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Joseph J. Fins [134]Joseph Jack Fins [1]
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Joseph Fins
Cornell University
  1.  20
    Recommendations for Responsible Development and Application of Neurotechnologies.Sara Goering, Eran Klein, Laura Specker Sullivan, Anna Wexler, Blaise Agüera Y. Arcas, Guoqiang Bi, Jose M. Carmena, Joseph J. Fins, Phoebe Friesen, Jack Gallant, Jane E. Huggins, Philipp Kellmeyer, Adam Marblestone, Christine Mitchell, Erik Parens, Michelle Pham, Alan Rubel, Norihiro Sadato, Mina Teicher, David Wasserman, Meredith Whittaker, Jonathan Wolpaw & Rafael Yuste - 2021 - Neuroethics 14 (3):365-386.
    Advancements in novel neurotechnologies, such as brain computer interfaces and neuromodulatory devices such as deep brain stimulators, will have profound implications for society and human rights. While these technologies are improving the diagnosis and treatment of mental and neurological diseases, they can also alter individual agency and estrange those using neurotechnologies from their sense of self, challenging basic notions of what it means to be human. As an international coalition of interdisciplinary scholars and practitioners, we examine these challenges and make (...)
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  2.  40
    The Effects of Closed-Loop Medical Devices on the Autonomy and Accountability of Persons and Systems.Philipp Kellmeyer, Thomas Cochrane, Oliver Müller, Christine Mitchell, Tonio Ball, Joseph J. Fins & Nikola Biller-Andorno - 2016 - Cambridge Quarterly of Healthcare Ethics 25 (4):623-633.
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  3.  44
    Quality Attestation for Clinical Ethics Consultants: A Two‐Step Model from the American Society for Bioethics and Humanities.Eric Kodish, Joseph J. Fins, Clarence Braddock, Felicia Cohn, Nancy Neveloff Dubler, Marion Danis, Arthur R. Derse, Robert A. Pearlman, Martin Smith, Anita Tarzian, Stuart Youngner & Mark G. Kuczewski - 2013 - Hastings Center Report 43 (5):26-36.
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  4. Disability Rights as a Necessary Framework for Crisis Standards of Care and the Future of Health Care.Laura Guidry-Grimes, Katie Savin, Joseph A. Stramondo, Joel Michael Reynolds, Marina Tsaplina, Teresa Blankmeyer Burke, Angela Ballantyne, Eva Feder Kittay, Devan Stahl, Jackie Leach Scully, Rosemarie Garland-Thomson, Anita Tarzian, Doron Dorfman & Joseph J. Fins - 2020 - Hastings Center Report 50 (3):28-32.
    In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both (...)
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  5.  41
    A Pilot Evaluation of Portfolios for Quality Attestation of Clinical Ethics Consultants.Joseph J. Fins, Eric Kodish, Felicia Cohn, Marion Danis, Arthur R. Derse, Nancy Neveloff Dubler, Barbara Goulden, Mark Kuczewski, Mary Beth Mercer, Robert A. Pearlman, Martin L. Smith, Anita Tarzian & Stuart J. Youngner - 2016 - American Journal of Bioethics 16 (3):15-24.
    Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step (...)
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  6.  16
    Mosaic Decisionmaking and Reemergent Agency after Severe Brain Injury.Joseph J. Fins - 2018 - Cambridge Quarterly of Healthcare Ethics 27 (1):163-174.
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  7.  72
    Clinical pragmatism: A method of moral problem solving.Joseph J. Fins, Matthew D. Bacchetta & Franklin G. Miller - 1997 - Kennedy Institute of Ethics Journal 7 (2):129-143.
    : This paper presents a method of moral problem solving in clinical practice that is inspired by the philosophy of John Dewey. This method, called "clinical pragmatism," integrates clinical and ethical decision making. Clinical pragmatism focuses on the interpersonal processes of assessment and consensus formation as well as the ethical analysis of relevant moral considerations. The steps in this method are delineated and then illustrated through a detailed case study. The implications of clinical pragmatism for the use of principles in (...)
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  8.  92
    Neuroimaging and disorders of consciousness: Envisioning an ethical research agenda.Joseph J. Fins, Judy Illes, James L. Bernat, Joy Hirsch, Steven Laureys & Emily Murphy - 2008 - American Journal of Bioethics 8 (9):3 – 12.
    The application of neuroimaging technology to the study of the injured brain has transformed how neuroscientists understand disorders of consciousness, such as the vegetative and minimally conscious states, and deepened our understanding of mechanisms of recovery. This scientific progress, and its potential clinical translation, provides an opportunity for ethical reflection. It was against this scientific backdrop that we convened a conference of leading investigators in neuroimaging, disorders of consciousness and neuroethics. Our goal was to develop an ethical frame to move (...)
