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965Ethical Issues in Text Mining for Mental HealthIn Morteza Dehghani & Ryan Boyd (eds.), The Atlas of Language Analysis in Psychology, Guilford Press. forthcoming.A recent systematic review of Machine Learning (ML) approaches to health data, containing over 100 studies, found that the most investigated problem was mental health (Yin et al., 2019). Relatedly, recent estimates suggest that between 165,000 and 325,000 health and wellness apps are now commercially available, with over 10,000 of those designed specifically for mental health (Carlo et al., 2019). In light of these trends, the present chapter has three aims: (1) provide an informative overview o…Read more
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471Persons or datapoints?: Ethics, artificial intelligence, and the participatory turn in mental health researchAmerican Psychologist 79 (1): 137-149. 2024.This article identifies and examines a tension in mental health researchers’ growing enthusiasm for the use of computational tools powered by advances in artificial intelligence and machine learning (AI/ML). Although there is increasing recognition of the value of participatory methods in science generally and in mental health research specifically, many AI/ML approaches, fueled by an ever-growing number of sensors collecting multimodal data, risk further distancing participants from research pr…Read more
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373The First Smart Pill: Digital Revolution or Last Gasp?Kennedy Institute of Ethics Journal 33 (3): 277-319. 2023.ABSTRACT: Abilify MyCite was granted regulatory approval in 2017, becoming the world’s first “smart pill” that could digitally track whether patients had taken their medication. The new technology was introduced as one that had gained the support of patients and ethicists alike, and could contribute to solving the widespread and costly problem of patient nonadherence. Here, we offer an in-depth exploration of this narrative, through an examination of the origins and development of Abilify, the d…Read more
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367Mind the Gaps: Ethical and Epistemic Issues in the Digital Mental Health Response to Covid‐19Hastings Center Report 51 (6): 23-26. 2021.Well before the COVID-19 pandemic, proponents of digital psychiatry were touting the promise of various digital tools and techniques to revolutionize mental healthcare. As social distancing and its knock-on effects have strained existing mental health infrastructures, calls have grown louder for implementing various digital mental health solutions at scale. Decisions made today will shape the future of mental healthcare for the foreseeable future. We argue that bioethicists are uniquely position…Read more
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101Personal responsibility within health policy: unethical and ineffectiveJournal of Medical Ethics Recent Issues 44 (1): 53-58. 2017.This paper argues against incorporating assessments of individual responsibility into healthcare policies by expanding an existing argument and offering a rebuttal to an argument in favour of such policies. First, it is argued that what primarily underlies discussions surrounding personal responsibility and healthcare is not causal responsibility, moral responsibility or culpability, as one might expect, but biases towards particular highly stigmatised behaviours. A challenge is posed for propon…Read more
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77Rethinking the Belmont Report?American Journal of Bioethics 17 (7): 15-21. 2017.This article reflects on the relevance and applicability of the Belmont Report nearly four decades after its original publication. In an exploration of criticisms that have been raised in response to the report and of significant changes that have occurred within the context of biomedical research, five primary themes arise. These themes include the increasingly vague boundary between research and practice, unique harms to communities that are not addressed by the principle of respect for person…Read more
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74Recommendations for Responsible Development and Application of NeurotechnologiesNeuroethics 14 (3): 365-386. 2021.Advancements in novel neurotechnologies, such as brain computer interfaces and neuromodulatory devices such as deep brain stimulators, will have profound implications for society and human rights. While these technologies are improving the diagnosis and treatment of mental and neurological diseases, they can also alter individual agency and estrange those using neurotechnologies from their sense of self, challenging basic notions of what it means to be human. As an international coalition of int…Read more
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69Educational pelvic exams on anesthetized women: Why consent mattersBioethics 32 (5): 298-307. 2018.It is argued here that the practice of medical students performing pelvic exams on women who are under anesthetic and have not consented is immoral and indefensible. This argument begins by laying out the ethical justification for the practice of informed consent, which can be found in autonomy and basic rights. Foregoing the process of consent within medicine can result in violations of both autonomy and basic rights, as well as trust, forming the basis of the wrong of unauthorized pelvic exami…Read more
