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Michal Pruski
University of Manchester
  1.  25
    Medical Acts and Conscientious Objection: What Can a Physician Be Compelled to Do.Nathan K. Gamble & Michal Pruski - 2019 - The New Bioethics 25 (3):262-282.
    A key question has been underexplored in the literature on conscientious objection: if a physician is required to perform ‘medical activities,’ what is a medical activity? This paper explores the question by employing a teleological evaluation of medicine and examining the analogy of military conscripts, commonly cited in the conscientious objection debate. It argues that physicians (and other healthcare professionals) can only be expected to perform and support medical acts – acts directed towards their patients’ health. That is, physicians cannot (...)
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  2.  15
    Conscientious Objection and Systemic Injustice.Michal Pruski - 2020 - Clinical Ethics (3):147775092090345.
    This paper follows on from a brief debate about the role of conscientious objection in healthcare, where the issue arose as to whether conscientious objection is (or can) be a tool of resistance against systemic injustice. The paper contributes to this debate by highlighting that some authors generally opposed to conscientious objection in healthcare have shown some support to this idea. Perhaps if there is one area in which all can agree, it is that in healthcare conscientious objection should be (...)
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  3. Why Are There No Platypuses at the Olympics?: A Teleological Case for Athletes with Disorders of Sexual Development to Compete Within Their Sex Category.Nathan Gamble & Michal Pruski - 2020 - South African Journal of Sports Medicine 32 (1).
    In mid-2019, the controversy regarding South African runner Caster Semenya’s eligibility to participate in competitions against other female runners culminated in a Court of Arbitration for Sport judgement. Semenya possessed high endogenous testosterone levels (arguably a performance advantage), secondary to a disorder of sexual development. In this commentary, Aristotelean teleology is used to defend the existence of ‘male’ and ‘female’ as discrete categories. It is argued that once the athlete’s sex is established, they should be allowed to compete in the (...)
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  4.  23
    Double Effect & Ectopic Pregnancy – Some Problems.Michal Pruski - 2019 - Catholic Medical Quarterly 69 (2):17-20.
    This paper looks at the Catholic justification of medical interventions in ectopic pregnancies. The paper first shows that the way how Double Effect Reasoning is often applied to ectopic pregnancies is not consistent with the way Aquinas introduces this mode of reasoning. The paper then shows certain problems in common defences of the use of salpingectomies. The paper then re-evaluates the medical interventions used in the management of ectopic pregnancies, with both a focus on the aim of the treatment and (...)
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  5.  8
    Reply to: Beyond Money: Conscientious Objection in Medicine as a Conflict of Interests.Michal Pruski - 2021 - Journal of Bioethical Inquiry 18 (1):177-180.
    Giubilini and Savulescu in their recent Journal of Bioethical Inquiry symposium article presented an account of conscientious objection that argues for its recognition as a non-financial conflict of interest. In this short commentary, I highlight some problems with their account. First, I discuss their solicitor analogy. Second, I discuss some problems surrounding their objectivity claim about standards of medical care. Next, I discuss some issues arising from consistently applying their approach. Finally, I highlight that conscientious objection should be viewed not (...)
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  6.  7
    To Die, to Sleep, Perchance to Dream? A Response to DeMichelis, Shaul and Rapoport.Joel L. Gamble, Nathan K. Gamble & Michal Pruski - 2019 - Journal of Medical Ethics 45 (12):832-834.
    In developing their policy on paediatric medical assistance in dying, DeMichelis, Shaul and Rapoport decide to treat euthanasia and physician-assisted suicide as ethically and practically equivalent to other end-of-life interventions, particularly palliative sedation and withdrawal of care. We highlight several flaws in the authors’ reasoning. Their argument depends on too cursory a dismissal of intention, which remains fundamental to medical ethics and law. Furthermore, they have not fairly presented the ethical analyses justifying other end-of-life decisions, analyses and decisions that were (...)
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  7.  31
    Teleology and Defining Sex.Nathan K. Gamble & Michal Pruski - 2018 - The New Bioethics 24 (2):176-189.
