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Abram Brummett [29]Abram L. Brummett [15]
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Abram Brummett
Oakland University William Beaumont School of Medicine
  1.  27
    Taxonomizing Views of Clinical Ethics Expertise.Erica K. Salter & Abram Brummett - 2019 - American Journal of Bioethics 19 (11):50-61.
    Our aim in this article is to bring some clarity to the clinical ethics expertise debate by critiquing and replacing the taxonomy offered by the Core Competencies report. The orienting question for our taxonomy is: Can clinical ethicists offer justified, normative recommendations for active patient cases? Views that answer “no” are characterized as a “negative” view of clinical ethics expertise and are further differentiated based on (a) why they think ethicists cannot give justified normative recommendations and (b) what they think (...)
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  2.  25
    Three Kinds of Decision-Making Capacity for Refusing Medical Interventions.Mark Christopher Navin, Abram L. Brummett & Jason Adam Wasserman - 2021 - American Journal of Bioethics 22 (11):73-83.
    According to a standard account of patient decision-making capacity, patients can provide ethically valid consent or refusal only if they are able to understand and appreciate their medical c...
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  3.  22
    Secular Clinical Ethicists Should Not Be Neutral Toward All Religious Beliefs: An Argument for a Moral-Metaphysical Proceduralism.Abram L. Brummett - 2021 - American Journal of Bioethics 21 (6):5-16.
    Moral pluralism poses a foundational problem for secular clinical ethics: How can ethical dilemmas be resolved in a context where there is disagreement not only on particular cases, but further, on...
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  4.  16
    The Quasi-religious Nature of Clinical Ethics Consultation.Abram Brummett - 2020 - HEC Forum 32 (3):199-209.
    What is the proper role of a clinical ethics consultant’s religious beliefs in forming recommendations for clinical ethics consultation? Where Janet Malek has argued that religious belief should have no influence on the formation of a CEC’s recommendations, Clint Parker has argued a CEC should freely appeal to all their background beliefs, including religious beliefs, in formulating their recommendations. In this paper, I critique both their views by arguing the position envisioned by Malek puts the CEC too far from religion (...)
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  5.  17
    Mapping the Moral Terrain of Clinical Deception.Abram Brummett & Erica K. Salter - 2023 - Hastings Center Report 53 (1):17-25.
    Legal precedent, professional‐society statements, and even many medical ethicists agree that some situations may call for a clinician to engage in an act of lying or nonlying deception of a patient or patient's family member. Still, the moral terrain of clinical deception is largely uncharted, and when it comes to practical guidance for clinicians, many might think that ethicists offer nothing more than the rule never to deceive. This guidance is insufficient to meet the real‐world demands of clinical practice, and (...)
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  6.  32
    Whose harm? Which metaphysic?Abram Brummett - 2019 - Theoretical Medicine and Bioethics 40 (1):43-61.
    Douglas Diekema has argued that it is not the best interest standard, but the harm principle that serves as the moral basis for ethicists, clinicians, and the courts to trigger state intervention to limit parental authority in the clinic. Diekema claims the harm principle is especially effective in justifying state intervention in cases of religiously motivated medical neglect in pediatrics involving Jehovah’s Witnesses and Christian Scientists. I argue that Diekema has not articulated a harm principle that is capable of justifying (...)
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  7.  22
    When conscientious objection runs amok: A physician refusing HIV preventative to a bisexual patient.Abram Brummett - 2021 - Clinical Ethics 16 (2):151-154.
    This paper reports of a case where a physician conscientiously objected to prescribing PrEP to a bisexual patient so as not to “enable immoral sexual behavior.” The case represents an instance of conscience creep, a phenomenon whereby clinicians invoke conscientious objection in sometimes objectionable ways that extend beyond the traditional contexts of abortion, sterilization, or physician aid in dying. This essay uses a reasonability view of conscientious objection to argue that the above case represents a discriminatory instance of conscience creep (...)
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  8.  9
    Two Troubling Trends in the Conversation Over Whether Clinical Ethics Consultants Have Ethics Expertise.Abram Brummett & Christopher J. Ostertag - 2018 - HEC Forum 30 (2):157-169.
    In a recent issue of the Journal of Medicine and Philosophy, several scholars wrote on the topic of ethics expertise in clinical ethics consultation. The articles in this issue exemplified what we consider to be two troubling trends in the quest to articulate a unique expertise for clinical ethicists. The first trend, exemplified in the work of Lisa Rasmussen, is an attempt to define a role for clinical ethicists that denies they have ethics expertise. Rasmussen cites the dependence of ethical (...)