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  9.  58
    Beyond Consent in Research.Emily Bell, Eric Racine, Paula Chiasson, Maya Dufourcq-Brana, Laura B. Dunn, Joseph J. Fins, Paul J. Ford, Walter Glannon, Nir Lipsman, Mary Ellen Macdonald, Debra J. H. Mathews & Mary Pat Mcandrews - 2014 - Cambridge Quarterly of Healthcare Ethics 23 (3):361-368.
    Vulnerability is an important criterion to assess the ethical justification of the inclusion of participants in research trials. Currently, vulnerability is often understood as an attribute inherent to a participant by nature of a diagnosed condition. Accordingly, a common ethical concern relates to the participant’s decisionmaking capacity and ability to provide free and informed consent. We propose an expanded view of vulnerability that moves beyond a focus on consent and the intrinsic attributes of participants. We offer specific suggestions for how (...)
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  10.  5
    Towards a Governance Framework for Brain Data.Marcello Ienca, Joseph J. Fins, Ralf J. Jox, Fabrice Jotterand, Silja Voeneky, Roberto Andorno, Tonio Ball, Claude Castelluccia, Ricardo Chavarriaga, Hervé Chneiweiss, Agata Ferretti, Orsolya Friedrich, Samia Hurst, Grischa Merkel, Fruzsina Molnár-Gábor, Jean-Marc Rickli, James Scheibner, Effy Vayena, Rafael Yuste & Philipp Kellmeyer - 2022 - Neuroethics 15 (2):1-14.
    The increasing availability of brain data within and outside the biomedical field, combined with the application of artificial intelligence (AI) to brain data analysis, poses a challenge for ethics and governance. We identify distinctive ethical implications of brain data acquisition and processing, and outline a multi-level governance framework. This framework is aimed at maximizing the benefits of facilitated brain data collection and further processing for science and medicine whilst minimizing risks and preventing harmful use. The framework consists of four primary (...)
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  11.  42
    A leg to stand on: Sir William Osler and Wilder penfield's "neuroethics".Joseph J. Fins - 2008 - American Journal of Bioethics 8 (1):37 – 46.
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  12.  13
    International Legal Approaches to Neurosurgery for Psychiatric Disorders.Jennifer A. Chandler, Laura Y. Cabrera, Paresh Doshi, Shirley Fecteau, Joseph J. Fins, Salvador Guinjoan, Clement Hamani, Karen Herrera-Ferrá, C. Michael Honey, Judy Illes, Brian H. Kopell, Nir Lipsman, Patrick J. McDonald, Helen S. Mayberg, Roland Nadler, Bart Nuttin, Albino J. Oliveira-Maia, Cristian Rangel, Raphael Ribeiro, Arleen Salles & Hemmings Wu - 2021 - Frontiers in Human Neuroscience 14.
    Neurosurgery for psychiatric disorders, also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This article reviews NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to (...)
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  13.  5
    Brain Organoids and Consciousness: Late Night Musings Inspired by Lewis Thomas.Joseph J. Fins - 2021 - Cambridge Quarterly of Healthcare Ethics 30 (4):557-560.
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  14.  13
    The Unintended Consequences of Chile’s Neurorights Constitutional Reform: Moving beyond Negative Rights to Capabilities.Joseph J. Fins - 2022 - Neuroethics 15 (3):1-11.
    As scholars envision a new regulatory or statutory neurorights schema it is important to imagine unintended consequences if reforms are implemented before their implications are fully understood. This paper critically evaluates provisions proposed for a new Chilean Constitution and evaluates this movement against efforts to improve the diagnosis of, and treatment for, individuals with disorders of consciousness within the broader context of disability law, international human rights, and a capabilities approach to health justice as advanced by Amartya Sen and Martha (...)
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  15.  24
    In the Blink of the Mind's Eye.Joseph J. Fins & Nicholas D. Schiff - 2010 - Hastings Center Report 40 (3):21-23.
  16.  24
    Clinical pragmatism: Bridging theory and practice.Joseph J. Fins, Franklin G. Miller & Matthew D. Bacchetta - 1998 - Kennedy Institute of Ethics Journal 8 (1):37-42.
    : This response to Lynn Jansen's critique of clinical pragmatism concentrates on two themes: (1) contrasting approaches to moral epistemology and (2) the connection between theory and practice in clinical ethics. Particular attention is paid to the status of principles and the role of consensus, with some closing speculations on how Dewey might view the current state of bioethics.