    Disorders of sexual differentiation lead to what is often referred to as an intersex state. This state has medical, as well as some legal, recognition. Nevertheless, the question remains whether intersex persons occupy a state in between maleness and femaleness or whether they are truly men or women. To answer this question, another important conundrum needs to be first solved: what defines sex? The answer seems rather simple to most people, yet when morphology does not coincide with haplotypes, and genetics (...)
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  8.  5
    Conscience and Vaccines: Lessons From Babylon 5 and COVID-19.Michal Pruski - 2021 - The New Bioethics 27 (3):266-284.
    Babylon 5, like other great sci-fi franchises, touched on important ethical questions. Two ethical conundrums relating to the series’ main characters included providing life-saving treatment to a c...
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  9.  39
    What Demarks the Metamorphosis of Human Individuals to Posthuman Entities?Michal Pruski - 2019 - The New Bioethics 25 (1):3-23.
    Humans often seek to improve themselves, whether through self-discipline or through the use of science and technology. At some point in the future, techniques might become available that will change humans to such a degree that they might have to be regarded as something other than human: posthuman. This essay tries to define the point at which such a human-to-posthuman metamorphosis may occur. This is achieved by discerning what is it that makes human substance distinct, i.e. what is the human (...)
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  10.  9
    Experience Adjusted Life Years and Critical Medical Allocations Within the British Context: Which Patient Should Live?Michal Pruski - 2018 - Medicine, Health Care and Philosophy 21 (4):561-568.
    Medical resource allocation is a controversial topic, because in the end it prioritises some peoples’ medical problems over those of others. This is less controversial when there is a clear clinical reason for such a prioritisation, but when such a reason is not available people might perceive it as deeming certain individuals more important than others. This article looks at the role of social utility in medical resource allocation, in a situation where the clinical outcome would be identical if either (...)
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  11.  8
    The Right to Choose to Abort an Abortion: Should Pro-Choice Advocates Support Abortion Pill Reversal?Michal Pruski, Dominic Whitehouse & Steven Bow - forthcoming - The New Bioethics:1-16.
    Abortion pill reversal treatment aims to halt an initiated medical abortion, wherein a pregnant woman takes progesterone after having taken the first of the two consecutive abortion pills, ty...
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  12. Professional Objections and Healthcare: More Than a Case of Conscience.Michal Pruski - 2019 - Ethics and Medicine 35 (3):149-160.
    While there is a prolific debate surrounding the issue of conscientious objection of individuals towards performing certain clinical acts, this debate ignores the fact that there are other reasons why clinicians might wish to object providing specific services. This paper briefly discusses the idea that healthcare workers might object to providing specific services because they are against their professional judgement, they want to maintain a specific reputation, or they have pragmatic reasons. Reputation here is not simply understood as being in (...)
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  13.  4
    Rapid Response: Covid 19: Christmas Relaxation Will Overwhelm Services (Rr20).Michal Pruski - unknown
    Dear Editor, -/- It is the responsibility of healthcare professionals to present patients with the available options for managing their conditions, including the potential benefits and anticipated negative consequences of each option. Patients then weigh the potential benefits and drawbacks of each option, and juxtapose them with their wider life goals and preferences. We generally accept that patients might not choose the option that is most health or life preserving because they might value other things more. We accept that forms (...)
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  14. The Relationship of Gametes to Those Who Procreate and Its Impact on Artificially Generated Gamete Technologies.Michal Pruski - 2017 - Ethics and Medicine 33 (1):27-41.
    Current developments in reproductive technology forecast that in the foreseeable future artificially generated gametes might be presented as a possible fertility treatment for infertile couples and for homosexual couples desiring to have children genetically originating from both partners. It is important to evaluate the ethical issues connected to this technology before its emergence. This article first reviews the meaning that gametes (sperm and eggs) might have to those who procreate, as well as their ontology. From this, suggestions are made as (...)
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  15. Should Parents Be Asked to Consent for Life-Saving Paediatric Interventions?Nathan K. Gamble & Michal Pruski - forthcoming - Journal of the Intensive Care Society.
    Informed consent, when given by proxy, has limitations: chiefly, it must be made in the interest of the patient. Here we critique the standard approach to parental consent, as present in Canada and the UK. Parents are often asked for consent, but are not given the authority to refuse medically beneficial treatment in many situations. This prompts the question of whether it is possible for someone to consent if they cannot refuse. We present two alternative and philosophically more consistent frameworks (...)
