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36Reasonableness, Credibility, and Clinical DisagreementAMA Journal of Ethics 19 (2): 176-182. 2017.Evidence in medicine can come from more or less trustworthy sources and be produced by more or less reliable methods, and its interpretation can be disputed. As such, it can be unclear when disagreements in medicine result from different, but reasonable, interpretations of the available evidence and when they result from unreasonable refusals to consider legitimate evidence. In this article, we seek to show how assessments of the relevance and implications of evidence are typically affected by f…Read more
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38OBJECTIVES: This article presents an original definition of surgical innovation and a practical tool for identifying planned innovations. These will support the responsible introduction of surgical innovations. BACKGROUND: Frameworks developed for the safer introduction of surgical innovations rely upon identifying cases of innovation; oversight cannot occur unless innovations are identified. However, there is no consensus among surgeons about which interventions they consider innovative; existi…Read more
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7Cost-Related Non-Adherence to Prescribed Medicines: What Are Physicians’ Moral Duties?American Journal of Bioethics 1-12. forthcoming.As the price of pharmaceuticals and biologicals rises so does the number of patients who cannot afford them. In this article, we argue that physicians have a moral duty to help patients access affordable medicines. We offer three grounds to support our argument: (i) the aim of prescribing is to improve health and well-being which can only be realized with secure access to treatment; (ii) there is no morally significant difference between medicines being unavailable and medicines being unaffordab…Read more
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41The Routledge Handbook of Feminist Bioethics (edited book)Routledge. 2022.The Routledge Handbook of Feminist Bioethics is an outstanding resource for anyone with an interest in feminist bioethics, with chapters covering topics from justice and power to the climate crisis. Comprising 42 chapters by emerging and established scholars, the volume is divided into six parts: Foundations of Feminist Bioethics Identity and Identifications Science, Technology and Research Health and Social Care Reproduction and Making Families Widening the Scope of Feminist Bioethics The volum…Read more
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134Maximizing the Benefits of Participatory Design for Human–Robot Interaction Research With Older AdultsHuman Factors 64 (3). 2021.Objective We reviewed human–robot interaction (HRI) participatory design (PD) research with older adults. The goal was to identify methods used, determine their value for design of robots with older adults, and provide guidance for best practices. Background Assistive robots may promote aging-in-place and quality of life for older adults. However, the robots must be designed to meet older adults’ specific needs and preferences. PD and other user-centered methods may be used to engage older adult…Read more
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10Scientists’ Views on the Ethics, Promises and Practices of Synthetic Biology: A Qualitative Study of Australian Scientific PracticeScience and Engineering Ethics 29 (6): 1-20. 2023.Synthetic biology is a broad term covering multiple scientific methodologies, technologies, and practices. Pairing biology with engineering, synbio seeks to design and build biological systems, either through improving living cells by adding in new functions, or creating new structures by combining natural and synthetic components. As with all new technologies, synthetic biology raises a number of ethical considerations. In order to understand what these issues might be, and how they relate to t…Read more
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64Ethical Justifications for Access to Unapproved Medical Interventions: An Argument for (Limited) Patient ObligationsAmerican Journal of Bioethics 14 (11): 3-15. 2014.Many health care systems include programs that allow patients in exceptional circumstances to access medical interventions of as yet unproven benefit. In this article we consider the ethical justifications for—and demands on—these special access programs (SAPs). SAPs have a compassionate basis: They give patients with limited options the opportunity to try interventions that are not yet approved by standard regulatory processes. But while they signal that health care systems can and will respond…Read more
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45Risk, Overdiagnosis and Ethical JustificationsHealth Care Analysis 27 (4): 231-248. 2019.Many healthcare practices expose people to risks of harmful outcomes. However, the major theories of moral philosophy struggle to assess whether, when and why it is ethically justifiable to expose individuals to risks, as opposed to actually harming them. Sven Ove Hansson has proposed an approach to the ethical assessment of risk imposition that encourages attention to factors including questions of justice in the distribution of advantage and risk, people’s acceptance or otherwise of risks, and…Read more
