University of Leeds
School of Philosophy, Religion, and History of Science
PhD, 2001
Sheffield, South Yorkshire, United Kingdom of Great Britain and Northern Ireland
  •  678
    Is the doctrine of double effect irrelevant in end-of-life decision making?
    with Mark Cobb, B. Jane Liddle, and Angela Mary Tod
    Nursing Philosophy 11 (3): 170-177. 2010.
    In this paper, we consider three arguments for the irrelevance of the doctrine of double effect in end-of-life decision making. The third argument is our own and, to that extent, we seek to defend it. The first argument is that end-of-life decisions do not in fact shorten lives and that therefore there is no need for the doctrine in justification of these decisions. We reject this argument; some end-of-life decisions clearly shorten lives. The second is that the doctrine of double effect is not …Read more
  •  237
    An aristotelian account of autonomy
    Journal of Value Inquiry 42 (1): 41-53. 2008.
    The purpose of this article is to set out an Aristotelian account of individual autonomy. Individual autonomy is the capacity of the individual to make and act upon judgments for which he is held morally accountable. This sense of autonomy may be contrasted to a number of other senses. Of these, the most important are political or legal autonomy and Kantian principled autonomy. Political or legal autonomy concerns the environment in which an individual operates. It exists where individuals are a…Read more
  •  236
    An Argument for the use of Aristotelian Method in Bioethics
    Medicine, Health Care and Philosophy 9 (1): 69-79. 2005.
    The main claim of this paper is that the method outlined and used in Aristotle’s Ethics is an appropriate and credible one to use in bioethics. Here “appropriate” means that the method is capable of establishing claims and developing concepts in bioethics and “credible” that the method has some plausibility, it is not open to obvious and immediate objection. It begins by suggesting why this claim matters and then gives a brief outline of Aristotle’s method. The main argument is made in three sta…Read more
  •  228
    A problem with inclusion in learning disability research
    with A. McClimens
    Nursing Ethics 18 (5): 633-639. 2011.
    People with severe learning disability are particularly difficult to include in the research process. As a result, researchers may be tempted to focus on those with learning disability who can be included. The problem is exacerbated in this field as the political agenda of inclusion and involvement is driven by those people with learning disability who are the higher functioning. To overcome this we should first detach the notion of consent from ideas about autonomy and think instead of it as a …Read more
  •  200
    Bayes and health care research
    Medicine, Health Care and Philosophy 7 (3): 321-332. 2004.
    Bayes’ rule shows how one might rationally change one’s beliefs in the light of evidence. It is the foundation of a statistical method called Bayesianism. In health care research, Bayesianism has its advocates but the dominant statistical method is frequentism. There are at least two important philosophical differences between these methods. First, Bayesianism takes a subjectivist view of probability (i.e. that probability scores are statements of subjective belief, not objective fact) whilst fr…Read more
  •  113
    Death with dignity
    Journal of Medical Ethics 28 (4): 255-257. 2002.
    The purpose of this article is to develop a conception of death with dignity and to examine whether it is vulnerable to the sort of criticisms that have been made of other conceptions. In this conception “death” is taken to apply to the process of dying; “dignity” is taken to be something that attaches to people because of their personal qualities. In particular, someone lives with dignity if they live well (in accordance with reason, as Aristotle would see it). It follows that health care p…Read more
  •  95
    Health, happiness and health promotion
    Journal of Applied Philosophy 22 (1). 2005.
    This article claims that health promotion is best practised in the light of an Aristotelian conception of the good life for humans and of the place of health within it.
  •  71
    Can there be an ethics of care?
    Journal of Medical Ethics 21 (1): 19-24. 1995.
    There is a growing body of writing, for instance from the nursing profession, espousing an approach to ethics based on care. I suggest that this approach is hopelessly vague and that the vagueness is due to an inadequate analysis of the concept of care. An analysis of 'care' and related terms suggests that care is morally neutral. Caring is not good in itself, but only when it is for the right things and expressed in the right way. 'Caring' ethics assumes wrongly that caring is good, thus it can…Read more
  •  66
    Popper and nursing theory
    Nursing Philosophy 4 (1): 4-16. 2003.
    Science seems to develop by inducing new knowledge from observation. However, it is hard to find a rational justification for induction. Popper offers one attempt to resolve this problem. Nursing theorists have tended to ignore or reject Popper, often on the false belief that he is a logical positivist (and hence hostile to qualitative research). Logical positivism claims that meaningful sentences containing any empirical content should ultimately be reducible to simple, observation statements. …Read more
  •  58
    Virtue and austerity
    Nursing Philosophy 14 (1): 45-52. 2013.
    Virtue ethics is often proposed as a third way in health‐care ethics, that while consequentialism and deontology focus on action guidelines, virtue focuses on character; all three aim to help agents discern morally right action although virtue seems to have least to contribute to political issues, such as austerity. I claim: This is a bad way to characterize virtue ethics. The 20th century renaissance of virtue ethics was first proposed as a response to the difficulty of making sense of ‘moral r…Read more
  •  35
    Should research samples reflect the diversity of the population?
