47 found
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  1.  3
    Yael Schenker, Robert M. Arnold & Alex John London (2014). The Ethics of Advertising for Health Care Services. American Journal of Bioethics 14 (3):34-43.
    Advertising by health care institutions has increased steadily in recent years. While direct-to-consumer prescription drug advertising is subject to unique oversight by the Federal Drug Administration, advertisements for health care services are regulated by the Federal Trade Commission and treated no differently from advertisements for consumer goods. In this article, we argue that decisions about pursuing health care services are distinguished by informational asymmetries, high stakes, and patient vulnerabilities, grounding fiduciary responsibilities on the part of health care providers and health (...)
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  2.  13
    Alex John London & Kevin J. S. Zollman (2010). Research at the Auction Block: Problems for the Fair Benefits Approach to International Research. Hastings Center Report 40 (4):34-45.
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  3.  21
    Alex John London (2005). Justice and the Human Development Approach to International Research. Hastings Center Report 35 (1):24-37.
    : The debate over when medical research may be performed in developing countries has steered clear of the broad issues of social justice in favor of what seem more tractable, practical issues. A better approach will reframe the question of justice in international research in a way that makes explicit the links between medical research, the social determinants of health, and global justice.
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  4.  31
    Danielle M. Wenner, Alex John London & Jonathan Kimmelman (2015). Patient-Funded Trials: Opportunity or Liability? Cell Stem Cell 17 (2):135-137.
    Patient-funded trials are gaining traction as a means of accelerating clinical translation. However, such trials sidestep mechanisms that promote rigor, relevance, efficiency, and fairness. We recommend that funding bodies or research institutions establish mechanisms for merit review of patient-funded trials, and we offer some basic criteria for evaluating PFT protocols.
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  5. Jonathan Kimmelman & Alex John London, Predicting Harms and Benefits in Translational Trials: Ethics, Evidence, and Uncertainty.
    First-in-human clinical trials represent a critical juncture in the translation of laboratory discoveries. However, because they involve the greatest degree of uncertainty at any point in the drug development process, their initiation is beset by a series of nettlesome ethical questions [1]: has clinical promise been sufficiently demonstrated in animals? Should trial access be restricted to patients with refractory disease? Should trials be viewed as therapeutic? Have researchers adequately minimized risks? The resolution of such ethical questions inevitably turns on claims (...)
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  6.  26
    Alex John London (2000). The Ambiguity and the Exigency: Clarifying 'Standard of Care' Arguments in International Research. Journal of Medicine and Philosophy 25 (4):379 – 397.
    This paper examines the concept of a 'standard of care' as it has been used in recent arguments over the ethics of international human-subjects research. It argues that this concept is ambiguous along two different axes, with the result that there are at least four possible standard of care arguments that have not always been clearly distinguished. As a result, it has been difficult to assess the implications of opposing standard of care arguments, to recognize important differences in their supporting (...)
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  7.  26
    Alex John London (2001). Equipose and International Human-Subjects Research. Bioethics 15 (4):312–332.
    This paper examines the role of equipoise in evaluating international research. It distinguishes two possible formulations of the equipoise requirement that license very different evaluations of international research proposals. The interpretation that adopts a narrow criterion of similarity between clinical contexts has played an important role in one recent controversy, but it suffers from a number of problems. An alternative interpretation that adopts a broader criterion of similarity does a better job of avoiding both exploitation of the brute fact of (...)
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  8.  5
    Alex John London (2007). Two Dogmas of Research Ethics and the Integrative Approach to Human-Subjects Research. Journal of Medicine and Philosophy 32 (2):99 – 116.
    This article argues that lingering uncertainty about the normative foundations of research ethics is perpetuated by two unfounded dogmas of research ethics. The first dogma is that clinical research, as a social activity, is an inherently utilitarian endeavor. The second dogma is that an acceptable framework for research ethics must impose constraints on this endeavor whose moral force is grounded in role-related obligations of either physicians or researchers. This article argues that these dogmas are common to traditional articulations of the (...)
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  9.  1
    Alex John London (2009). Clinical Equipoise: Foundational Requirement or Fundamental Error. In Bonnie Steinbock (ed.), The Oxford Handbook of Bioethics. OUP Oxford
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  10.  16
    Alex John London (2005). Does Research Ethics Rest on a Mistake? The Common Good, Reasonable Risk and Social Justice. American Journal of Bioethics 5 (1):37 – 39.
