65 found
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  1. Principles for Allocation of Scarce Medical Interventions.Govind Persad, Alan Wertheimer & Ezekiel J. Emanuel - 2009 - The Lancet 373 (9661):423--431.
    Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and (...)
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  2.  57
    Fair Allocation of Scarce Medical Resources in the Time of Covid-19.Ezekiel J. Emanuel, Govind Persad, Ross Upshur, Beatriz Thome, Michael Parker, Aaron Glickman, Cathy Zhang, Connor Boyle & James P. Phillips - 2020 - New England Journal of Medicine:10.1056/NEJMsb2005114.
    Four ethical values — maximizing benefits, treating equally, promoting and rewarding instrumental value, and giving priority to the worst off — yield six specific recommendations for allocating medical resources in the Covid-19 pandemic: maximize benefits; prioritize health workers; do not allocate on a first-come, first-served basis; be responsive to evidence; recognize research participation; and apply the same principles to all Covid-19 and non–Covid-19 patients.
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  3. The Obligation to Participate in Biomedical Research.G. Owen Schaefer, Ezekiel J. Emanuel & Alan Wertheimer - 2009 - Journal of the American Medical Association 302 (1):67-72.
    The current prevailing view is that participation in biomedical research is above and beyond the call of duty. While some commentators have offered reasons against this, we propose a novel public goods argument for an obligation to participate in biomedical research. Biomedical knowledge is a public good, available to any individual even if that individual does not contribute to it. Participation in research is a critical way to support an important public good. Consequently, all have a duty to participate. The (...)
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  4.  81
    The Oxford Textbook of Clinical Research Ethics.Ezekiel J. Emanuel (ed.) - 2008 - Oxford University Press.
    Comprehensive in scope and research, this book will be a crucial resource for researchers in the medical sciences, as well as teachers and students alike.
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  5.  49
    Undue Inducement: Nonsense on Stilts?Ezekiel J. Emanuel - 2005 - American Journal of Bioethics 5 (5):9-13.
    1. The opinions expressed are the author's own. They do not reflect any position or policy of the National Institutes of Health, Public Health Service, Department of Health and Human Services, or any of the authors affiliated organizations.
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  6.  61
    Exploitation and Developing Countries: The Ethics of Clinical Research.Jennifer S. Hawkins & Ezekiel J. Emanuel - 2008 - Princeton, NJ, USA: Princeton Univ Pr.
    This book was inspired originally by the debates at the turn of the century about placebo controlled trials of antiretrovirals in HIV positive pregnant women in developing countries. Moving forward from this one limited example, the book includes several additional controversial cases of clinical research conducted in developing countries, and asks probing philosophical questions about the ethics of such trials. All clinical research by its very nature uses people to acquire generalizable knowledge to help future people. But what sorts of (...)
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  7.  22
    The Ethics of COVID-19 Immunity-Based Licenses (“Immunity Passports”).Govind Persad & Ezekiel J. Emanuel - 2020 - Journal of the American Medical Association:doi:10.1001/jama.2020.8102.
    Certifications of immunity are sometimes called “immunity passports” but are better conceptualized as immunity-based licenses. Such policies raise important questions about fairness, stigma, and counterproductive incentives but could also further individual freedom and improve public health. Immunity licenses should not be evaluated against a baseline of normalcy, ie, uninfected free movement. Rather, they should be compared to the alternatives of enforcing strict public health restrictions for many months or permitting activities that could spread infection, both of which exacerbate inequalities and (...)
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  8. The Case for Resource Sensitivity: Why It Is Ethical to Provide Cheaper, Less Effective Treatments in Global Health.Govind C. Persad & Ezekiel J. Emanuel - 2017 - Hastings Center Report 47 (5):17-24.
    We consider an ethical dilemma in global health: is it ethically acceptable to provide some patients cheaper treatments that are less effective or more toxic than the treatments other patients receive? We argue that it is ethical to consider local resource constraints when deciding what interventions to provide. The provision of cheaper, less effective health care is frequently the most effective way of promoting health and realizing the ethical values of utility, equality, and priority to the worst off.