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44Ethical issues raised by thyroid cancer overdiagnosis: A matter for public health?Bioethics 31 (8): 590-598. 2017.Current practices of identifying and treating small indolent thyroid cancers constitute an important but in some ways unusual form of overdiagnosis. Overdiagnosis refers to diagnoses that generally harm rather than benefit patients, primarily because the diagnosed condition is not a harmful form of disease. Patients who are overdiagnosed with thyroid cancer are harmed by the psycho-social impact of a cancer diagnosis, as well as treatment interventions such partial or total thyroidectomy, lifelo…Read more
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49Addressing Deficits and Injustices: The Potential Epistemic Contributions of Patients to ResearchHealth Care Analysis 25 (4): 386-403. 2017.Patient or public involvement in health research is increasingly expected as a matter of policy. In theory, PPI can contribute both to the epistemic aims intrinsic to research, and to extrinsically valued features of research such as social inclusion and transparency. In practice, the aims of PPI have not always been clear, although there has been a tendency to encourage the involvement of so-called ordinary people who are regarded as representative of an assumed patient perspective. In this pap…Read more
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59Reframing the Debate Around State Responses to Infertility: Considering the Harms of Subfertility and Involuntary ChildlessnessPublic Health Ethics 9 (3): 290-300. 2016.Many countries are experiencing increasing levels of demand for access to assisted reproductive technologies. Policies regarding who can access ART and with what support from a collective purse are highly contested, raising questions about what state responses are justified. Whilst much of this debate has focused on the status of infertility as a disease, we argue that this is something of a distraction, since disease framing does not provide the far-reaching, robust justification for state supp…Read more
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42Revisiting the equity debate in COVID-19: ICU is no panaceaJournal of Medical Ethics 46 (10): 641-645. 2020.Throughout March and April 2020, debate raged about how best to allocate limited intensive care unit resources in the face of a growing COVID-19 pandemic. The debate was dominated by utility-based arguments for saving the most lives or life-years. These arguments were tempered by equity-based concerns that triage based solely on prognosis would exacerbate existing health inequities, leaving disadvantaged patients worse off. Central to this debate was the assumption that ICU admission is a valuab…Read more
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25What Feminist Bioethics Can Bring to Synthetic BiologyInternational Journal of Feminist Approaches to Bioethics 16 (2): 46-63. 2023.Synthetic biology (synbio) involves designing and creating new living systems to serve human ends, using techniques including molecular biology, genomics, and engineering. Existing bioethical analyses of synbio focus largely on balancing benefits against harms, the dual-use dilemma, and metaphysical questions about creating and commercializing synthetic organisms. We argue that these approaches fail to consider key feminist concerns. We ground our normative claims in two case studies, focusing o…Read more
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64Background There is a growing concern about artificial intelligence (AI) applications in healthcare that can disadvantage already under-represented and marginalised groups (eg, based on gender or race). Objectives Our objectives are to canvas the range of strategies stakeholders endorse in attempting to mitigate algorithmic bias, and to consider the ethical question of responsibility for algorithmic bias. Methodology The study involves in-depth, semistructured interviews with healthcare workers,…Read more
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51Vulnerability: New Essays in Ethics and Feminist Philosophy (edited book)Oup Usa. 2013.This volume breaks new ground by investigating the ethics of vulnerability. Drawing on various ethical traditions, the contributors explore the nature of vulnerability, the responsibilities owed to the vulnerable, and by whom
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131Vulnerability in Research Ethics: a Way ForwardBioethics 27 (6): 333-340. 2013.Several foundational documents of bioethics mention the special obligation researchers have to vulnerable research participants. However, the treatment of vulnerability offered by these documents often relies on enumeration of vulnerable groups rather than an analysis of the features that make such groups vulnerable. Recent attempts in the scholarly literature to lend philosophical weight to the concept of vulnerability are offered by Luna and Hurst. Luna suggests that vulnerability is irreducib…Read more
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35Details Matter—Definitions and Context Can’t Be Glossed Over When Managing InnovationAmerican Journal of Bioethics 19 (6): 28-29. 2019.Volume 19, Issue 6, June 2019, Page 28-29.
