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1511Making Fair Choices on the Path to Universal Health CoverageWorld Health Organisation. 2014.This report by the WHO Consultative Group on Equity and Universal Health Coverage addresses how countries can make fair progress towards the goal of universal coverage. It explains the relevant tradeoffs between different desirable ends and offers guidance on how to make these tradeoffs.
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1311Faire Des Choix Justes Pour Une Couverture Sanitaire UniverselleWorld Health Organization. 2015.This report from the WHO Consultative Group on Equity and Universal Health Coverage offers advice on how to make progress fairly towards universal health coverage.
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1056Cómo tomar decisiones justas en el camino hacia la cobertura universal de saludPan-American Health Organization (PAHO). 2015.La cobertura universal de salud está en el centro de la acción actual para fortalecer los sistemas de salud y mejorar el nivel y la distribución de la salud y los servicios de salud. Este documento es el informe fi nal del Grupo Consultivo de la OMS sobre la Equidad y Cobertura Universal de Salud. Aquí se abordan los temas clave de la justicia (fairness) y la equidad que surgen en el camino hacia la cobertura universal de salud. Por lo tanto, el informe es pertinente para cada agente que infl uy…Read more
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348‘Perhaps the most important primary good’: self-respect and Rawls’s principles of justicePolitics, Philosophy and Economics 4 (2): 195-219. 2005.The article begins by reconstructing the just distribution of the social bases of self-respect, a principle of justice that is covert in Rawls’s writing. I argue that, for Rawls, justice mandates that each social basis for self-respect be equalized. Curiously, for Rawls, that principle ranks higher than Rawls’s two more famous principles of justice - equal liberty and the difference principle. I then recall Rawls’s well-known confusion between self-respect and another form of self-appraisal, nam…Read more
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188Is the Body Special? Review of Cécile Fabre, Whose Body is it Anyway? Justice and the Integrity of the Person: Nir EyalUtilitas 21 (2): 233-245. 2009.Both left libertarians, who support the redistribution of income and wealth through taxation, and right libertarians, who oppose redistributive taxation, share an important view: that, looming catastrophes aside, the state must never redistribute any part of our body or our person without our consent. Cécile Fabre rejects that view. For her, just as the undeservedly poor have a just claim to money from their fellow citizens in order to lead a minimally flourishing life, the undeservedly ‘medical…Read more
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124Reframing Consent for Clinical Research: A Function-Based ApproachAmerican Journal of Bioethics 17 (12): 3-11. 2017.Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and …Read more
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111Measuring the Global Burden of Disease: Philosophical Dimensions (edited book)Oup Usa. 2020.The Global Burden of Disease Study is one of the largest-scale research collaborations in global health, producing critical data for researchers, policy-makers, and health workers about more than 350 diseases, injuries, and risk factors. Such an undertaking is, of course, extremely complex from an empirical perspective. But it also raises complex ethical and philosophical questions. In this volume, a group of leading philosophers, economists, epidemiologists, and policy scholars identify and dis…Read more
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108Egalitarian justice and innocent choiceJournal of Ethics and Social Philosophy 2 (1): 1-19. 2006.This article argues that, in its standard formulation, luck-egalitarianism is false. In particular, I show that disadvantages that result from perfectly free choice can constitute egalitarian injustice. I also propose a modified formulation of luck-egalitarianism that would withstand my criticism. One merit of the modification is that it helps us to reconcile widespread intuitions about distributive justice with equally widespread intuitions about punitive justice.
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94Using informed consent to save trustJournal of Medical Ethics 40 (7): 437-444. 2014.Increasingly, bioethicists defend informed consent as a safeguard for trust in caretakers and medical institutions. This paper discusses an ‘ideal type’ of that move. What I call the trust-promotion argument for informed consent states:1. Social trust, especially trust in caretakers and medical institutions, is necessary so that, for example, people seek medical advice, comply with it, and participate in medical research.2. Therefore, it is usually wrong to jeopardise that trust.3. Coercion, dec…Read more
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90Why continuing uncertainties are no reason to postpone challenge trials for coronavirus vaccinesJournal of Medical Ethics 46 (12): 808-812. 2020.To counter the pandemic caused by severe acute respiratory syndrome coronavirus 2, some have proposed accelerating SARS-CoV-2 vaccine development through controlled human infection trials. These trials would involve the deliberate exposure of relatively few young, healthy volunteers to SARS-CoV-2. We defend this proposal against the charge that there is still too much uncertainty surrounding the risks of COVID-19 to responsibly run such a trial.