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  9.  45
    Ending Concerns About Undue Inducement.Ezekiel J. Emanuel - 2004 - Journal of Law, Medicine and Ethics 32 (1):100-105.
  10.  29
    An Ethical Framework for Biomedical Research.Ezekiel J. Emanuel, David Wendler & C. Grady - 2008 - In The Oxford Textbook of Clinical Research Ethics. Oxford University Press. pp. 123--135.
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  11.  14
    Ending Concerns About Undue Inducement.Ezekiel J. Emanuel - 2004 - Journal of Law, Medicine and Ethics 32 (1):100-105.
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  12. The Current State of Medical School Education in Bioethics, Health Law, and Health Economics.Govind C. Persad, Linden Elder, Laura Sedig, Leonardo Flores & Ezekiel J. Emanuel - 2008 - Journal of Law, Medicine and Ethics 36 (1):89-94.
    Current challenges in medical practice, research, and administration demand physicians who are familiar with bioethics, health law, and health economics. Curriculum directors at American Association of Medical Colleges-affiliated medical schools were sent confidential surveys requesting the number of required hours of the above subjects and the years in which they were taught, as well as instructor names. The number of relevant publications since 1990 for each named instructor was assessed by a PubMed search.In sum, teaching in all three subjects combined (...)
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  13. Ethical and Regulatory Aspects of Clinical Research: Readings and Commentary.Ezekiel J. Emanuel (ed.) - 2003 - Johns Hopkins University Press.
    All investigators funded by the National Institutes of Health are now required to receive training about the ethics of clinical research. Based on a course taught by the editors at NIH, Ethical and Regulatory Aspects of Clinical Research is the first book designed to help investigators meet this new requirement. The book begins with the history of human subjects research and guidelines instituted since World War II. It then covers various stages and components of the clinical trial process: designing the (...)
     
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  14. Clinical Research: Should Patients Pay to Play?Ezekiel J. Emanuel, Steven Joffe, Christine Grady, David Wendler & Govind Persad - 2015 - Science Translational Medicine 7 (298):298ps16.
    We argue that charging people to participate in research is likely to undermine the fundamental ethical bases of clinical research, especially the principles of social value, scientific validity, and fair subject selection.
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  15.  24
    Money and Distorted Ethical Judgments About Research: Ethical Assessment of the TeGenero TGN1412 Trial. [REVIEW]Ezekiel J. Emanuel & Franklin G. Miller - 2007 - American Journal of Bioethics 7 (2):76-81.
    The recent TeGenero phase I trial of a novel monoclonal antibody in healthy volunteers produced a drastic inflammatory reaction in participants receiving the experimental agent. Commentators on the ethics of the research have focused considerable attention on the role of financial considerations: the for-profit status of the biotechnology company and Contract Research Organization responsible respectively for sponsoring and conducting the trial and the amount of monetary compensation to participants. We argue that these financial considerations are largely irrelevant and distort ethical (...)
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  16. The Ethics of Research on Enhancement Interventions.Lev Ori, G. Miller Franklin & J. Emanuel Ezekiel - 2010 - Kennedy Institute of Ethics Journal 20 (2):101-113.
    Traditionally, biomedical research has been devoted to improvement in the understanding and treatment or prevention of disease. Building on the knowledge generated by the long history of disease-oriented research, the next few decades will witness an explosion of biomedical enhancements to make people faster, stronger, smarter, less forgetful, happier, prettier, and live longer (Turner et al. 2003; Vastag 2004; Rose 2002). As with other biomedical interventions, research to assess the safety and efficacy of these enhancements in humans should be conducted (...)
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  17. What is the Great Benefit of Legalizing Euthanasia or Physican‐Assisted Suicide?Ezekiel J. Emanuel - 1999 - Ethics 109 (3):629-642.