  11. Alex John London, Jonathan Kimmelman & Marina Elena Emborg, Beyond Access Vs. Protection in Trials of Innovative Therapies.
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  12.  6
    Alex John London & Jonathan Kimmelman, Why Clinical Translation Cannot Succeed Without Failure.
    The high rates of attrition that occur in drug development are widely regarded as problematic, but the failure of well-designed studies benefits both researchers and healthcare systems by, for example, generating evidence about disease theories and demonstrating the limits of proven drugs. A wider recognition of these benefits will help the biomedical research enterprise to take full advantage of all the information generated during the drug development process.
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  13.  3
    Patrina Sexton, Katrina Hui, Donna Hanrahan, Mark Barnes, Jeremy Sugarman, Alex John London & Robert Klitzman (2016). Reviewing HIV‐Related Research in Emerging Economies: The Role of Government Reviewing Agencies. Developing World Bioethics 16 (1):4-14.
    Little research has explored the possible effects of government institutions in emerging economies on ethical reviews of multinational research. We conducted semi-structured, in-depth telephone interviews with 15 researchers, Research Ethics Committees personnel, and a government agency member involved in multinational HIV Prevention Trials Network research in emerging economies. Ministries of Health or other government agencies often play pivotal roles as facilitators or barriers in the research ethics approval process. Government agency RECs reviewing protocols may face particular challenges, as they can (...)
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  14.  2
    Alex John London (2006). The Moral Foundations of Equipoise and its Role in International Research. American Journal of Bioethics 6 (4):48 – 51.
  15.  10
    Alex John London (2012). A Non-Paternalistic Model of Research Ethics and Oversight: Assessing the Benefits of Prospective Review. Journal of Law, Medicine & Ethics 40 (4):930-944.
    This paper offers a non-paternalistic justification for prospective research review as providing a credible social assurance that the institutions of scientific advancement respect and affirm the moral equality of all community members and as creating a “market” in which stakeholders working to advance diverse ends also advance the common good.
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  16. Michael Benatar, Leslie Cannold, Dena Davis, Merle Spriggs, Julian Savulescu, Heather Draper, Neil Evans, Richard Hull, Stephen Wilkinson, David Wasserman, Donna Dickenson, Guy Widdershoven, Françoise Baylis, Stephen Coleman, Rosemarie Tong, Hilde Lindemann, David Neil & Alex John London (2006). Cutting to the Core: Exploring the Ethics of Contested Surgeries. Rowman & Littlefield Publishers.
    When the benefits of surgery do not outweigh the harms or where they do not clearly do so, surgical interventions become morally contested. Cutting to the Core examines a number of such surgeries, including infant male circumcision and cutting the genitals of female children, the separation of conjoined twins, surgical sex assignment of intersex children and the surgical re-assignment of transsexuals, limb and face transplantation, cosmetic surgery, and placebo surgery.
     
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  17.  2
    Alex John London (2003). Threats to the Common Good: Biochemical Weapons and Human Subjects Research. Hastings Center Report 33 (5):17-25.
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  18.  5
    Frauke Hoss & Alex John London (forthcoming). Assessing the Moral Coherence and Moral Robustness of Social Systems: Proof of Concept for a Graphical Models Approach. Science and Engineering Ethics:1-19.
    This paper presents a proof of concept for a graphical models approach to assessing the moral coherence and moral robustness of systems of social interactions. “Moral coherence” refers to the degree to which the rights and duties of agents within a system are effectively respected when agents in the system comply with the rights and duties that are recognized as in force for the relevant context of interaction. “Moral robustness” refers to the degree to which a system of (...)
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  19.  4
    Alex John London (2005). Undue Inducements and Reasonable Risks: Will the Dismal Science Lead to Dismal Research Ethics? American Journal of Bioethics 5 (5):29 – 32.
  20.  20
    Alex John London, Responsiveness to Host Community Health Needs.
