•  14
    Reinvigorating Public Health Ethics: Values, Topics and Theory
    Public Health Ethics 16 (2): 113-116. 2023.
    As we have now completed 15 years of journal content, it seems like a good time to take stock and reflect upon the development and nature of public health ethic.
  •  7
    Language of Incarceration and of Persons Subject to Incarceration
    Public Health Ethics 15 (2): 191-193. 2022.
    Reflecting on Smith (2021) in this issue, this commentary extends our consideration of issues in carceral health and questions the dehumanizing language we sometimes use—including in public health and public health ethics—to talk about persons held in incarceration. Even the language we use for the carceral system itself (such as ‘criminal justice system’) is fraught: it casts a laudatory light on the system and papers over its role in compounding racial health inequities and in sustaining colon…Read more
  •  6
    Piketty and the Body: On the Relevance of Wealth Inequality to Bioethics
    International Journal of Feminist Approaches to Bioethics 8 (2): 250-265. 2015.
    In Capital in the Twenty-First Century, Thomas Piketty argues that markets, absent political intervention, tend toward economic divergence and that this has deleterious consequences for democratic ideals of equal voice and meritocracy. His goal is to foster a public conversation about what a society dominated by wealth—which we already beginning to experience as the twenty-first century begins—would look like if we wish to maintain an egalitarian ethos. His work will contribute to and further mo…Read more
  •  7
    Solidarity in Relational Public Health: A Commentary on "Public Health and Precarity" by Michael D. Doan and Ami Harbin
    International Journal of Feminist Approaches to Bioethics 13 (2): 141-147. 2020.
    In "Public Health and Precarity," Michael Doan and Ami Harbin have done important work extending Sherwin's concept of relational autonomy to encompass relational agency—including agents such as communities and states. This opens up new ways of thinking about responsibility for public health in long-standing debates about the role of the state in public health.The case studies Doan and Harbin analyze are also important for thinking of the account of relational solidarity that Sherwin developed to…Read more
  •  75
    Triage of critical care resources in COVID-19: a stronger role for justice
    Journal of Medical Ethics 46 (8): 526-530. 2020.
    Some ethicists assert that there is a consensus that maximising medical outcomes takes precedence as a principle of resource allocation in emergency triage of absolutely scarce resources. But the nature of the current severe acute respiratory syndrome-related coronavirus 2 pandemic and the history of debate about balancing equity and efficiency in resource allocation do not support this assertion. I distinguish a number of concerns with justice and balancing considerations that should play a rol…Read more
  •  66
    Compensation for Gamete Donation: The Analogy with Jury Duty
    with Natalie Ram and R. Brown
    Cambridge Quarterly of Healthcare Ethics 16 (1): 35-43. 2007.
    In Canada, laws and policies consistently reject the commodification of human organs and tissues, and Canadian practice is consistent with international standards in this regard. Until the Assisted Human Reproduction Act of 2004, gamete donation in Canada was an exception: Canadians could pay and be paid open market rates for gametes for use in in vitro fertilization. As sections of the AHR Act forbidding payment for gametes and permitting only reimbursement of receipted expenses gradually came …Read more
  •  32
    Scientism in medical education distracts educators from focusing on the content of learning; it focuses attention instead on individual achievement and validity in its measurement. I analyze the specific form that scientism takes in medicine and in medical education. The competencies movement attempts to challenge old “scientistic” views of the role of physicians, but in the end it has invited medical educators to focus on validity in the measurement of individual performance for attitudes and s…Read more
  •  20
    Piketty and the Body: On the Relevance of Wealth Inequality to Bioethics
    International Journal of Feminist Approaches to Bioethics 8 (2): 250-265. 2015.
    In Capital in the Twenty-First Century, Thomas Piketty argues that markets, absent political intervention, tend toward economic divergence and that this has deleterious consequences for democratic ideals of equal voice and meritocracy. His goal is to foster a public conversation about what a society dominated by wealth—which we already beginning to experience as the twenty-first century begins—would look like if we wish to maintain an egalitarian ethos. His work will contribute to and further mo…Read more
  •  34
    Truth or Spin? Disease Definition in Cancer Screening
    Journal of Medicine and Philosophy 42 (4): 385-404. 2017.
    Are the small and indolent cancers found in abundance in cancer screening normal variations, risk factors, or disease? Naturalists in philosophy of medicine turn to pathophysiological findings to decide such questions objectively. To understand the role of pathophysiological findings in disease definition, we must understand how they mislead in diagnostic reasoning. Participants on all sides of the definition of disease debate attempt to secure objectivity via reductionism. These reductivist rou…Read more
  •  25
    Long-term care, globalization, and justice, by Lisa A. Eckenwiler
    International Journal of Feminist Approaches to Bioethics 6 (1): 172-177. 2013.
    Lisa A. Eckenwiler, Long-term care, globalization, and justice, Baltimore: The Johns Hopkins University Press, 2012, reviewed by Lynette Reid
  •  31
    Brains, genes, and the making of the self
    American Journal of Bioethics 5 (2). 2005.
    This Article does not have an abstract
  •  15
    Nice work if you can get it
    American Journal of Bioethics 5 (5). 2005.
