Sydney, New South Wales, Australia
Areas of Specialization
Applied Ethics
Areas of Interest
Applied Ethics
  •  41
    Innovative surgery: the ethical challenges
    with Jane Johnson
    Journal of Medical Ethics 38 (1): 9-12. 2012.
    Innovative surgery raises four kinds of ethical challenges: potential harms to patients; compromised informed consent; unfair allocation of healthcare resources; and conflicts of interest. Lack of adequate data on innovations and lack of regulatory oversight contribute to these ethical challenges. In this paper these issues and the extent to which problems may be resolved by better evidence-gathering and more comprehensive regulation are explored. It is suggested that some ethical issues will be…Read more
  •  6
    Revisiting the equity debate in COVID-19: ICU is no panacea
    with Angela Ballantyne, Vikki Entwistle, and Cindy Towns
    Journal 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
  •  4
    Responding to unethical research: the importance of transparency
    with Wendy C. Higgins, Angela Ballantyne, and Wendy Lipworth
    Journal of Medical Ethics 46 (10): 691-692. 2020.
    We thank Goldstein and Peterson, Caplan, and Bramstedt for engaging with our paper on the ethics of publishing and using Chinese transplant research that involves organs procured from executed prisoners.1–4 In that paper, we examine consequentialist and deontological arguments for and against using data from unethical research. Goldstein and Peterson question the relationship between the social and scientific value of the research and the decision to publish the results. They argue that the fail…Read more
  •  6
    Against the use and publication of contemporary unethical research: the case of Chinese transplant research
    with Wendy C. Higgins, Angela Ballantyne, and Wendy Lipworth
    Journal of Medical Ethics 46 (10): 678-684. 2020.
    Recent calls for retraction of a large body of Chinese transplant research and of Dr Jiankui He’s gene editing research has led to renewed interest in the question of publication, retraction and use of unethical biomedical research. In Part 1 of this paper, we briefly review the now well-established consequentialist and deontological arguments for and against the use of unethical research. We argue that, while there are potentially compelling justifications for use under some circumstances, thes…Read more
  •  3
    Defining Disease in the Context of Overdiagnosis
    Medicine, Health Care and Philosophy: A European Journal 20 (2): 269-280. 2017.
    Recently, concerns have been raised about the phenomenon of 'overdiagnosis', the diagnosis of a condition that is not causing harm, and will not come to cause harm. Along with practical, ethical, and scientific questions, overdiagnosis raises questions about our concept of disease. In this paper, we analyse overdiagnosis as an epistemic problem and show how it challenges many existing accounts of disease. In particular, it raises questions about conceptual links drawn between disease and dysfunc…Read more
  •  3
    Ethics, Pandemic Planning and Communications
    with Connal Lee
    Monash Bioethics Review 25 (4): 9-18. 2006.
    In this article we examine the role and ethics of communications in planning for an influenza pandemic. We argue that ethical communication must not only he effective, so that pandemic plans can be successfully implemented, communications should also take specific account of the needs of the disadvantaged, so that they are not further disenfranchised. This will require particular attention to the role of the mainstream media which may disadvantage the vulnerable through misrepresentation and exc…Read more
  •  33
    Fragility, uncertainty, and healthcare
    Theoretical Medicine and Bioethics 37 (1): 71-83. 2016.
    Medicine seeks to overcome one of the most fundamental fragilities of being human, the fragility of good health. No matter how robust our current state of health, we are inevitably susceptible to future illness and disease, while current disease serves to remind us of various frailties inherent in the human condition. This article examines the relationship between fragility and uncertainty with regard to health, and argues that there are reasons to accept rather than deny at least some forms of …Read more
  •  37
    The Line-drawing Problem in Disease Definition
    Journal of Medicine and Philosophy 42 (4): 405-423. 2017.
    Biological dysfunction is regarded, in many accounts, as necessary and perhaps sufficient for disease. But although disease is conceptualized as all-or-nothing, biological functions often differ by degree. A tension is created by attempting to use a continuous variable as the basis for a categorical definition, raising questions about how we are to pinpoint the boundary between health and disease. This is the line-drawing problem. In this paper, we show how the line-drawing problem arises within…Read more
  •  24
    Current Dilemmas in Defining the Boundaries of Disease
    with Jenny Doust and Mary Jean Walker
    Journal of Medicine and Philosophy 42 (4): 350-366. 2017.
    Boorse’s biostatistical theory states that diseases should be defined in ways that reflect disturbances of biological function and that are objective and value free. We use three examples from contemporary medicine that demonstrate the complex issues that arise when defining the boundaries of disease: polycystic ovary syndrome, chronic kidney disease, and myocardial infarction. We argue that the biostatistical theory fails to provide sufficient guidance on where the boundaries of disease should …Read more
  •  12
    Diagnosis, narrative identity, and asymptomatic disease
    Theoretical Medicine and Bioethics 38 (4): 307-321. 2017.
