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Govind Persad [36]Govind C. Persad [6]
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Govind Persad
University of Denver
  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.  37
    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. Considering Quality of Life While Repudiating Disability Injustice: A Pathways Approach to Setting Priorities.Govind Persad - 2019 - Journal of Law, Medicine and Ethics 47 (2):294-303.
    This article proposes a novel strategy, one that draws on insights from antidiscrimination law, for addressing a persistent challenge in medical ethics and the philosophy of disability: whether health systems can consider quality of life without unjustly discriminating against individuals with disabilities. It argues that rather than uniformly considering or ignoring quality of life, health systems should take a more nuanced approach. Under the article's proposal, health systems should treat cases where quality of life suffers because of disability-focused exclusion or (...)
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  4.  57
    The Case for Valuing Non-Health and Indirect Benefits.Govind Persad & Jessica du Toit - 2020 - In Ole F. Norheim, Ezekiel J. Emanuel & Joseph Millum (eds.), Global Health Priority-Setting: Beyond Cost-Effectiveness. New York, NY, USA: pp. 207-222.
    Health policy is only one part of social policy. Although spending administered by the health sector constitutes a sizeable fraction of total state spending in most countries, other sectors such as education and transportation also represent major portions of national budgets. Additionally, though health is one important aspect of economic and social activity, people pursue many other goals in their social and economic lives. Similarly, direct benefits—those that are immediate results of health policy choices—are only a small portion of the (...)
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  5. Will More Organs Save More Lives? Cost‐Effectiveness and the Ethics of Expanding Organ Procurement.Govind Persad - 2019 - Bioethics 33 (6):684-690.
    The assumption that procuring more organs will save more lives has inspired increasingly forceful calls to increase organ procurement. This project, in contrast, directly questions the premise that more organ transplantation means more lives saved. Its argument begins with the fact that resources are limited and medical procedures have opportunity costs. Because many other lifesaving interventions are more cost‐effective than transplantation and compete with transplantation for a limited budget, spending on organ transplantation consumes resources that could have been used to (...)
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  6. The Tarasoff Rule: The Implications of Interstate Variation and Gaps in Professional Training.Rebecca Johnson, Govind Persad & Dominic Sisti - 2014 - Journal of the American Academy of Psychiatry and the Law Online 42 (4):469-477.
    Recent events have revived questions about the circumstances that ought to trigger therapists' duty to warn or protect. There is extensive interstate variation in duty to warn or protect statutes enacted and rulings made in the wake of the California Tarasoff ruling. These duties may be codified in legislative statutes, established in common law through court rulings, or remain unspecified. Furthermore, the duty to warn or protect is not only variable between states but also has been dynamic across time. In (...)
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  7. Authority Without Identity: Defending Advance Directives Via Posthumous Rights Over One’s Body.Govind Persad - 2019 - Journal of Medical Ethics 45 (4):249-256.
    This paper takes a novel approach to the active bioethical debate over whether advance medical directives have moral authority in dementia cases. Many have assumed that advance directives would lack moral authority if dementia truly produced a complete discontinuity in personal identity, such that the predementia individual is a separate individual from the postdementia individual. I argue that even if dementia were to undermine personal identity, the continuity of the body and the predementia individual’s rights over that body can support (...)
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  8.  55
    Cost-Effectiveness in Animal Health: An Ethical Analysis.Govind Persad - 2019 - In Bob Fischer (ed.), Routledge Handbook of Animal Ethics. New York: Routledge.
    -/- This chapter evaluates the ethical issues that using cost-effectiveness considerations to set animal health priorities might present, and its conclusions are cautiously optimistic. While using cost-effectiveness calculations in animal health is not without ethical pitfalls, these calculations offer a pathway toward more rigorous priority-setting efforts that allow money spent on animal well-being to do more good. Although assessing quality of life for animals may be more challenging than in humans, implementing prioritization based on cost-effectiveness is less ethically fraught.
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  9. Justice and Public Health.Govind Persad - 2019 - In Anna Mastroianni, Jeff Kahn & Nancy Kass (eds.), Oxford Handbook of Public Health Ethics. New York, NY, USA: pp. ch. 4.