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85Physician brain drain: Can nothing be done?Public Health Ethics 1 (2): 180-192. 2008.Next SectionAccess to medicines, vaccination and care in resource-poor settings is threatened by the emigration of physicians and other health workers. In entire regions of the developing world, low physician density exacerbates child and maternal mortality and hinders treatment of HIV/AIDS. This article invites philosophers to help identify ethical and effective responses to medical brain drain. It reviews existing proposals and their limitations. It makes a case that, in resource-poor countrie…Read more
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70Justice, luck, and knowledge, by Susan L. Hurley. Harvard university press, 2003. VIII + 341 pages (review)Economics and Philosophy 21 (1): 164-171. 2005.
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51Making Fair Choices on the Path to Universal Health Coverage: Applying Principles to Difficult CasesHealth Systems and Reform 3 (4): 1-12. 2017.Progress towards Universal Health Coverage (UHC) requires making difficult trade-offs. In this journal, Dr. Margaret Chan, the WHO Director-General, has endorsed the principles for making such decisions put forward by the WHO Consultative Group on Equity and UHC. These principles include maximizing population health, priority for the worse off, and shielding people from health-related financial risks. But how should one apply these principles in particular cases and how should one adjudicate bet…Read more
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51Why Treat Noncompliant Patients? Beyond the Decent Minimum AccountJournal of Medicine and Philosophy 36 (6): 572-588. 2011.Patients’ medical conditions can result from their own avoidable risk taking. Some lung diseases result from avoidable smoking and some traffic accidents result from victims’ reckless driving. Although in many nonmedical areas we hold people responsible for taking risks they could avoid, it is normally harsh and inappropriate to deny patients care because they risked needing it. Why? A popular account is that protecting everyone’s "decent minimum," their basic needs, matters more than the benefi…Read more
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50Adding Lithium to Drinking Water for Suicide Prevention—The EthicsPublic Health Ethics 12 (3): 274-286. 2019.Recent observations associate naturally occurring trace levels of Lithium in ground water with significantly lower suicide rates. It has been suggested that adding trace Lithium to drinking water could be a safe and effective way to reduce suicide. This article discusses the many ethical implications of such population-wide Lithium medication. It compares this policy to more targeted solutions that introduce trace amounts of Lithium to groups at higher risk of suicide or lower risk of adverse ef…Read more
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49Inequalities in HIV Care: Chances Versus OutcomesAmerican Journal of Bioethics 11 (12): 42-44. 2011.We analyse three moral dilemmas involving resource allocation in care for HIV-positive patients. Ole Norheim and Kjell Arne Johansson have argued that these cases reveal a tension between egalitarian concerns and concerns for better population health. We argue, by contrast, that these cases reveal a tension between, on the one hand, a concern for equal *chances*, and, on the other hand, both a concern for better health and an egalitarian concern for equal *outcomes*. We conclude that, in these c…Read more
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49Nudges and Noodges: The Ethics of Health Promotion—New York StylePublic Health Ethics 6 (3). 2013.Michael Bloomberg's three terms in New York City's mayoral office are coming to a close. His model of governance for public health influenced cities and governments around the world. What should we make of that model? This essay introduces a symposium in which ethicists Sarah Conly, Roger Brownsword and Alex Rajczi discuss that legacy
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49Inequality in Political Philosophy and in Epidemiology: A RemarriageJournal of Applied Philosophy. 2018.In political philosophy and in economics, unfair inequality is usually assessed between individuals, nowadays often on luck-egalitarian grounds. You have more than I do and that's unfair. By contrast, in epidemiology and sociology, unfair inequality is traditionally assessed between groups. More is concentrated among people of your class or race than among people of mine, and that's unfair. I shall call this difference the egalitarian ‘divorce’. Epidemiologists, and their ‘divorce lawyers’ Paula…Read more
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48Informed consent, the value of trust, and hedonsJournal of Medical Ethics 40 (7): 447-447. 2014.Sissela Bok's1 and Torbjörn Tännsjö's2 writings on trust and informed consent were sources of inspiration for my article.3 It is gratifying to have a chance to respond to their thoughtful comments.Bok concurs with my scepticism that the ‘trust-promotion argument for informed consent’ can successfully generate commonsense morality's full set of informed consent norms. But she finds that argument even more wanting, perhaps so wanting as to be unworthy of critical attention. What she seems to find …Read more
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47Paternalism, French fries and the weak-willed WitnessJournal of Medical Ethics 40 (5): 353-354. 2014.Most books on ethics are boring. Against Autonomy 1 is fun to read because its helpful and profound points are made without a fuss. Author Sarah Conly is right that “when individuals engage in behavior that undercuts their own chances of happiness, state interference may be justified”.In what follows I argue that Conly misinterprets that thesis in three ways. First, she says that her paternalism seeks to “help people get where they want to go... live the lives they truly want to live”. That's a …Read more
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45Reconciling informed consent with prescription drug requirementsJournal of Medical Ethics 38 (10): 589-591. 2012.