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65National Standards for Public Involvement in Research: missing the forest for the treesJournal of Medical Ethics 44 (12): 801-804. 2018.Biomedical research funding bodies across Europe and North America increasingly encourage—and, in some cases, require—investigators to involve members of the public in funded research. Yet there remains a striking lack of clarity about what ‘good’ or ‘successful’ public involvement looks like. In an effort to provide guidance to investigators and research organisations, representatives of several key research funding bodies in the UK recently came together to develop the National Standards for P…Read more
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65Pain, placebo, and cognitive penetrationMind and Language 36 (5): 771-791. 2021.There is compelling evidence that pain experience is influenced by cognitive states. We explore one specific form of such influence, namely placebo analgesia, and examine its relevance for the cognitive penetration debate in philosophy of mind. We single out as important a form of influence on experience that we termradical cognitive penetration,and argue that some cases of placebo analgesia constitute compelling instances of this phenomenon. Still, we urge caution in extrapolating from this to …Read more
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62Ethics review of big data research: What should stay and what should be reformed?BMC Medical Ethics 22 (1): 1-13. 2021.BackgroundEthics review is the process of assessing the ethics of research involving humans. The Ethics Review Committee (ERC) is the key oversight mechanism designated to ensure ethics review. Whether or not this governance mechanism is still fit for purpose in the data-driven research context remains a debated issue among research ethics experts.Main textIn this article, we seek to address this issue in a twofold manner. First, we review the strengths and weaknesses of ERCs in ensuring ethical…Read more
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53Placebo effects and racial and ethnic health disparities: an unjust and underexplored connectionJournal of Medical Ethics Recent Issues 44 (11): 774-781. 2018.While a significant body of bioethical literature considers how the placebo effect might introduce a conflict between autonomy and beneficence, the link between justice and the placebo effect has been neglected. Here, we bring together disparate evidence from the field of placebo studies and research on health inequalities related to race and ethnicity, and argue that, collectively, this evidence may provide the basis for an unacknowledged route by which health disparities are exacerbated. This …Read more
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50Birthing Alone: An Ethical Analysis of Pandemic Policies Banning Birthing PartnersInternational Journal of Feminist Approaches to Bioethics 14 (2): 114-143. 2021.During the COVID-19 pandemic, several hospitals implemented “birthing alone” policies, banning companions from accompanying individuals giving birth. We offer an ethical analysis of these policies. First, we examine them through a consequentialist framework of risks and benefits. Second, we consider the significance of birth, highlighting the unique ways in which risks, relationships, and rights are understood in the context of obstetrics. We conclude that birthing alone policies are largely unj…Read more
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49Concerns about genetic testing for schizophrenia among young adults at clinical high risk for psychosisAJOB Empirical Bioethics 7 (3): 193-198. 2016.Background: Genetic tests for schizophrenia may introduce risks and benefits. Among young adults at clinical high risk for psychosis, little is known about their concerns and how they assess potential risks. Methods: We conducted semistructured interviews with 15 young adults at clinical high risk for psychosis to ask about their concerns. Results: Participants expressed concerns about test reliability, data interpretation, stigma, psychological harm, family planning, and privacy. Participants’ …Read more
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48Standpoint Theory and the Psy Sciences: Can Marginalization and Critical Engagement Lead to an Epistemic Advantage?Hypatia 37 (4): 659-687. 2022.As participatory research practices are increasingly taken up in health research, claims related to experiential authority and expertise are frequently made. Here, in an exploration of what grounds such claims, we consider how feminist standpoint theory might apply to the psy sciences (psychiatry, psychology, psychotherapy, psychoanalysis, and so on). Standpoint theory claims that experiences of marginalization and critical engagement can lead to a standpoint that offers an epistemic advantage w…Read more
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47The Hopkins-Oxford Psychedelics Ethics (HOPE) Working Group Consensus StatementAmerican Journal of Bioethics 24 (7): 6-12. 2024.Volume 24, Issue 7, July 2024, Page 6-12.
