•  544
    When is deception in research ethical?
    Clinical Ethics 4 (1): 44-49. 2009.
    This article examines when deceptive withholding of information is ethically acceptable in research. The first half analyses the concept of deception. We argue that there are two types of accounts of deception: normative and non-normative, and argue that non-normative accounts are preferable. The second half of the article argues that the relevant ethical question which ethics committees should focus on is not whether the person from whom the information is withheld will be deceived, but rather …Read more
  •  264
    Is respect for autonomy defensible?
    Journal of Medical Ethics 33 (6): 353-356. 2007.
    Three main claims are made in this paper. First, it is argued that Onora O’Neill has uncovered a serious problem in the way medical ethicists have thought about both respect for autonomy and informed consent. Medical ethicists have tended to think that autonomous choices are intrinsically worthy of respect, and that informed consent procedures are the best way to respect the autonomous choices of individuals. However, O’Neill convincingly argues that we should abandon both these thoughts. Second…Read more
  •  197
    Transhumanism and moral equality
    Bioethics 21 (8). 2007.
    Conservative thinkers such as Francis Fukuyama have produced a battery of objections to the transhumanist project of fundamentally enhancing human capacities. This article examines one of these objections, namely that by allowing some to greatly extend their capacities, we will undermine the fundamental moral equality of human beings. I argue that this objection is groundless: once we understand the basis for human equality, it is clear that anyone who now has sufficient capacities to count as a…Read more
  •  156
    Nietzsche and equality
    In Gudrun von Tevenar (ed.), Nietzsche and Ethics, Peter Lang. 2007.
    The idea that there is something ethically corrupt or ethically corrupting about Nietzsche’s work is an anathema to Nietzsche scholars today. Although there are some serious moral philosophers, such as Philippa Foot, Jonathan Glover and Martha Nussbaum who write about Nietzsche whilst finding his position ethically deplorable, most Nietzsche scholars tend to focus rather more heavily on his positive aspects. This means that negative ethical assessments of Nietzsche now tend to be relatively few …Read more
  •  125
    Could there be a right to own intellectual property?
    Law and Philosophy 28 (4). 2009.
    Intellectual property typically involves claims of ownership of types, rather than particulars. In this article I argue that this difference in ontology makes an important moral difference. In particular I argue that there cannot be an intrinsic moral right to own intellectual property. I begin by establishing a necessary condition for the justification of intrinsic moral rights claims, which I call the Rights Justification Principle. Briefly, this holds that if we want to claim that there is an…Read more
  •  117
    Universal Health Coverage, Priority Setting and the Human Right to Health.
    with Benedict Rumbold, Octavio Ferraz, Sarah Hawkes, Rachel Baker, Carleigh Crubiner, Peter Littlejohns, Ole Frithjof Norheim, Thomas Pegram, Annette Rid, Sridhar Venkatapuram, Alex Voorhoeve, Albert Weale, Alicia Ely Yamin, and Daniel Wang
    The Lancet 390 (10095): 712-14. 2017.
    As health policy-makers around the world seek to make progress towards universal health coverage, they must navigate between two important ethical imperatives: to set national spending priorities fairly and efficiently; and to safeguard the right to health. These imperatives can conflict, leading some to conclude that rights-based approaches present a disruptive influence on health policy, hindering states’ efforts to set priorities fairly and efficiently. Here, we challenge this perception. We …Read more
  •  114
    Ontology and the Regulation of Intellectual Property
    The Monist 93 (3): 450-463. 2010.
    Philosophical reflection on intellectual property (IP) is still very young. Whilst much has been written by lawyers on intellectual property, the vast majority of this writing is philosophically unsophisticated. This paper aims to at least partially remedy this philosophical deficit by examining what reflection on the ontology of intellectual property can add to our understanding of how to regulate IP. I argue that ontological reflection should bring us to an important basic fact, namely that ow…Read more
  •  87
    Not so special after all? Daniels and the social determinants of health
    Journal of Medical Ethics 35 (1): 3-6. 2009.
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  •  83
    Hard paternalism, fairness and clinical research: why not?
    with Sarah J. L. Edwards
    Bioethics 26 (2). 2012.
    Jansen and Wall suggest a new way of defending hard paternalism in clinical research. They argue that non-therapeutic research exposing people to more than minimal risk should be banned on egalitarian grounds: in preventing poor decision-makers from making bad decisions, we will promote equality of welfare. We argue that their proposal is flawed for four reasons.First, the idea of poor decision-makers is much more problematic than Jansen and Wall allow. Second, pace Jansen and Wall, it may be pr…Read more
  •  80
    Justice and the Social Determinants of Health: An Overview
    Public Health Ethics 2 (3): 210-213. 2009.
