•  3
    Just caring: screening needs limits
    Journal of Medical Ethics. forthcoming.
    This personal narrative tugs at the heart strings. However, personal narratives are not sufficient to justify public funding for any screening policy. We have to take seriously the ‘just caring’ problem. We have only limited resources to meet virtually unlimited health care needs. No doubt, screening tests often save lives. The author wants public funding for prostate-specific antigen screening for prostate cancer. However, why only prostate cancer? Numerous cancers at various stages can be scre…Read more
  •  6
    Precision QALYs, Precisely Unjust
    Cambridge Quarterly of Healthcare Ethics 28 (3): 439-449. 2019.
    :Warwick Heale has recently defended the notion of individualized and personalized Quality-Adjusted Life Years in connection with health care resource allocation decisions. Ordinarily, QALYs are used to make allocation decisions at the population level. If a health care intervention costs £100,000 and generally yields only two years of survival, the cost per QALY gained will be £50,000, far in excess of the £30,000 limit per QALY judged an acceptable use of resources within the National Health S…Read more
  •  7
    First Come, First Served in the Intensive Care Unit: Always?
    Cambridge Quarterly of Healthcare Ethics 27 (1): 52-61. 2018.
  •  19
    Controlling Healthcare Costs: Just Cost Effectiveness or “Just” Cost Effectiveness?
    Cambridge Quarterly of Healthcare Ethics 27 (2): 271-283. 2018.
  •  6
    Choosing Wisely
    Cambridge Quarterly of Healthcare Ethics 25 (3): 366-376. 2016.
  •  7
    Despairing about Health Disparities
    Hastings Center Report 47 (5): 43-44. 2017.
    I have never doubted that the problem of inequalities in health status and access to needed care is a difficult ethical and political challenge. After reading the essays in Understanding Health Inequalities and Justice: New Conversations across the Disciplines, edited by Mara Buchbinder, Michele Rivkin-Fish, and Rebecca Walker, I concluded that despair was the only suitable response in the face of daunting ethical and political complexity. The editors of this volume have three questions in mind …Read more
  • G. H. Mead's Pragmatic Theory of Knowledge
    Dissertation, Saint Louis University. 1975.
  •  17
    Is Reality Meaningful? By Kelvin Van Nuys
    Modern Schoolman 47 (2): 258-259. 1970.
  •  12
  •  40
    Personalized Medicine's Ragged Edge
    Hastings Center Report 40 (5): 16-18. 2010.
    The phrase "personalized medicine" has a built-in positive spin. Simple genetic tests can sometimes predict whether a particular individual will have a positive response to a particular drug or, alternatively, suffer costly and debilitating side effects. But little attention has been given to some challenging issues of justice raised by personalized medicine. How should we determine who would have a just claim to access particular treatments, especially very expensive ones? How effective do thos…Read more
  •  32
    Abortion, deformed fetuses, and the omega pill
    Philosophical Studies 36 (3). 1979.
  •  531
    On being genetically "irresponsible"
    with Judith Andre and Thomas Tomlinson
    Kennedy Institute of Ethics Journal 10 (2): 129-146. 2000.
    : New genetic technologies continue to emerge that allow us to control the genetic endowment of future children. Increasingly the claim is made that it is morally "irresponsible" for parents to fail to use such technologies when they know their possible children are at risk for a serious genetic disorder. We believe such charges are often unwarranted. Our goal in this article is to offer a careful conceptual analysis of the language of irresponsibility in an effort to encourage more care in its …Read more
  •  41
    Just Caring: Health Care Rationing, Terminal Illness, and the Medically Least Well Off
    Journal of Law, Medicine and Ethics 39 (2): 156-171. 2011.
    What does it mean to be a “just” and “caring” society in meeting the health care needs of the terminally ill when we have only limited resources to meet virtually unlimited health care needs? That question is the focus of this essay. Put another way: relative to all the other health care needs in our society, especially the need for lifesaving or life-prolonging health care, how high a priority ought the health care needs of persons who are terminally ill have? On the one hand, we might see the …Read more
  •  7
    The Price of Compromise: The Massachusetts Health Care Reform
    with Sarah Kemble and Susanne L. King
    Hastings Center Report 37 (1): 4. 2007.
  •  25
    Four Volumes in Health Care Ethics
    Teaching Philosophy 36 (1): 59-70. 2013.
    This review discusses four recently published textbooks in health care ethics. The theme I emphasize here is that the more common health care ethics issues addressed in these texts are of enormous personal, political and professional relevance today. More specifically, these issues have been enormously socially divisive, as the rhetoric about “death panels” illustrates. A course in health care ethics ought to provide students (future citizens in a liberal, pluralistic, democratic society) with t…Read more
  • " Nanoethics"? What's new?
    Hastings Center Report 37 (1): 22-25. 2007.
  •  36
    Just Caring: Defining a Basic Benefit Package
    Journal of Medicine and Philosophy 36 (6): 589-611. 2011.
    What should be the content of a package of health care services that we would want to guarantee to all Americans? This question cannot be answered adequately apart from also addressing the issue of fair health care rationing. Consequently, as I argue in this essay, appeal to the language of "basic," "essential," "adequate," "minimally decent," or "medically necessary" for purposes of answering our question is unhelpful. All these notions are too vague to be useful. Cost matters. Effectiveness ma…Read more
  •  34
    Whoopie Pies, Supersized Fries
    Cambridge Quarterly of Healthcare Ethics 21 (1): 5-19. 2012.
  •  120
  •  8
    Rationing: don't give up
    Hastings Center Report 32 (2): 35. 2002.
  • Book Review (review)
    Cambridge Quarterly of Healthcare Ethics 10 (2): 214-218. 2001.
  •  2
    Book reviews (review)
    with Norman R. Beaupre, Robert E. Haskell, Spencer Lavan, Sandra L. Bertman, Lois LaCivita Nixon, Willard P. Green, Rosa Lynn Pinkus, Joel Frader, Marilynn Rosenthal, T. Forcht Dagi, Daniel M. Fox, Erwin A. Blackstone, Norman Gevitz, and William B. Bondeson
    Journal of Medical Humanities and Bioethics 9 (1): 60-94. 1988.
  •  21
    I agree with Professor ter Meulen that there is no need to make a forced choice between “justice” and “solidarity” when it comes to determining what should count as fair access to needed health care. But he also asserts that solidarity is more fundamental than justice. That claim needs critical assessment. Ter Meulen recognizes that the concept of solidarity has been criticized for being excessively vague. He addresses this criticism by introducing the more precise notion of “humanitarian solida…Read more
  •  11