•  24
    Ethical Issues in Near-Future Socially Supportive Smart Assistants for Older Adults
    IEEE Transactions on Technology and Society. forthcoming.
    Abstract:This paper considers novel ethical issues pertaining to near-future artificial intelligence (AI) systems that seek to support, maintain, or enhance the capabilities of older adults as they age and experience cognitive decline. In particular, we focus on smart assistants (SAs) that would seek to provide proactive assistance and mediate social interactions between users and other members of their social or support networks. Such systems would potentially have significant utility for users…Read more
  •  67
    There is considerable enthusiasm about the prospect that artificial intelligence (AI) will help to improve the safety and efficacy of health services and the efficiency of health systems. To realize this potential, however, AI systems will have to overcome structural problems in the culture and practice of medicine and the organization of health systems that impact the data from which AI models are built, the environments into which they will be deployed, and the practices and incentives that st…Read more
  •  10
    A Dilemma for Respecting Autonomy: Bridge Technologies and the Hazards of Sequential Decision-Making
    with Aidan Kestigian
    Journal of Medicine and Philosophy 47 (2): 293-310. 2022.
    Respect for patient autonomy can apply at two levels: ensuring that patient care reflects their considered values and wishes and honoring patient preferences about how to make momentous decisions. Caregivers who seek to respect patient autonomy in the context of some end-of-life decisions face a dilemma. Because these decisions are fraught, patients may prefer to approach them sequentially, only making decisions at the time they arise. However, respecting patients’ preferences for a sequential a…Read more
  •  194
    Cutting to the Core: Exploring the Ethics of Contested Surgeries
    with Michael Benatar, Leslie Cannold, Dena Davis, Merle Spriggs, Julian Savulescu, Heather Draper, Neil Evans, Richard Hull, Stephen Wilkinson, David Wasserman, Donna Dickenson, Guy Widdershoven, Françoise Baylis, Stephen Coleman, Rosemarie Tong, Hilde Lindemann, and David Neil
    Rowman & Littlefield Publishers. 2006.
    When the benefits of surgery do not outweigh the harms or where they do not clearly do so, surgical interventions become morally contested. Cutting to the Core examines a number of such surgeries, including infant male circumcision and cutting the genitals of female children, the separation of conjoined twins, surgical sex assignment of intersex children and the surgical re-assignment of transsexuals, limb and face transplantation, cosmetic surgery, and placebo surgery
  •  14
    Perspective: The Maltese Conjoined Twins: Two Views of Their Separation
    with Lori P. Knowles
    Hastings Center Report 31 (1): 48. 2001.
  •  212
    The foundations of research ethics are riven with fault lines emanating from a fear that if research is too closely connected to weighty social purposes an imperative to advance the common good through research will justify abrogating the rights and welfare of study participants. The result is an impoverished conception of the nature of research, an incomplete focus on actors who bear important moral responsibilities, and a system of ethics and oversight highly attuned to the dangers of research…Read more
  •  8
    Weight(s) of complicity
    with Alec Walker
    Journal of Medical Ethics 45 (1): 69-70. 2019.
    International non-governmental organisations face a dilemma when deciding whether to intervene in crisis situations where their efforts can be exploited or co-opted by others: intervene and risk becoming complicit with wrongdoing or sit on the sidelines and consign vulnerable people to the ravages of neglect or oppression. In “‘He who helps the guilty, shares the crime’? INGOs, moral narcissism and complicity in wrongdoing,” Buth et al argue that concerns about complicity often stifle ethical de…Read more
  •  349
    Patient-Funded Trials: Opportunity or Liability?
    with Danielle M. Wenner and Jonathan Kimmelman
    Cell Stem Cell 17 (2): 135-137. 2015.
    Patient-funded trials are gaining traction as a means of accelerating clinical translation. However, such trials sidestep mechanisms that promote rigor, relevance, efficiency, and fairness. We recommend that funding bodies or research institutions establish mechanisms for merit review of patient-funded trials, and we offer some basic criteria for evaluating PFT protocols
  •  27
    Reviewing HIV‐Related Research in Emerging Economies: The Role of Government Reviewing Agencies
    with Patrina Sexton, Katrina Hui, Donna Hanrahan, Mark Barnes, Jeremy Sugarman, and Robert Klitzman
    Developing World Bioethics 16 (1): 4-14. 2016.
