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132Are All Abortions Equal? Should There Be Exceptions to the Criminalization of Abortion for Rape and Incest?Journal of Law, Medicine and Ethics 43 (1): 87-104. 2015.Politics, public discourse, and legislation restricting abortion has settled on a moderate orthodoxy: restrict abortion, but leave exceptions for pregnancies that result from rape and incest. I challenge that consensus and suggest it may be much harder to defend than those who support the compromise think. From both Pro-Life and Pro-Choice perspectives, there are good reasons to treat all abortions as equal
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115Transplant Tourism: The Ethics and Regulation of International Markets for OrgansJournal of Law, Medicine and Ethics 41 (1): 269-285. 2013.“Medical Tourism” is the travel of residents of one country to another country for treatment. In this article I focus on travel abroad to purchase organs for transplant, what I will call “Transplant Tourism.” With the exception of Iran, organ sale is illegal across the globe, but many destination countries have thriving black markets, either due to their willful failure to police the practice or more good faith lack of resources to detect it. I focus on the sale of kidneys, the most common subje…Read more
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76Using Social Media as a Research Recruitment Tool: Ethical Issues and RecommendationsAmerican Journal of Bioethics 17 (3): 3-14. 2017.The use of social media as a recruitment tool for research with humans is increasing, and likely to continue to grow. Despite this, to date there has been no specific regulatory guidance and there has been little in the bioethics literature to guide investigators and institutional review boards faced with navigating the ethical issues such use raises. We begin to fill this gap by first defending a nonexceptionalist methodology for assessing social media recruitment; second, examining respect for…Read more
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76Fetal Pain, Abortion, Viability, and the ConstitutionJournal of Law, Medicine and Ethics 39 (2): 235-242. 2011.In early 2010, the Nebraska state legislature passed a new abortion restricting law asserting a new, compelling state interest in preventing fetal pain. In this article, we review existing constitutional abortion doctrine and note difficulties presented by persistent legal attention to a socially derived viability construct. We then offer a substantive biological, ethical, and legal critique of the new fetal pain rationale
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73Editing the Genome of the Human Germline: May Cool Heads PrevailAmerican Journal of Bioethics 15 (12): 40-42. 2015.
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62The Ethics of Smart Pills and Self-Acting Devices: Autonomy, Truth-Telling, and Trust at the Dawn of Digital MedicineAmerican Journal of Bioethics 18 (9): 38-47. 2018.Digital medicine is a medical treatment that combines technology with drug delivery. The promises of this combination are continuous and remote monitoring, better disease management, self-tracking, self-management of diseases, and improved treatment adherence. These devices pose ethical challenges for patients, providers, and the social practice of medicine. For patients, having both informed consent and a user agreement raises questions of understanding for autonomy and informed consent, therap…Read more
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59What Should ChatGPT Mean for Bioethics?American Journal of Bioethics 23 (10): 8-16. 2023.In the last several months, several major disciplines have started their initial reckoning with what ChatGPT and other Large Language Models (LLMs) mean for them – law, medicine, business among other professions. With a heavy dose of humility, given how fast the technology is moving and how uncertain its social implications are, this article attempts to give some early tentative thoughts on what ChatGPT might mean for bioethics. I will first argue that many bioethics issues raised by ChatGPT are…Read more
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48How to Regulate Medical Tourism (and Why It Matters for Bioethics)Developing World Bioethics 12 (1): 9-20. 2012.A growing literature examines descriptive and normative questions about medical tourism such as: How does it operate? What are its effects? Are home country patients or their governments failing in moral duties by engaging in or permitting medical tourism?By contrast, much less has been written on the regulatory dimension: What might be done about medical tourism if we were convinced that it posed ethical issues and were motivated to act? I shall argue that this kind of regulatory analysis is es…Read more
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43Review of Paul Knoepfler, GMO Sapiens: The Life-Changing Science of Designer Babies (review)American Journal of Bioethics 16 (9): 1-3. 2016.
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42This Is Your Brain on Human Rights: Moral Enhancement and Human RightsLaw and Ethics of Human Rights 9 (1): 1-41. 2015.
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39Artificial Wombs and Abortion RightsHastings Center Report 47 (4). 2017.In a study published in late April in Nature Communications, the authors were able to sustain 105- to 115-day-old premature lamb fetuses—whose level of development was comparable to that of a twenty-three-week-old human fetus—for four weeks in an artificial womb, enabling the lambs to develop in a way that paralleled age-matched controls. The oldest lamb of the set, more than a year old at the time the paper came out, appeared completely normal. This kind of research brings us one step closer to…Read more
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39Prohibiting Anonymous Sperm Donation and the Child Welfare ErrorHastings Center Report 41 (5): 13-14. 2011.Should anonymous sperm “donation”—a misnomer, since sperm is usually purchased—be permitted? A number of countries, including Sweden, Austria, Germany, Switzerland, the Netherlands, Norway, New Zealand, and several Australian states, have answered no.1 The United Kingdom recently joined this list, instituting a system whereby new sperm (and egg) donors must put information into a registry, and a donor-conceived child “is entitled to request and receive their donor’s name and last known address, …Read more
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36Mitigating Racial Bias in Machine LearningJournal of Law, Medicine and Ethics 50 (1): 92-100. 2022.When applied in the health sector, AI-based applications raise not only ethical but legal and safety concerns, where algorithms trained on data from majority populations can generate less accurate or reliable results for minorities and other disadvantaged groups.
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34Gene Editing Sperm and Eggs (not Embryos): Does it Make a Legal or Ethical Difference?Journal of Law, Medicine and Ethics 48 (3): 619-621. 2020.