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  9.  10
    Defending secular clinical ethics expertise from an Engelhardt-inspired sense of theoretical crisis.Abram Brummett - 2022 - Theoretical Medicine and Bioethics 43 (1):47-66.
    The national standards for clinical ethics consultation set forth by the American Society for Bioethics and Humanities endorse an “ethics facilitation” approach, which characterizes the role of the ethicist as one skilled at facilitating consensus within the range of ethically acceptable options. To determine the range of ethically acceptable options, ASBH recommends the standard model of decision-making, which is grounded in the values of autonomy, beneficence, nonmaleficence, and justice. H. Tristram Engelhardt Jr. has sharply criticized the standard model for presuming (...)
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  10.  6
    Phenomenology, Saudi Arabia, and an argument for the standardization of clinical ethics consultation.Abram Brummett & Ruaim Muaygil - 2021 - Philosophy, Ethics and Humanities in Medicine 16 (1):1-9.
    BackgroundThe purpose of this study is to make a philosophical argument against the phenomenological critique of standardization in clinical ethics. We used the context of clinical ethics in Saudi Arabia to demonstrate the importance of credentialing clinical ethicists.MethodsPhilosophical methods of argumentation and conceptual analysis were used.ResultsWe found the phenomenological critique of standardization to be flawed because it relies on a series of false dichotomies.ConclusionsWe concluded that the phenomenological framing of the credentialing debate relies upon two extreme views to be navigated (...)
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  11.  31
    Reaching Across The ‘Deepest Divide’: Moral Acquaintanceship, Religion, And Bioethics.Abram Brummett - 2020 - Heythrop Journal 61 (4):677-688.
  12.  10
    Credentialing Ethics Expertise.Abram L. Brummett - 2020 - American Journal of Bioethics 20 (3):50-52.
    Volume 20, Issue 3, March 2020, Page 50-52.
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  13. Should Positive Claims of Conscience Receive the Same Protection as Negative Claims of Conscience? Clarifying the Asymmetry Debate.Abram Brummett - 2020 - Journal of Clinical Ethics 31 (2).
    In the debate over clinicians’ conscience, there is a greater ethical, legal, and scholarly focus on negative, rather than positive, claims of conscience. This asymmetry produces a seemingly unjustified double standard with respect to clinicians’ conscience under the law. For example, a Roman Catholic physician working at a secular institution may refuse to provide physician-aid-in-dying on the basis of conscience, but a secular physician working at a Roman Catholic institution may not insist on providing physician-aid-in-dying on the basis of conscience. (...)
     
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  14.  6
    The many metaphysical commitments of secular clinical ethics: Expanding the argument for a moral–metaphysical proceduralism.Abram Brummett & Jason T. Eberl - 2022 - Bioethics 36 (7):783-793.
    Bioethics, Volume 36, Issue 7, Page 783-793, September 2022.
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  15.  5
    It’s Worth What You Can Sell It for: A Survey of Employment and Compensation Models for Clinical Ethicists.Jason Adam Wasserman, Abram Brummett & Mark Christopher Navin - forthcoming - HEC Forum:1-16.
    This article reports results of a survey about employment and compensation models for clinical ethics consultants working in the United States and discusses the relevance of these results for the professionalization of clinical ethics. This project uses self-reported data from healthcare ethics consultants to estimate compensation across different employment models. The average full-time annualized salary of respondents with a clinical doctorate is $188,310.08 (SD=$88,556.67), $146,134.85 (SD=$55,485.63) for those with a non-clinical doctorate, and $113,625.00 (SD=$35,872.96) for those with a masters as (...)
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  16.  3
    Should Positive Claims of Conscience Receive the Same Protection as Negative Claims of Conscience? Clarifying the Asymmetry Debate.Abram L. Brummett - 2020 - Journal of Clinical Ethics 31 (2):136-142.
    In the debate over clinicians’ conscience, there is a greater ethical, legal, and scholarly focus on negative, rather than positive, claims of conscience. This asymmetry produces a seemingly unjustified double standard with respect to clinicians’ conscience under the law. For example, a Roman Catholic physician working at a secular institution may refuse to provide physician-aid-in-dying on the basis of conscience, but a secular physician working at a Roman Catholic institution may not insist on providing physician-aid-in-dying on the basis of conscience. (...)
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  17.  12
    We have nothing left to bury.Abram Brummett, Andrea Thornton, Erica K. Salter & Samuel Deters - 2022 - Hastings Center Report 52 (1):12-14.
    Hastings Center Report, Volume 52, Issue 1, Page 12-14, January/February 2022.