    Little research has explored the possible effects of government institutions in emerging economies on ethical reviews of multinational research. We conducted semi-structured, in-depth telephone interviews with 15 researchers, Research Ethics Committees personnel, and a government agency member involved in multinational HIV Prevention Trials Network research in emerging economies. Ministries of Health or other government agencies often play pivotal roles as facilitators or barriers in the researc…Read more
  •  4
    Ethical Issues in Modern Medicine
    with Bonnie Steinbock and John D. Arras
    Ethical Theory and Moral Practice 6 (4): 447-448. 2003.
  •  20
    No abstract
  •  15
    The high rates of attrition that occur in drug development are widely regarded as problematic, but the failure of well-designed studies benefits both researchers and healthcare systems by, for example, generating evidence about disease theories and demonstrating the limits of proven drugs. A wider recognition of these benefits will help the biomedical research enterprise to take full advantage of all the information generated during the drug development process
  •  44
    The Ethics of Advertising for Health Care Services
    with Yael Schenker and Robert M. Arnold
    American Journal of Bioethics 14 (3): 34-43. 2014.
    Advertising by health care institutions has increased steadily in recent years. While direct-to-consumer prescription drug advertising is subject to unique oversight by the Federal Drug Administration, advertisements for health care services are regulated by the Federal Trade Commission and treated no differently from advertisements for consumer goods. In this article, we argue that decisions about pursuing health care services are distinguished by informational asymmetries, high stakes, and pat…Read more
  • Virtue, Wisdom, and the Art of Ruling in Plato
    Dissertation, University of Virginia. 1999.
    This dissertation explores Plato's conception of the nature and value of wisdom and its relationship to the ethical virtues. It is argued that throughout what are referred to as Plato's early and middle dialogues, wisdom is identified with the political art and that, as such, those, dialogues consistently treat moral knowledge as a kind of craft knowledge. When this conception of wisdom is combined with the Socratic doctrine of the unity of the virtues, however, it raises serious problems for So…Read more
  •  11
    Uncommon misconceptions and common morality
    Journal of Medical Ethics 45 (12): 778-779. 2019.
    One of the fundamental challenges in any field of practical ethics is to articulate a framework for deliberation and decision making that is capable of providing warranted guidance about contentious ethical questions.1 Such a framework has to function effectively in the face of empirical uncertainty and what Rawls refers to as the fact of reasonable pluralism—the fact that individuals often differ in their ideals, ambitions, preferences and conceptions of the good life. One of the perennial ques…Read more
  •  12
    Virtue and Consequences
    Social Theory and Practice 24 (1): 1-23. 1998.
  •  1
    Virtue and Consequences
    Social Theory and Practice 24 (1): 1-23. 1998.
  •  6
    The Pluralism of Coherent Approaches to Global Health
    Hastings Center Report 47 (5): 26-27. 2017.
    Stakeholders in global health, including governments, international and nongovernmental organizations, and corporations, face complex decisions about how to help improve the lives of those most burdened by sickness and disease while upholding their rights and facilitating the transition to a more just social and political order. In “The Case for Resource-Sensitivity: Why It Is Ethical to Provide Cheaper, Less Effective Treatments in Global Health,” Govind Persad and Ezekiel Emanuel argue that “[…Read more
  •  8
    The Maltese conjoined twins. A separate peace
    Hastings Center Report 31 (1): 49. 2001.
  •  29
    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
  •  16
    In “The Real Problem With Equipoise,” Chiong (2006) raises two distinct, but interrelated issues concerning the concept of equipoise. The first deals with the role of equipoise in evaluating intern...
  •  191
    The independence of practical ethics
    Theoretical Medicine and Bioethics 22 (2): 87-105. 2001.
    After criticizing three common conceptions of therelationship between practical ethics and ethical theory, analternative modeled on Aristotle's conception of the relationshipbetween rhetoric and philosophical ethics is explored. Thisaccount is unique in that it neither denigrates the project ofsearching for an adequate comprehensive ethical theory norsubordinates practical ethics to that project. Because the purpose of practical ethics, on this view, is tosecure the cooperation of other persons …Read more
  •  63
    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