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47Public involvement in the governance of population-level biomedical research: unresolved questions and future directionsJournal of Medical Ethics 47 (7): 522-525. 2021.Population-level biomedical research offers new opportunities to improve population health, but also raises new challenges to traditional systems of research governance and ethical oversight. Partly in response to these challenges, various models of public involvement in research are being introduced. Yet, the ways in which public involvement should meet governance challenges are not well understood. We conducted a qualitative study with 36 experts and stakeholders using the World Café method to…Read more
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47Towards an account of the placebo effect: a critical evaluation alongside current evidenceBiology and Philosophy 35 (1): 1-23. 2020.This paper offers a critical analysis of several accounts of the placebo effect that have been put forward. While the placebo effect is most often thought of as a control in research and as a deceptive tool in practice, a growing body of research suggests that it ought to be thought of as a powerful phenomenon in its own right. Several accounts that aim to draw boundaries around the placebo effect are evaluated in relation to current evidence and it is argued that none of them adequately capture…Read more
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42IRBs and the Protection-Inclusion Dilemma: Finding a BalanceAmerican Journal of Bioethics 23 (6): 75-88. 2022.Institutional review boards, tasked with facilitating ethical research, are often pulled in competing directions. In what we call the protection-inclusion dilemma, we acknowledge the tensions IRBs face in aiming to both protect potential research participants from harm and include under-represented populations in research. In this manuscript, we examine the history of protectionism that has dominated research ethics oversight in the United States, as well as two responses to such protectionism: …Read more
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40Medically Assisted Dying and Suicide: How Are They Different, and How Are They Similar?Hastings Center Report 50 (1): 32-43. 2020.The practice of medically assisted dying has long been contentious, and the question of what to call it has become increasingly contentious as well. Particularly among U.S. proponents of legalizing the practice, there has been a growing push away from calling it “physician‐assisted suicide,” with assertions that medically assisted dying is fundamentally different from suicide. Digging deeper into this claim about difference leads to an examination of the difference between two kinds of suffering…Read more
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40The Challenge of Demandingness in Citizen Science and Participatory ResearchAmerican Journal of Bioethics 19 (8): 33-35. 2019.Wiggins and Wilbanks’s (2019) article draws attention to the rise of citizen science in the medical domain, part of a larger participatory turn in which citizens and patients are increasingly invol...
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39Trust, trustworthiness and sharing patient data for researchJournal of Medical Ethics 47 (12). 2021.When it comes to using patient data from the National Health Service for research, we are often told that it is a matter of trust: we need to trust, we need to build trust, we need to restore trust. Various policy papers and reports articulate and develop these ideas and make very important contributions to public dialogue on the trustworthiness of our research institutions. But these documents and policies are apparently constructed with little sustained reflection on the nature of trust and tr…Read more
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39White Ignorance in Pain Research: Racial Differences and Racial DisparitiesKennedy Institute of Ethics Journal 32 (2): 205-235. 2022.Racial disparities in pain treatment are well documented. Such disparities are explained with reference to factors related to providers, health care structures, and patient behaviors. Racial differences in pain experiences, although well documented, are less well understood. Explanations for such differences usually involve genetic or psychological factors. Here, we argue that racial differences in pain experiences might also be explained by disparities in pain treatment. Based on what we know a…Read more
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38Expanding Outcome Measures in Schizophrenia Research: Does the Research Domain Criteria Pose a Threat?Philosophy, Psychiatry, and Psychology 26 (3): 243-260. 2019.In the introduction to a recent anthology of contemporary issues in philosophy of psychiatry, editors Jeffrey Poland and Şerife Tekin declare this to be a moment of crisis within the field. They suggest that the state of psychiatry today reflects Thomas Kuhn's conception of a period of extraordinary science, which occurs when anomalies begin to build up, confidence in the dominant paradigm is shook, competing theories arise, and philosophical questions come to the fore. Although perhaps not all …Read more
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34A Place for Subjectivity in PsychiatryAmerican Journal of Bioethics Neuroscience 8 (2): 116-117. 2017.
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33Extraordinary science and psychiatry: Responses to the crisis in mental health research (review)Philosophical Psychology 31 (1): 146-150. 2018.
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32More Harm Than Good: Neurotechnological Thought Apprehension in Forensic PsychiatryAmerican Journal of Bioethics Neuroscience 10 (1): 17-19. 2019.
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31Equitable Access to Research Benefits: Considerations for COVID-19 Vaccine Development and Clinical Trial CrossoverAmerican Journal of Bioethics 21 (3): 86-88. 2021.COVID-19 vaccine research success and emergency use authorizations have shown the life sciences’ potential for positive health impact. But they also underscore potentially divergent and conf...
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30On Female Genital Cutting: Factors to be Considered When Confronted With a Request to Re-infibulateJournal of Bioethical Inquiry 15 (4): 549-555. 2018.According to the World Health Organization, female genital cutting affects millions of girls and women worldwide, particularly on the African continent and in the Middle East. This paper presents a plausible, albeit hypothetical, clinical vignette and then explores the legal landscape as well as the ethical landscape physicians should use to evaluate the adult patient who requests re-infibulation. The principles of non-maleficence, beneficence, justice, and autonomy are considered for guidance, …Read more
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30Transforming Bioethics: The Need for Strong Objectivity and StandpointsAmerican Journal of Bioethics 21 (2): 58-60. 2021.In their target article, Zamina Mithani, Jane Cooper, and J. Wesley Boyd make a compelling case for the importance of “counter storytelling” in bioethics. They obse...