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  18.  2
    Responding to Fiester’s Critique of a Bioethical Consensus Project.Jamie C. Watson & Abram L. Brummett - 2022 - Journal of Clinical Ethics 33 (3):198-201.
    We respond to Autumn Fiester’s critique that our proposed bioethical consensus project amounts to “ethical hegemony,” and evaluate her claim that ethicists should restrict themselves to “mere process” recommendations. We argue that content recommendations are an inescapable aspect of clinical ethics consultation, and our primary concern is that, without standardization of bioethical consensus, our field will vacillate among appeals to the disparate claims in the 22 “Core References,” unsustainable efforts to defend value-neutral process recommendations, or become a practice of Lone (...)
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  19.  8
    Philosophical Failure and the Reasonability View of Conscientious Objection: Can Reason Adjudicate Metaphysical or Religious Claims?Abram L. Brummett - 2023 - Journal of Medicine and Philosophy 48 (1):12-20.
    Robert Card has proposed a reasonability view of conscientious objection that asks providers to state the reasons for their objection for evaluation and approval by a review board. Jason Marsh has challenged Card to provide explicit criteria for what makes a conscientious objection reasonable, which he claims will be too difficult a task given that such objections often involve contentious metaphysical or religious claims. Card has responded by outlining standards by which a conscientious objection could be judged reasonable. In this (...)
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  20.  14
    Affirming the Existence and Legitimacy of Secular Bioethical Consensus, and Rejecting Engelhardt’s Alternative: A Reply to Nick Colgrove and Kelly Kate Evans.Abram Brummett - 2023 - HEC Forum 35 (1):95-109.
    One of the most significant and persistent debates in secular clinical ethics is the question of ethics expertise, which asks whether ethicists can make justified moral recommendations in active patient cases. A critical point of contention in the ethics expertise debate is whether there is, in fact, a bioethical consensus upon which secular ethicists can ground their recommendations and whether there is, in principle, a way of justifying such a consensus in a morally pluralistic context. In a series of recent (...)
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  21.  12
    Burying the basilisk of bioethics: What can be resolved, dissolved, and refocused in the ethics expertise debate.Abram Brummett - 2023 - Bioethics 37 (6):515-522.
    Since the inception of bioethics, some theorists have denied that clinical ethicists have ethics expertise, understood as the ability to give justified moral recommendations in patient cases. These denials have caused considerable alarm, leading some to argue that the entire discipline needs to be fundamentally reconsidered. Although this debate has been a source of academic attention for decades, these challenges to ethics expertise can now be either resolved by showing they are based on an untenable view of moral justification or (...)
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  22.  11
    Conscience claims, metaphysics, and avoiding an LGBT eugenic.Abram Brummett - 2018 - Bioethics 32 (5):272-280.
    Novel assisted reproductive technologies (ART) are poised to present our society with strange new ethical questions, such as whether lesbian, gay, bisexual, and transgender (LGBT) couples should be allowed to produce children biologically related to both parents, or whether trans‐women who want to experience childbirth should be allowed to receive uterine transplants. Clinicians opposed to offering such technologies to LGBT couples on moral grounds are likely to seek legal shelter through the conscience clauses enshrined in U.S. law. This paper begins (...)
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  23.  7
    Defending, Improving, Expanding, and Applying a Moral-Metaphysical Proceduralism for Secular Clinical Ethics.Abram L. Brummett - 2021 - American Journal of Bioethics 21 (7):6-9.
    A paradox has always lingered at the heart of secular clinical ethics: How are ethicists to provide moral guidance in a pluralistic society? I want to thank all the commentary authors for being suc...
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  24.  10
    Putting the Asymmetry Debate in Its Place.Abram L. Brummett - 2021 - American Journal of Bioethics 21 (8):68-69.
    The target article by Kyle Fritz draws attention to the asymmetry debate, an under-analyzed issue within the broader debate over the proper role of physician conscience in healthcare. The as...
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  25.  6
    What is the appropriate role of reason in secular clinical ethics? An argument for a compatibilist view of public reason.Abram Brummett - 2021 - Medicine, Health Care and Philosophy 24 (2):281-290.
    This article describes and rejects three standard views of reason in secular clinical ethics. The first, instrumental reason view, affirms that reason may be used to draw conceptual distinctions, map moral geography, and identify invalid forms of argumentation, but prohibits recommendations because reason cannot justify any content-full moral or metaphysical commitments. The second, public reason view, affirms instrumental reason, and claims ethicists may make recommendations grounded in the moral and metaphysical commitments of bioethical consensus. The third, comprehensive reason view, also (...)
