•  4
    Clinician Perspectives on Opioid Treatment Agreements: A Qualitative Analysis of Focus Groups
    with Nathan Richards, Martin Fried, Nicole Thomas, Patricia J. Zettler, and Dana Howard
    AJOB Empirical Bioethics. 2023.
    Background Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, li…Read more
  •  9
    E-Cigarettes, the FDA, Public Health, and Harm Reduction: A Response to the Open Peer Commentaries
    with Dana Howard and Micah L. Berman
    American Journal of Bioethics 23 (1): 1-4. 2022.
    We appreciate that all our commentators accepted the central framework we argued for, namely that the FDA has multiple roles and attendant responsibilities, and we are excited to see this framework...
  •  457
    ‘First Do No Harm’: physician discretion, racial disparities and opioid treatment agreements
    with Adrienne Sabine Beck and Dana Howard
    Journal of Medical Ethics 48 (10): 753-758. 2022.
    The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potentia…Read more
  •  383
    Holding Responsible Reconsidered
    Public Affairs Quarterly 34 (4): 321-339. 2020.
    Following Strawson, many philosophers have claimed that holding someone responsible necessitates its being appropriate to feel or express the negative reactive attitudes (e.g., resentment) toward her. This view, while compelling, is unable to capture the full range of cases in which we hold others responsible in ordinary life. Consider the parent who holds her five-year-old responsible for not teasing his sister, or the therapist who holds her patient responsible for avoiding self-injurious beha…Read more
  •  295
    E-Cigarettes and the Multiple Responsibilities of the FDA
    with Dana Howard and Micah L. Berman
    American Journal of Bioethics 22 (10): 5-14. 2021.
    This paper considers the responsibilities of the FDA with regard to disseminating information about the benefits and harms of e-cigarettes. Tobacco harm reduction advocates claim that the FDA has been overcautious and has violated ethical obligations by failing to clearly communicate to the public that e-cigarettes are far less harmful than cigarettes. We argue, by contrast, that the FDA’s obligations in this arena are more complex than they may appear at first blush. Though the FDA is accountab…Read more
  •  89
    Opioid Treatment Agreements and Patient Accountability
    Hastings Center Report 51 (4): 46-9. 2021.
    Opioid treatment agreements are written agreements between physicians and patients enumerating the risks associated with opioid medications along with the requirements that patients must meet to receive these medications on an ongoing basis. The choice to use such agreements goes beyond the standard informed consent process, and has a distinctive symbolic significance. Specifically, it suggests that physicians regard it as important to hold their patients accountable for adhering to various pro…Read more
  •  579
    Responsibility and the Problem of So-Called Marginal Agents
    Journal of the American Philosophical Association 6 (2): 246-263. 2020.
    Philosophical views of responsibility often identify responsible agency with capacities like rationality and self-control. Yet in ordinary life, we frequently hold individuals responsible who are deficient in these capacities, such as children or people with mental illness. The existing literature that addresses these cases has suggested that we merely pretend to hold these agents responsible, or that they are responsible to a diminished degree. In this paper, I demonstrate that neither of these…Read more