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Leonard M. Fleck [50]Leonard Michael Fleck [1]
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Leonard M. Fleck
Michigan State University
  1. Deliberative Democracy for Bioethics: Could the Web Help?Leonard M. Fleck - 2001 - Hastings Center Report 31 (4):7.
     
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  2.  33
    Whoopie Pies, Supersized Fries.Leonard M. Fleck - 2012 - Cambridge Quarterly of Healthcare Ethics 21 (1):5-19.
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  3. On Being Genetically "Irresponsible".Judith Andre, Leonard M. Fleck & Thomas Tomlinson - 2000 - Kennedy Institute of Ethics Journal 10 (2):129-146.
    : New genetic technologies continue to emerge that allow us to control the genetic endowment of future children. Increasingly the claim is made that it is morally "irresponsible" for parents to fail to use such technologies when they know their possible children are at risk for a serious genetic disorder. We believe such charges are often unwarranted. Our goal in this article is to offer a careful conceptual analysis of the language of irresponsibility in an effort to encourage more care (...)
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  4.  39
    Personalized Medicine's Ragged Edge.Leonard M. Fleck - 2010 - Hastings Center Report 40 (5):16-18.
    The phrase "personalized medicine" has a built-in positive spin. Simple genetic tests can sometimes predict whether a particular individual will have a positive response to a particular drug or, alternatively, suffer costly and debilitating side effects. But little attention has been given to some challenging issues of justice raised by personalized medicine. How should we determine who would have a just claim to access particular treatments, especially very expensive ones? How effective do those treatments need to be?If there were a (...)
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  5.  3
    Precision QALYs, Precisely Unjust.Leonard M. Fleck - 2019 - Cambridge Quarterly of Healthcare Ethics 28 (3):439-449.
    :Warwick Heale has recently defended the notion of individualized and personalized Quality-Adjusted Life Years in connection with health care resource allocation decisions. Ordinarily, QALYs are used to make allocation decisions at the population level. If a health care intervention costs £100,000 and generally yields only two years of survival, the cost per QALY gained will be £50,000, far in excess of the £30,000 limit per QALY judged an acceptable use of resources within the National Health Service in the United Kingdom. (...)
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  6.  28
    Just Caring: Oregon, Health Care Rationing, and Informed Democratic Deliberation.Leonard M. Fleck - 1994 - Journal of Medicine and Philosophy 19 (4):367-388.
    This essay argues that our national efforts at health reform ought to be informed by eleven key lessons from Oregon. Specifically, we must learn that the need for health care rationing is inescapable, that any rationing process must be public and visible, and that fair rationing protocols must be self-imposed through a process of rational democratic deliberation. Part I of this essay notes that rationing is a ubiquitous feature of our health care system at present, but it is mostly hidden (...)
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  7.  41
    Just Caring: In Defense of Limited Age-Based Healthcare Rationing.Leonard M. Fleck - 2010 - Cambridge Quarterly of Healthcare Ethics 19 (1):27.
    The debate around age-based healthcare rationing was precipitated by two books in the late 1980s, one by Daniel Callahan and the other by Norman Daniels. These books ignited a firestorm of criticism, best captured in the claim that any form of age-based healthcare rationing was fundamentally ageist, discriminatory in a morally objectionable sense. That is, the elderly had equal moral worth and an equal right to life as the nonelderly. If an elderly and nonelderly person each had essentially the same (...)
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  8.  30
    Just Caring: Health Reform and Health Care Rationing.Leonard M. Fleck - 1994 - Journal of Medicine and Philosophy 19 (5):435-443.
    Health reform must include health care rationing, both for reasons of fairness and efficiency. Few politicians are willing to accept this claim, including the Clinton Administration. Brown and others have argued that enormous waste and inefficiency must be wrung out of our health care system before morally problematic cost constraining options, such as rationing, can be justifiably adopted. However, I argue that most of the policies and practices that would diminish waste and inefficiency include implicit (and therefore morally problematic) rationing. (...)
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  9.  3
    First Come, First Served in the Intensive Care Unit: Always?Leonard M. Fleck & Timothy F. Murphy - 2018 - Cambridge Quarterly of Healthcare Ethics 27 (1):52-61.
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  10.  17
    Controlling Healthcare Costs: Just Cost Effectiveness or “Just” Cost Effectiveness?Leonard M. Fleck - 2018 - Cambridge Quarterly of Healthcare Ethics 27 (2):271-283.
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  11.  20
    Children and Organ Donation: Some Cautionary Remarks.Leonard M. Fleck - 2004 - Cambridge Quarterly of Healthcare Ethics 13 (2):161-166.
    My task is to provide some critical commentary on the preceding essays. My unfortunate conclusion will be that the issues that are their primary focus are more likely to become more ethically intractable over the next several years as medicine progresses. I do not see any easy or obvious way to avoid this conclusion.
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  12.  8
    Rationing: Don't Give Up.Leonard M. Fleck - 2002 - Hastings Center Report 32 (2):35.
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  13.  25
    The Oregon Medicaid Experiment: Is It Just Enough?Leonard M. Fleck - 1990 - Business and Professional Ethics Journal 9 (3/4):201-217.