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  18. The Ethics of Expanding Access to Cheaper, Less Effective Treatments.Govind C. Persad & Ezekiel J. Emanuel - 2016 - The Lancet:S0140-6736(15)01025-9.
    This article examines a fundamental question of justice in global health. Is it ethically preferable to provide a larger number of people with cheaper treatments that are less effective (or more toxic), or to restrict treatments to a smaller group to provide a more expensive but more effective or less toxic alternative? We argue that choosing to provide less effective or more toxic interventions to a larger number of people is favored by the principles of utility, equality, and priority for (...)
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  19.  39
    The Ends of Human Life: Medical Ethics in a Liberal Polity.Ezekiel J. Emanuel - 1991 - Harvard University Press.
    INTRODUCTION The Questions of Medical Ethics Call him Andrew. His face is gaunt and unshaven but peaceful. His eyelids are gently closed. ...
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  20.  44
    Four Paradigms of Clinical Research and Research Oversight.Ezekiel J. Emanuel & Christine Grady - 2007 - Cambridge Quarterly of Healthcare Ethics 16 (1):82-96.
    The understanding of appropriate ethical protections for participants of biomedical research has not been static. It has evolved over time, with the evolution of biomedical research as well as social values. Since World War II, there have been four major paradigms of research and research oversight operative in the United States. These paradigms incorporate different values and provide different approaches to research oversight and the protection of research participants.
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  21.  9
    Clarifying Confusions About Coercion.Jennifer S. Hawkins & Ezekiel J. Emanuel - 2005 - Hastings Center Report 35 (5):16.
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  22.  84
    Clarifying Confusions About Coercion.Jennifer Susan Hawkins & Ezekiel J. Emanuel - 2005 - Hastings Center Report 35 (5):16-19.
    Commentators often claim that medical research subjects are coerced into participating in clinical studies. In recent years, such claims have appeared especially frequently in ethical discussions of research in developing countries. Medical research ethics is more important than ever as we move into the 21st century because worldwide the pharmaceutical industry has grown so much and shows no sign of slowing its growth. This means that more people are involved in medical research today than ever before, and in the future (...)
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  23.  31
    Protecting Communities in Research: Current Guidelines and Limits of Extrapolation.Charles Weijer, Gary Goldsand & Ezekiel J. Emanuel - unknown
    As genetic research increasingly focuses on communities, there have been calls for extending research protections to them. We critically examine guidelines developed to protect aboriginal communities and consider their applicability to other communities. These guidelines are based on a model of researcher-community partnership and span the phases of a research project, from protocol development to publication. The complete list of 23 protections may apply to those few non-aboriginal communities, such as the Amish, that are highly cohesive. Although some protections may (...)
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  24.  4
    Key Ethical Concepts and Their Application to COVID-19 Research.Angus Dawson, Ezekiel J. Emanuel, Michael Parker, Maxwell J. Smith & Teck Chuan Voo - forthcoming - Public Health Ethics:phaa017.
    During the WHO-GloPID COVID-19 Global Research and Innovation Forum meeting held in Geneva on the 11th and 12th of February 2020 a number of different ethical concepts were used. This paper briefly states what a number of these concepts mean and how they might be applied to discussions about research during the COVID-19 pandemic and related outbreaks. This paper does not seek to be exhaustive and other ethical concepts are, of course, relevant and important.
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  25. Standing by Our Principles: Meaningful Guidance, Moral Foundations, and Multi-Principle Methodology in Medical Scarcity.Govind C. Persad, Alan Wertheimer & Ezekiel J. Emanuel - 2010 - American Journal of Bioethics 10 (4):46 – 48.
    In this short response to Kerstein and Bognar, we clarify three aspects of the complete lives system, which we propose as a system of allocating scarce medical interventions. We argue that the complete lives system provides meaningful guidance even though it does not provide an algorithm. We also defend the investment modification to the complete lives system, which prioritizes adolescents and older children over younger children; argue that sickest-first allocation remains flawed when scarcity is absolute and ongoing; and argue that (...)
