Philosophy Commons^™

Ethics And Epidemiology Workshop Report: Towards Ethics-Informed Epidemiology And Epidemiology-Informed Ethics, Zoe Ritchie, Brendan T. Smith Phd, Maxwell J. Smith Phd

Health Studies Publications

Two key groups of researchers have worked in parallel to advance health equity—one on the descriptive component (those in public health sciences, e.g., epidemiologists) and one on the normative component (those in the humanities and social sciences, e.g., philosophers and ethicists). Yet a significant gulf exists between their respective research. Consequently, advances in thinking regarding the philosophical underpinnings and normative requirements of health equity have been largely divorced from the design of public health interventions that seek to reduce health inequities. As a consequence, public health interventions aiming to advance health equity may fail to target the most appropriate populations …

Death Of The Clinic: Trans-Informing The Clinical Gaze To Counter Epistemic Violence, Diana E. Kuhl

Electronic Thesis and Dissertation Repository

This case study research (Patton, 2002, 2014; Flyvberg, 2006) has grown out of an awareness of deep resistance from the psy disciplines to trans-informed epistemologies as a source of legitimate knowledge (Tosh, 2015, 2016; Winters, 2008). It focuses on examining how the closure of The Gender Identity Clinic (GIC) for Children and Youth at the Centre for Addiction and Mental Health (CAMH) in Toronto, Ontario, Canada, signaled a paradigm shift from the ‘treatment model’ to the ‘affirmative model’ with respect to clinical approaches for supporting trans and gender diverse children and youth. As such the case study involved tracing the …

Assessing Decision-Making Capacity After Severe Brain Injury, Andrew Peterson

Electronic Thesis and Dissertation Repository

Severe brain injury is a leading cause of death and disability. Following severe brain injury diagnosis is difficult and errors frequently occur. Recent findings in clinical neuroscience may offer a solution. Neuroimaging has been used to detect preserved cognitive function and awareness in some patients clinically diagnosed as being in a vegetative state. Remarkably, neuroimaging has also been used to communicate with some vegetative patients through a series of yes/no questions. Some have speculated that, one day, this method may allow severely brain-injured patients to make medical decisions. Yet, skepticism is rife, due in part to the inherent difficulty of …

Fertility Preservation Technologies For Women: A Feminist Ethical Analysis, Angel Petropanagos

Electronic Thesis and Dissertation Repository

In this dissertation I examine ethical issues that concern fertility preservation (FP) technologies for women from a feminist perspective. FP technologies involve the removal, cryopreservation and subsequent storage of reproductive materials for future use. The aim of these technologies is to preserve the option of future genetic reproduction. FP technologies have been developed in the cancer context because infertility is one of the long-term side-effects of many cancers or cancer therapies. Many FP technologies are still experimental, but some technologies are becoming available to healthy women who wish to guard against age-related infertility. Although FP technologies are expanding women’s reproductive …

Conceptual Problems In Research Ethics, Charles Weijer

Research Day (Arts & Humanities, FIMS, and Education)

This poster addresses these issues:
• What good is medical research?
• What is owed to the study subject?
• When is research risk acceptable?
• How should we conduct research in developing countries?
• How should we conduct research involving communities?

Harm Or Mere Inconvenience? Denying Women Emergency Contraception, Carolyn Mcleod

Philosophy Publications

This paper addresses the likely impact on women of being denied emergency contraception (EC) by pharmacists who conscientiously refuse to provide it. A common view—defended by Elizabeth Fenton and Loren Lomasky, among others—is that these refusals inconvenience rather than harm women so long as the women can easily get EC somewhere else nearby. I argue from a feminist perspective that the refusals harm women even when they can easily get EC somewhere else nearby.

Ethical Challenges In Icu Research, Charles Weijer

Philosophy Presentations

No abstract provided.

When Can Physicians Say “No” To Families And Patients?, Charles Weijer

Philosophy Presentations

No abstract provided.

Referral In The Wake Of Conscientious Objection To Abortion, Carolyn Mcleod

Philosophy Publications

Currently, the preferred accommodation for conscientious objection to abortion in medicine is to allow the objector to refuse to accede to the patient's request so long as the objector refers the patient to a physician who performs abortions. The referral part of this arrangement is controversial, however. Pro-life advocates claim that referrals make objectors complicit in the performance of acts that they, the objectors, find morally offensive. McLeod argues that the referral requirement is justifiable, although not in the way that people usually assume.