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  14.  6
    Miscellaneous.Leonard M. Fleck - 2002 - Hastings Center Report 32 (2):35-36.
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  15.  31
    Abortion, Deformed Fetuses, and the Omega Pill.Leonard M. Fleck - 1979 - Philosophical Studies 36 (3):271 - 283.
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  16.  5
    Just Caring: Do Future Possible Children Have a Just Claim to a Sufficiently Healthy Genome?Leonard M. Fleck - 2002 - In Rosamond Rhodes, Margaret P. Battin & Anita Silvers (eds.), Medicine and Social Justice: Essays on the Distribution of Health Care. Oup Usa. pp. 446.
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  17.  31
    Can We Trust "Democratic Deliberation"?Leonard M. Fleck - 2007 - Hastings Center Report 37 (4):22-25.
  18.  19
    The Costs of Caring: Who Pays? Who Profits? Who Panders?Leonard M. Fleck - 2006 - Hastings Center Report 36 (3):13-17.
  19.  13
    Justice, Hmos, and the Invisible Rationing of Health Care Resources.Leonard M. Fleck - 1990 - Bioethics 4 (2):97–120.
  20.  39
    Just Health Care : Is Beneficence Enough?Leonard M. Fleck - 1989 - Theoretical Medicine and Bioethics 10 (2).
    Few in our society believe that access to health care should be determined primarily by ability to pay. We believe instead that society has an obligation to assure access to adequate health care for all. This is the view explicitly endorsed in the President's Commission Report Securing Access to Health Care. But there is an important moral ambiguity here, for this obligation may be construed as being either beneficence-based or justice -based. A beneficience-based construal would yield a much weaker obligation (...)
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  21.  73
    Just Health Care : Is Equality Too Much?Leonard M. Fleck - 1989 - Theoretical Medicine and Bioethics 10 (4).
    In a previous essay I criticized Engelhardt's libertarian conception of justice, which grounds the view that society's obligation to assure access to adequate health care for all is a matter of beneficence [1].Beneficence fails to capture the moral stringency associated with many claims for access to health care. In the present paper I argue that these claims are really matters of justice proper, where justice is conceived along moderate egalitarian lines, such as those suggested by Rawls and Daniels, rather than (...)
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  22.  29
    Free Will and Determinism. Ed. Bernard Bernofsky.Leonard M. Fleck - 1968 - Modern Schoolman 45 (2):169-170.
  23.  33
    Research Guide in Philosophy.Leonard M. Fleck - 1977 - Teaching Philosophy 2 (1):77-79.
  24.  19
    DRGs: Justice and the Invisible Rationing of Health Care Resources.Leonard M. Fleck - 1987 - Journal of Medicine and Philosophy 12 (2):165-196.
    Are DRGs just? This is the primary question which this essay will answer. But there is a prior methodological question that also needs to be addressed: How do we go about rationally (non-arbitrarily) assessing whether DRGs are just or not? I would suggest that grand, ideal theories of justice (Rawls, Nozick) have only very limited utility for answering this question. What we really need is a theory of “interstitial justice,” that is, an approach to making justice judgments that is suitable (...)
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  25.  25
    Four Volumes in Health Care Ethics.Leonard M. Fleck - 2013 - Teaching Philosophy 36 (1):59-70.
    This review discusses four recently published textbooks in health care ethics. The theme I emphasize here is that the more common health care ethics issues addressed in these texts are of enormous personal, political and professional relevance today. More specifically, these issues have been enormously socially divisive, as the rhetoric about “death panels” illustrates. A course in health care ethics ought to provide students (future citizens in a liberal, pluralistic, democratic society) with the skills they need to address these issues (...)
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  26.  38
    Just Caring: Health Care Rationing, Terminal Illness, and the Medically Least Well Off.Leonard M. Fleck - 2011 - Journal of Law, Medicine and Ethics 39 (2):156-171.
    What does it mean to be a “just” and “caring” society in meeting the health care needs of the terminally ill when we have only limited resources to meet virtually unlimited health care needs? That question is the focus of this essay. Put another way: relative to all the other health care needs in our society, especially the need for lifesaving or life-prolonging health care, how high a priority ought the health care needs of persons who are terminally ill have? (...)
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  27.  17
    Civil Disobedience and Moral Law in Nineteenth-Century American Philosophy. By Edward H. Madden.Leonard M. Fleck - 1969 - Modern Schoolman 46 (4):367-368.
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  28.  7
    Despairing About Health Disparities.Leonard M. Fleck - 2017 - Hastings Center Report 47 (5):43-44.
    I have never doubted that the problem of inequalities in health status and access to needed care is a difficult ethical and political challenge. After reading the essays in Understanding Health Inequalities and Justice: New Conversations across the Disciplines, edited by Mara Buchbinder, Michele Rivkin-Fish, and Rebecca Walker, I concluded that despair was the only suitable response in the face of daunting ethical and political complexity. The editors of this volume have three questions in mind that they asked contributors to (...)
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  29.  29
    Ethics and the Clinical Encounter.Leonard M. Fleck - 1989 - Teaching Philosophy 12 (1):61-64.
