference should be honored, even though the patient lacks decision-making capacity, and the preference contradicts the wishes of the surrogate.
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17Burying 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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16Defending 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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16Credentialing Ethics ExpertiseAmerican Journal of Bioethics 20 (3): 50-52. 2020.Volume 20, Issue 3, March 2020, Page 50-52.
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15Philosophical 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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15The 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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15Neuroethics and the Naturalistic FallacyAmerican Journal of Bioethics Neuroscience 10 (3): 124-126. 2019.
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14What is the appropriate role of reason in secular clinical ethics? An argument for a compatibilist view of public reasonMedicine, Health Care and Philosophy 24 (2): 281-290. 2021.This article describes and rejects three standard views of reason in secular clinical ethics. The first, instrumental reason view, affirms that reason may be used to draw conceptual distinctions, map moral geography, and identify invalid forms of argumentation, but prohibits recommendations because reason cannot justify any content-full moral or metaphysical commitments. The second, public reason view, affirms instrumental reason, and claims ethicists may make recommendations grounded in the mor…Read more
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14Conscientious 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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13Capacities 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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13Phenomenology, Saudi Arabia, and an argument for the standardization of clinical ethics consultationPhilosophy, Ethics and Humanities in Medicine 16 (1): 1-9. 2021.BackgroundThe purpose of this study is to make a philosophical argument against the phenomenological critique of standardization in clinical ethics. We used the context of clinical ethics in Saudi Arabia to demonstrate the importance of credentialing clinical ethicists.MethodsPhilosophical methods of argumentation and conceptual analysis were used.ResultsWe found the phenomenological critique of standardization to be flawed because it relies on a series of false dichotomies.ConclusionsWe conclud…Read more
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12Two Troubling Trends in the Conversation Over Whether Clinical Ethics Consultants Have Ethics ExpertiseHEC Forum 30 (2): 157-169. 2018.In a recent issue of the Journal of Medicine and Philosophy, several scholars wrote on the topic of ethics expertise in clinical ethics consultation. The articles in this issue exemplified what we consider to be two troubling trends in the quest to articulate a unique expertise for clinical ethicists. The first trend, exemplified in the work of Lisa Rasmussen, is an attempt to define a role for clinical ethicists that denies they have ethics expertise. Rasmussen cites the dependence of ethical e…Read more
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11It’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
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 |