     
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  16. Acts and Distance—a Commentary on Brummett's ‘When Conscientious Objection Runs Amok’.Michal Pruski - forthcoming - Clinical Ethics.
    In his ‘When conscientious objection runs amok: A physician refusing human immunodeficiency virus (HIV) preventative to a bisexual patient’, Brummett has argued that Catholic physicians (or indeed any other healthcare practitioner) should not be able to raise conscientious objections to HIV pre-exposure prophylaxis for bisexual patients, as this constitutes discrimination. Brummett argues that such a conscientious objection represents an instance of conscience creep, which he argues is undesirable. Here I re-analyse the case presented by Brummett using a teleological framework and (...)
     
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  17.  6
    The Rule of Right Vs Might: A Reply to Wischik's ‘Nazis, Teleology, and the Freedom of Conscience'.Nathan K. Gamble & Michal Pruski - 2021 - The New Bioethics 27 (1):81-95.
    Wischik presents an extensive reply to our paper on conscientious objection, which explores the implications of distinguishing ‘medical acts’ from ‘socioclinical acts’. He provides an extensive leg...
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  18.  7
    Withdrawal of Nutrition and Hydration, and Withdrawal of Ventilation - What Does Tradition Say?Michal Pruski - 2020 - Catholic Medical Quarterly 70 (1):16-19.
    With recent guidance from the BMA and RCP on the withdrawal of nutrition from patients, and how the cause of death is being recorded (1), and the case of Vincent Lambert (2), the debate surrounding withdrawal of care and treatment has been rekindled in Catholic circles. In this article, I wish to highlight some of traditional principles that form the basis of such decision-making. I discuss these within the context of the withdrawal of nutrition and hydration (NaH), as well as (...)
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  19. Reply: Conscientious Objection to Deceased Organ Donation by Healthcare Professionals.Michal Pruski & Toni C. Saad - 2018 - Journal of the Intensive Care Society 19 (4):NP1.
    Here we respond to Shaw et al., and show why the application of Conscientious Objection cannot be dismissed from cases of organ donation, where the donor is presumed to be dead.
     
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  20. Reasonable Parental and Medical Obligations in Pediatric Extraordinary Therapy.Michal Pruski & Nathan K. Gamble - 2019 - The Linacre Quarterly 86 (2-3):198-206.
    The English cases of Charlie Gard and Alfie Evans involved a conflict between the desires of their parents to preserve their children’s lives and judgments of their medical teams in pursuit of clinically appropriate therapy. The treatment the children required was clearly extraordinary, including a wide array of advanced life-sustaining technological support. The cases exemplify a clash of worldviews rooted in different philosophies of life and medical care. The article highlights the differing perspectives on parental authority in medical care in (...)
     
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  21.  1
    Alta Fixsler: Medico-Legal Paternalism in UK Paediatric Best Interest Decisions.Michal Pruski - 2022 - Issues in Law and Medicine 37 (1):81-93.
    The case of Alta Fixsler, where a judge ruled that withdrawing life sustaining care was in her best interest rather than transferring her to Israel, as her parents wanted, is the latest in a series of controversial paediatric best interest decisions. Using this case, as well as some other recent cases, I argue that the UK exhibits a high degree of medico-legal paternalism in best interest decisions, even though paternalism seems to be ubiquitously negatively perceived in medical ethics. Firstly, I (...)
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  22. Why Read The Works Of Braine. [REVIEW]Michal Pruski - 2019 - Catholic Medical Quarterly 69:20.
  23.  1
    Friendship as a Framework for Resolving Dilemmas in Clinical Ethics.Michal Pruski - 2021 - Monash Bioethics Review 39 (2):143-156.
    Healthcare professionals often need to make clinical decisions that carry profound ethical implications. As such, they require a tool that will make decision-making intuitive. While the discussion about the principles that should guide clinical ethics has been going on for over two thousand years, it does not seem that making such decisions is becoming any more straight forward. With an abundance of competing ethical systems and frameworks for their application in real life, the clinician is still often not sure how (...)
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