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47I 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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25Evaluating 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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62Evaluating 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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34The 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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15Rationing, 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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72Can 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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53The impairment/disability distinction: a response to ShakespeareJournal of Medical Ethics 34 (1): 26-27. 2008.Tom Shakespeare’s important new book includes, among other topics, a persuasive critique of the social model of disability. A key component in his case against that model consists in an argument against the impairment/disability distinction as this is understood within the social model. The present paper focuses on the case Shakespeare makes against that distinction. Three arguments mounted by Shakespeare are summarised and responded to. It is argued that the responses adequately rebut Shakespea…Read more
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23Ethical 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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13Editorial: the unexpected power of research ethicsResearch Ethics 16 (1-2): 1-3. 2020.Research Ethics, Ahead of Print.
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34Manipulation 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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63What are the limits to the obligations of the nurse?Journal of Medical Ethics 22 (2): 90-94. 1996.This paper enquires into the nature and the extent of the obligations of nurses. It is argued that nurses appear to be obliged to undertake supererogatory acts if they take clause one of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) Code of Professional Conduct seriously (as, indeed, they are required to do). In the first part of the paper, the nature of nursing obligations is outlined, and then the groups and individuals to whom nurses have obligations are…Read more
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59The 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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25Safeguarding 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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19Response 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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30Research 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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34Ethics 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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30Evidence 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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19Ethics 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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24Editorial: Do mechanistic studies have more to prove than positive results?Research Ethics 8 (4): 187-190. 2012.
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13Governing 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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19Inequalities 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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95Hard 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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48Dismantling the Disability/Handicap DistinctionJournal of Medicine and Philosophy 22 (6): 589-606. 1997.This paper discusses the distinction between disability and handicap as it is proposed by the World Health Organization (WHO) in their publication International Classification of Impairments, Disabilities and Handicaps (WHO, 1993 (first published, 1980)). Following criticism of this an attempt to salvage the distinction by Nordenfelt (1993, 1983) is discussed. It is argued that neither the WHO nor Nordenfelt are successful in their attempts to preserve the distinction between disability and hand…Read more
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8An 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
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9Limitations to Contingency Measures: Reflections from COVID-19 Surges in the UKAmerican Journal of Bioethics 21 (8): 31-34. 2021.Alfandre et al. helpfully outlines the case for attending to contingency planning as well as to crisis measures during a pandemic. The authors provides a helpful framework for reflecting on...
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16The Ottawa statement on the ethical design and conduct of cluster randomized trials: A short reportResearch Ethics 11 (1): 52-60. 2015.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 com…Read more
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16Recognising values and engaging communities across cultures: towards developing a cultural protocol for researchersBMC Medical Ethics 22 (1): 1-8. 2021.Efforts to build research capacity and capability in low and middle income countries (LMIC) has progressed over the last three decades, yet it confronts many challenges including issues with communicating or even negotiating across different cultures. Implementing global research requires a broader understanding of community engagement and participatory research approaches. There is a considerable amount of guidance available on community engagement in clinical trials, especially for studies for…Read more