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11Bio-Psycho-Spiritual Perspectives on Psychedelics: Clinical and Ethical ImplicationsPerspectives in Biology and Medicine 67 (1): 117-142. 2024.ABSTRACT:Psychedelics have again become a subject of widespread interest, owing to the reinvigoration of research into their traditional uses, possible medical applications, and social implications. As evidence for psychedelics' clinical potential mounts, the field has increasingly focused on searching for mechanisms to explain the effects of psychedelics and therapeutic efficacy of psychedelic-assisted therapy (PAT). This paper reviews three general frameworks that encompass several prominent m…Read more
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7Introduction to the Special Section on Psychedelics Research and TreatmentPerspectives in Biology and Medicine 67 (1): 114-116. 2024.In lieu of an abstract, here is a brief excerpt of the content:Introduction to the Special Section on Psychedelics Research and TreatmentDominic SistiAgainst a backdrop of post-pandemic malaise, diseases of despair, and a fragmented mental health care system, psychedelics have enjoyed a resurgence of interest as powerful psychotherapeutic agents and as catalysts of personal growth. The true power of these substances—some of which are considered sacramental by Indigenous peoples—has been shrouded…Read more
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329The case of Terri Schiavo: ethics at the end of life (edited book)Prometheus Books. 2006.Gathers medical and legal documents, opinions from various perspectives, and a timeline of events in the Terri Shiavo case to provide a resource for examining the moral and ethical issues surrounding end-of-life decisions.
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133Health, Disease, and Illness: Concepts in Medicine (edited book)Georgetown University Press. 2004.Health, Disease, and Illness brings together a sterling list of classic and contemporary thinkers to examine the history, state, and future of ever-changing "concepts" in medicine.
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4Clinical Wisdom and Evidence-Based Medicine Are (Indeed) Complementary: A Reply to Bursztajn and ColleaguesJournal of Clinical Ethics 23 (1): 37-40. 2012.We briefly respond to Bursztajn and colleagues’ commentary on our article, “Clinical Wisdom in Psychoanalysis and Psychodynamic Psychotherapy: A Philosophical and Qualitative Analysis.”
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26Help Wanted: Entrepreneurs Needed to Serve Bioethics' OutsidersAmerican Journal of Bioethics 1 (3): 48-49. 2001.
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52Past Is Prologue: Ethical Issues in Pediatric Psychedelics Research and TreatmentPerspectives in Biology and Medicine 66 (1): 129-144. 2023.Abstractabstract:Recent clinical trials of psychedelic drugs aim to treat a range of psychiatric conditions in adults. MDMA and psilocybin administered with psychotherapy have received FDA designation as "breakthrough therapies" for post-traumatic stress disorder (PTSD) and treatment-resistant depression (TRD) respectively. Given the potential benefit for minors burdened with many of the same disorders, calls to expand experimentation to minors are inevitable. This essay examines psychedelic res…Read more
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19Skip the Trip? Five Arguments on the Use of Nonhallucinogenic Psychedelics in PsychiatryCambridge Quarterly of Healthcare Ethics 31 (4): 472-476. 2022.
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38Journeying to Ixtlan: Ethics of Psychedelic Medicine and Research for Alzheimer’s Disease and Related DementiasAmerican Journal of Bioethics Neuroscience 14 (2): 107-123. 2023.In this paper, we examine the case of psychedelic medicine for Alzheimer’s disease and related dementias (AD/ADRD). These “mind-altering” drugs are not currently offered as treatments to persons with AD/ADRD, though there is growing interest in their use to treat underlying causes and associated psychiatric symptoms. We present a research agenda for examining the ethics of psychedelic medicine and research involving persons living with AD/ADRD, and offer preliminary analyses of six ethical issue…Read more
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The concept of diseaseIn Miriam Solomon, Jeremy R. Simon & Harold Kincaid (eds.), The Routledge Companion to Philosophy of Medicine, Routledge. 2016.
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33Borderline personality disorder, therapeutic privilege, integrated care: is it ethical to withhold a psychiatric diagnosis?Journal of Medical Ethics 48 (11): 801-804. 2021.Once common, therapeutic privilege—the practice whereby a physician withholds diagnostic or prognostic information from a patient intending to protect the patient—is now generally seen as unethical. However, instances of therapeutic privilege are common in some areas of clinical psychiatry. We describe therapeutic privilege in the context of borderline personality disorder, discuss the implications of diagnostic non-disclosure on integrated care and offer recommendations to promote diagnostic di…Read more
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20A Call for Greater Regulation of Digital Mental Health TechnologiesAmerican Journal of Bioethics Neuroscience 13 (3): 193-195. 2022.