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34Institutions as an ethical locus of research prioritisationJournal of Medical Ethics 43 (12): 816-818. 2017.Ensuring that clinical trials, once launched, successfully complete and generate useful knowledge is an important and indeed ethically imperative goal, given the risks and burdens borne by research participants. Since there are insufficient willing research participants to power all the trials that are currently undertaken,1 addressing underenrolment will require prioritisation decisions that reduce the number of trials competing for participants. While there are multiple levels at which researc…Read more
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31Response to Open Peer Commentaries on “The Ethics of Smart Pills and Self-Acting Devices: Autonomy, Truth-Telling, and Trust at the Dawn of Digital Medicine”American Journal of Bioethics 18 (10): 4-7. 2018.
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30A Response to CommentariesHastings Center Report 46 (S2): 45-48. 2016.Our article “NFL Player Health Care: Addressing Club Doctors’ Conflicts of Interests and Promoting Player Trust” focused on an inherent structural conflict that faces club doctors in the National Football League. The conflict stems from club doctors’ dual role of providing medical care to players and providing strategic advice to clubs. We recommended assigning these roles to different individuals, with the medical staff members who are responsible for providing player care being chosen and subj…Read more
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29Medical Crowdfunding for Unproven Medical Treatments: Should Gofundme Become a Gatekeeper?Hastings Center Report 49 (6): 32-38. 2019.Medical crowdfunding has raised many ethical concerns, among them that it may undermine privacy, widen health inequities, and commodify health care. One motivation for medical crowdfunding has received particular attention among ethicists. Recent studies have shown that many individuals are using crowdfunding to finance access to scientifically unsupported medical treatments. Recently, GoFundMe prohibited campaigns for antivaccination groups on the grounds that they “promote misinformation about…Read more
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29Of Modest Proposals and Non-Identity: A Comment on the Right to Know Your Genetic ParentsAmerican Journal of Bioethics 13 (5): 45-47. 2013.No abstract
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26Legal and Ethical Issues in the Report Heritable Human Genome EditingHastings Center Report 51 (3): 8-12. 2021.This essay discusses the new report, Heritable Human Genome Editing, by the National Academy of Medicine, the National Academy of Sciences, and the Royal Society. After summarizing the report, we argue that the report takes four quite bold steps away from prior reports, namely (1) rejecting an omnibus approach to heritable human genome editing (HHGE) in favor of a case‐by‐case analysis of possible uses of HHGE, accepting that HHGE is acceptable in some cases; (2) recognizing that the interest in…Read more
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25Complexifying Commodification, Consumption, ART, and AbortionJournal of Law, Medicine and Ethics 43 (2): 307-311. 2015.This commentary on Madeira's paper complicates the relationships between commodification, consumption, abortion, and assisted reproductive technologies she draws in two ways. First, I examine under what conditions the commodification of ARTs, gametes, and surrogacy lead to patients becoming consumers. Second, I show that there are some stark difference between applying commodification critiques to ART versus abortion.
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25Fetal Pain, Abortion, Viability, and the ConstitutionJournal of Law, Medicine and Ethics 39 (2): 235-242. 2011.On April 13, 2010, Nebraska enacted a new state ban on abortion in the Pain-Capable Unborn Child Protection Act that ha caught the attention of many on both sides of the abortion debate, and has inspired other states to attempt similar measures. The statute requires the referring or abortion-providing physician to make a “determination of the probable postfertilization age of the unborn child” and makes it illegal to induce or attempt to perform or induce an abortion upon a woman when the “proba…Read more
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24The Legality of Biometric Screening of Professional AthletesAmerican Journal of Bioethics 17 (1): 65-67. 2017.
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24Confronting Biospecimen Exceptionalism in Proposed Revisions to the Common RuleHastings Center Report 46 (1): 4-5. 2016.On September 8, 2015, the Department of Health and Human Services issued a Notice of Proposed Rule Making to revise the Federal Policy for the Protection of Human Subjects, widely known as the “Common Rule.” The NPRM proposes several changes to the current system, including a dramatic shift in the approach to secondary research using biospecimens and data. Under the current rules, it is relatively easy to use biospecimens and data for secondary research. This approach systematically facilitates …Read more
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24American Journal of Law & Medicine and Harvard Law & Health Care SocietyJournal of Law, Medicine and Ethics 28 (3): 305-307. 2000.
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23A Proposal to Address NFL Club Doctors’ Conflicts of Interest and to Promote Player TrustHastings Center Report 46 (S2): 2-24. 2016.How can we ensure that players in the National Football League receive excellent health care they can trust from providers who are as free from conflicts of interest as realistically possible? NFL players typically receive care from the club's own medical staff. Club doctors are clearly important stakeholders in player health. They diagnose and treat players for a variety of ailments, physical and mental, while making recommendations to the player concerning those ailments. At the same time, clu…Read more
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23When clinical trials compete: prioritising study recruitmentJournal of Medical Ethics 43 (12): 803-809. 2017.It is not uncommon for multiple clinical trials at the same institution to recruit concurrently from the same patient population. When the relevant pool of patients is limited, as it often is, trials essentially compete for participants. There is evidence that such a competition is a predictor of low study accrual, with increased competition tied to increased recruitment shortfalls. But there is no consensus on what steps, if any, institutions should take to approach this issue. In this article,…Read more
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23The Lumbering Crawl Toward Human Germline EditingJournal of Law, Medicine and Ethics 46 (4): 1010-1012. 2018.