    Journal of Medical Ethics 30 (2): 185-189. 2004.
    Recent research governance documents say that the body of research evidence must reflect population diversity. The response to this needs to be more sophisticated than simply ensuring minorities are present in samples. For quantitative research looking primarily at treatment effects of drugs and devices four suggestions are made. First, identify where the representation of minorities in samples matters—for example, where ethnicity may cause different treatment effects. Second, where the rep…Read more
  •  34
    Choosing Health and the inner citadel
    Journal of Medical Ethics 32 (1): 3-6. 2006.
    It is argued in this paper that the latest UK government white paper on public health, Choosing Health, is vulnerable to a charge of paternalism. For some years libertarians have levelled this charge at public health policies. The white paper tries to avoid it by constant reference to informed choice and choice related terms. The implication is that the government aims only to inform the public of health issues; how they respond is up to them. It is argued here, however, that underlying the …Read more
  •  31
    Is it in a neonate's best interest to enter a randomised controlled trial?
    Journal of Medical Ethics 27 (2): 110-113. 2001.
    Clinicians are required to act in the best interest of neonates.However, it is not obvious that entry into a randomised controlled trial (RCT) is in a neonate’s best interest because such trials often involve additional onerous procedures (such as intramuscular injections) in return for which the neonate receives unproven treatment or a placebo.On the other hand, neonatology needs to develop its evidence base, and RCTs are central to this task. The solution posited here is based on two …Read more
  •  30
    Objective: To assess whether continuous consent, a process in which information is given to research participants at different stages in a trial, and clinician training in that process were effective when used by clinicians while gaining consent to the Total Body Hypothermia (TOBY) trial. The TOBY trial is a randomised controlled trial (RCT) investigating the use of whole-body cooling for neonates with evidence of perinatal asphyxia. Obtaining valid informed consent for the TOBY trial is difficu…Read more
  •  28
    Should desperate volunteers be included in randomised controlled trials?
    Journal of Medical Ethics 32 (9): 548-553. 2006.
    Randomised controlled trials (RCTs) sometimes recruit participants who are desperate to receive the experimental treatment. This paper defends the practice against three arguements that suggest it is unethical first, desperate volunteers are not in equipoise. Second clinicians, entering patients onto trials are disavowing their therapeutic obligation to deliver the best treatment; they are following trial protocols rather than delivering individualised care. Research is not treatment; it…Read more
  •  27
    Mental health ethics: the human context
    Nursing Philosophy 13 (2): 151-152. 2012.
  •  25
    Reply to Ann Bradshaw
    Journal of Medical Ethics 22 (1): 13-15. 1996.
    My original paper suggested that an ethics of care which failed to specify how, and about what, to care would be devoid of normative and descriptive content. Bradshaw's approach provides such a specification and is, therefore, not devoid of such content. However, as all ethical approaches suggest something about the 'what' and 'how' of care, they are all 'ethics of care' in this broader sense. This reinforces rather than undermines my original conclusion. Furthermore, Bradshaw's 'ethics of care'…Read more
  •  21
    How should public health professionals engage with lay epidemiology?
    Journal of Medical Ethics 32 (8): 460-463. 2006.
    “Lay epidemiology” is a term used to describe the processes through which health risks are understood and interpreted by laypeople. It is seen as a barrier to public health when the public disbelieves or fails to act on public health messages. Two elements to lay epidemiology are proposed: empirical beliefs about the nature of illness and values about the place of health and risks to health in a good life. Both elements have to be dealt with by effective public health schemes or programmes, whic…Read more
  •  19
    Ethical issues in the use of in-depth interviews: literature review and discussion
    with Jonathan Boote, Eleni Chambers, Amanda Clarke, Ann McDonnell, Andrew Thompson, and Angela Mary Tod
    Research Ethics 5 (2): 48-54. 2009.
    This paper reports a literature review on the topic of ethical issues in in-depth interviews. The review returned three types of article: general discussion, issues in particular studies, and studies of interview-based research ethics. Whilst many of the issues discussed in these articles are generic to research ethics, such as confidentiality, they often had particular manifestations in this type of research. For example, privacy was a significant problem as interviews sometimes probe unexpecte…Read more
  •  8
    Aristotle for nursing
    Nursing Philosophy 18 (3). 2017.
    This article aims: (1) to introduce the wider philosophy of Aristotle to nurses and healthcare practitioners; (2) to show that Aristotle's philosophical system is an interdependent whole; and (3) to defend its plausibility and usefulness despite its ancient and alien origins.Aristotle's system can be set out as a hierarchy, with metaphysics at the top and methodology running throughout. Beneath metaphysics are the sciences, with theoretical, practical and productive (or craft) sciences in hierar…Read more