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Daniel P. Sulmasy [56]Daniel Sulmasy [6]Daniel Patrick Sulmasy [1]
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Daniel Sulmasy
Georgetown University
  1. What is Conscience and Why is Respect for It so Important?Daniel P. Sulmasy - 2008 - Theoretical Medicine and Bioethics 29 (3):135-149.
    The literature on conscience in medicine has paid little attention to what is meant by the word ‘conscience.’ This article distinguishes between retrospective and prospective conscience, distinguishes synderesis from conscience, and argues against intuitionist views of conscience. Conscience is defined as having two interrelated parts: (1) a commitment to morality itself; to acting and choosing morally according to the best of one’s ability, and (2) the activity of judging that an act one has done or about which one is deliberating (...)
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  2.  48
    Tolerance, Professional Judgment, and the Discretionary Space of the Physician.Daniel P. Sulmasy - 2017 - Cambridge Quarterly of Healthcare Ethics 26 (1):18-31.
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  3.  6
    Whole-Brain Death and Integration: Realigning the Ontological Concept with Clinical Diagnostic Tests.Daniel P. Sulmasy - 2019 - Theoretical Medicine and Bioethics 40 (5):455-481.
    For decades, physicians, philosophers, theologians, lawyers, and the public considered brain death a settled issue. However, a series of recent cases in which individuals were declared brain dead yet physiologically maintained for prolonged periods of time has challenged the status quo. This signals a need for deeper reflection and reexamination of the underlying philosophical, scientific, and clinical issues at stake in defining death. In this paper, I consider four levels of philosophical inquiry regarding death: the ontological basis, actual states of (...)
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  4.  25
    Conscience, Tolerance, and Pluralism in Health Care.Daniel P. Sulmasy - 2019 - Theoretical Medicine and Bioethics 40 (6):507-521.
    Increasingly, physicians are being asked to provide technical services that many believe are morally wrong or inconsistent with their beliefs about the meaning and purposes of medicine. This controversy has sparked persistent debate over whether practitioners should be permitted to decline participation in a variety of legal practices, most notably physician-assisted suicide and abortion. These debates have become heavily politicized, and some of the key words and phrases are being used without a clear understanding of their meaning. In this essay, (...)
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  5.  10
    Unrealistic Optimism in Early-Phase Oncology Trials.Lynn A. Jansen, Paul S. Appelbaum, William Mp Klein, Neil D. Weinstein, William Cook, Jessica S. Fogel & Daniel P. Sulmasy - 2011 - IRB: Ethics & Human Research 33 (1):1.
    Unrealistic optimism is a bias that leads people to believe, with respect to a specific event or hazard, that they are more likely to experience positive outcomes and/or less likely to experience negative outcomes than similar others. The phenomenon has been seen in a range of health-related contexts—including when prospective participants are presented with the risks and benefits of participating in a clinical trial. In order to test for the prevalence of unrealistic optimism among participants of early-phase oncology trials, we (...)
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  6.  20
    The Last Low Whispers of Our Dead: When is It Ethically Justifiable to Render a Patient Unconscious Until Death?Daniel Sulmasy - 2018 - Theoretical Medicine and Bioethics 39 (3):233-263.
    A number of practices at the end of life can causally contribute to diminished consciousness in dying patients. Despite overlapping meanings and a confusing plethora of names in the published literature, this article distinguishes three types of clinically and ethically distinct practices: double-effect sedation, parsimonious direct sedation, and sedation to unconsciousness and death. After exploring the concept of suffering, the value of consciousness, the philosophy of therapy, the ethical importance of intention, and the rule of double effect, these three practices (...)
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  7.  49
    The Varieties of Human Dignity: A Logical and Conceptual Analysis.Daniel P. Sulmasy - 2013 - Medicine, Health Care and Philosophy 16 (4):937-944.
    The word ‘dignity’ is used in a variety of ways in bioethics, and this ambiguity has led some to argue that the term must be expunged from the bioethical lexicon. Such a judgment is far too hasty, however. In this article, the various uses of the word are classified into three serviceable categories: intrinsic, attributed, and inflorescent dignity. It is then demonstrated that, logically and linguistically, the attributed and inflorescent meanings of the word presuppose the intrinsic meaning. Thus, one cannot (...)
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  8. Speaking of the Value of Life.Daniel P. Sulmasy - 2011 - Kennedy Institute of Ethics Journal 21 (2):181-199.