    An increasing number of patients receive diagnoses of disease without having any symptoms. These include diseases detected through screening programs, as incidental findings from unrelated investigations, or via routine checks of various biological variables like blood pressure or cholesterol. In this article, we draw on narrative identity theory to examine how the process of making sense of being diagnosed with asymptomatic disease can trigger certain overlooked forms of harm for patients. We s…Read more
  •  23
    Defining disease in the context of overdiagnosis
    Medicine, Health Care and Philosophy 20 (2): 269-280. 2017.
    Recently, concerns have been raised about the phenomenon of ‘overdiagnosis’, the diagnosis of a condition that is not causing harm, and will not come to cause harm. Along with practical, ethical, and scientific questions, overdiagnosis raises questions about our concept of disease. In this paper, we analyse overdiagnosis as an epistemic problem and show how it challenges many existing accounts of disease. In particular, it raises ques- tions about conceptual links drawn between disease and dysfu…Read more
  •  20
    Introduction: The Boundaries of Disease
    Journal of Medicine and Philosophy 42 (4): 343-349. 2017.
    Although health and disease occupy opposite ends of a spectrum, distinguishing between them can be difficult. This is the “line-drawing” problem. The papers in this special issue engage with this challenge of delineating the boundaries of disease. The authors explore different views as to where the boundary between disease and nondisease lies, and related questions, such as how we can identify, or decide, what counts as a disease and what does not; the nature of the boundary between the two cate…Read more
  •  16
    Précising definitions as a way to combat overdiagnosis
    Journal of Evaluation in Clinical Practice 24 (5): 1019-1025. 2018.
  •  4
    Bioethics and activism
    with Heather Draper, Greg Moorlock, and Jackie Leach Scully
    Bioethics 33 (8): 853-856. 2019.
  •  14
    Bioethics and activism: A natural fit?
    Bioethics 33 (8): 881-889. 2019.
    Bioethics, EarlyView.
  •  15
    Analysing the ethics of breast cancer overdiagnosis: a pathogenic vulnerability
    Medicine, Health Care and Philosophy 22 (1): 129-140. 2019.
    Breast cancer screening aims to help women by early identification and treatment of cancers that might otherwise be life-threatening. However, breast cancer screening also leads to the detection of some cancers that, if left undetected and untreated, would not have damaged the health of the women concerned. At the time of diagnosis, harmless cancers cannot be identified as non-threatening, therefore women are offered invasive breast cancer treatment. This phenomenon of identifying non-harmful ca…Read more
  •  9
    Casting the net too wide on overdiagnosis: benefits, burdens and non-harmful disease
    with Yishai Mintzker
    Journal of Medical Ethics 42 (11): 717-719. 2016.
  •  9
    Response to Bjorn Hofmann: Clarifying overdiagnosis without losing conceptual complexity
    with Yishai Mintzker
    Journal of Evaluation in Clinical Practice 23 (5): 1120-1121. 2017.
  •  9
    Editors’ Introduction
    International Journal of Feminist Approaches to Bioethics 5 (2): 1-10. 2012.
  •  107
    Why bioethics needs a concept of vulnerability
    International Journal of Feminist Approaches to Bioethics 5 (2): 11-38. 2012.
  •  7
  •  6
    General slowing alone cannot explain age-related search effects: Reply to Cerella
    with Arthur D. Fisk and Donald L. Fisher
    Journal of Experimental Psychology: General 121 (1): 73-78. 1992.
  •  8
    Toward an understanding of age-related memory and visual search effects
    with Arthur D. Fisk
    Journal of Experimental Psychology: General 120 (2): 131-149. 1991.
  • Editorial
    Journal of Experimental Psychology: Applied 14 (1): 1-4. 2008.
  •  24
    Financial and nonfinancial conflicts of interest in medicine and surgery are troubling because they have the capacity to skew decision making in ways that might be detrimental to patient care and well-being. The recent case of the Articular Surface Replacement (ASR) hip provides a vivid illustration of the harmful effects of conflicts of interest in surgery
  •  9
    Virtue ethics and public health: a practice-based analysis
    Monash Bioethics Review 23 (1): 10-21. 2004.
    Public health plays an important, albeit often unnoticed, role in protecting and promoting the health of populations. The activities of public health are complex, performed by multiple professionals, and range from the innocuous to the intrusive. Ethical analyses in public health reflect some of this complexity and fragmentation, with no one approach able to capture the full range of ethical considerations raised by public health activities. There are however, good reasons why we should pursue s…Read more
  • Gender inequalities in health research : An australian perspective
    with Belinda Bennett, Isabel Karpin, and Angela Ballantyne
    In Michael D. A. Freeman (ed.), Law and Bioethics / Edited by Michael Freeman, Oxford University Press. 2008.
  •  14
    Practical Ethics for General Practice
    Oxford University Press. 2004.
    The aim of this book is to provide an accessible account of ethics in general practice, addressing concerns identified by practitioners. It contains many examples and allows the reader to gain practical insights into how to identify and analyze the ethical issues they encounter in everyday general practice.