    There is near universal agreement within the scientific and ethics communities that a necessary condition for the moral permissibility of cross-national, collaborative research is that it be responsive to the health needs of the host community. It has proven difficult, however, to leverage or capitalize on this consensus in order to resolve lingering disputes about the ethics of international medical research. This is largely because different sides in these debates have sometimes provided different interpretations of what this requirement amounts to (...)
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  21.  41
    Alex John London (2001). The Independence of Practical Ethics. Theoretical Medicine and Bioethics 22 (2):87-105.
    After criticizing three common conceptions of therelationship between practical ethics and ethical theory, analternative modeled on Aristotle's conception of the relationshipbetween rhetoric and philosophical ethics is explored. Thisaccount is unique in that it neither denigrates the project ofsearching for an adequate comprehensive ethical theory norsubordinates practical ethics to that project. Because the purpose of practical ethics, on this view, is tosecure the cooperation of other persons in a way that respectstheir status as free and equal, it seeks to influence thejudgments (...)
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  22.  4
    Alex John London, Reasonable Risks In Clinical Research: A Critique and a Proposal for the Integrative Approach.
    Before participants can be enrolled in a clinical trial, an institutional review board must determine that the risks that the research poses to participants are ‘reasonable.’ This paper examines the two dominant frameworks for assessing research risks and argues that each approach suffers from significant shortcomings. It then considers what issues must be addressed in order to construct a framework for risk assessment that is grounded in a compelling normative foundation and might provide more operationally precise guidance to the deliberations (...)
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  23.  18
    Alex John London (2001). Editor's Introduction: Theory and Engagement in Bioethics. Theoretical Medicine and Bioethics 22 (2):65-68.
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  24.  4
    Alex John London (2010). Justice in the Application of Science: Beyond Fair Benefits. American Journal of Bioethics 10 (6):54-56.
  25.  4
    Alex John London & Joseph B. Kadane (2003). Sham Surgery and Genuine Standards of Care: Can the Two Be Reconciled? American Journal of Bioethics 3 (4):61-64.
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  26. Bonnie Steinbock, John D. Arras & Alex John London (2003). Ethical Issues in Modern Medicine. Ethical Theory and Moral Practice 6 (4):447-448.
     
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  27.  16
    Alex John London (2006). What Is Social and Global Justice to Bioethics or Bioethics to Social and Global Justice? Hastings Center Report 36 (4):3-3.
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  28.  38
    Alex John London (2000). Amenable to Reason: Aristotle's Rhetoric and the Moral Psychology of Practical Ethics. Kennedy Institute of Ethics Journal 10 (4):287-305.
    : An Aristotelian conception of practical ethics can be derived from the account of practical reasoning that Aristotle articulates in his Rhetoric and this has important implications for the way we understand the nature and limits of practical ethics. An important feature of this conception of practical ethics is its responsiveness to the complex ways in which agents form and maintain moral commitments, and this has important implications for the debate concerning methods of ethics in applied ethics. In particular, this (...)
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  29.  10
    Ashok J. Bharucha, Alex John London, David Barnard, Howard Wactlar, Mary Amanda Dew & Charles F. Reynolds (2006). Ethical Considerations in the Conduct of Electronic Surveillance Research. Journal of Law, Medicine & Ethics 34 (3):611-619.
    The extant clinical literature indicates profound problems in the assessment, monitoring, and documentation of care in long-term care facilities. The lack of adequate resources to accommodate higher staff-to-resident ratios adds additional urgency to the goal of identifying more costeffective mechanisms to provide care oversight. The ever expanding array of electronic monitoring technologies in the clinical research arena demands a conceptual and pragmatic framework for the resolution of ethical tensions inherent in the use of such innovative tools. CareMedia is a project (...)
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  30.  2
    Alex John London, Sham Surgery and Reasonable Risk.
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  31.  4
    Emily L. Evans & Alex John London (2006). Equipoise and the Criteria for Reasonable Action. Journal of Law, Medicine & Ethics 34 (2):441-450.
    Critics of clinical equipoise have long argued that it represents an overly permissive, and therefore morally unacceptable, mechanism for resolving the tensions inherent in clinical research. In particular, the equipoise requirement is often attacked on the grounds that it is not sufficiently responsive to the interests of individual patients. In this paper, we outline a view of equipoise that not only withstands a stronger version of this objection, which was recently articulated by Deborah Hellman, but also plays important roles in (...)
