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32When Religious Language Blocks Discussion About Health Care Decision MakingHEC Forum 31 (2): 151-166. 2019.There is a curious asymmetry in cases where the use of religious language involves a breakdown in communication and leads to a seemingly intractable dispute. Why does the use of religious language in such cases almost always arise on the side of patients and their families, rather than on the side of clinicians or others who work in healthcare settings? I suggest that the intractable disputes arise when patients and their families use religious language to frame their problem and the possibiliti…Read more
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59Recommendations for Nanomedicine Human Subjects Research Oversight: An Evolutionary Approach for an Emerging FieldJournal of Law, Medicine and Ethics 40 (4): 716-750. 2012.Nanomedicine is yielding new and improved treatments and diagnostics for a range of diseases and disorders. Nanomedicine applications incorporate materials and components with nanoscale dimensions where novel physiochemical properties emerge as a result of size-dependent phenomena and high surface-to-mass ratio. Nanotherapeutics and in vivo nanodiagnostics are a subset of nanomedicine products that enter the human body. These include drugs, biological products, implantable medical devices, and c…Read more
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Ritual, society and communityIn David Solomon, Ruiping Fan & Bingxiang Luo (eds.), Ritual and the moral life: reclaiming the tradition, Springer. 2012.
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16Thinking Theologically About Reproductive and Genetic Enhancements: The ChallengeChristian Bioethics 5 (2): 154-182. 1999.Current philosophical and legal bioethical reflection on reprogenetics provides little more than a rationalization of the interests of science. There are two reasons for this. First, bioethicists attempt to address ethical issues in a “language of precision” that characterizes science, and this works against analogical and narratological modes of discourse that have traditionally provided guidance for understanding human nature and purpose. Second, the current ethical and legal debate is framed …Read more
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5Why Bioethics Needs the Philosophy of Medicine: Some Implications of Reflection on Concepts of Health and DiseaseTheoretical Medicine: An International Journal for the Philosophy and Methodology of Medical Research and Practice 18 (1-2): 145-163. 1997.Germund Hesslow has argued that concepts of health and disease serve no important scientific, clinical, or ethical function. However, this conclusion depends upon the particular concept of disease he espouses; namely, on Boorse's functional notion. The fact/value split embodied in the functional notion of disease leads to a sharp split between the "science" of medicine and bioethics, making the philosophy of medicine irrelevant for both. By placing this disease concept in the broader context of …Read more
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32Embryo Research: The Ethical Geography of the DebateJournal of Medicine and Philosophy 22 (5): 495-519. 1997.Three basic political positions on embryo research will be identified as libertarian, conservative, and social-democratic. The Human Embryo Research Panel will be regarded as an expression of the social-democratic position. A taxonomy of the ethical issues addressed by the Panel will then be developed at the juncture of political and ethical modes of reflection. Among the arguments considered will be those for the separability of the abortion and embryo research debates; arguments against the po…Read more
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51A Framework for Understanding Medical EpistemologiesJournal of Medicine and Philosophy 38 (5): 461-486. 2013.What clinicians, biomedical scientists, and other health care professionals know as individuals or as groups and how they come to know and use knowledge are central concerns of medical epistemology. Activities associated with knowledge production and use are called epistemic practices. Such practices are considered in biomedical and clinical literatures, social sciences of medicine, philosophy of science and philosophy of medicine, and also in other nonmedical literatures. A host of different ki…Read more
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18The value of comparative analysis in framing the problems of organizational ethicsHEC Forum 13 (2): 125-131. 2001.
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8The domain of parental discretion in treatment of neonates: Beyond the impasse between a sanctity-of-life and quality-of-life ethicIn Julia Lai Po-Wah Tao (ed.), Cross-cultural perspectives on the (im) possibility of global bioethics, Kluwer Academic. pp. 277--298. 2002.
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24The Social Conditions for Nanomedicine: Disruption, Systems, and Lock-inJournal of Law, Medicine and Ethics 34 (4): 733-740. 2006.Here we consider two ways that nanomedicine might be disruptive. First, low-end disruptions that are intrinsically unpredictable but limited in scope, and second, high end disruptions that involve broader societal issues but can be anticipated, allowing opportunity for ethical reflection
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37Robert L. Perkins (ed.), International Kierkegaard commentary: Either/or, part I Robert L. Perkins (ed.), International Kierkegaard commentary: Either/or, part II (review)International Journal for Philosophy of Religion 46 (2): 122-125. 1999.
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40Hegel and the Spirit (review)The Owl of Minerva 26 (1): 71-77. 1994.In most of the philosophy of the last 150 years, theological concerns have been increasingly marginalized. This does not mean that the issues that were addressed theologically in the past are no longer addressed. Rather, the perennial concerns have been reconstructed so that they are no longer tied to a religious context. Ecclesiology has become political theory, moral theology has become ethics, and doctrines of revelation have become epistemology. Such a list could be made fairly exhaustive, a…Read more
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24Bioethics in a Liberal Society (review)International Studies in Philosophy 30 (2): 124-125. 1998.