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35Hips, Knees, and Hernia Mesh: When Does Gender Matter in Surgery?International Journal of Feminist Approaches to Bioethics 10 (1): 148-174. 2017.This paper draws attention to gendered dimensions of surgical device failure, focusing on two case studies—hernia repair mesh for pelvic organ prolapse, and metal-on-metal hip implants. We explore possible reasons for higher rates of harms to women, including systematic biases in health research and device regulation. Given that these factors are readily identifiable, we look to feminist scholarship to understand what might maintain them, including the role of cultural factors within surgery, su…Read more
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43Device representatives in hospitals: are commercial imperatives driving clinical decision-making?Journal of Medical Ethics 44 (9): 589-592. 2018.Despite concerns about the relationships between health professionals and the medical device industry, the issue has received relatively little attention. Prevalence data are lacking; however, qualitative and survey research suggest device industry representatives, who are commonly present in clinical settings, play a key role in these relationships. Representatives, who are technical product specialists and not necessarily medically trained, may attend surgeries on a daily basis and be availabl…Read more
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37Understanding Corporate Responsibility: Culture and ComplicityAmerican Journal of Bioethics 11 (9): 18-20. 2011.The American Journal of Bioethics, Volume 11, Issue 9, Page 18-20, September 2011
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46What Can Feminist Epistemology Do for Surgery?Hypatia 29 (2): 404-421. 2014.Surgery is an important part of contemporary health care, but currently much of surgery lacks a strong evidence base. Uptake of evidence-based medicine (EBM) methods within surgical research and among practitioners has been slow compared with other areas of medicine. Although this is often viewed as arising from practical and cultural barriers, it also reflects a lack of epistemic fit between EBM research methods and surgical practice. In this paper we discuss some epistemic challenges in surger…Read more
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61A New Approach to Defining DiseaseJournal of Medicine and Philosophy 43 (4): 402-420. 2018.In this paper, we examine recent critiques of the debate about defining disease, which claim that its use of conceptual analysis embeds the problematic assumption that the concept is classically structured. These critiques suggest, instead, developing plural stipulative definitions. Although we substantially agree with these critiques, we resist their implication that no general definition of “disease” is possible. We offer an alternative, inductive argument that disease cannot be classically de…Read more
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175Why bioethics needs a concept of vulnerabilityInternational Journal of Feminist Approaches to Bioethics 5 (2): 11-38. 2012.Concern for human vulnerability seems to be at the heart of bioethical inquiry, but the concept of vulnerability is under-theorized in the bioethical literature. The aim of this article is to show why bioethics needs an adequately theorized and nuanced conception of vulnerability. We first review approaches to vulnerability in research ethics and public health ethics, and show that the bioethical literature associates vulnerability with risk of harm and exploitation, and limited capacity for aut…Read more
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33Strengthening the ethical assessment of placebo-controlled surgical trials: three proposalsBMC Medical Ethics 15 (1): 78. 2014.Placebo-controlled surgical trials can provide important information about the efficacy of surgical interventions. However, they are ethically contentious as placebo surgery entails the risk of harms to recipients, such as pain, scarring or anaesthetic misadventure. This has led to claims that placebo-controlled surgical trials are inherently unethical. On the other hand, without placebo-controlled surgical trials, it may be impossible to know whether an apparent benefit from surgery is due to t…Read more
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47Equity Under the Knife: Justice and Evidence in SurgeryBioethics 28 (3): 119-126. 2012.Surgery is an increasingly common and expensive mode of medical intervention. The ethical dimensions of the surgeon-patient relationship, including respect for personal autonomy and informed consent, are much discussed; but broader equity issues have not received the same attention. This paper extends the understanding of surgical ethics by considering the nature of evidence in surgery and its relationship to a just provision of healthcare for individuals and their populations
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22Editors’ IntroductionInternational Journal of Feminist Approaches to Bioethics 5 (2): 1-10. 2012.
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15The Ethics of Surgical Research and InnovationIn Tomas Zima & David N. Weisstub (eds.), Medical Research Ethics: Challenges in the 21st Century, Springer Verlag. pp. 217-232. 2022.Surgical advances can provide great benefits to patients but can come at a cost. The successes are often matched by failures that cause harm to patients. The risks of surgery create a strong ethical imperative for research to establish the safety and efficacy of new treatments. Surgical research is, however, challenging for a number of reasons including the lack of a clear boundary between variations in practice, innovation and research, its irreversible nature, the difficulty of performing plac…Read more
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325Forms of Artificial Intelligence (AI) are already being deployed into clinical settings and research into its future healthcare uses is accelerating. Despite this trajectory, more research is needed regarding the impacts on patients of increasing AI decision making. In particular, the impersonal nature of AI means that its deployment in highly sensitive contexts-of-use, such as in healthcare, raises issues associated with patients’ perceptions of (un) dignified treatment. We explore this issue t…Read more
Sydney, New South Wales, Australia
Areas of Specialization
Applied Ethics |
Areas of Interest
Applied Ethics |