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  26.  89
    The Problem with Single-Payer Plans.Ezekiel J. Emanuel - 2008 - Hastings Center Report 38 (1):38-41.
  27.  28
    Justice and Managed Care: Four Principles for the Just Allocation of Health Care Resources.Ezekiel J. Emanuel - 2000 - Hastings Center Report 30 (3):8-16.
    The debate about justice and health care has occurred largely at a remove from the institutions it concerns; it has been about our most general moral principles, and about what things we value. This debate has foundered. But if the debate is turned in another direction, toward some moral principles that are widely accepted within those institutions, and toward principles that have to do with control over allocation decisions rather than with actually how to make those decisions, agreement may be (...)
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  28. The Concept of Conflicts of Interest.Ezekiel J. Emanuel & Dennis F. Thompson - 2008 - In The Oxford Textbook of Clinical Research Ethics. Oxford University Press. pp. 758--766.
     
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  29.  89
    Improving Access to Health Care: A Consensus Ethical Framework to Guide Proposals for Reform.Mark A. Levine, Matthew K. Wynia, Paul M. Schyve, J. Russell Teagarden, David A. Fleming, Sharon King Donohue, Ron J. Anderson, James Sabin & Ezekiel J. Emanuel - 2007 - Hastings Center Report 37 (5):14-19.
  30. Dilemmas in Access to Medicines: A Humanitarian Perspective – Authors' Reply.Ezekiel J. Emanuel & Govind Persad - 2017 - Lancet 387 (10073):1008-1009.
    Our Viewpoint argues that expanding access to less effective or more toxic treatments is supported not only by utilitarian ethical reasoning but also by two other ethical frameworks: those that emphasise equality and those that emphasise giving priority to the patients who are worst off. The inadequate resources available for global health reflect not only natural constraints but also unwise social and political choices. However, pitting efforts to reduce inequality and better fund global health against efforts to put available resources (...)
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  31. 10. Uma Narayan, Dislocating Cultures: Identities, Traditions, and Third World Feminism Uma Narayan, Dislocating Cultures: Identities, Traditions, and Third World Feminism (Pp. 668-671). [REVIEW]Judith Jarvis Thomson, Dan W. Brock, Paul J. Weithman, Gerald Dworkin, F. M. Kamm, J. David Velleman & Ezekiel J. Emanuel - 1999 - Ethics 109 (3).
  32.  18
    The Quality of Informed Consent in a Clinical Research Study in Thailand.Christine Pace, Ezekiel J. Emanuel, Theshinee Chuenyam, Chris Duncombe, Judith D. Bebchuk, David Wendler, Jorge A. Tavel, Laura A. McNay, Praphan Phanuphak & Heidi P. Forster - 2004 - IRB: Ethics & Human Research 27 (1):9-17.
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  33.  31
    Research Benefits for Hypothetical HIV Vaccine Trials: The Views of Ugandans in the Rakai District.Christine Grady, Jennifer Wagman, Robert Ssekubugu, Maria J. Wawer, David Serwadda, Mohammed Kiddugavu, Fred Nalugoda, Ronald H. Gray, David Wendler, Qian Dong, Dennis O. Dixon, Bryan Townsend, Elizabeth Wahl & Ezekiel J. Emanuel - 2008 - IRB: Ethics & Human Research 30 (2):1.
    Controversy persists over the ethics of compensating research participants and providing posttrial benefits to communities in developing countries. Little is known about residents' views on these subjects. In this study, interviews about compensation and posttrial benefits from a hypothetical HIV vaccine trial were conducted in Uganda’s Rakai District. Most respondents said researchers owed the community posttrial benefits and research compensation, but opinions differed as to what these should be. Debates about posttrial benefits and compensation rarely include residents' views like these, (...)
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  34.  65
    Tiers Without Tears: The Ethics of a Two-Tiered Health Care System.Benjamin J. Krohmal & Ezekiel J. Emanuel - 2009 - In Bonnie Steinbock (ed.), The Oxford Handbook of Bioethics. Oxford University Press.