    The notion of the value of life is often invoked in discussions regarding medical care for the sick and the dying. This theme has figured in arguments about medical ethics for decades, but many of the phrases associated with this concept have received little serious scrutiny. It is true that some philosophers have declared a few commonly used phrases such as “the sanctity of life,” “the infinite value of life,” and “the value of life itself” to be unclear at best (...)
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  9.  22
    Should Institutions Disclose the Names of Employees with Covid‐19?Daniel P. Sulmasy & Robert M. Veatch - 2020 - Hastings Center Report 50 (3):25-27.
  10. Book Review: T. A. Cavanaugh, Double-Effect Reasoning: Doing Good and Avoiding Evil . Xxiv + 220 Pp. £45 , ISBN 978—0—19— 927219—8. [REVIEW]Daniel P. Sulmasy - 2008 - Studies in Christian Ethics 21 (3):438-442.
  11. Dignity and Bioethics : History, Theory, and Selected Applications.Daniel P. Sulmasy - 2008 - In Adam Schulman (ed.), Human Dignity and Bioethics: Essays Commissioned by the President's Council on Bioethics. [President's Council on Bioethics.
     
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  12.  59
    “Reinventing” the Rule of Double Effect.Daniel P. Sulmasy - 2007 - In Bonnie Steinbock (ed.), The Oxford Handbook of Bioethics. Oxford University Press. pp. 114--49.
    The Rule of Double Effect has played an important role in bioethics, especially during the last fifty years. Its major application in bioethics has been in providing physicians who are opposed to euthanasia with a moral justification for using opioid analgesics in treating the pain of patients whose death might thereby be hastened. It has also prominently been applied to certain obstetric cases. The scope of application of double effect is actually much broader than medical ethics, extending to cover such (...)
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  13.  19
    Christian Witness in Health Care.Daniel P. Sulmasy - 2016 - Christian Bioethics 22 (1):45-61.
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  14.  75
    Diseases and Natural Kinds.Daniel P. Sulmasy - 2005 - Theoretical Medicine and Bioethics 26 (6):487-513.
    David Thomasma called for the development of a medical ethics based squarely on the philosophy of medicine. He recognized, however, that widespread anti-essentialism presented a significant barrier to such an approach. The aim of this article is to introduce a theory that challenges these anti-essentialist objections. The notion of natural kinds presents a modest form of essentialism that can serve as the basis for a foundationalist philosophy of medicine. The notion of a natural kind is neither static nor reductionistic. Disease (...)
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  15.  90
    Proportionality, Terminal Suffering and the Restorative Goals of Medicine.Lynn A. Jansen & Daniel P. Sulmasy - 2002 - Theoretical Medicine and Bioethics 23 (4-5):321-337.
    Recent years have witnessed a growing concern that terminally illpatients are needlessly suffering in the dying process. This has ledto demands that physicians become more attentive in the assessment ofsuffering and that they treat their patients as `whole persons.'' Forthe most part, these demands have not fallen on deaf ears. It is nowwidely accepted that the relief of suffering is one of the fundamentalgoals of medicine. Without question this is a positive development.However, while the importance of treating suffering has generally (...)
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  16.  18
    Edmund Pellegrino's Philosophy and Ethics of Medicine: An Overview.Daniel P. Sulmasy - 2014 - Kennedy Institute of Ethics Journal 24 (2):105-112.
    Pellegrino was there at the beginning of the field. In the 1950s and 60s, before there was a Kennedy Institute of Ethics or a Hastings Center; before the word ‘bioethics’ itself was coined, Pellegrino was writing articles such as "Ethical Considerations in the Practice of Medicine and Nursing," published in 1964. He was among those who started the Society for Health and Human Values—a precursor organization to the American Society for Bioethics and Humanities. He was the founding editor of the (...)
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  17.  9
    The Ethical Obligation of the Dead Donor Rule.Anne L. Dalle Ave, Daniel P. Sulmasy & James L. Bernat - 2020 - Medicine, Health Care and Philosophy 23 (1):43-50.
    The dead donor rule originally stated that organ donors must not be killed by and for organ donation. Scholars later added the requirement that vital organs should not be procured before death. Some now argue that the DDR is breached in donation after circulatory determination of death programs. DCDD programs do not breach the original version of the DDR because vital organs are procured only after circulation has ceased permanently as a consequence of withdrawal of life-sustaining therapy. We hold that (...)
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  18.  53
    Patient Expectations of Benefit From Phase I Clinical Trials: Linguistic Considerations in Diagnosing a Therapeutic Misconception.K. P. Weinfurt, Daniel P. Sulmasy, Kevin A. Schulman & Neal J. Meropol - 2003 - Theoretical Medicine and Bioethics 24 (4):329-344.