Infertility And Moral Luck: The Politics Of Women Blaming Themselves For Infertility, Carolyn Mcleod, Julie Ponesse

Philosophy Publications

Infertility can be an agonizing experience, especially for women. And, much of the agony has to do with luck: with how unlucky one is in being infertile, and in how much luck is involved in determining whether one can weather the storm of infertility and perhaps have a child in the end. We argue that bad luck associated with being infertile is often bad moral luck for women. The infertile woman often blames herself or is blamed by others for what is happening to her, even when she cannot control or prevent what is happening to her. She has simply …

The Stem Cell Debate Continues: The Buying And Selling Of Eggs For Research, Françoise Baylis, Carolyn Mcleod

Philosophy Publications

Now that stem cell scientists are clamouring for human eggs for cloning-based stem cell research, there is vigorous debate about the ethics of paying women for their eggs. Generally speaking, some claim that women should be paid a fair wage for their reproductive labour or tissues, while others argue against the further commodification of reproductive labour or tissues and worry about voluntariness among potential egg providers. Siding mainly with those who believe that women should be financially compensated for providing eggs for research, the new stem cell guidelines of the International Society for Stem Cell Research (ISSCR) legitimise both reimbursement …

For Dignity Or Money: Feminists On The Commodification Of Women’S Reproductive Labour, Carolyn Mcleod

Philosophy Publications

No abstract provided.

Revisiting The Ethics Of Hiv Prevention Research In Developing Countries, Charles Weijer, Guy Leblanc

Philosophy Presentations

Issues: We present key aspects of our paper, commissioned by UNAIDS in 2005, entitled, “Revisiting the ethics of HIV prevention research in developing countries.” In 2004 and 2005 we witnessed the closure or suspension of three international clinical trials testing tenofovir in the prevention of HIV infection in high risk groups due to the failure to provide free treatment to those who seroconvert during the conduct of the study. We examine critically moral claims for the provision of treatment to those who seroconvert in HIV prevention trials and ask whether it is a matter of moral obligation or moral negotiation? …

Mere And Partial Means: The Full Range Of The Objectification Of Women, Carolyn Mcleod

Philosophy Publications

No abstract provided.

Clinical Equipoise And Rct Design, Charles Weijer

Philosophy Presentations

This presentation addresses these questions:
• “Upon what ethical grounds may the physician offer RCT enrollment to a patient?”
• Which is the preferred moral basis of the RCT?

Relational Autonomy, Self-Trust, And Health Care For Patients Who Are Oppressed, Carolyn Mcleod, Susan Sherwin

Philosophy Publications

No abstract provided.

Self-Trust And Reproductive Autonomy, Carolyn Mcleod

Philosophy Publications

In this thesis. I give a theory of the nature of self-trust and an explanation of its role in autonomous decision-making. We tend to think of trust as essentially interpersonal which casts doubt on the coherence of the concept of self-trust. Drawing on patients' experiences in reproductive medicine. I argue that self-trust is a meaningful as well as a useful concept. I provide autobiographical sketches of a number of women's experiences. supplemented by my own observations made while doing a clinical practicum in reproductive medicine, to illustrate that what many women feel toward themselves in a variety of reproductive health …

Trudy Govier’S Dilemmas Of Trust, Carolyn Mcleod, S. Burns

Philosophy Publications

No abstract provided.

Selecting Subjects For Participation In Clinical Research: An Empirical Inquiry And Ethical Analysis, Charles Weijer

Philosophy Publications

Procedures for the selection of subjects for participation in randomized clinical trials--usually formalized as eligibility criteria in the study protocol--have both scientific and ethical implications. In this thesis, I undertake an examination of eligibility criteria at three stages in the genesis and dissemination of medical knowledge: clinical trial protocol, interpretation by investigators, and reporting of study results.

In the first chapter, ethical issues in subject selection are reviewed and the main study questions are presented. In the second chapter, the results of an examination of eligibility criteria in two sets of clinical trials, one sponsored by the NSABP, the other …

Characterizing The Population In Clinical Trials: Barriers, Comparability, And Implications For Review, Charles Weijer

Philosophy Publications

The definition of the study population for a clinical trial via the criteria for trial eligibility has implications for the validity of the study and its applicability to clinical practice. Though issues of equity regarding the selection of subjects for research have long been a concern of ethicists, issues regarding the impact of subject selection on a trial's generalizability have only recently attracted ethical scrutiny. After a review of the history of the ethics of subject selection, I focus on three empirical questions regarding the generalizability of clinical trials. (1) What proportion of diseased populations are studied in clinical trials? …