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Are discrepancies between research ethics committees always morally problematicBioethics 18 (4): 408-427. 2004.
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8The purpose of this study is to examine the importance that real patients attach to their right to withdraw from an on-going feasibility randomised trial (RCT) evaluating types and timings of breast reconstruction (two parallel trials) following mastectomy for breast cancer. Our results show that, while some respondents appreciated that exercising the right to withdraw would defeat the scientific objective of the trial, some patients with a surgical preference consented only given the knowledge …Read more
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10I know what you're thinking: brain imaging and mental privacy (edited book)Oxford University Press. 2012.'I know what you're thinking' is a fascinating exploration into the neuroscientific evidence on 'mind reading'.
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9Evaluating Interventions in Health: A Reconciliatory ApproachBioethics 26 (9): 455-463. 2012.Health‐related Quality of Life measures have recently been attacked from two directions, both of which criticize the preference‐based method of evaluating health states they typically incorporate. One attack, based on work by Daniel Kahneman and others, argues that ‘experience’ is a better basis for evaluation. The other, inspired by Amartya Sen, argues that ‘capability’ should be the guiding concept. In addition, opinion differs as to whether health evaluation measures are best derived from con…Read more
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7Evaluating interventions in health: A reconciliatory approachBioethics 26 (9): 455-463. 2011.Health-related Quality of Life measures have recently been attacked from two directions, both of which criticize the preference-based method of evaluating health states they typically incorporate. One attack, based on work by Daniel Kahneman and others, argues that ‘experience’ is a better basis for evaluation. The other, inspired by Amartya Sen, argues that ‘capability’ should be the guiding concept. In addition, opinion differs as to whether health evaluation measures are best derived from con…Read more
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9The Ottawa statement on the ethical design and conduct of cluster randomized trials: A short reportResearch Ethics 10 (2): 77-85. 2014.Owing to unique features of their design, cluster randomized trials complicate the interpretation of standard ethics guidelines. The recently published Ottawa statement on the ethical design and conduct of cluster randomized trials provides researchers and research ethics committees with detailed guidance on the design, conduct and review of cluster trials. The Ottawa statement sets out 15 recommendations, including guidance on the justification of study design, the need for research ethics comm…Read more
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4Rationing, randomising, and researching in health care provisionJournal of Medical Ethics 28 (1): 20-23. 2002.In this paper the need for valid evidence of the cost-effectiveness of treatments that have not been properly evaluated, yet are already available, albeit in short supply, are examined. Such treatments cannot be withdrawn, pending proper evaluation, nor can they be made more widely available until they have been shown to be cost-effective. As a solution to this impasse the argument put forward recently by Toroyan et al is discussed. They say that randomised controlled trials of such resources co…Read more
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19Research ethics committees and paternalismJournal of Medical Ethics 30 (1): 88-91. 2004.In this paper the authors argue that research ethics committees should not be paternalistic by rejecting research that poses risk to people competent to decide for themselves. However it is important they help to ensure valid consent is sought from potential recruits and protect vulnerable people who cannot look after their own best interests. The authors first describe the tragic deaths of Jesse Gelsinger and Ellen Roche. They then discuss the following claims to support their case: competent i…Read more
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4Can unequal be more fair? A response to Andrew AvinsJournal of Medical Ethics 26 (3): 179-182. 2000.In this paper, we respond to Andrew Avins's recent review of methods whose use he advocates in clinical trials, to make them more ethical. He recommends in particular, “unbalanced randomisation”. However, we argue that, before such a recommendation can be made, it is important to establish why unequal randomisation might offer ethical advantages over equal randomisation, other things being equal. It is important to make a pragmatic distinction between trials of treatments that are already routin…Read more
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5Ethical concerns regarding guidelines for the conduct of clinical research on childrenJournal of Medical Ethics 31 (6): 351-354. 2005.In this article we examine ethical aspects of the involvement of children in clinical research, specifically those who are incapable of giving informed consent to participate. The topic is, of course, not a new one in medical ethics but there are some tensions in current guidelines that, in our view, need to be made explicit and which need to be responded to by the relevant official bodies. In particular, we focus on tensions between the World Medical Association Declaration of Helsinki, and the…Read more
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12Editorial: the unexpected power of research ethicsResearch Ethics 16 (1-2): 1-3. 2020.Research Ethics, Ahead of Print.