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  32.  18
    Alex John London (2001). Moral Knowledge and the Acquisition of Virtue in Aristotle's "Nicomachean" and "Eudemian Ethics". Review of Metaphysics 54 (3):553 - 583.
  33.  6
    Alex John London, The Maltese Conjoined Twins: Two Views of Their Separation.
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  34.  5
    Alex John London & Lori P. Knowles (forthcoming). Perspective: The Maltese Conjoined Twins: Two Views of Their Separation. Hastings Center Report.
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  35.  10
    Alex John London (1998). Virtue and Consequences. Social Theory and Practice 24 (1):1-23.
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  36.  3
    Alex John London (forthcoming). Review: Henry S. [REVIEW] Philosophical Explorations.
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  37.  1
    Yael Schenker, Robert M. Arnold & Alex John London (2014). Response to Open Peer Commentaries on “The Ethics of Advertising for Health Care Services”. American Journal of Bioethics 14 (4):W3 - W4.
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  38.  7
    Alex John London (2011). Equipoise, Research Stalemates, and the Limits of New Data. American Journal of Bioethics 11 (2):10 - 12.
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  39.  2
    Alex John London (2001). The Maltese Conjoined Twins. A Separate Peace. Hastings Center Report 31 (1):49.
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  40.  4
    Alex John London (2002). Embryos, Stem Cells, and the "Strategic" Element of Public Moral Reasoning. American Journal of Bioethics 2 (1):56-57.
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  41.  1
    Alex John London (2013). Richardson, Henry S.Moral Entanglements: The Ancillary-Care Obligations of Medical Researchers. Oxford: Oxford University Press, 2012. Pp. 253. $45.00. [REVIEW] Ethics 124 (1):206-209.
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  42. Ashok J. Bharucha, Alex John London, David Barnard, Howard Wactlar, Mary Amanda Dew & Charles F. Reynolds (2006). Ethical Considerations in the Conduct of Electronic Surveillance Research. Journal of Law, Medicine and Ethics 34 (3):611-619.
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  43. Emily L. Evans & Alex John London (2006). Equipoise and the Criteria for Reasonable Action. Journal of Law, Medicine and Ethics 34 (2):441-450.
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  44. Jonathan Kimmelman, Alex John London, Bernard Ravina, Tim Ramsay, Mark Bernstein, Alan Fine, Frank W. Stahnisch & Marina Elena Emborg, Launching Invasive, First-in-Human Trials Against Parkinson’s Disease: Ethical Considerations.
    The decision to initiate invasive, first-in-human trials involving Parkinson’s disease presents a vexing ethical challenge. Such studies present significant surgical risks, and high degrees of uncertainty about intervention risks and biological effects. We argue that maintaining a favorable riskbenefit balance in such circumstances requires a higher than usual degree of confidence that protocols will lead to significant direct and/or social benefits. One critical way of promoting such confidence is through the application of stringent evidentiary standards for preclinical studies. We close (...)
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  45. Alex John London (2012). A Non-Paternalistic Model of Research Ethics and Oversight: Assessing the Benefits of Prospective Review. Journal of Law, Medicine and Ethics 40 (4):930-944.
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  46. Alex John London, David A. Borasky & Anant Bhan, Improving Ethical Review of Research Involving Incentives for Health Promotion.
    Within international development [1], public health [2], and clinical medicine [3]–[5], there is increasing interest in determining whether cash payments or other economic incentives can be used to influence the choices and behavior of individuals and groups in order to promote desired health goals. However, a number of complex issues affect the review and approval by research ethics committees of research studying the effectiveness of using financial incentives to promote desired health goals. Current ethical and regulatory frameworks regard the provision (...)
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  47. Alex John London (1999). Virtue, Wisdom, and the Art of Ruling in Plato. Dissertation, University of Virginia
    This dissertation explores Plato's conception of the nature and value of wisdom and its relationship to the ethical virtues. It is argued that throughout what are referred to as Plato's early and middle dialogues, wisdom is identified with the political art and that, as such, those, dialogues consistently treat moral knowledge as a kind of craft knowledge. When this conception of wisdom is combined with the Socratic doctrine of the unity of the virtues, however, it raises serious problems for Socrates' (...)
     
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