•  583
    Exploitation and Sweatshop Labor: Perspectives and Issues
    Business Ethics Quarterly 20 (2): 187-213. 2010.
    In this review, I survey theoretical accounts of exploitation in business, chiefly through the example of low wage or sweatshop labor. This labor is associated with wages that fall below a living wage standard and include long working hours. Labor of this kind is often described as self-evidently exploitative and immoral (Van Natta 1995). But for those who defend sweatshop labor as the first rung on a ladder toward greater economic development, the charge that sweatshop labor is self-evidently e…Read more
  •  225
    What’s the Matter with Price Gouging?
    Business Ethics Quarterly 19 (2): 275-293. 2009.
    When prices for basic commodities increase following a disaster, these price increases are often condemned as ‘price gouging.’ In this paper, I discuss what moral wrongs, if any, are most reasonably ascribed to accusations of price gouging. This discussion keeps in mind both practical and moral defenses of price increase following disasters. I first examine existing anti-gouging legislation for commonalities in their definitions of gouging and then present arguments in favor of the permissibilit…Read more
  •  162
    Needs Exploitation
    Ethical Theory and Moral Practice 11 (4): 389-405. 2008.
    Sweatshop labor is often cited as an example of the worst and most pervasive form of exploitation today, yet understanding what is meant by the charge has proven surprisingly difficult for philosophers. I develop an account of what I call “Needs Exploitation,” grounded in a specification of the duty of beneficence. In the case of sweatshop labor, I argue that employers face a duty to extend to employees a wage sufficient to meet their basic needs. This duty is limited by the degree of the employ…Read more
  •  161
    Efficiency, Equity, and Price Gouging: A Response to Zwolinski
    Business Ethics Quarterly 19 (2): 303-306. 2009.
    In this response, I reiterate my argument that price gouging undercuts the goal of equity in access to essential goods whereas Zwolinski emphasizes the importance of the efficient provision of essential goods above all other goals. I agree that the efficient provision of essential goods is important as I argue for the goal of equitable access to sufficient of the goods essential to living a minimally flourishing human life. However, efficiency is a means to this goal rather than the end itself. …Read more
  •  125
    Perceptions of the Ethics of Medical Tourism: Comparing Patient and Academic Perspectives
    with V. A. Crooks and R. Johnston
    Public Health Ethics 5 (1): 38-46. 2012.
    Medical tourism is a practice, whereby individuals travel across national borders with the intention of receiving medical care. Medical tourists are motivated to travel abroad by a number of factors, including the affordability of care abroad, access to treatments not available at home, and wait times for care at home. In this article, we share the findings of interviews conducted with 32 Canadian medical tourists with the aim of developing a better understanding of medical tourism, the ethical …Read more
  •  77
    Beyond sun, sand, and stitches: Assigning responsibility for the Harms of medical tourism
    with Valorie Crooks, Rory Johnston, and Paul Kingsbury
    Bioethics 27 (5): 233-242. 2013.
    Medical tourism (MT) can be conceptualized as the intentional pursuit of non-emergency surgical interventions by patients outside their nation of residence. Despite increasing popular interest in MT, the ethical issues associated with the practice have thus far been under-examined. MT has been associated with a range of both positive and negative effects for medical tourists' home and host countries, and for the medical tourists themselves. Absent from previous explorations of MT is a clear argu…Read more
  •  73
    Risk communication and informed consent in the medical tourism industry: A thematic content analysis of canadian broker websites (review)
    with Kali Penney, Valorie A. Crooks, and Rory Johnston
    BMC Medical Ethics 12 (1): 17-. 2011.
    Background: Medical tourism, thought of as patients seeking non-emergency medical care outside of their home countries, is a growing industry worldwide. Canadians are amongst those engaging in medical tourism, and many are helped in the process of accessing care abroad by medical tourism brokers - agents who specialize in making international medical care arrangements for patients. As a key source of information for these patients, brokers are likely to play an important role in communicating th…Read more
  •  61
    Easy Rescues and Organ Transplantation
    HEC Forum 21 (1): 27-53. 2009.