    This chapter discusses how justice applies to public health. It begins by outlining three different metrics employed in discussions of justice: resources, capabilities, and welfare. It then discusses different accounts of justice in distribution, reviewing utilitarianism, egalitarianism, prioritarianism, and sufficientarianism, as well as desert-based theories, and applies these distributive approaches to public health examples. Next, it examines the interplay between distributive justice and individual rights, such as religious rights, property rights, and rights against discrimination, by discussing examples such as mandatory (...)
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  10. Downward Mobility and Rawlsian Justice.Govind Persad - 2018 - Philosophical Studies 175 (2):277-300.
    Technological and societal changes have made downward social and economic mobility a pressing issue in real-world politics. This article argues that a Rawlsian society would not provide any special protection against downward mobility, and would act rightly in declining to provide such protection. Special treatment for the downwardly mobile can be grounded neither in Rawls’s core principles—the basic liberties, fair equality of opportunity, and the difference principle—nor in other aspects of Rawls’s theory. Instead, a Rawlsian society is willing to sacrifice (...)
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  11. 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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  12.  14
    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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  13. Public Preferences About Fairness and the Ethics of Allocating Scarce Medical Interventions.Govind Persad - 2017 - In Meng Li & David Tracer (eds.), Interdisciplinary Perspectives on Fairness, Equity, and Justice. pp. 51-65.
    This chapter examines how social- scientific research on public preferences bears on the ethical question of how those resources should in fact be allocated, and explain how social-scientific researchers might find an understanding of work in ethics useful as they design mechanisms for data collection and analysis. I proceed by first distinguishing the methodologies of social science and ethics. I then provide an overview of different approaches to the ethics of allocating scarce medical interventions, including an approach—the complete lives system—which (...)
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  14. Are Physicians Willing to Ration Health Care? Conflicting Findings in a Systematic Review of Survey Research.Daniel Strech, Govind Persad, Georg Marckmann & Marion Danis - 2009 - Health Policy 90 (2):113-124.
    Several quantitative surveys have been conducted internationally to gather empirical information about physicians’ general attitudes towards health care rationing. Are physicians ready to accept and implement rationing, or are they rather reluctant? Do they prefer implicit bedside rationing that allows the physician–patient relationship broad leeway in individual decisions? Or do physicians prefer strategies that apply explicit criteria and rules?
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  15. 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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  16. Transparency Trade-Offs: Priority Setting, Scarcity, and Health Fairness.Govind Persad - 2019 - In I. Glenn Cohen, Barbara Evans, Holly Lynch & Carmel Shachar (eds.), Transparency in Health and Health Care. New York: Cambridge UP.
    This chapter argues that rather than viewing transparency as a right, we should regard it as a finite resource whose allocation involves tradeoffs. It then argues that those tradeoffs should be resolved by using a multi-principle approach to distributive justice. The relevant principles include maximizing welfare, maximizing autonomy, and giving priority to the worst off. Finally, it examines some of the implications for law of recognizing the tradeoffs presented by transparency proposals.
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  17. When, and How, Should Cognitive Bias Matter to Law.Govind Persad - 2014 - Law and Ineq 32:31.
    Recent work in the behavioral sciences asserts that we are subject to a variety of cognitive biases. For example, we mourn losses more than we prize equivalently sized gains; we are more inclined to believe something if it matches our previous beliefs; and we even relate more warmly or coldly to others depending on whether the coffee cup we are holding is warm or cold. Drawing on this work, case law and legal scholarship have asserted that we have reason to (...)
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  18. 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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  19.  84
    Sufficiency, Comprehensiveness of Health Care Coverage, and Cost-Sharing Arrangements in the Realpolitik of Health Policy.Govind Persad & Harald Schmidt - 2016 - In Carina Fourie & Annette Rid (eds.), What is Enough?: Sufficiency, Justice, and Health. New York: Oxford University Press. pp. 267-280.
    This chapter explores two questions in detail: How should we determine the threshold for costs that individuals are asked to bear through insurance premiums or care-related out-of-pocket costs, including user fees and copayments? and What is an adequate relationship between costs and benefits? This chapter argues that preventing impoverishment is a morally more urgent priority than protecting households against income fluctuations, and that many health insurance plans may not adequately protect individuals from health care costs that threaten to drop their (...)