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  17.  17
    Deep Brain Stimulation as a Probative Biology: Scientific Inquiry and the Mosaic Device.Joseph J. Fins - 2012 - American Journal of Bioethics Neuroscience 3 (1):4-8.
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  18.  17
    The Therapeutic “Mis”conception: An Examination of its Normative Assumptions and a Call for its Revision.Debra J. H. Mathews, Joseph J. Fins & Eric Racine - 2018 - Cambridge Quarterly of Healthcare Ethics 27 (1):154-162.
    Dissecting Bioethics, edited by Tuija Takala and Matti Hayry, welcomes contributions on the conceptual and theoretical dimensions of bioethics. The department is dedicated to the idea that words defined by bioethicists and others should not be allowed to imprison people’s actual concerns, emotions, and thoughts. Papers that expose the many meanings of a concept, describe the different readings of a moral doctrine, or provide an alternative angle to seemingly self-evident issues are particularly appreciated. To submit a paper or to discuss (...)
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  19.  70
    Rethinking disorders of consciousness: New research and its implications.Joseph J. Fins - 2005 - Hastings Center Report 35 (2):22-24.
  20.  19
    Credentialing the clinical ethics consultant: an academic medical center affirms professionalism and practice.Cathleen A. Acres, Kenneth Prager, George E. Hardart & Joseph J. Fins - 2012 - Journal of Clinical Ethics 23 (2):156.
    In response to national trends calling for increasing accountability and an emerging dialogue within bioethics, we describe an effort to credential clinical ethicists at a major academic medical center. This effort is placed within the historical context of prior calls for credentialing and certification and efforts currently underway within organized bioethics to engage this issue. The specific details, and conceptual rationale, behind the New York-Presbyterian Hospital’s graduated credentialing plan are shared as is their evolution and ratification within the context of (...)
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  21.  61
    Neuroethics and neuroimaging: Moving toward transparency.Joseph J. Fins - 2008 - American Journal of Bioethics 8 (9):46 – 52.
    Without exaggeration, it could be said that we are entering a golden age of neuroscience. Informed by recent developments in neuroimaging that allow us to peer into the working brain at both a structural and functional level, neuroscientists are beginning to untangle mechanisms of recovery after brain injury and grapple with age-old questions about brain and mind and their correlates neural mechanisms and consciousness. Neuroimaging, coupled with new diagnostic categories and assessment scales are helping us develop a new diagnostic nosology (...)
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  22.  30
    Shades of Gray: New Insights into the Vegetative State.Joseph J. Fins & Nicholas D. Schiff - 2006 - Hastings Center Report 36 (6):8-8.
  23.  19
    Resuscitating Patient Rights during the Pandemic: COVID-19 and the Risk of Resurgent Paternalism.Joseph J. Fins - 2021 - Cambridge Quarterly of Healthcare Ethics 30 (2):215-221.
    The COVID-19 Pandemic a stress test for clinical medicine and medical ethics, with a confluence over questions of the proportionality of resuscitation. Drawing upon his experience as a clinical ethicist during the surge in New York City during the Spring of 2020, the author considers how attitudes regarding resuscitation have evolved since the inception of do-not-resuscitate orders decades ago. Sharing a personal narrative about a DNR quandry he encountered as a medical intern, the author considers the balance of patient rights (...)
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  24.  6
    How We Die.Joseph J. Fins & Sherwin B. Nuland - 1995 - Hastings Center Report 25 (2):38.
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  25.  18
    Conflicts of interest in deep brain stimulation research and the ethics of transparency.Joseph J. Fins & Nicholas D. Schiff - 2010 - Journal of Clinical Ethics 21 (2):125-132.
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  26.  5
    Dignity of Risk, Reemergent Agency, and the Central Thalamic Stimulation Trial for Moderate to Severe Brain Injury.Joseph J. Fins & Megan S. Wright - 2022 - Perspectives in Biology and Medicine 65 (2):307-315.
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  27.  45
    The Humanities and the Future of Bioethics Education.Joseph J. Fins - 2010 - Cambridge Quarterly of Healthcare Ethics 19 (4):518-521.
    Let’s face it, the humanities are in trouble. Last year, in The Chronicle of Higher Education, Thomas H. Benton warned prospective graduate students to avoid doctoral studies in the humanities. His rationale: a job market down 40%, the improbability of tenure, the more certain prospect of life as an adjunct, and eventual outright exile from one’s chosen field. Benton, the pen name of William Pannapacker, an associate professor of English at Hope College in Holland, Michigan, pulled no punches. His piece (...)