    Many people in desperate need of an organ will die on waiting lists for transplantation or face increased morbidity because of their wait. This circumstance is particularly troubling since many viable organs for transplantation go unused when individuals fail to participate in their local organ donation system. In this paper, I consider whether participating in organ transplantation should be considered a form of a rescue of others from the great harms caused by a shortage in transplantable orga…Read more
  •  56
    Human subject trials of pharmaceuticals in low and middle income countries have been associated with the moral wrong of exploitation on two grounds. First, these trials may include a placebo control arm even when proven treatments for a condition are in use in other parts of the world. Second, the trial researchers or sponsors may fail to make a successful treatment developed through the trial available to either the trial participants or the host community following the trial.Many commentators …Read more
  •  54
    The 'patient's physician one-step removed': the evolving roles of medical tourism facilitators
    with V. A. Crooks, K. Adams, P. Kingsbury, and R. Johnston
    Journal of Medical Ethics 37 (9): 530-534. 2011.
    Background: Medical tourism involves patients travelling internationally to receive medical services. This practice raises a range of ethical issues, including potential harms to the patient's home and destination country and risks to the patient's own health. Medical tourists often engage the services of a facilitator who may book travel and accommodation and link the patient with a hospital abroad. Facilitators have the potential to exacerbate or mitigate the ethical concerns associated with m…Read more
  •  45
    Medical tourism—the practice where patients travel internationally to privately access medical care—may limit patients’ regular physicians’ abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors’ typical involvement in patients’ informed decision-making is challenged when their patients engage in medical tourism
  •  43
    Issues and Challenges in Research on the Ethics of Medical Tourism: Reflections from a Conference (review)
    with Valorie Crooks and Leigh Turner
    Journal of Bioethical Inquiry 8 (1): 3-6. 2011.
    The authors co-organized (Snyder and Crooks) and gave a keynote presentation at (Turner) a conference on ethical issues in medical tourism. Medical tourism involves travel across international borders with the intention of receiving medical care. This care is typically paid for out-of-pocket and is motivated by an interest in cost savings and/or avoiding wait times for care in the patient’s home country. This practice raises numerous ethical concerns, including potentially exacerbating health in…Read more
  •  42
    Promoting social responsibility amongst health care users: medical tourists' perspectives on an information sheet regarding ethical concerns in medical tourism
    with Krystyna Adams, Valorie A. Crooks, and Rory Johnston
    Philosophy, Ethics, and Humanities in Medicine 8 19. 2013.
    Medical tourists, persons that travel across international borders with the intention to access non-emergency medical care, may not be adequately informed of safety and ethical concerns related to the practice of medical tourism. Researchers indicate that the sources of information frequently used by medical tourists during their decision-making process may be biased and/or lack comprehensive information regarding individual safety and treatment outcomes, as well as potential impacts of the medi…Read more
  •  34
    Is Health Worker Migration a Case of Poaching?
    American Journal of Bioethics 9 (3): 3-7. 2009.
    Many nations in the developing world invest scarce funding into training health workers. When these workers migrate to richer countries, particularly when this migration occurs before the source community can recoup the costs of training, the destination community realizes a net gain in resources by obtaining the workers' skills without having to pay for their training. This effect of health worker migration has frequently been condemned as 'poaching' or a case of theft. I assess the charge that…Read more
  •  29
    Ballantyne correctly notes the need for clarification as to the standard of fairness that should guide nonexploitative international research on human subjects. When accounts of exploitation are applied to pharmaceutical development (as well as other areas), there is too often an uncritical acceptance that exploitation involves a form of unfairness. Moreover, these authors typically fail to produce an account of fairness by which exploitation should be identified. Ballantyne should be applauded …Read more
  •  28
    Book review (review)
    Journal of Value Inquiry 40 (1): 115-121. 2006.
  •  26
    New ethical perspectives on medical tourism in the developing world
    with Valorie A. Crooks
    Developing World Bioethics 12 (1). 2012.
  •  26
    Relative Versus Absolute Standards for Everyday Risk in Adolescent HIV Prevention Trials: Expanding the Debate
    with Cari L. Miller and Glenda Gray
    American Journal of Bioethics 11 (6). 2011.
