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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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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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84An 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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25What Hope for Reason? A Critique of New Natural Law TheoryChristian Bioethics 22 (2): 238-264. 2016.
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60A 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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15The ethics of nano/neuro convergenceIn Judy Illes & Barbara J. Sahakian (eds.), Oxford Handbook of Neuroethics, Oxford University Press. pp. 467--92. 2011.This article outlines a few representative areas of research in nano- and neuroscience and then considers the complex continuum of entangled research practices that results. The point of this review is to give a realistic sense of the distributed, opportunistic character of this research, and to show how such emergent practices challenge conventional assumptions about how ethics and science should be advanced. It evaluates the risk profile of research related to that type as if it designated som…Read more
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75An ethics discussion series for hospital administratorsHEC Forum 10 (2): 177-185. 1998.Peer Reviewed.
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20Stem cells and the man on the moon: Should we go there from here?American Journal of Bioethics 2 (1). 2002.This Article does not have an abstract
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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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77Ethics, politics, and health care reformJournal of Medicine and Philosophy 19 (5): 397-405. 1994.
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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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18The concept of faith: A philosophical investigation (review)International Journal for Philosophy of Religion 41 (2): 126-128. 1997.
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20A Sympathetic but Critical Assessment of Nanotechnology InitiativesJournal of Law, Medicine and Ethics 34 (4): 655-657. 2006.
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10Owning up to Our Agendas: On the Role and Limits of Science in Debates about Embryos and Brain DeathJournal of Law, Medicine and Ethics 34 (1): 58-76. 2006.”Merely fact-minded sciences make merely factminded people.”“ …the positivistic concept of science in our time is, historically speaking, a residual concept. It has dropped all the questions which had been considered under the now narrower, now broader concepts of metaphysics….all these ‘metaphysical’ questions, taken broadly – commonly called specifically philosophical questions – surpass the world understood as the universe of mere facts. They surpass it precisely as being questions with the i…Read more
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16What Is Unique About Nanomedicine? The Significance of the MesoscaleJournal of Law, Medicine and Ethics 40 (4): 780-794. 2012.Unlike drugs and medical devices, for which long standing and continuously improving quality assurance/quality control infrastructures exist, many nano-based products lack well-defined standards that are useful to manufacturers and regulators. Inherent variabilities in nanoparticle sizes and shapes, their large surface-to-volume ratios, and their mesoscale interactions with subcellular structures, suggest new complexities and challenges that must be met before widespread application of nanomedic…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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1Theoretical foundations for organizational ethics: developing norms for a new kind of healthcareIn Denis Gordon Arnold (ed.), Ethics and the Business of Biomedicine, Cambridge University Press. pp. 220. 2009.
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23Owning up to our Agendas: On the Role and Limits of Science in Debates about Embryos and Brain DeathJournal of Law, Medicine and Ethics 34 (1): 58-76. 2006.The ethical issues integral to embryo research and brain death are intertwined with comprehensive views of life that are not explicitly discussed in most policy debate. I consider three representative views – a naturalist, romantic, and theist – and show how these might inform the way practical ethical issues are addressed. I then consider in detail one influential argument in embryo research that attempts to bypass deep values. I show that this twinning argument is deeply flawed. It presupposes…Read more
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