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  28.  67
    Islam and Informed Consent: Notes from Doha.Pablo Rodríguez Del Pozo & Joseph J. Fins - 2008 - Cambridge Quarterly of Healthcare Ethics 17 (3):273-279.
    Informed consent is a perennial topic in bioethics. It has given the field a place in clinical practice and the law and is often the starting point for introductory instruction in medical ethics. One would think that nearly everything has been said and done on this well-worn topic.
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  29.  9
    Rethinking Disorders of Consciousness: New Research and Its Implications.Joseph J. Fins - 2005 - Hastings Center Report 35 (2):22.
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  30.  15
    Minding Rights: Mapping Ethical and Legal Foundations of ‘Neurorights’.Sjors Ligthart, Marcello Ienca, Gerben Meynen, Fruzsina Molnar-Gabor, Roberto Andorno, Christoph Bublitz, Paul Catley, Lisa Claydon, Thomas Douglas, Nita Farahany, Joseph J. Fins, Sara Goering, Pim Haselager, Fabrice Jotterand, Andrea Lavazza, Allan McCay, Abel Wajnerman Paz, Stephen Rainey, Jesper Ryberg & Philipp Kellmeyer - forthcoming - Cambridge Quarterly of Healthcare Ethics:1-21.
    The rise of neurotechnologies, especially in combination with artificial intelligence (AI)-based methods for brain data analytics, has given rise to concerns around the protection of mental privacy, mental integrity and cognitive liberty – often framed as “neurorights” in ethical, legal, and policy discussions. Several states are now looking at including neurorights into their constitutional legal frameworks, and international institutions and organizations, such as UNESCO and the Council of Europe, are taking an active interest in developing international policy and governance guidelines (...)
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  31. Clinical pragmatism and the care of brain damaged patients: Towards a palliative neuroethics for disorders of consciousness.Joseph J. Fins - 2006 - In Steven Laureys (ed.), Boundaries of Consciousness. Elsevier.
  32.  20
    My Time in Medicine.Joseph J. Fins - 2017 - Perspectives in Biology and Medicine 60 (1):19-32.
    Autobiographical essays can be an indulgence. Often self-congratulatory and low on self-reflection, they seldom serve a purpose other than to stoke nostalgia. So when given this opportunity to write about my life in medicine and bioethics, I decided I would take stock, and not simply celebrate whatever accomplishments I might have had. Rather, I would use this opportunity to look for themes that linked the decades together. My hope was that the process might assemble the mosaic that has been my (...)
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  33.  18
    Whither the “Improvement Standard”? Coverage for Severe Brain Injury after Jimmo v. Sebelius.Joseph J. Fins, Megan S. Wright, Claudia Kraft, Alix Rogers, Marina B. Romani, Samantha Godwin & Michael R. Ulrich - 2016 - Journal of Law, Medicine and Ethics 44 (1):182-193.
    As improvements in neuroscience have enabled a better understanding of disorders of consciousness as well as methods to treat them, a hurdle that has become all too prevalent is the denial of coverage for treatment and rehabilitation services. In 2011, a settlement emerged from a Vermont District Court case, Jimmo v. Sebelius, which was brought to stop the use of an “improvement standard” that required tangible progress over an identifiable period of time for Medicare coverage of services. While the use (...)
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  34.  74
    Late recovery from the minimally conscious state: Ethical and policy implications.Joseph J. Fins, Nicholas D. Schiff & Kathleen M. Foley - 2007 - Neurology 68 (4):304-307.
  35.  30
    Engineering Medical Decisions.Meredith Stark & Joseph J. Fins - 2013 - Cambridge Quarterly of Healthcare Ethics 22 (4):373-381.
  36.  3
    Ethics Consultation in Surgical Specialties.Nicole A. Meredyth, Joseph J. Fins & Inmaculada de Melo-Martin - 2021 - HEC Forum 34 (1):89-102.
    Multiple studies have been performed to identify the most common ethical dilemmas encountered by ethics consultation services. However, limited data exists comparing the content of ethics consultations requested by specific hospital specialties. It remains unclear whether the scope of ethical dilemmas prompting an ethics consultation differ between specialties and if there are types of ethics consultations that are more or less frequently called based on the specialty initiating the ethics consult. This study retrospectively assessed the incidence and content of ethics (...)
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  37.  5
    Mosaic Decisionmaking and Severe Brain Injury: Adding Another Piece to the Argument.Joseph J. Fins - 2019 - Cambridge Quarterly of Healthcare Ethics 28 (4):737-743.
