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181From research governance to research integrity: What’s in a name?Research Ethics 9 (1): 3-5. 2013.
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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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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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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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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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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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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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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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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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41A Radical Approach to Ebola: Saving Humans and Other AnimalsAmerican Journal of Bioethics 18 (10): 35-42. 2018.As the usual regulatory framework did not fit well during the last Ebola outbreak, innovative thinking still needed. In the absence of an outbreak, randomised controlled trials of clinical efficacy in humans cannot be done, while during an outbreak such trials will continue to face significant practical, philosophical, and ethical challenges. This article argues that researchers should also test the safety and effectiveness of novel vaccines in wild apes by employing a pluralistic approach to ev…Read more
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40Research participation and the right to withdrawBioethics 19 (2). 2005.Most ethics committees which review research protocols insist that potential research participants reserve unconditional or absolute ‘right’ of withdrawal at any time and without giving any reason. In this paper, I examine what consent means for research participation and a sense of commitment in relation to this right to withdraw. I suggest that, once consent has been given (and here I am excluding incompetent minors and adults), participants should not necessarily have unconditional or absolut…Read more
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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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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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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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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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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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29Restricted treatments, inducements, and research participationBioethics 20 (2). 2006.ABSTRACT In this paper, I support the claim that placing certain restrictions on public access to possible new treatments is morally problematic under some exceptional circumstances. Very ill patients may find that all available standard treatments are unacceptable, either because they are ineffective or have serious adverse effects, and these patients may understandably be desperate to try something new even if this means stepping into the unknown. Faced with certain death, it is rational to wa…Read more
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29The Role, Remit and Function of the Research Ethics Committee — 3. Balancing Potential Social Benefits against Risks to SubjectsResearch Ethics 6 (3): 96-100. 2010.This is the third in a series of five papers on the role, remit and function of research ethics committees which are intended to provide for REC members a broad understanding of the most important issues in research ethics and governance. This paper examines the role of ethics committees in balancing the social value of the research it reviews against the risks it imposes on those who take part. The ethics committee's role in assessing the social value of research goes well beyond checking its s…Read more
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27Assessing the Remedy: The Case for Contracts in Clinical TrialsAmerican Journal of Bioethics 11 (4): 3-12. 2011.Current orthodoxy in research ethics assumes that subjects of clinical trials reserve rights to withdraw at any time and without giving any reason. This view sees the right to withdraw as a simple extension of the right to refuse to participate all together. In this paper, however, I suggest that subjects should assume some responsibilities for the internal validity of the trial at consent and that these responsibilities should be captured by contract. This would allow the researcher to impose a…Read more
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25Response to Open Peer Commentaries on “Assessing the Remedy: The Case for Contracts in Clinical Trials”American Journal of Bioethics 11 (4). 2011.No abstract
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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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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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24Response to Open Peer Commentaries on “A Radical Approach to Ebola: Saving Humans and Other Animals”American Journal of Bioethics 19 (1). 2019.
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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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23The 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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23The Case for Methodological Pluralism in Medical ScienceAmerican Journal of Bioethics 20 (9): 39-41. 2020.Volume 20, Issue 9, September 2020, Page 39-41.
Areas of Interest
Applied Ethics |
Philosophy of Social Science |