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  20. Distributive Justice and the Relief of Household Debt.Govind Persad - 2018 - Journal of Political Philosophy 26 (3):327-343.
    Household debt has been widely discussed among social scientists, policy makers, and activists. Many have questioned the levels of debt households are required to take on, and have made various proposals for assisting households in debt. Yet theorists of distributive justice have left household debt underexamined. This article offers a normative examination of the distributive justice issues presented by proposals to relieve household debt or protect households from overindebtedness. I examine two goals at which debt relief proposals aim: remedying disadvantage (...)
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  21. Misuse Made Plain: Evaluating Concerns About Neuroscience in National Security.Kelly Lowenberg, Brenda M. Simon, Amy Burns, Libby Greismann, Jennifer M. Halbleib, Govind Persad, David L. M. Preston, Harker Rhodes & Emily R. Murphy - 2010 - American Journal of Bioethics Neuroscience 1 (2):15-17.
    In this open peer commentary, we categorize the possible “neuroscience in national security” definitions of misuse of science and identify which, if any, are uniquely presented by advances in neuroscience. To define misuse, we first define what we would consider appropriate use: the application of reasonably safe and effective technology, based on valid and reliable scientific research, to serve a legitimate end. This definition presents distinct opportunities for assessing misuse: misuse is the application of invalid or unreliable science, or is (...)
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  22. 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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  23. Should Research Ethics Encourage the Production of Cost-Effective Interventions?Govind Persad - 2016 - In Daniel Strech & Marcel Mertz (eds.), Ethics and Governance of Biomedical Research: Theory and Practice. Springer. pp. 13-28.
    This project considers whether and how research ethics can contribute to the provision of cost-effective medical interventions. Clinical research ethics represents an underexplored context for the promotion of cost-effectiveness. In particular, although scholars have recently argued that research on less-expensive, less-effective interventions can be ethical, there has been little or no discussion of whether ethical considerations justify curtailing research on more expensive, more effective interventions. Yet considering cost-effectiveness at the research stage can help ensure that scarce resources such as tissue (...)
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  24. Libertarian Patriarchalism: Nudges, Procedural Roadblocks, and Reproductive Choice.Govind Persad - 2014 - Women’s Rights L. Rep 35:273--466.
    Cass Sunstein and Richard Thaler's proposal that social and legal institutions should steer individuals toward some options and away from others-a stance they dub "libertarian paternalism"-has provoked much high-level discussion in both academic and policy settings. Sunstein and Thaler believe that steering, or "nudging," individuals is easier to justify than the bans or mandates that traditional paternalism involves. -/- This Article considers the connection between libertarian paternalism and the regulation of reproductive choice. I first discuss the use of nudges to (...)
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  25.  15
    Differential Payments to Research Participants in the Same Study: An Ethical Analysis.Govind Persad, Holly Fernandez Lynch & Emily Largent - 2019 - Journal of Medical Ethics 1:10.1136/medethics-2018-105140.
    Recognizing that offers of payment to research participants can serve various purposes—reimbursement, compensation, and incentive—helps uncover differences between participants that can justify differential payment of participants within the same study. Participants with different study-related expenses will need different amounts of reimbursement to be restored to their pre-participation financial baseline. Differential compensation can be acceptable when some research participants commit more time or assume greater burdens than others, or if inter-site differences affect the value of compensation. Finally, it may be permissible (...)
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  26. Risk, Everyday Intuitions, and the Institutional Value of Tort Law.Govind C. Persad - 2009 - Stan. L. Rev 62:1445.
    This Note offers a normative critique of cost-benefit analysis, one informed by deontological moral theory, in the context of the debate over whether tort litigation or a non-tort approach is the appropriate response to mass harm. The first Part argues that the difference between lay and expert intuitions about risk and harm often reflects a difference in normative judgments about the existing facts, rather than a difference in belief about what facts exist, which makes the lay intuitions more defensible. The (...)
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  27. Priority Setting, Cost-Effectiveness, and the Affordable Care Act.Govind Persad - 2015 - American Journal of Law and Medicine 41 (1):119-166.
