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109The ethics of NBIC convergenceJournal of Medicine and Philosophy 32 (3). 2007.This Article does not have an abstract
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91Recommendations 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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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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81Expanding 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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77Ethics, politics, and health care reformJournal of Medicine and Philosophy 19 (5): 397-405. 1994.
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76Why 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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74An ethics discussion series for hospital administratorsHEC Forum 10 (2): 177-185. 1998.Peer Reviewed.
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65Beware 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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60Intolerant toleranceJournal of Medicine and Philosophy 19 (2): 161-181. 1994.The Hyde Amendment and Roman Catholic attempts to put restrictions on Title X funding have been criticized for being intolerant. However, such criticism fails to appreciate that there are two competing notions of tolerance, one focusing on the limits of state force and accepting pluralism as unavoidable, and the other focusing on the limits of knowledge and advancing pluralism as a good. These two types of tolerance, illustrated in the writings of John Locke and J.S. Mill, each involve an intole…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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58A Matter of Respect: A Defense of the Dead Donor Rule and of a "Whole-Brain" Criterion for Determination of DeathJournal of Medicine and Philosophy 35 (3): 330-364. 2010.Many accounts of the historical development of neurological criteria for determination of death insufficiently distinguish between two strands of interpretation advanced by advocates of a "whole-brain" criterion. One strand focuses on the brain as the organ of integration. Another provides a far more complex and nuanced account, both of death and of a policy on the determination of death. Current criticisms of the whole-brain criterion are effective in refuting the first interpretation, but not …Read more
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56Handbook of bioethics: taking stock of the field from a philosophical perspective (edited book)Kluwer Academic. 2004.This book is for those interested in an extensive review of the field of bioethics. It is for philosophers who wish to understand the core conceptual issues in health care ethics, and for bioethicists who wish to better understand classical problems in philosophy that have a bearing on health care ethics. The Handbook of Bioethics: Taking Stock of the Field from a Philosophical Perspective: -presents a comprehensive survey of bioethics in one volume; -has 27 of the most prominent scholars in the…Read more
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49A 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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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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46Thinking 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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41A radical rupture in the paradigm of modern medicine: Conflicts of interest, fiduciary obligations, and the scientific idealJournal of Medicine and Philosophy 23 (1). 1998.Conflicts of interest serve as a cipher for a radical rupture in the Flexnerian paradigm of medicine, and they can only be addressed if we recognize that health care is now practiced by institutions, not just individual physicians. By showing how "appropriate utilization of services" or "that which is medically indicated" is a function of socioeconomic factors related to institutional responsibilities, I point toward an administrative and organizational ethic as a needed component for addressing…Read more
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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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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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36Open 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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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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31Embryo 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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28Announcing a new section and a call for papers administrative and organizational ethicsHEC Forum 9 (4): 299-309. 1997.
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28Setting organizational ethics within a broader social and legal contextHEC Forum 14 (2): 77-85. 2002.
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28Struggling 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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25What Hope for Reason? A Critique of New Natural Law TheoryChristian Bioethics 22 (2): 238-264. 2016.
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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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24Bioethics in a Liberal Society (review)International Studies in Philosophy 30 (2): 124-125. 1998.
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