•  40
    Sages and Cranks
    In Katrina Hutchison & Fiona Jenkins (eds.), Women in Philosophy: What Needs to Change?, Oup Usa. pp. 103. 2013.
  •  35
    This paper raises questions about the epistemological foundations of evidence-based medicine . We argue that EBM is based upon reliabilist epistemological assumptions, and that this is appropriate - we should focus on identifying the most reliable processes for generating and collecting medical knowledge. However, we note that this should not be reduced to narrow questions about which research methodologies are the best for gathering evidence. Reliable processes for generating medical evidence m…Read more
  •  26
    Evidence for personalised medicine: mechanisms, correlation, and new kinds of black box
    with Mary Jean Walker and Justin Bourke
    Theoretical Medicine and Bioethics 40 (2): 103-121. 2019.
    Personalised medicine has been discussed as a medical paradigm shift that will improve health while reducing inefficiency and waste. At the same time, it raises new practical, regulatory, and ethical challenges. In this paper, we examine PM strategies epistemologically in order to develop capacities to address these challenges, focusing on a recently proposed strategy for developing patient-specific models from induced pluripotent stem cells so as to make individualised treatment predictions. We…Read more
  •  25
    OBJECTIVES: This article presents an original definition of surgical innovation and a practical tool for identifying planned innovations. These will support the responsible introduction of surgical innovations. BACKGROUND: Frameworks developed for the safer introduction of surgical innovations rely upon identifying cases of innovation; oversight cannot occur unless innovations are identified. However, there is no consensus among surgeons about which interventions they consider innovative; existi…Read more
  •  24
    Patient or public involvement in health research is increasingly expected as a matter of policy. In theory, PPI can contribute both to the epistemic aims intrinsic to research, and to extrinsically valued features of research such as social inclusion and transparency. In practice, the aims of PPI have not always been clear, although there has been a tendency to encourage the involvement of so-called ordinary people who are regarded as representative of an assumed patient perspective. In this pap…Read more
  •  23
    Hips, Knees, and Hernia Mesh: When Does Gender Matter in Surgery?
    with Wendy Rogers
    International Journal of Feminist Approaches to Bioethics 10 (1): 148-174. 2017.
    When implanted devices fail, the harms are significant. In addition to the patient’s original problem, the failure of the device can cause its own considerable damage, requiring removal of the implant and, in some cases, precipitating ongoing health problems. One recent high profile case of device failure is that of the metal-on-metal De Puy ASR hip replacement system, which left tens of thousands of people with cobalt-chromium toxicity and the need for a joint revision. Another concerns tissue …Read more
  •  22
    Details Matter—Definitions and Context Can’t Be Glossed Over When Managing Innovation
    with Jane Johnson and Wendy A. Rogers
    American Journal of Bioethics 19 (6): 28-29. 2019.
    Volume 19, Issue 6, June 2019, Page 28-29.
  •  18
    Justice and Surgical Innovation: The Case of Robotic Prostatectomy
    with Jane Johnson and Drew Carter
    Bioethics 30 (7): 536-546. 2016.
    Surgical innovation promises improvements in healthcare, but it also raises ethical issues including risks of harm to patients, conflicts of interest and increased injustice in access to health care. In this article, we focus on risks of injustice, and use a case study of robotic prostatectomy to identify features of surgical innovation that risk introducing or exacerbating injustices. Interpreting justice as encompassing matters of both efficiency and equity, we first examine questions relating…Read more
  •  17
    One day soon it may be possible to replace a failing heart, liver, or kidney with a long-lasting mechanical replacement or perhaps even with a 3-D printed version based on the patient's own tissue. Such artificial organs could make transplant waiting lists and immunosuppression a thing of the past. Supposing that this happens, what will the ongoing care of people with these implants involve? In particular, how will the need to maintain the functioning of artificial organs over an extended period…Read more
  •  16
    Strengthening the ethical assessment of placebo-controlled surgical trials: three proposals
    with Wendy Rogers, Zoë C. Skea, and Marion K. Campbell
    BMC Medical Ethics 15 (1): 78. 2014.
    Placebo-controlled surgical trials can provide important information about the efficacy of surgical interventions. However, they are ethically contentious as placebo surgery entails the risk of harms to recipients, such as pain, scarring or anaesthetic misadventure. This has led to claims that placebo-controlled surgical trials are inherently unethical. On the other hand, without placebo-controlled surgical trials, it may be impossible to know whether an apparent benefit from surgery is due to t…Read more
  •  13
    Social Dimensions of Moral Responsibility (edited book)
    with Marina Oshana and Catriona Mackenzie
    Oup Usa. 2018.
    The essays in this volume open up reflection on the implications of social inequality for theorizing about moral responsibility. Collectively, they focus attention on the relevance of the social context, and of structural and epistemic injustice, stereotyping and implicit bias, for critically analyzing our moral responsibility practices.
  •  11
    Device representatives in hospitals: are commercial imperatives driving clinical decision-making?
    with Quinn Grundy, Jane Johnson, Brette Blakely, Robyn Clay-Wlliams, Bernadette Richards, and Wendy A. Rogers
    Journal of Medical Ethics 44 (9): 589-592. 2018.
    Despite concerns about the relationships between health professionals and the medical device industry, the issue has received relatively little attention. Prevalence data are lacking; however, qualitative and survey research suggest device industry representatives, who are commonly present in clinical settings, play a key role in these relationships. Representatives, who are technical product specialists and not necessarily medically trained, may attend surgeries on a daily basis and be availabl…Read more
  •  10
    In this article, I describe how gender bias can affect the design, testing, clinical trials, regulatory approval, and clinical use of implantable devices. I argue that bad outcomes experienced by women patients are a cumulative consequence of small biases and inattention at various points of the design, testing, and regulatory process. However, specific instances of inattention and bias can be difficult to identify, and risks are difficult to predict. This means that even if systematic gender bi…Read more
  •  5
    Women in Philosophy: What Needs to Change? (edited book)
    with Fiona Jenkins
    Oxford University Press USA. 2013.
    Despite its place in the humanities, the career prospects and numbers of women in philosophy much more closely resemble those found in the sciences and engineering. This book collects a series of critical essays by female philosophers pursuing the question of why philosophy continues to be inhospitable to women and what can be done to change it. By examining the social and institutional conditions of contemporary academic philosophy in the Anglophone world as well as its methods, culture, and ch…Read more
  •  3
    Four types of gender bias affecting women surgeons and their cumulative impact
    Journal of Medical Ethics 46 (4): 236-241. 2020.
    Women are under-represented in surgery, especially in leadership and academic roles, and face a gender pay gap. There has been little work on the role of implicit biases in women’s under-representation in surgery. Nor has the impact of epistemic injustice, whereby stereotyping influences knowledge or credibility judgements, been explored. This article reports findings of a qualitative in-depth interview study with women surgeons that investigates gender biases in surgery, including subtle types …Read more
  •  1
    Let me first thank Samantha Brennan, Carolyn McLeod and Brandi Braud Scully for their detailed and constructive commentaries. In this brief response I wish to highlight and engage with three main points they raise. First, I will address McLeod’s argument that female surgeons are not merely harmed, but also wronged by the forms of bias found in the study. Second, I will discuss a concern voiced by both Scully and Brennan that my emphasis on small and implicit biases fails to acknowledge the ongoi…Read more