    The Affordable Care Act (ACA) may be the most important health law statute in American history, yet much of the most prominent legal scholarship examining it has focused on the merits of the court challenges it has faced rather than delving into the details of its priority-setting provisions. In addition to providing an overview of the ACA’s provisions concerning priority setting and their developing interpretations, this Article attempts to defend three substantive propositions. First, I argue that the ACA is neither (...)
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  28.  6
    Differential Payment to Research Participants in the Same Study: An Ethical Analysis.Govind Persad, Holly Fernandez Lynch & Emily Largent - 2019 - Journal of Medical Ethics 45 (5):318-322.
    Recognising that offers of payment to research participants can serve various purposes—reimbursement, compensation and incentive—helps uncover differences between participants, which can justify differential payment of participants within the same study. Participants with different study-related expenses will need different amounts of reimbursement to be restored to their preparticipation financial baseline. Differential compensation can be acceptable when some research participants commit more time or assume greater burdens than others, or if inter-site differences affect the value of compensation. Finally, it may be permissible (...)
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  29. Democratic Deliberation and the Ethical Review of Human Subjects Research.Govind Persad - 2014 - In I. Glenn Cohen & Holly Fernandez Lynch (eds.), Human Subjects Research Regulation: Perspectives on the Future. MIT Press. pp. 157-72.
    In the United States, the Presidential Commission for the Study of Bioethical Issues has proposed deliberative democracy as an approach for dealing with ethical issues surrounding synthetic biology. Deliberative democracy might similarly help us as we update the regulation of human subjects research. This paper considers how the values that deliberative democratic engagement aims to realize can be realized in a human subjects research context. Deliberative democracy is characterized by an ongoing exchange of ideas between participants, and an effort to (...)
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  30. What Marriage Law Can Learn From Citizenship Law.Govind Persad - 2013 - Tul. Jl and Sexuality 22:103.
    Citizenship and marriage are legal statuses that generate numerous privileges and responsibilities. Legal doctrine and argument have analogized these statuses in passing: consider, for example, Ted Olson’s statement in the Hollingsworth v. Perry oral argument that denying the label “marriage” to gay unions “is like you were to say you can vote, you can travel, but you may not be a citizen.” However, the parallel between citizenship and marriage has rarely been investigated in depth. This paper investigates the marriage-citizenship parallel (...)
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  31. Equality Via Mobility: Why Socioeconomic Mobility Matters for Relational Equality, Distributive Equality, and Equality of Opportunity.Govind Persad - 2015 - Social Philosophy and Policy 31 (2):158-179.
    This essay examines the connection between socioeconomic mobility and equality, and argues for two conclusions. First, socioeconomic mobility is conceptually distinct from three common species of equality: (1) equality of opportunity, (2) equality of outcome, and (3) relational equality. Second, socioeconomic mobility is connected — in different ways — to each species of equality, and, if we value one or more of these species of equality, these connections endow mobility with derivative normative significance.
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  32. Expanding Deliberation in Critical-Care Policy Design.Govind C. Persad - 2016 - American Journal of Bioethics 16 (1):60-63.
    In this commentary, I suggest expanding the deliberative aspects of critical care policy development in two ways. First, critical-care policy development should expand the scope of deliberation by leaving fewer issues up to expertise or private choice. For instance. it should allow deliberation about the relevance of age, disability, social position, and psychological well-being to allocation decisions. Second, it should broaden both the set of costs considered and the set of stakeholders represented in the deliberative process. In particular, it should (...)
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  33. Offensive Defensive Medicine: The Ethics of Digoxin Injections in Response to the Partial Birth Abortion Ban.Colleen Denny, Govind Persad & Elena Gates - 2014 - Contraception 90 (3):304.
    Since the Supreme Court upheld the partial birth abortion ban in 2007, more U.S. abortion providers have begun performing intraamniotic digoxin injections prior to uterine dilation and evacuations. These injections can cause medical harm to abortion patients. Our objective is to perform an in-depth bioethical analysis of this procedure, which is performed mainly for the provider’s legal benefit despite potential medical consequences for the patient.
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  34. 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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  35. 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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  36.  9
    Are Medicaid Closed Formularies Unethical? Social Values and Limit-Setting.Leah Rand & Govind Persad - 2019 - AMA Journal of Ethics 21 (8):E654-E660.