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34Psychiatric Research EthicsIn Ana S. Iltis & Douglas MacKay (eds.), The Oxford Handbook of Research Ethics, Oxford University Press. 2020.Psychiatric research often poses special ethical concerns. This chapter first provides historical context, including scandals that stoked public concern about psychiatric research and led to the promulgation of canonical documents and bioethics scholarship, and then explores issues related to the decision-making capacity and safety of participants—including the use of placebos and washout periods, the design of suicide prevention studies, and research in emergency psychiatry. The chapter then de…Read more
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13Editor's Introduction to the Special Issue on Mental Health and IllnessPerspectives in Biology and Medicine 64 (1): 1-5. 2021.Mental illness affects every aspect of life and society, from relationships between individuals and within families, to small communities and entire polities. People with serious mental illness die decades before those without. Mentally ill people suffer daily as they struggle to function in societies that are unforgiving and uninterested in their pain. Those with serious mental illness may be incarcerated because of their sickness, they may be passed over or fired from jobs, subjected to ridicu…Read more
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20When patients refuse COVID-19 testing, quarantine, and social distancing in inpatient psychiatry: clinical and ethical challengesJournal of Medical Ethics 46 (9): 579-580. 2020.The COVID-19 pandemic has introduced new ethical challenges in the care of patients with serious psychiatric illness who require inpatient treatment and who may have beeen exposed to COVID-19 or have mild to moderate COVID-19 but refuse testing and adherence to infection prevention protocols. Such situations increase the risk of infection to other patients and staff on psychiatric inpatient units. We discuss medical and ethical considerations for navigating this dilemma and offer a set of policy…Read more
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66Ethics and ego dissolution: the case of psilocybinJournal of Medical Ethics 47 (12): 807-814. 2021.Despite the fact that psychedelics were proscribed from medical research half a century ago, recent, early-phase trials on psychedelics have suggested that they bring novel benefits to patients in the treatment of several mental and substance use disorders. When beneficial, the psychedelic experience is characterized by features unlike those of other psychiatric and medical treatments. These include senses of losing self-importance, ineffable knowledge, feelings of unity and connection with othe…Read more
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51Ethical Advocacy Across the Autism Spectrum: Beyond Partial RepresentationAmerican Journal of Bioethics 20 (4): 13-24. 2020.Recent debates within the autism advocacy community have raised difficult questions about who can credibly act as a representative of a particular population and what responsibilities that...
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23Prescribing medical cannabis: ethical considerations for primary care providersJournal of Medical Ethics 46 (4): 227-230. 2020.Medical cannabis is widely available in the USA and legalisation is likely to expand. Despite the increased accessibility and use of medical cannabis, physicians have significant knowledge gaps regarding evidence of clinical benefits and potential harms. We argue that primary care providers have an ethical obligation to develop competency to provide cannabis to appropriate patients. Furthermore, specific ethical considerations should guide the recommendation of medical cannabis. In many cases, t…Read more
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21Decision-Making Capacity Will Have a Limited Effect on Civil Commitment PracticesAmerican Journal of Bioethics 19 (10): 86-88. 2019.Volume 19, Issue 10, October 2019, Page 86-88.
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46Physician Aid-in-Dying for Individuals With Serious Mental Illness: Clarifying Decision-Making Capacity and Psychiatric FutilityAmerican Journal of Bioethics 19 (10): 61-63. 2019.Volume 19, Issue 10, October 2019, Page 61-63.
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77Social Media, E‐Health, and Medical EthicsHastings Center Report 49 (1): 24-33. 2019.Given the profound influence of social media and emerging evidence of its effects on human behavior and health, bioethicists have an important role to play in the development of professional standards of conduct for health professionals using social media and in the design of online systems themselves. In short, social media is a bioethics issue that has serious implications for medical practice, research, and public health. Here, we inventory several ethical issues across four areas at the inte…Read more
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37Policing Compliance: Digital Medicine and Criminal Justice-Involved PersonsAmerican Journal of Bioethics 18 (9): 57-58. 2018.Klugman et al. (2018) describe how new medical devices track treatment adherence more accurately than a clinician relying on his or her patient’s self-report. For example, these devices promise to...
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22Comparing Patient, Clinician, and Caregiver Perceptions of Care for Early Psychosis: A Free Listing StudyNarrative Inquiry in Bioethics 8 (2): 157-178. 2018.
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5What We Owe the Psychopath: A Pragmatic ReplyAmerican Journal of Bioethics Neuroscience 4 (2): 24-26. 2013.
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7Paradigms of Addiction and Evidence for Addiction MedicationAmerican Journal of Bioethics Neuroscience 4 (3): 46-48. 2013.
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44Clinical Wisdom in Psychoanalysis and Psychodynamic Psychotherapy: A Philosophical and Qualitative AnalysisJournal of Clinical Ethics 23 (1): 13-27. 2012.To precisely define wisdom has been an ongoing task of philosophers for millennia. Investigations into the psychological dimensions of wisdom have revealed several features that make exemplary persons "wise." Contemporary bioethicists took up this concept as they retrieved and adapted Aristotle's intellectual virtue of phronesis for applications in medical contexts. In this article, we build on scholarship in both psychology and medical ethics by providing an account of clinical wisdom qua phron…Read more
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23Health and Disease: Conceptual Perspectives and Ethical ImplicationsIn Vardit Ravitsky, Autumn Fiester & Arthur L. Caplan (eds.), The Penn Center Guide to Bioethics, Springer Publishing Company. pp. 59. 2009.
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41Assessing Decision-Making Capacity: A Primer for the Development of Hospital Practice GuidelinesHEC Forum 26 (2): 159-168. 2014.Decision making capacity (DMC) is a fundamental concept grounding the principle of respect for autonomy and the practice of obtaining informed consent. DMC must be determined and documented every time a patient undergoes a hospital procedure and for routine care when there is reason to believe decision making ability is compromised. In this paper we explore a path toward ethically informed development and implementation of a hospital policy related to DMC assessment. We begin with a review of th…Read more
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136How do high school students justify internet plagiarism?Ethics and Behavior 17 (3). 2007.Internet plagiarism continues unabated and may even be increasing. Questions pertaining to the ethical-moral construct employed by students to justify Internet plagiarism among high school students have remained relatively untouched. Understanding not simply the prevalence of Internet plagiarism but also the variety of explanations used by students to justify their plagiarism seems crucial to curtailing its practice. In this study, I surveyed 160 high school students and endeavored to understand…Read more
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21Assent as an ethical imperative in the treatment of ADHDJournal of Medical Ethics 41 (12): 977-981. 2015.
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University of PennsylvaniaRegular Faculty
Philadelphia, Pennsylvania, United States of America
Areas of Interest
Applied Ethics |