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15What is Unique about Nanomedicine? The Significance of the MesoscaleJournal of Law, Medicine and Ethics 40 (4): 780-794. 2012.In prominent funding and policy statements, a particle with at least one dimension in the 1-300 nm size range must have novel physicochemical properties to count as a “nanoparticle.” Size is thus only one factor. Novelty of a particle's properties is also essential to its “nano” classification. When particles in this size range are introduced into living systems, they often interact with their host in novel ways that require some modification of existing methods and models used by pharmaceutical…Read more
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59The Aesthetics of Clinical Judgment: Exploring the Link between Diagnostic Elegance and Effective Resource UtilizationMedicine, Health Care and Philosophy 2 (2): 141-159. 1999.Many physicians assert that new cost-control mechanisms inappropriately interfere with clinical decision-making. They claim that high costs arise from poorly practiced medicine, and argue that effective utilization of resources is best promoted by advancing the scientific and ethical ideals of medicine. However, the claim is not warranted by empirical evidence. In this essay, I show how it rests upon aesthetic considerations associated with diagnostic elegance. I first consider scientific ration…Read more
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47The Institute of Medicine’s Reports on Quality and Safety: Paradoxes and Tensions (review)HEC Forum 20 (1): 1-14. 2008.
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29Struggling to understand and the nature of organizational ethicsHEC Forum 11 (4): 285-287. 1999.
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28Illness, the Problem of Evil, and the Analogical Structure of Healing: On the Difference Christianity Makes in BioethicsChristian Bioethics 1 (1): 102-120. 1995.A Christian bioethic needs to place the medical approach to sickness, suffering, and death within the context of redemption and the renewal of humanity in the image of God. This can be done by accounting for the way in which the disruptions of the human life-world that attend the illness experience manifest the structure of the problem of evil and point toward an answer that transcends the individual and the medical community. Further, the disease-oriented approach to medicine, when understood i…Read more
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82Expanding the horizon of reflection on health and diseaseJournal of Medicine and Philosophy 20 (5): 461-473. 1995.Last updated - 2020-01-06.
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22A hierarchical architecture for nano-scale science and technology: taking stock of the claims about science made by advocates of NBIC convergenceIn Baird D. (ed.), Discovering the Nanoscale, Ios. pp. 21--33. 2004.
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77Why bioethics needs the philosophy of medicine: Some implications of reflection on concepts of health and diseaseTheoretical Medicine and Bioethics 18 (1-2): 145-163. 1997.Germund Hesslow has argued that concepts of health and disease serve no important scientific, clinical, or ethical function. However, this conclusion depends upon the particular concept of disease he espouses; namely, on Boorse's functional notion. The fact/value split embodied in the functional notion of disease leads to a sharp split between the science of medicine and bioethics, making the philosophy of medicine irrelevant for both. By placing this disease concept in the broader context of me…Read more
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110The ethics of NBIC convergenceJournal of Medicine and Philosophy 32 (3). 2007.This Article does not have an abstract
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20The Social Conditions for Nanomedicine: Disruption, Systems, and Lock-InJournal of Law, Medicine and Ethics 34 (4): 733-740. 2006.Many believe that nanotechnology will be disruptive to our society. Presumably, this means that some people and even whole industries will be undermined by technological developments that nanoscience makes possible. This, in turn, implies that we should anticipate potential workforce disruptions, mitigate in advance social problems likely to arise, and work to fairly distribute the future benefits of nanotechnology. This general, somewhat vague sense of disruption, is very difficult to specify –…Read more
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14Reflections on the Dignity of Guan Zhong: A Comparison of Confucian and Western Liberal Notions of SuicideConfucian Bioethics. forthcoming.
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12Hegel and the Spirit (review)The Owl of Minerva 26 (1): 71-77. 1994.In most of the philosophy of the last 150 years, theological concerns have been increasingly marginalized. This does not mean that the issues that were addressed theologically in the past are no longer addressed. Rather, the perennial concerns have been reconstructed so that they are no longer tied to a religious context. Ecclesiology has become political theory, moral theology has become ethics, and doctrines of revelation have become epistemology. Such a list could be made fairly exhaustive, a…Read more
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66Beware of mereologists bearing gifts: prolegomena to a medical metaphysicsTheoretical Medicine and Bioethics 34 (5): 385-408. 2013.This essay considers implications of formal mereologies and ontologies for medical metaphysics. Edward Fried’s extensional mereological account of the human body is taken as representative of a prominent strand in analytic metaphysics that has close affinities with medical positivism. I show why such accounts fail. First, I consider how Fried attempts to make sense of the medical case of Barney Clark, the first recipient of an artificial heart, and show that his analytic metaphysical categories …Read more
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83An agenda for future debate on concepts of health and diseaseMedicine, Health Care and Philosophy 10 (1): 19-27. 2007.The traditional contrast between naturalist and normativist disease concepts fails to capture the most salient features of the health concepts debate. By using health concepts as a window on background notions of medical science and ethics, I show how Christopher Boorse (an influential naturalist) and Lennart Nordenfelt (an influential normativist) actually share deep assumptions about the character of medicine. Their disease concepts attempt, in different ways, to shore up the same medical mode…Read more
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20The case for managed care: Reappraising medical and socio-political idealsJournal of Medicine and Philosophy 24 (5). 1999.The arguments against managed care can be divided into two general clusters. One cluster concerns the way managed care undermines the ethical ideals of medical professionalism. Since those ideals largely focus on the physician-patient relation, the first cluster comes under the rubric of micro-ethics; namely, the ethics of individual-individual relations. The second cluster of criticisms focuses on macro-ethical issues, primarily on issues of justice and policy. By reviewing these arguments, it …Read more
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37Open questions in the ethics of convergenceJournal of Medicine and Philosophy 32 (3). 2007.After historically situating NBIC Convergence in the context of earlier bioethical debate on genetics, ten questions are raised in areas related to the ethics of Convergence, indicating where future research is needed.
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