    The ethical treatment of cancer patientsparticipating in clinical trials requiresthat patients are well-informed about thepotential benefits and risks associated withparticipation. When patients enrolled in phaseI clinical trials report that their chance ofbenefit is very high, this is often taken as evidence of a failure of the informed consent process. We argue, however, that some simple themes from the philosophy of language may make such a conclusion less certain. First, the patient may receive conflicting statements from multiple speakers about the expected (...)
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  19.  59
    Killing and Allowing to Die: Another Look.Daniel P. Sulmasy - 1998 - Journal of Law, Medicine and Ethics 26 (1):55-64.
  20.  91
    Commentary: Double Effect—Intention is the Solution, Not the Problem.Daniel P. Sulmasy - 2000 - Journal of Law, Medicine and Ethics 28 (1):26-29.
  21.  85
    Deliberative Democracy and Stem Cell Research in New York State: The Good, the Bad, and the Ugly.Daniel P. Sulmasy - 2009 - Kennedy Institute of Ethics Journal 19 (1):pp. 63-78.
    Many states in the U.S. have adopted policies regarding human embryonic stem cell (hESC) research in the last few years. Some have arrived at these policies through legislative debate, some by referendum, and some by executive order. New York has chosen a unique structure for addressing policy decisions regarding this morally controversial issue by creating the Empire State Stem Cell Board with two Committees—an Ethics Committee and a Funding Committee. This essay explores the pros and cons of various policy arrangements (...)
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  22.  39
    Moral Status, Justice, and the Common Morality: Challenges for the Principlist Account of Moral Change.Kevin E. Hodges & Daniel P. Sulmasy - 2013 - Kennedy Institute of Ethics Journal 23 (3):275-296.
    The idea that ethics can be derived from a common morality, while controversial, has become very influential in biomedical ethics. Although the concept is employed by several theories, it has most prominently been given a central role in principlism, an ethical theory endorsed by Tom Beauchamp and James Childress in Principles of Biomedical Ethics (2009).1 This text has become a cornerstone of medical ethics education, an achievement that has been commended by critics and supporters alike. It articulates a system of (...)
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  23.  23
    Perceptions of Control and Unrealistic Optimism in Early-Phase Cancer Trials.Lynn A. Jansen, Daruka Mahadevan, Paul S. Appelbaum, William M. P. Klein, Neil D. Weinstein, Motomi Mori, Catherine Degnin & Daniel P. Sulmasy - 2018 - Journal of Medical Ethics 44 (2):121-127.
    Purpose Recent research has found unrealistic optimism among patient-subjects in early-phase oncology trials. Our aim was to investigate the cognitive and motivational factors that evoke this bias in this context. We expected perceptions of control to be a strong correlate of unrealistic optimism. Methods A study of patient-subjects enrolled in early-phase oncology trials was conducted at two sites in the USA. Respondents completed questionnaires designed to assess unrealistic optimism and several risk attribute variables that have been found to evoke the (...)
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  24.  63
    What is an Oath and Why Should a Physician Swear One?Daniel P. Sulmasy - 1999 - Theoretical Medicine and Bioethics 20 (4):329-346.
    While there has been much discussion about the role of oaths in medical ethics, this discussion has previously centered on the content of various oaths. Little conceptual work has been done to clarify what an oath is, or to show how an oath differs from a promise or a code of ethics, or to explore what general role oath-taking by physicians might play in medical ethics. Oaths, like promises, are performative utterances. But oaths are generally characterized by their greater moral (...)
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  25. Death, Dignity, and the Theory of Value.Daniel P. Sulmasy - 2002 - Ethical Perspectives 9 (2):103-130.
    The word ‘dignity’ arises continuously in the debate over euthanasia and assisted suicide, both in Europe and in North America. Unlike the phrases ‘autonomy’ and ‘slippery slope’, ‘dignity’ is used by those on both sides of the question. For example, the organizations most prominently associated with the campaign that culminated in the recent legalization of euthanasia in Belgium are the Association pour la Droit de Mourir dans la Dignité and Recht op Waardig Sterven. Yet when Belgium passed its euthanasia law, (...)
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  26.  22
    Death and Dignity in Catholic Christian Thought.Daniel P. Sulmasy - 2017 - Medicine, Health Care and Philosophy 20 (4):537-543.