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  26.  5
    Non-Roman Catholic Physicians Should Be Permitted to Write Prescriptions for Birth Control in Roman Catholic Institutions.Eric J. James & Abram L. Brummett - 2021 - Journal of Clinical Ethics 32 (3):265-270.
    The legal and ethical asymmetry between honoring positive claims of conscience versus negative claims of conscience was recently analyzed by several articles in this journal. The first author of this article (ALB) identified unique but defeasible reasons against honoring positive claims of conscience, such as the greater threat they post to institutional values and institutional resources than negative claims of conscience. However, ALB wrote, when these reasons can be overcome, positive claims of conscience should enjoy the same ethical and legal (...)
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  27.  28
    The Right to Be Childfree.Andrea Eisenberg & Abram L. Brummett - 2023 - Narrative Inquiry in Bioethics 13 (1):59-64.
    Abstract:In this manuscript, we start with a real life account of an Ob/Gyn experience with a young patient from the childfree movement requesting permanent sterilization. A narrative ethics approach invites the reader to experience the encounter in an immersive way for this growing issue. This approach allows readers to reflect on their reaction to the patient and consider how that can affect other patient encounters. Additionally, it explores the stigma these young patients encounter making a permanent decision to never have (...)
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  28.  12
    Neuroethics and the Naturalistic Fallacy.Abram L. Brummett - 2019 - American Journal of Bioethics Neuroscience 10 (3):124-126.
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  29. Are conscientious objectors morally obligated to refer?Samuel Reis-Dennis & Abram L. Brummett - 2022 - Journal of Medical Ethics 48 (8):547-550.
    In this paper, we argue that providers who conscientiously refuse to provide legal and professionally accepted medical care are not always morally required to refer their patients to willing providers. Indeed, we will argue that refusing to refer is morally admirable in certain instances. In making the case, we show that belief in a sweeping moral duty to refer depends on an implicit assumption that the procedures sanctioned by legal and professional norms are ethically permissible. Focusing on examples of female (...)
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  30. Two internal critiques for theists who oppose moral enhancement on a process virtue basis.Abram Brummett & Parker Crutchfield - 2021 - Bioethics 36 (4):367-373.
  31.  3
    Conscientious Objection to Aggressive Interventions for Patients in a Vegetative State.Jason Adam Wasserman, Abram L. Brummett, Mark Christopher Navin & Daniel Londyn Menkes - forthcoming - American Journal of Bioethics:1-12.
    Some physicians refuse to perform life-sustaining interventions, such as tracheostomy, on patients who are very likely to remain permanently unconscious. To explain their refusal, these clinicians often invoke the language of “futility”, but this can be inaccurate and can mask problematic forms of clinical power. This paper explores whether such refusals should instead be framed as conscientious objections. We contend that the refusal to provide interventions for patients very likely to remain permanently unconscious meets widely recognized ethical standards for the (...)
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  32.  3
    Correction to: It’s Worth What You Can Sell It for: A Survey of Employment and Compensation Models for Clinical Ethicists.Jason Adam Wasserman, Abram Brummett & Mark Christopher Navin - forthcoming - HEC Forum:1-2.
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  33.  6
    Capacities to Refuse Treatment: A Reply.Mark Christopher Navin, Abram Brummett & Jason Adam Wasserman - 2024 - American Journal of Bioethics 24 (3):1-5.
    The three of us work as academics and clinical ethicists. In our clinical ethics work, we often encounter patients who lack decision-making capacity, but who nonetheless have strong preferences abo...
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  34.  8
    Locked In.Abram Brummett - 2022 - Hastings Center Report 52 (6):4-5.
    Tiffany was seventeen when injury to her brain stem put her in the intensive care unit on life‐sustaining treatment and in a permanently locked‐in state—fully conscious but able to control no bodily movements other than her eye movements. As a clinical ethicist at the hospital, I was consulted by her neurologist, who had established a blink‐once‐for‐yes, twice‐for‐no system of communication so that Tiffany could respond to questions. Her mother wanted Tiffany to continue receiving treatment that could prolong her life for (...)
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  35. Catholic Hospitals Should Permit Physicians to Provide Emergency Contraception to Rape Victims as an Act of Conscientious Provision.Abram Brummett, Marlee Mason-Maready & Victoria Whiting - 2022 - The Linacre Quarterly.
    While many Catholic hospitals permit the prescription of the emergency contraception drug levonorgestrel for rape victims, some continue to prohibit this practice as a matter of institutional conscience. While the standard approach to this issue has been to offer an argument that levonorgestrel either is or is not morally permissible, we have taken a different tack. We begin by briefly describing and acknowledging that reasonable disagreement exists on this question (part one), and then arguing that the reasonable disagreement itself can (...)
