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The Ethics of Public Policy RCTs

October 11, 2017
In this article, I ask whether a principle analogous to the principle of clinical equipoise should govern the design and conduct of RCTs evaluating the effectiveness of policy interventions. I answer this question affirmatively, and introduce and defend the principle of policy equipoise. According to this principle, all arms of...

Weighing Obligations to Home Care Workers and Medicaid Recipients

July 25, 2017
In June 2016, a US Department of Labor rule extending minimum wage and overtime pay protections to home care workers such as certified nursing assistants and home health aides survived its final legal challenge and became effective. However, Medicaid officials in certain states reported that during the intervening decades when...

Experienced Utility or Decision Utility for QALY Calculation?

May 6, 2017
Policy-makers must allocate scarce resources to support constituents’ health needs. This requires policy-makers to be able to evaluate health states and allocate resources according to some principle of allocation. The most prominent approach to evaluating health states is to appeal to the strength of people’s preferences to avoid occupying them,...

The Duty to Rescue and Investigators’ Obligations

March 31, 2017
We examine current applications of the moral duty to rescue to justify clinical investigators’ duties of ancillary care and standard of care to subjects in resource-poor settings. These applications fail to explain why investigators possess obligations to research participants, in particular, and not to people in need, in general. Further,...

Calculating QALYs

March 7, 2017
Abstract:The value of health states is often understood to depend on their impact on the goodness of people’s lives. As such, prominent health states metrics are grounded in particular conceptions of wellbeing – e.g. hedonism or preference satisfaction. In this paper, I consider how liberals committed to the public justification...

Nudges, Autonomy, and Organ Donor Registration Policies

January 23, 2017
I am very grateful to the authors of the open peer commentaries, as well as Cass R. Sunstein, for their challenging and insightful comments on our article “The Ethics of Organ Donor Registration Policies: Nudges and Respect for Autonomy. A number of commentators find our analysis largely compelling and explore...

(Book Review) Patients With Passports

December 20, 2016
Glenn Cohen’s Patients with Passports: Medical Tourism, Law, and Ethics offers a thorough examination of the growing practice of medical tourism, the legal regulations governing it, and the many ethical issues it raises for policy-makers, health care providers, and prospective medical tourists. Demonstrating mastery of the relevant literatures in the...

The Ethics of Organ Donor Registration Policies

December 20, 2016
Governments must determine the legal procedures by which their residents are registered, or can register, as organ donors. Provided that governments recognize that people have a right to determine what happens to their organs after they die, there are four feasible options to choose from: opt-in, opt-out, mandated active choice,...

Fair Subject Selection in Clinical Research

December 20, 2016
In this paper, I explore the ethics of subject selection in the context of biomedical research. I reject a key principle of what I shall refer to as the standard view According to this principle, investigators should select participants so as to minimise aggregate risk to participants and maximise aggregate...

Are Skill-Selective Immigration Policies Just?

December 20, 2016
Many high-income countries have skill-selective immigration policies, favoring prospective immigrants who are highly skilled. I investigate whether it is permissible for high-income countries to adopt such policies. Adopting what Joseph Carens calls a “realistic approach” to the ethics of immigration, I argue first that it is in principle permissible for...