    The WHO Commission on the Social Determinants of Health revealed that there is a 28-year disparity between the life expectancy in the poorest postcode and the richest postcode of Glasgow (CSDH, 2008). There are two sets of questions that it is important to ask about health inequalities like these: first, epidemiological questions about the mechanisms that cause inequalities in health and the measures that are effective in reducing them. Second, normative questions about which inequalities in hea…Read more
  •  77
    When we talk about intellectual property, it is often implicitly assumed that we are talking about private intellectual property. However, private property and the idea of private ownership do not exhaust the possibilities for accounts of ownership and of property. There are other ways that ownership can operate, such as common property. A resource is common property if its use is ‘governed by rules whose point is to make them available for use by all or any members of the society.’
  •  76
    Research Exceptionalism
    with David Hunter
    American Journal of Bioethics 10 (8): 45-54. 2010.
    Research involving human subjects is much more stringently regulated than many other nonresearch activities that appear to be at least as risky. A number of prominent figures now argue that research is overregulated. We argue that the reasons typically offered to justify the present system of research regulation fail to show that research should be subject to more stringent regulation than other equally risky activities. However, there are three often overlooked reasons for thinking that researc…Read more
  •  62
    Just health: meeting health needs fairly is an ambitious book, in which Norman Daniels attempts to bring together in a single framework all his work on health and justice from the past 25 years. One major aim is to reconcile his earlier work on the special moral importance of healthcare with his later work on the social determinants of health. In his earlier work, Daniels argued that healthcare is of special moral importance because it protects opportunity. In this later work, Daniels argues tha…Read more
  •  52
    Privacy Rights and Public Information
    Journal of Political Philosophy 27 (1): 3-25. 2019.
    This article concerns the nature and limits of individuals’ rights to privacy over information that they have made public. For some, even suggesting that an individual can have a right to privacy over such information may seem paradoxical. First, one has no right to privacy over information that was never private to begin with. Second, insofar as one makes once-private information public – whether intentionally or unintentionally – one waives one’s right to privacy to that information. In this a…Read more
  •  49
    Rights (edited book)
    John Wiley and Sons. 2007.
    We are all familiar with assertions of rights: we talk of the right to confi dentiality, the right to health care and, more controversially, the right to die. But beneath this surface familiarity lies a heap of diffi culties about what it is to have a right, how we should go about determining which assertions of rights are genuine and what role (if any) rights should play in our broader moral thinking. This chapter aims to offer a guide through these perplexities.
  •  48
    The infant mortality rate in Liberia is 50 times higher than it is in Sweden, whilst a child born in Japan has a life expectancy at birth of more than double that of one born in Zambia. 1 And within countries, we see differences which are nearly as great. For example, if you were in the USA and travelled the short journey from the poorer parts of Washington to Montgomery County Maryland, you would find that ‘for each mile travelled life expectancy rises about a year and a half. There is a twenty…Read more
  •  36
    In this chapter we argue that the four principles of medical ethics -- beneficence, non-maleficence, respect for autonomy and justice (Beauchamp & Childress, 2001; Gillon, 1985), a new Family Interest Principle (introduced below) and a consideration of ‘capacity’ provide a reasoned practice guide for work with mothers experiencing health problems, focussing here on mental health when a parent is a patient. Our concern is the relationship of the clinician with a parent and through the parent thei…Read more
  •  34
    Self-tests for influenza: an empirical ethics investigation
    with Benedict Rumbold and Clare Wenham
    BMC Medical Ethics 18 (1): 33. 2017.
    In this article we aim to assess the ethical desirability of self-test diagnostic kits for influenza, focusing in particular on the potential benefits and challenges posed by a new, mobile phone-based tool currently being developed by i-sense, an interdisciplinary research collaboration based at University College London and funded by the Engineering and Physical Sciences Research Council. Our study adopts an empirical ethics approach, supplementing an initial review into the ethical considerati…Read more
  •  33
    Drugs are much more expensive whilst they are subject to patent protection than once patents expire: patented drugs make up only 20% of NHS drugs prescriptions, but consume 80% of the total NHS drugs bill. This article argues that, given the relatively uncontroversial assumption that we should save the greater number in cases where all are equally deserving and we cannot save both groups, it is more difficult than is usually thought to justify why publicly funded healthcare systems should pay fo…Read more
  •  30
  •  29
    Persons, post-persons and thresholds
    Journal of Medical Ethics 38 (3): 143-144. 2012.