    This article traces the history of the concept of dignity in Western thought, arguing that it became a formal Catholic theological concept only in the late nineteenth century. Three uses of the word are distinguished: intrinsic, attributed, and inflorescent dignity, of which, it is argued, the intrinsic conception is foundational. The moral norms associated with respect for intrinsic dignity are discussed briefly. The scriptural and theological bases for adopting the concept of dignity as a Christian idea are elucidated. The article (...)
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  27.  15
    Context and scale: Distinctions for improving debates about physician “rationing”.Jon C. Tilburt & Daniel P. Sulmasy - 2017 - Philosophy, Ethics, and Humanities in Medicine 2017 12:1 12 (1):5.
    Important discussions about limiting care based on professional judgment often devolve into heated debates over the place of physicians in bedside rationing. Politics, loaded rhetoric, and ideological caricature from both sides of the rationing debate obscure precise points of disagreement and consensus, and hinder critical dialogue around the obligations and boundaries of professional practice. We propose a way forward by reframing the rationing conversation, distinguishing between the scale of the decision and its context avoiding the word “rationing.” We propose to (...)
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  28.  44
    Terri Schiavo and the Roman Catholic Tradition of Forgoing Extraordinary Means of Care.Daniel P. Sulmasy - 2005 - Journal of Law, Medicine and Ethics 33 (2):359-362.
  29.  13
    Context and Scale: Distinctions for Improving Debates About Physician “Rationing”.Jon C. Tilburt & Daniel P. Sulmasy - 2017 - Philosophy, Ethics, and Humanities in Medicine 12:5.
    Important discussions about limiting care based on professional judgment often devolve into heated debates over the place of physicians in bedside rationing. Politics, loaded rhetoric, and ideological caricature from both sides of the rationing debate obscure precise points of disagreement and consensus, and hinder critical dialogue around the obligations and boundaries of professional practice. We propose a way forward by reframing the rationing conversation, distinguishing between the scale of the decision and its context avoiding the word “rationing.” We propose to (...)
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  30.  10
    Bioethics, Conflicts of Interest, the Limits of Transparency.Lynn A. Jansen & Daniel P. Sulmasy - 2003 - Hastings Center Report 33 (4):40-43.
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  31.  26
    Dear Dr. Peabody.Daniel P. Sulmasy - 2016 - Perspectives in Biology and Medicine 59 (4):562-566.
    Francis W. Peabody, MDDepartment of MedicineBoston City Hospital and Harvard Medical SchoolBoston, MassachusettsMarch 19, 2017Dear Dr. Peabody,Thank you for giving us the opportunity to review your manuscript "The Care of the Patient." It has been carefully considered by the editors and two external reviewers. We regret to inform you that it cannot be considered further for publication in the Prestigious Journal of Medicine.Chief among our reasons is that it is overly long. Opinion pieces—especially non-data driven articles about topics like ethics—should (...)
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  32. Catholic Health Care: Not Dead Yet.Daniel P. Sulmasy - 2001 - The National Catholic Bioethics Quarterly 1 (1):41-50.
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  33. Emergency Contraception for Women Who Have Been Raped: Must Catholics Test for Ovulation, or is Testing for Pregnancy Morally Sufficient?Daniel P. Sulmasy - 2006 - Kennedy Institute of Ethics Journal 16 (4):305-331.
    : On the grounds that rape is an act of violence, not a natural act of intercourse, Roman Catholic teaching traditionally has permitted women who have been raped to take steps to prevent pregnancy, while consistently prohibiting abortion even in the case of rape. Recent scientific evidence that emergency contraception (EC) works primarily by preventing ovulation, not by preventing implantation or by aborting implanted embryos, has led Church authorities to permit the use of EC drugs in the setting of rape. (...)
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  34.  10
    On Substituted Arguments.Daniel P. Sulmasy & Lois Snyder Sulmasy - 2015 - Journal of Medical Ethics 41 (9):732-733.
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  35.  55
    The Logos of the Genome: Genomes as Parts of Organisms.Daniel P. Sulmasy - 2006 - Theoretical Medicine and Bioethics 27 (6):535-540.
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  36. What's so Special About Medicine?Daniel P. Sulmasy - 1993 - Theoretical Medicine and Bioethics 14 (1):379-380.
    Health care has increasingly come to be understood as a commodity. The ethical implications of such an understanding are significant. The author argues that health care is not a commodity because health care (1) is non-proprietary, (2) serves the needs of persons who, as patients, are uniquely vulnerable, (3) essentially involves a special human relationship which ought not be bought or sold, (4) helps to define what is meant by necessity and cannot be considered a commodity when subjected to rigorous (...)