  30.  16
    Pricing Human Life.Leonard M. Fleck - 1989 - Social Philosophy Today 2:286-299.
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  31.  3
    JUST Rationing or Just Rationing? THE Challenge of Health Reform.Leonard M. Fleck - 2015 - Jurisprudence 6 (1):131-137.
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  32.  19
    The Great Awakening: How to Accomplish the Reform That Justice Requires.Leonard M. Fleck - 2008 - Hastings Center Report 38 (2):4-4.
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  33.  16
    Just Solidarity: The Key to Fair Health Care Rationing.Leonard M. Fleck - 2015 - Diametros 43:44-54.
    I agree with Professor ter Meulen that there is no need to make a forced choice between “justice” and “solidarity” when it comes to determining what should count as fair access to needed health care. But he also asserts that solidarity is more fundamental than justice. That claim needs critical assessment. Ter Meulen recognizes that the concept of solidarity has been criticized for being excessively vague. He addresses this criticism by introducing the more precise notion of “humanitarian solidarity.” However, I (...)
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  34.  31
    Pricing Life: Why It's Time for Health Care Rationing, by Peter A. Ubel, M.D. Cambridge, Mass.: MIT Press, 2000. 208 Pp. $25.00. [REVIEW]Leonard M. Fleck - 2001 - Cambridge Quarterly of Healthcare Ethics 10 (2):214-218.
    This is a book for reflective laypersons and health professionals who wish to better understand what the problem of healthcare rationing is all about. Ubel says clearly in the Introduction that it is unlikely that professional economists or philosophers are going to be very satisfied with this effort. For him it is more important (p. xix). This is a reasonable aim made achievable by Ubel's clear and engaging writing style. Probably the people who most need to be drawn into these (...)
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  35.  6
    Choosing Wisely.Leonard M. Fleck - 2016 - Cambridge Quarterly of Healthcare Ethics 25 (3):366-376.
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  36.  15
    Is Reality Meaningful? By Kelvin Van Nuys.Leonard M. Fleck - 1970 - Modern Schoolman 47 (2):258-259.
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  37.  10
    Just Caring: Health Care Rationing, Terminal Illness, and the Medically Least Well Off.Leonard M. Fleck - 2011 - Journal of Law, Medicine and Ethics 39 (2):156-171.
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  38.  14
    Courtney S. Campbell is the Hundere.Helen Stanton Chapple, Jessica C. Cox, Leonard M. Fleck, Marian Fontana, Susan Gilbert & Lawrence O. Gostin - forthcoming - Hastings Center Report.
  39.  13
    Mary HM Bach is a Student in the School of Pharmacy at the University of Washington, Seattle. Keith A. Bauer, MSW, is a Graduate Student in the Department of Philosophy/Medical Ethics at the University of Tennessee, Knoxville. His Dissertation Addresses the Ethics and Social Dimensions of Home-Based Telemedicine, the Use of Infor. [REVIEW]Thomas A. Cavanaugh, Jean E. Chambers, Tony Cornford, Leonard M. Fleck, Matti Häyry & Thomas K. Hazlet - 2001 - Cambridge Quarterly of Healthcare Ethics 10:123-124.
  40.  11
    Mending Mother Nature: Alpha, Beta and Omega Pills.Leonard M. Fleck - 1984 - Philosophical Studies 46 (3):381 - 393.
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  41.  13
    Bette Anton, MLS, is Head Librarian of the Pamela and Kenneth Fong Optometry and Health Sciences Library. This Library Serves the University of California, Berkeley–University of California, San Francisco Joint Medical Pro-Gram and the University of California, Berkeley School of Optometry.Richard E. Champlin, Ka Wah Chan, Leonard M. Fleck, John Harris, Matti Häyry, Søren Holm, Kenneth V. Iserson, Lynn A. Jansen & Martin Korbling - 2004 - Cambridge Quarterly of Healthcare Ethics 13:117-118.
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  42.  11
    "The Ways of Reason," by Joseph LaLumia.Leonard M. Fleck - 1968 - Modern Schoolman 45 (3):278-279.
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  43.  5
    Justice, Hmos, and the Invisible Rationing of Health Care Resources.Leonard M. Fleck - 1990 - Bioethics 4 (2):97-120.
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  44.  16
    Review of Shlomi Segall, Health, Luck, and Justice[REVIEW]Leonard M. Fleck - 2010 - Notre Dame Philosophical Reviews 2010 (2).
  45.  7
    The Price of Compromise: The Massachusetts Health Care Reform.Sarah Kemble, Susanne L. King & Leonard M. Fleck - 2007 - Hastings Center Report 37 (1):4.
  46.  8
    Leonard M. Fleck Replies.Leonard M. Fleck - 2011 - Hastings Center Report 41 (3):7-8.
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  47.  4
    Pricing Human Life: The Visibility Issue.Leonard M. Fleck - 1989 - Social Philosophy Today 2:286-299.
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  48. That Personal Touch Reply.Leonard M. Fleck - 2011 - Hastings Center Report 41 (3):7-8.
     
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