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  36. Conscientious objection and LGBTQ discrimination in the United States.Abram Brummett & Lisa Campo-Engelstein - 2021 - Journal of Public Health Policy 42 (2).
    Given recent legal developments in the United States, now is a critical time to draw attention to how ‘conscientious objection’ is sometimes used by health care providers to discriminate against the LGBTQ community. We review legal developments from 2019 and present several cases where health care providers used conscientious objection in ways that discriminate against the LGBTQ community, resulting in damaged trust by this underserved population. We then discuss two important conceptual points in this debate. The first involves the interpretation (...)
     
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  37.  10
    Dementia, beauty, and play: A way of seeing and being with the wearisome patient.Abram Brummett & Michelle Bach - 2022 - Clinical Ethics 17 (1):87-89.
    We describe a case of an elderly patient suffering from advanced dementia whose chronic confusion has become a source of frustration for her caregivers. Mrs. M experiences a touching interaction with a new nurse who takes a different approach with her. We describe this interaction and elaborate upon it by drawing from Catholic social teaching and the philosophy of play. Cases like these do not involve dramatic or esoteric ethical problematics, but rather the sort of dilemma born of the everyday (...)
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  38.  5
    Fostering medical staff reflection on the technological alienation of parents in the NICU.Abram Brummett & Annie B. Friedrich - 2022 - Clinical Ethics 17 (4):449-451.
    We describe a case of parents refusing a tracheostomy for an otherwise healthy newborn. The refusal was not honored because permitting the refusal would have violated state law, which required a child to have a qualifying condition (e.g. a terminal diagnosis, permanent unconsciousness, incurable condition with severe suffering) to remove or withhold life-sustaining treatment. However, this case strained the relationship between the parents and medical staff, who worried about sending the newborn home with a tracheostomy where she was not wanted. (...)
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  39. Non-Roman Catholic Physicians Should Be Permitted to Write Prescriptions for Birth Control in Roman Catholic Institutions.Abram Brummett - 2021 - Journal of Clinical Ethics 32 (3).
    The legal and ethical asymmetry between honoring positive claims of conscience versus negative claims of conscience was recently analyzed by several articles in this journal. The first author of this article (ALB) identified unique but defeasible reasons against honoring positive claims of conscience, such as the greater threat they post to institutional values and institutional resources than negative claims of conscience. However, ALB wrote, when these reasons can be overcome, positive claims of conscience should enjoy the same ethical and legal (...)
     
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  40.  6
    Public Health Approaches and the Human Enhancement Debate.Abram Brummett - 2016 - Perspectives in Biology and Medicine 59 (4):536-546.
    Cognitive enhancement refers to any technology that raises some aspect of cognition beyond the species-typical level. It is often considered distinct from and less controversial than cognitive therapy, which raises the cognition of a deficient individual to the species-typical level. The debate over CE is a result of the excitement surrounding the potential of neuroscience to one day enable us to enhance our own cognition in significant ways. Some of the aspects of cognition targeted by enhancement and therapeutic technologies include (...)
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  41.  12
    Response to Open Peer Commentaries “Taxonomizing Views of Clinical Ethics Expertise”.Abram Brummett & Erica Salter - 2020 - American Journal of Bioethics 20 (1):W5-W8.
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  42.  15
    The prisoner dilemma: Inconsistent decisions for continuing life-sustaining treatment between a patient with very limited communication and their surrogate.Abram Brummett - 2021 - Clinical Ethics 16 (1):46-48.
    This case raises the difficult question of how to respond to patients who appear to lack decision-making capacity, yet retain limited communication that allows them to state a preference for life-sustaining treatment that conflicts with the choice of their surrogate. I argue that the patient’s preference should be honored, even though the patient lacks decision-making capacity, and the preference contradicts the wishes of the surrogate.
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  43. In Response to Davis.Eric J. James & Abram L. Brummett - 2022 - Journal of Clinical Ethics 33 (1):77-77.
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  44.  3
    An Argument for Standardized Ethical Directives for Secular Healthcare Services.Jamie C. Watson & Abram L. Brummett - 2022 - Journal of Clinical Ethics 33 (3):175-188.
    We argue that the American Society for Bioethics and Humanities has endorsed a facilitation approach to clinical ethics consultation that asserts that bioethicists can offer moral recommendations that are well-grounded in bioethical consensus. We claim that the closest thing the field currently has to a citable, nationally endorsed bioethical consensus are the 22 Core References used to construct the questions for the Healthcare Ethics Consultant-Certified (HEC-C) exam. We acknowledge that the Core References reflect some important points of bioethical consensus, but (...)
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