    DeGrazia argues that post-persons have as much justification in believing that they have higher moral status than persons as persons have in believing that they have higher moral status than animals. DeGrazia's claim presupposes that what Buchanan calls the “moral equality assumption” is false. This article argues that DeGrazia has given us no reason to disbelieve the moral equality assumption. Further, even if DeGrazia's arguments about moral status were sound, it is unclear that his first-orde…Read more
  •  27
    Public Reasoning and Health-Care Priority Setting: The Case of NICE
    with Benedict Rumbold, Albert Weale, Annette Rid, and Peter Littlejohns
    Kennedy Institute of Ethics Journal 27 (1): 107-134. 2017.
    Health systems that provide for universal patient access through a scheme of prepayments—whether through taxes, social insurance, or a combination of the two—need to make decisions on the scope of coverage that they secure. Such decisions are inherently controversial, implying, as they do, that some patients will receive less than comprehensive health care, or less than complete protection from the financial consequences of ill-heath, even when there is a clinically effective therapy to which th…Read more
  •  26
    Affordability and Non-Perfectionism in Moral Action
    with Benedict Rumbold, Victoria Charlton, Annette Rid, Polly Mitchell, Peter Littlejohns, Catherine Max, and Albert Weale
    Ethical Theory and Moral Practice 22 (4): 973-991. 2019.
    One rationale policy-makers sometimes give for declining to fund a service or intervention is on the grounds that it would be ‘unaffordable’, which is to say, that the total cost of providing the service or intervention for all eligible recipients would exceed the budget limit. But does the mere fact that a service or intervention is unaffordable present a reason not to fund it? Thus far, the philosophical literature has remained largely silent on this issue. However, in this article, we conside…Read more
  •  26
    Freedom of Information and Research Data
    Research Ethics 7 (3): 107-111. 2011.
    Research data produced in both universities and the NHS are subject to the Freedom of Information Act 2000. This article examines the practical and ethical implications of freedom of information for research data, arguing that increased openness is both here to stay and is ethically justifiable. Researchers need to learn how best to cope with this
  •  26
  •  23
    Responses to Open Peer Commentaries on “Research Exceptionalism”
    with David Hunter
    American Journal of Bioethics 10 (8). 2010.
    Research involving human subjects is much more stringently regulated than many other nonresearch activities that appear to be at least as risky. A number of prominent figures now argue that research is overregulated. We argue that the reasons typically offered to justify the present system of research regulation fail to show that research should be subject to more stringent regulation than other equally risky activities. However, there are three often overlooked reasons for thinking that researc…Read more
  •  21
    In the book Valuing Health, Daniel Hausman sets out a normative framework for assessing social policy, which he calls restricted consequentialism. For the restricted consequentialist, government policy-making not only is, but ought to be, largely siloed in individual government departments. Each department has its own goal linked to a fundamental public value, which it should pursue in a maximizing way. I argue that, first, Hausman’s argument appears to be internally inconsistent: his case for t…Read more
  •  19
    Since the 1960s we have moved rapidly from a “doctor-knows-best” society which in which medical paternalism -- such as withholding information from patients “for their benefit” -- was common, towards a society which celebrates patients’ rights to make informed decisions about their care. In Choosing Life, Choosing Death, Charles Foster mounts a polemic against the current enthusiasm for respect for autonomy in medical ethics and law
  •  16
    This article introduces a symposium on Daniel Hausman’s Valuing Health: Well-Being, Suffering and Freedom. The symposium contains papers by Elselijn Kingma, Adam Oliver, Anna Alexandrova, Erik Nord, Alex Voorhoeve and James Wilson, with replies by Daniel Hausman. In Valuing Health, Hausman argues that, despite apparently measuring health, projects such as the Global Burden of Disease Study in fact measure judgments about the value of health. Once this has been clarified, the key question is how …Read more
  •  11
    Applying a Public Health Ethics Framework to Consider Scaled-Up Verbal Autopsy and Verbal Autopsy with Immediate Disclosure of Cause of Death in Rural Nepal
    with Joanna Morrison, Edward Fottrell, Bharat Budhatokhi, Jon Bird, Machhindra Basnet, Mangala Manandhar, Rita Shrestha, and Dharma Manandhar
    Public Health Ethics. forthcoming.
    Verbal autopsy presents the opportunity to understand the disease burden in many low-income countries where vital registration systems are underdeveloped and most deaths occur in the community. Advances in technology have led to the development of software that can provide probable cause of death information in real time, and research considering the ethical implications of these advances is necessary to inform policy. Our research explores these ethical issues in rural Nepal using a public heal…Read more