    The concept of minimal risk has been used to regulate and limit participation by adolescents in clinical trials. It can be understood as setting an absolute standard of what risks are considered minimal or it can be interpreted as relative to the actual risks faced by members of the host community for the trial. While commentators have almost universally opposed a relative interpretation of the environmental risks faced by potential adolescent trial participants, we argue that the ethical concer…Read more
  •  25
    Exploitation and demeaning choices
    Politics, Philosophy and Economics 12 (4): 345-360. 2013.
    Scholarship aiming to describe the wrongness of exploitation, especially when it is voluntary and mutually beneficial, has increased greatly in recent years. In this paper, I expand the scope of this discussion by highlighting a set of additional ethical concerns associated with many cases of mutually voluntary and beneficial exploitation. Specifically, I argue that the phenomenon of persons desperately seeking out and gratefully accepting exploitative interactions raises special moral concerns.…Read more
  •  21
    Developing an informational tool for ethical engagement in medical tourism
    with Krystyna Adams, Valorie A. Crooks, and Rory Johnston
    Philosophy, Ethics, and Humanities in Medicine 12 4. 2017.
    BackgroundMedical tourism, the practice of persons intentionally travelling across international boundaries to access medical care, has drawn increasing attention from researchers, particularly in relation to potential ethical concerns of this practice. Researchers have expressed concern for potential negative impacts to individual safety, public health within both countries of origin for medical tourists and destination countries, and global health equity. However, these ethical concerns are no…Read more
  •  20
    Medical tourism is international travel with the intention of receiving medical care. Medical tourists travel for many reasons, including cost savings, limited domestic access to specific treatments, and interest in accessing unproven interventions. Medical tourism poses new health and safety risks to patients, including dangers associated with travel following surgery, difficulty assessing the quality of care abroad, and complications in continuity of care. Online resources are important to the…Read more
  •  20
    Medical Tourism and Bariatric Surgery: More Moral Challenges
    with Valorie A. Crooks
    American Journal of Bioethics 10 (12): 28-30. 2010.
    This Article does not have an abstract
  •  19
    I would like to thank all of the respondents to my article both for their expansions on the theme of health worker migration and for their criticisms of my argument against the use of the term ’poaching’ in the context of international health worker migration. In this response, I will clarify my argument in light of the worries raised primarily by Tache and Schillinger and Ari Zivotofsky and Naomi Zivotofsky.
  •  18
    Caring Comportment and the Hospitalist Model
    with Brian Zanoni
    Virtual Mentor 8 (2): 114-117. 2006.
  •  14
    Attitudes toward Post‐Trial Access to Medical Interventions: A Review of Academic Literature, Legislation, and International Guidelines (review)
    with Kori Cook and John Calvert
    Developing World Bioethics 16 (2): 70-79. 2016.
    There is currently no international consensus around post-trial obligations toward research participants, community members, and host countries. This literature review investigates arguments and attitudes toward post-trial access. The literature review found that academic discussions focused on the rights of research participants, but offered few practical recommendations for addressing or improving current practices. Similarly, there are few regulations or legislation pertaining to post-trial a…Read more
  •  14
    How Medical Tourism Enables Preferential Access to Care: Four Patterns from the Canadian Context
    with Rory Johnston, Valorie A. Crooks, Jeff Morgan, and Krystyna Adams
    Health Care Analysis 25 (2): 138-150. 2017.
    Medical tourism is the practice of traveling across international borders with the intention of accessing medical care, paid for out-of-pocket. This practice has implications for preferential access to medical care for Canadians both through inbound and outbound medical tourism. In this paper, we identify four patterns of medical tourism with implications for preferential access to care by Canadians: Inbound medical tourism to Canada’s public hospitals; Inbound medical tourism to a First Nations…Read more
  •  14
    The international migration of health workers, including long-term care workers for aging populations, contributes to a shortage of these workers in many parts of the world. In the Anglophone Caribbean, LCW shortages and the migration of nurses to take on LCW positions abroad threaten the health of local populations and widen global inequities in health. Many responses have been proposed to address the international migration of health workers generally, including making it more difficult for th…Read more