    American health care reformers face a number of ethical issues, including familiar debates over the merits of a single-payer system and publicly provided universal health insurance. No matter how these debates are resolved, a further ethical question must be addressed. Both universal coverage and a single-payer system are compatible with permitting some patients to pay more for faster, better, or more health care choices. Should the United States continue to have a two-tier health care system in which wealth grants some (...)
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  35.  45
    What Are Bioethicists.Ezekiel J. Emanuel - 2008 - Hastings Center Report 38 (2).
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  36.  12
    Informed Consent: Practices and Views of Investigators in a Multinational Clinical Trial.Lindsay Sabik, Christine A. Pace, Heidi P. Forster-Gertner, David Wendler, Judith D. Bebchuk, Jorge A. Tavel, Laura A. McNay, Jack Killen, Ezekiel J. Emanuel & Christine Grady - 2004 - IRB: Ethics & Human Research 27 (5):13-18.
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  37.  22
    Protecting Communities in Research: From a New Principle to Rational Protections.Ezekiel J. Emanuel & Charles Weijer - unknown
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  38.  24
    Conserving Scarce Resources: Willingness of Health Insurance Enrollees to Choose Cheaper Options.Samia A. Hurst, J. Russell Teagarden, Elizabeth Garrett & Ezekiel J. Emanuel - 2004 - Journal of Law, Medicine and Ethics 32 (3):496-499.
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  39.  8
    Medical Ethics in the Era of Managed Care: The Need for Institutional Structures Instead of Principles for Individual Cases.Ezekiel J. Emanuel - 1995 - Journal of Clinical Ethics 6 (4):335.
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  40.  8
    Filthy Lucre or Fitting Offer? Understanding Worries About Payments to Research Participants.Holly Fernandez Lynch, Ezekiel J. Emanuel & Emily A. Largent - 2019 - American Journal of Bioethics 19 (9):1-4.
    Volume 19, Issue 9, September 2019, Page 1-4.
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  41.  8
    Decisions at the End of Life Guided by Communities of Patients.Linda L. Emanuel & Ezekiel J. Emanuel - 1993 - Hastings Center Report 23 (5):6.
  42.  43
    Living Wills: Past, Present, and Future.Ezekiel J. Emanuel & Linda L. Emanuel - 1990 - Journal of Clinical Ethics 1 (1):9.
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  43.  13
    The Beinning of the End of Principlism.Ezekiel J. Emanuel - 1995 - Hastings Center Report 25 (4):37-38.
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  44.  15
    A Communal Vision of Care for Incompetent Patients.Ezekiel J. Emanuel - 1987 - Hastings Center Report 17 (5):15-20.
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  45.  7
    The Beginning of the End of PrinciplismPrinciples of Biomedical Ethics.Ezekiel J. Emanuel, Tom L. Beauchamp & James F. Childress - 1995 - Hastings Center Report 25 (4):37.
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  46.  39
    Empirical Studies on Euthanasia and Assisted Suicide.Ezekiel J. Emanuel - 1995 - Journal of Clinical Ethics 6 (2):158-160.
  47.  16
    Response to Commentators on “Undue Inducement: Nonsense on Stilts?”.Ezekiel J. Emanuel - 2005 - American Journal of Bioethics 5 (5):W8-W11.
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  48. The Evolving Norms of Medical Ethics.Ezekiel J. Emanuel - 2008 - In Ronald Michael Green, Aine Donovan & Steven A. Jauss (eds.), Global Bioethics: Issues of Conscience for the Twenty-First Century. Oxford University Press.
     
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  49.  30
    The Blossoming of Bioethics at NIH.Ezekiel J. Emanuel - 1998 - Kennedy Institute of Ethics Journal 8 (4):455-466.
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  50.  15
    Prescribing Our Future: Ethical Challenges in Genetic Counseling (Book).Ezekiel J. Emanuel - 1994 - Ethics and Behavior 4 (1):69 – 73.
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