    This Article does not have an abstract
  •  42
    From the special issue editors
    Journal of Bioethical Inquiry 3 (1-2): 11-13. 2006.
  •  15
    The Interrogation of Meletus: Apology 24c4–28a1
    Classical Quarterly 45 (2): 372-388. 1995.
    The interrogation of Meletus in the Apology at 24c4–28al is not infrequently seen as a typical case of all that is intellectually and artistically dissatisfying in Plato's practice of the genre of philosophical dialogue: not only are we presented with a philosopher who makes some claim to being committed to setting a particularly stringent standard for honesty in argumentation making sophistical arguments, but we are presented also with a cardboard interlocutor who is forced by the hand of Plato…Read more
  •  105
    Wittgenstein’s Ladder: The Tractatus and Nonsense
    Philosophical Investigations 21 (2). 1998.
    I discuss some reservations about the exegetical power of the claim that the Tractatus is “anti-metaphysical.” The “resolute” reading has the virtue of fidelity to important and neglected features of the work, both its anti-metaphysical moves and its account of the nature of the activity of philosophy and its status. However, its proponents underestimate the barriers to maintaining a consistent fidelity to these features of the text. The image of a ladder suggests a mere instrumental means to ar…Read more
  •  32
    Some argue that the concept of medical need is inadequate to inform the design of a universal health care system—particularly an institutional rather than a residual system. They argue that the concept contradicts the idea of comprehensiveness; leads to unsustainable expenditures; is too indeterminate for policy; and supports only a prioritarian distribution. I argue that ‘comprehensive’ understood as ‘including the full continuum of care’ and ‘medically necessary’ understood as ‘prioritized by …Read more
  •  24
    In bioethics and health policy, we often discuss the appropriate boundaries of public funding; how the interface of public and private purchasers and providers should be organized and regulated receives less attention. In this paper, I discuss ethical and regulatory issues raised at this interface by three medical practice models in which physicians provide insured services while requiring or requesting that patients pay for services or for the non-insured services of the physicians themselves o…Read more
  •  8
    Systems of universal health coverage may aspire to provide care based on need and not ability to pay; the complexities of this aspiration call for normative analysis. This special issue arises in the wake of a judicial inquiry into preferential access in the Canadian province of Alberta, the Vertes Commission. I describe this inquiry and set out a taxonomy of forms of differential and preferential access. Papers in this special issue focus on the conceptual specification of health system boundar…Read more
  •  32
    The harm-benefit tradeoff in "bad deal" trials
    with Gillian Nycum
    Kennedy Institute of Ethics Journal 17 (4): 321-350. 2007.
    : This paper examines the nature of the harm-benefit tradeoff in early clinical research for interventions that involve remote possibility of direct benefit and likelihood of direct harms to research participants with fatal prognoses, by drawing on the example of gene transfer trials for glioblastoma multiforme. We argue that the appeal made by the component approach to clinical equipoise fails to account fully for the nature of the harm-benefit tradeoff—individual harm for social benefit—that w…Read more
  •  56
    Medical Professionalism and the Social Contract
    Perspectives in Biology and Medicine 54 (4): 455-469. 2011.
    The professionalism movement has animated medical education and practice; an extensive literature expresses and categorizes many interpretations of the concept (Hafferty 2006a; Hafferty and Levinson 2008). The inception of the current wave of the movement was in the American Board of Internal Medicine's Project Professionalism. In the face of threats from the growth of managed care and public concerns about conflict of interest, the ABIM's "Physician Charter" called for the profession to publica…Read more
  •  32
    Verweij and Dawson claim that population health has a distributive dimension; Coggon argues that this presupposes a normative commitment to equity in the very definition of population health, which should, rather, be neutral. I describe possible sources of the distributive view, several of which do not presuppose egalitarian commitments. Two relate to the nature of health as a property of individuals ; two relate to the epistemology and pragmatics of public and population health. A fifth source …Read more
  •  14
    Long-term care, globalization, and justice by Lisa A. Eckenwiler (review)
    International Journal of Feminist Approaches to Bioethics 6 (1): 172-177. 2013.
    Lisa A. Eckenwiler, Long-term care, globalization, and justice, Baltimore: The Johns Hopkins University Press, 2012, reviewed by Lynette Reid
  •  50
    Temkin asks how we should distribute resources between the social determinants of health and health care; Sreenivasan argues that if our goal is fair opportunity, funding universal health coverage is the wrong policy. He argues that social equality in health has not improved under UHC and concludes that fair opportunity would be better served by using the resources to address the SDOH instead. His criticism applies more broadly than he claims: it applies to any argument for UHC based on health e…Read more
  •  21
    Networking Genetics, Populations, and Race
    American Journal of Bioethics 9 (6-7): 50-52. 2009.
    No abstract
  •  62
    The seriousness of the risk that healthcare workers faced during SARS, and their response of service in the face of this risk, brings to light unrealistic assumptions about duty and risk that informed the debate on duty to care in the early years of HIV/AIDS. Duty to care is not based upon particular virtues of the health professions, but arises from social reflection on what response to an epidemic would be consistent with our values and our needs, recognizing our shared vulnerability to diseas…Read more