    State Medicaid programs have proposed closed formularies to limit spending on drugs. Closed formularies can be justified when they enable spending on other socially valuable aims. However, it is still necessary to justify guidelines informing formulary design, which can be done through a process of decision making that includes the public. This article examines criticisms that Medicaid closed formularies limit deliberation about decisions that affect drug access and unfairly disadvantage poor patients. Although unfairness to poor patients is a risk, it (...)
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  37. On H. M. Oliver’s “Established Expectations and American Economic Policies”.Govind Persad - 2015 - Ethics 125 (3):829-832,.
    In this retrospective for Ethics, I discuss H.M. Oliver’s “Established Expectations and American Economic Policies.” This article, by a then-modestly-famous economist, has been ignored (no citations) since its 1940 publication. Yet it bears directly on a normative problem at the intersection of ethics and economics that challenges today’s policymakers but has received comparatively little philosophical attention: how should we balance potentially desirable institutional change against the disruption of established expectations? -/- Oliver details how the principle of fulfilling established expectations cuts (...)
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  38.  23
    Evaluating the Legality of Age-Based Criteria in Health Care: From Nondiscrimination and Discretion to Distributive Justice.Govind Persad - 2019 - Boston College Law Review 60 (3):889-949.
    Recent disputes over whether older people should pay more for health insurance, or receive lower priority for transplantable organs, highlight broader disagreements regarding the legality of using age-based criteria in health care. These debates will likely intensify given the changing age structure of the American population and the turmoil surrounding the financing of American health care. This Article provides a comprehensive examination of the legality and normative desirability of age-based criteria. I defend a distributive justice approach to age-based criteria and (...)
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  39.  7
    Examining Pharmaceutical Exceptionalism: Intellectual Property, Practical Expediency, and Global Health.Govind Persad - 2019 - Yale Journal of Health Policy, Law, and Ethics 18:157-90.
    Advocates, activists, and academics have criticized pharmaceutical intellectual property ("pharma IP") rights as obstacles to access to medicines for the global poor. These criticisms of pharma IP holders are frequently exceptionalist: they focus on pharma IP holders while ignoring whether others also bear obligations to assist patients in need. These others include holders of other lucrative IP rights, such as music copyrights or technology patents; firms, such as energy companies and banks, that do not rely on IP; and wealthy private (...)
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  40.  2
    Eliminating Categorical Exclusion Criteria in Crisis Standards of Care Frameworks.Catherine L. Auriemma, Ashli M. Molinero, Amy J. Houtrow, Govind Persad, Douglas B. White & Scott D. Halpern - forthcoming - American Journal of Bioethics:1-9.
    During public health crises including the COVID-19 pandemic, resource scarcity and contagion risks may require health systems to shift—to some degree—from a usual clinical ethic, focused on the wel...
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  41.  1
    Respecting Disability Rights — Toward Improved Crisis Standards of Care.Michelle M. Mello, Govind Persad & Douglas B. White - 2020 - New England Journal of Medicine:DOI: 10.1056/NEJMp2011997.
    We propose six guideposts that states and hospitals should follow to respect disability rights when designing policies for the allocation of scarce, lifesaving medical treatments. Four relate to criteria for decisions. First, do not use categorical exclusions, especially ones based on disability or diagnosis. Second, do not use perceived quality of life. Third, use hospital survival and near-term prognosis (e.g., death expected within a few years despite treatment) but not long-term life expectancy. Fourth, when patients who use ventilators in their (...)
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  42.  19
    What Is the Relevance of Procedural Fairness to Making Determinations About Medical Evidence?Govind Persad - 2017 - AMA Journal of Ethics 19 (2):183-191.
    Approaches relying on fair procedures rather than substantive principles have been proposed for answering dilemmas in medical ethics and health policy. These dilemmas generally involve two questions: the epistemological (factual) question of which benefits an intervention will have, and the ethical (value) question of how to distribute those benefits. This article focuses on the potential of fair procedures to help address epistemological and factual questions in medicine, using the debate over antidepressant efficacy as a test case. In doing so, it (...)
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