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43The Diverse Ethics of Translational ResearchAmerican Journal of Bioethics 10 (8): 19-30. 2010.Commentators on the ethics of translational research find it morally problematic. Types of translational research are said to involve questionable benefits, special risks, additional barriers to informed consent, and severe conflicts of interest. Translational research conducted on the global poor is thought to exploit them and increase international disparities. Some commentators support especially stringent ethical review. However, such concerns are grounded only in pre-approval translational …Read more
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40How to keep high-risk studies ethical: classifying candidate solutionsJournal of Medical Ethics 43 (2): 74-77. 2017.
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37Several contributions in this book tell of doctors' increasing emigration from developing countries where they are in critical shortage, especially from the underserved rural and public sectors of countries in sub-Saharan Africa (SSA) and South Asia. They point out the severe harm from that migration to some of the world's poorest and sickest populations who have no other doctors to turn to, and gain little from their emigration. Since significant harm to the badly off is bad, decline in that mi…Read more
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36Dependence on Digital Medicine in Resource-Limited SettingsAmerican Journal of Bioethics 18 (9): 54-56. 2018.
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36Too Poor To Treat? The Complex Ethics of Cost-Effective Tobacco Policy in the Developing WorldPublic Health Ethics 4 (2): 109-120. 2011.The majority of deaths due to tobacco in the twenty-first century will occur in the developing world, where over 80% of current tobacco users live. In November 2010 guidelines were adopted for implementing Article 14 of the World Health Organization’s Framework Convention on Tobacco Control (FCTC). The guidelines call on all countries to promote tobacco treatment programs. Nevertheless, some experts argue for a strict focus, at least in developing countries, on population-based measures such as …Read more
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36Translational Research Beyond Approval: A Two-Stage Ethics ReviewAmerican Journal of Bioethics 10 (8). 2010.Commentators on the ethics of translational research find it morally problematic. Types of translational research are said to involve questionable benefits, special risks, additional barriers to informed consent, and severe conflicts of interest. Translational research conducted on the global poor is thought to exploit them and increase international disparities. Some commentators support especially stringent ethical review. However, such concerns are grounded only in pre-approval translational …Read more
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32Precommitting to Serve the UnderservedAmerican Journal of Bioethics 12 (5): 23-34. 2012.In many countries worldwide, especially in Sub-Saharan Africa, a shortage of physicians limits the provision of lifesaving interventions. One existing strategy to increase the number of physicians in areas of critical shortage is conditioning medical school scholarships on a precommitment to work in medically underserved areas later. Current practice is usually to demand only one year of service for each year of funded studies. We show the effectiveness of scholarships conditional on such precom…Read more
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32Non-Consequentialist UtilitarianismEthics and Economics 11 (2). 2014.Full Text / Article complet.
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Harvard UniversityRegular Faculty
Cambridge, Massachusetts, United States of America
Areas of Interest
Normative Ethics |
Social and Political Philosophy |
17th/18th Century Philosophy |