     
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  37.  11
    Religion in Organized Medicine: The AMA’s Committee and Department of Medicine and Religion, 1961–1974.Daniel Kim, Farr Curlin, Kelly Wolenberg & Daniel Sulmasy - 2014 - Perspectives in Biology and Medicine 57 (3):393-414.
    Although the relationship between medicine and spirituality has come to be considered problematic in the contemporary Western world, a concern with spiritual questions in healing and caregiving is as old as the recorded history of medicine itself. Illness ineluctably raises questions of a spiritual nature, of meaning and value, and of one’s relationship with other persons and the transcendent. The world’s religions have long been vital resources for making sense of one’s spiritual experiences in illness and health, for they each (...)
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  38.  15
    Why the Common-Sense Distinction Between Killing and Allowing-to-Die Is So Easy to Grasp but So Hard to Explain.Daniel P. Sulmasy & Mariele A. Courtois - 2019 - Cambridge Quarterly of Healthcare Ethics 28 (2):353-358.
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  39.  40
    Futility and the Varieties of Medical Judgment.Daniel P. Sulmasy - 1997 - Theoretical Medicine and Bioethics 18 (1-2):63-78.
    Pellegrino has argued that end-of-life decisions should be based upon the physician's assessment of the effectiveness of the treatment and the patient's assessment of its benefits and burdens. This would seem to imply that conditions for medical futility could be met either if there were a judgment of ineffectiveness, or if the patient were in a state in which he or she were incapable of a subjective judgment of the benefits and burdens of the treatment. I argue that a theory (...)
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  40.  23
    Macklin, Ruth. Against Relativism: Cultural Diversity and the Search for Ethical Universals in Medicine.Daniel P. Sulmasy - 2001 - The National Catholic Bioethics Quarterly 1 (3):467-469.
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  41.  13
    Unlike Diamonds, Defibrillators Aren’T Forever: Why It Is Sometimes Ethical to Deactivate Cardiac Implantable Electrical Devices.Daniel P. Sulmasy & Mariele A. Courtois - 2019 - Cambridge Quarterly of Healthcare Ethics 28 (2):338-346.
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  42.  50
    End-of-Life Decision Making: When Patients and Surrogates Disagree.Peter B. Terry, Margaret Vettese, John Song, Jane Forman, Karen B. Haller, Deborah J. Miller, R. Stallings & Daniel P. Sulmasy - 1998 - Journal of Clinical Ethics 10 (4):286-293.
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  43.  76
    Crossing the Bridge: A Time of Transition for Theoretical Medicine and Bioethics.Daniel P. Sulmasy - 2002 - Theoretical Medicine and Bioethics 23 (1):5-7.
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  44.  58
    Editorial: Theoretical Medicine and Bioethics Celebrates its 25th Birthday.Daniel P. Sulmasy - 2004 - Theoretical Medicine and Bioethics 25 (1):1-2.
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  45.  7
    Engaging Pellegrino’s Philosophy of Medicine: Can One of the Founders of the Field Still Help Us Today?Daniel Sulmasy - 2019 - Theoretical Medicine and Bioethics 40 (3):165-168.
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  46.  18
    Sedation and Care at the End of Life.Daniel Sulmasy - 2018 - Theoretical Medicine and Bioethics 39 (3):171-180.
    This special issue of Theoretical Medicine and Bioethics takes up the question of palliative sedation as a source of potential concern or controversy among Christian clinicians and thinkers. Christianity affirms a duty to relieve unnecessary suffering yet also proscribes euthanasia. Accordingly, the question arises as to whether it is ever morally permissible to render dying patients unconscious in order to relieve their suffering. If so, under what conditions? Is this practice genuinely morally distinguishable from euthanasia? Can one ever aim directly (...)
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  47.  17
    Ethical Principles, Process, and the Work of Bioethics Commissions.Daniel P. Sulmasy - 2017 - Hastings Center Report 47 (S1):S50-S53.
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  48.  26
    Patients' Perceptions of the Quality of Informed Consent for Common Medical Procedures.Daniel P. Sulmasy, Lisa S. Lehmann, David M. Levine & R. R. Raden - 1994 - Journal of Clinical Ethics 5 (3):189.
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  49.  27
    Catholic Health Care at the Edge of Ground Zero.Daniel P. Sulmasy - 2002 - The National Catholic Bioethics Quarterly 2 (1):15-16.
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  50.  22
    The Diagnosis of St. Francis: Evidence for Leprosy.Joanne Schatzlein & Daniel P. Sulmasy - 1987 - Franciscan Studies 47 (1):181-217.
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