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  38.  13
    Off the Charts: Medical documentation and selective redaction in the age of transparency.Matthew William McCarthy, Diego Real de Asua, Ezra Gabbay & Joseph J. Fins - 2018 - Perspectives in Biology and Medicine 61 (1):118-129.
    A 47-year-old woman with a history of anxiety disorder is admitted to the hospital for shortness of breath. On the third day of hospitalization, she asks her physician for a copy of all documents pertaining to her care. What expectation should she have for full disclosure? Are there limits on her access to her medical records and do her physician's concerns about professional privilege matter?The virtues of transparency in medicine have been well described. As proponents of transparency, we favor patient (...)
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  39.  11
    Pragmatic Convergence and the Epistemology of an Adolescent Neuroethics.Joseph J. Fins & Judy Illes - 2018 - Cambridge Quarterly of Healthcare Ethics 27 (4):554-557.
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  40.  35
    The Patient's Work.Leonard C. Groopman, Franklin G. Miller & Joseph J. Fins - 2007 - Cambridge Quarterly of Healthcare Ethics 16 (1):44-52.
    In The Healer's Power, Howard Brody placed the concept of power at the heart of medicine's moral discourse. Struck by the absence of “power” in the prevailing vocabulary of medical ethics, yet aware of peripheral allusions to power in the writings of some medical ethicists, he intuited the importance of power from the silence surrounding it. He formulated the problem of the healer's power and its responsible use as “the central ethical problem in medicine.” Through the prism of power he (...)
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  41.  21
    “Humanities are the Hormones:” Osler, Penfield and “Neuroethics” Revisited.Joseph J. Fins - 2008 - American Journal of Bioethics 8 (1):5-8.
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  42.  61
    Neurological diagnosis is more than a state of mind: Diagnostic clarity and impaired consciousness.Joseph J. Fins & F. Plum - 2004 - Archives of Neurology 61 (9):1354-1355.
  43.  7
    Pandemics, Protocols, and the Plague of Athens: Insights from Thucydides.Joseph J. Fins - 2020 - Hastings Center Report 50 (3):50-53.
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  44.  13
    Guardianship and Clinical Research Participation: The Case of Wards with Disorders of Consciousness.Megan S. Wright, Michael R. Ulrich & Joseph J. Fins - 2017 - Kennedy Institute of Ethics Journal 27 (1):43-70.
    Incapacitated adults with a legally appointed guardian or conservator may be recruited for or involved with medical, behavioral, or social science research. Much of the research in which such persons participate is aimed at evaluating medical interventions for them, or contributing to general knowledge about disorders from which they may suffer. In this paper we will consider how the appointment of guardians for patients with disorders of consciousness —severe brain injuries that affect a patient’s level of arousal and ability to (...)
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  45. Deep brain stimulation.Joseph J. Fins & S. G. Post - 2004 - Encyclopedia of Bioethics 2:629-634.
     
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  46.  24
    The economics of clinical ethics programs: a quantitative justification.Matthew D. Bacchetta & Joseph J. Fins - 1997 - Cambridge Quarterly of Healthcare Ethics 6 (4):451-.
    The restructuring of the healthcare marketplace has exerted pressure directly and indirectly on clinical ethics programs. The fiscal orientation and emphasis on efficiency, outcome measures, and cost control have made it increasingly difficult to communicate arguments in support of the existence or growth of ethics programs. In the current marketplace, arguments that rely on the claim that ethics programs protect patient rights or assist in the professional formation of practitioners often result in minimal levels of funding and preclude program growth. (...)
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  47.  25
    Reinvigorating ethics consultations: An impetus from the “quality” debate. [REVIEW]Elizabeth G. Nilson & Joseph J. Fins - 2006 - HEC Forum 18 (4):298-304.
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  48.  13
    When No One Notices: Disorders of Consciousness and the Chronic Vegetative State.Joseph J. Fins - 2019 - Hastings Center Report 49 (4):14-17.
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  49.  12
    Inching Toward Health Decision Exceptionalism.Meredith Stark & Joseph J. Fins - 2013 - American Journal of Bioethics 13 (5):18-19.
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  50.  37
    The Ethical Imperative to Think about Thinking.Meredith Stark & Joseph J. Fins - 2014 - Cambridge Quarterly of Healthcare Ethics 23 (4):386-396.
    While the medical ethics literature has well explored the harm to patients, families, and the integrity of the profession in failing to disclose medical errors once they occur, less often addressed are the moral and professional obligations to take all available steps to prevent errors and harm in the first instance. As an expanding body of scholarship further elucidates the causes of medical error, including the considerable extent to which medical errors, particularly in diagnostics, may be attributable to cognitive sources, (...)
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