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7Manipulation of information in medical research: Can it be morally justified?Research Ethics 8 (1): 9-23. 2012.The aim of this article is to examine whether informational manipulation, used intentionally by the researcher to increase recruitment in the research study, can be morally acceptable. We argue that this question is better answered by following a non-normative account, according to which the ethical justifiability of informational manipulation should not be relevant to its definition. The most appropriate criterion by which informational manipulation should be considered as morally acceptable or…Read more
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6The Role, Remit and Function of the Research Ethics Committee — 5. Collective Decision-Making and Research Ethics CommitteesResearch Ethics 7 (1): 19-23. 2011.Part 5, the concluding essay in the series describing and discussing the role, remit and function of research ethics committees, bases an enquiry into the nature of decision-making by research ethics committees on the processes followed by the committees in their deliberations leading to the final outcome
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8Safeguarding children in clinical researchNursing Ethics 19 (4): 530-537. 2012.Current UK guidelines regarding clinical research on children permit research that is non-therapeutic from the perspective of that particular child. The guidelines permit research interventions that cause temporary pain, bruises or scars. It is argued here that such research conflicts with the Declaration of Helsinki according to which the interests of the research subject outweigh all other interests. Given this, in the context of clinical research, who is best placed to protect the child from …Read more
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3Response to Open Peer Commentaries on “Ethics of Clinical Science in a Public Health Emergency: Drug Discovery at the Bedside”American Journal of Bioethics 13 (9). 2013.No abstract
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14Research ethics committees: Differences and moral judgementBioethics 18 (5). 2004.ABSTRACT Many people argue that disagreements and inconsistencies between Research Ethics Committees are morally problematic and there has been much effort to ‘harmonise’ their judgements. Some inconsistencies are bad because they are due to irrationality, or carelessness, or the operation of conflicting interests, and so should be reduced or removed. Other inconsistencies, we argue, are not bad and should be left or even encouraged. In this paper we examine three arguments to reject the view th…Read more
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6Ethics review of research: in pursuit of proportionalityJournal of Medical Ethics 34 (7): 568-572. 2008.The ethics review system of research is now well-established, at least in the developed world, although there are many differences in how countries view it and go about managing it. The UK specifically is now seeking to revise its system by speeding up the process of ethics approval but only for some studies. It is proposed that only those studies which pose “no material ethical issues” should be “fast-tracked”. However, it is unclear what this means, who should decide and what should be include…Read more
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7Evidence of Efficacy and Human Right to HealthAmerican Journal of Bioethics 12 (6): 35-37. 2012.The American Journal of Bioethics, Volume 12, Issue 6, Page 35-37, June 2012
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11Ethics of Clinical Science in a Public Health Emergency: Drug Discovery at the BedsideAmerican Journal of Bioethics 13 (9): 3-14. 2013.Clinical research under the usual regulatory constraints may be difficult or even impossible in a public health emergency. Regulators must seek to strike a good balance in granting as wide therapeutic access to new drugs as possible at the same time as gathering sound evidence of safety and effectiveness. To inform current policy, I reexamine the philosophical rationale for restricting new medicines to clinical trials, at any stage and for any population of patients (which resides in the precaut…Read more
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3Editorial: Do mechanistic studies have more to prove than positive results?Research Ethics 8 (4): 187-190. 2012.
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8Governing taste: data, temporality and everyday kiwifruit dry matter performancesAgriculture and Human Values 40 (2): 519-531. 2022.Data is essential to governing those emerging matters of concern that confront the agrifood every day. But data is no neutral intermediary. It disrupts, exposes, and creates new social, economic, political, and environmental possibilities, whilst simultaneously hiding, excluding, and foreclosing others. Scholars have become attuned to both the constitutive role of data in creating everyday worlds, and the need to develop critical accounts of the materialities, spatialities and multiplicities of …Read more
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8Inequalities and Fairness in Cluster TrialsResearch Ethics 7 (2): 58-65. 2011.Cluster randomized controlled trials (cluster RCTs) randomize whole clusters of individuals in testing two or more competing interventions. Here we will present the ethical problems raised by cluster RCTs concerning their effect on inequality. We argue that some inequalities generated by cluster RCTs are larger in scope than those generated from individual RCTs. We also argue that any cluster RCT-generated inequalities, which divide groups rather than individuals, are more problematic in type th…Read more
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11Hard paternalism, fairness and clinical research: why not?Bioethics 26 (2). 2010.Jansen and Wall suggest a new way of defending hard paternalism in clinical research. They argue that non-therapeutic research exposing people to more than minimal risk should be banned on egalitarian grounds: in preventing poor decision-makers from making bad decisions, we will promote equality of welfare. We argue that their proposal is flawed for four reasons.First, the idea of poor decision-makers is much more problematic than Jansen and Wall allow. Second, pace Jansen and Wall, it may be pr…Read more
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5The Art of NursingNursing Ethics 5 (5): 393-400. 1998.This article discusses the question of whether, as is often claimed, nursing is properly described as an art. Following critical remarks on the claims of Carper, Chinn and Watson, and Johnson, the account of art provided by RG Collingwood is described, with particular reference to his influential distinction between art and craft. The question of whether nursing is best described as an art or a craft is then discussed. The conclusion is advanced that nursing cannot properly be described as an ar…Read more
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6An ethics of anthropology‐informed community engagement with COVID‐19 clinical trials in AfricaDeveloping World Bioethics 23 (3): 242-251. 2023.The COVID‐19 pandemic has reinforced the critical role of ethics and community engagement in designing and conducting clinical research during infectious disease outbreaks where no vaccine or treatment already exists. In reviewing current practices across Africa, we distinguish between three distinct roles for community engagement in clinical research that are often conflated: 1) the importance of community engagement for identifying and honouring cultural sensitivities; 2) the importance of rec…Read more