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Ross E. G. Upshur [40]Ross Upshur [34]Ross EG Upshur [3]Ross E. Upshur [1]
Ross E. . G. Upshur [1]
  1. 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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  2.  14
    Going From Evidence to Recommendations: Can GRADE Get Us There?Mathew Mercuri, Brian Baigrie & Ross E. G. Upshur - 2018 - Journal of Evaluation in Clinical Practice 24 (5):1232-1239.
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  3. Reason and Value: Making Reasoning Fit for Practice.Michael Loughlin, Robyn Bluhm, Stephen Buetow, Ross E. G. Upshur, Maya J. Goldenberg, Kirstin Borgerson, Vikki Entwistle & Elselijn Kingma - 2012 - Journal of Evaluation in Clinical Practice 18 (5):929-937.
    Editors' introduction to 3rd thematic issue on philosophy of medicine.
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  4.  43
    Taking Stock of Evidence‐Based Medicine: Opportunities for its Continuing Evolution.Stephen Buetow, Ross Upshur, Andrew Miles & Michael Loughlin - 2006 - Journal of Evaluation in Clinical Practice 12 (4):399-404.
  5.  34
    Pandemic Influenza Preparedness: An Ethical Framework to Guide Decision-Making. [REVIEW]Alison Thompson, Karen Faith, Jennifer Gibson & Ross Upshur - 2006 - BMC Medical Ethics 7 (1):1-11.
    Background Planning for the next pandemic influenza outbreak is underway in hospitals across the world. The global SARS experience has taught us that ethical frameworks to guide decision-making may help to reduce collateral damage and increase trust and solidarity within and between health care organisations. Good pandemic planning requires reflection on values because science alone cannot tell us how to prepare for a public health crisis. Discussion In this paper, we present an ethical framework for pandemic influenza planning. The ethical (...)
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  6. Philosophy, Ethics, Medicine and Health Care: The Urgent Need for Critical Practice.Michael Loughlin, Ross E. G. Upshur, Maya J. Goldenberg, Robyn Bluhm & Kirstin Borgerson - 2010 - Journal of Evaluation in Clinical Practice 16 (2):249-259.
  7.  87
    Meaning and Measurement: An Inclusive Model of Evidence in Health Care.Ross E. G. Upshur, Elizabeth G. VanDenKerkhof & Vivek Goel - 2001 - Journal of Evaluation in Clinical Practice 7 (2):91-96.
  8.  55
    End-of-Life Decision-Making in Canada: The Report by the Royal Society of Canada Expert Panel on End-of-Life Decision-Making.Udo Schüklenk, Johannes J. M. van Delden, Jocelyn Downie, Sheila A. M. Mclean, Ross Upshur & Daniel Weinstock - 2011 - Bioethics 25 (s1):1-73.
    ABSTRACTThis report on end‐of‐life decision‐making in Canada was produced by an international expert panel and commissioned by the Royal Society of Canada. It consists of five chapters.Chapter 1 reviews what is known about end‐of‐life care and opinions about assisted dying in Canada.Chapter 2 reviews the legal status quo in Canada with regard to various forms of assisted death.Chapter 3 reviews ethical issues pertaining to assisted death. The analysis is grounded in core values central to Canada's constitutional order.Chapter 4 reviews the (...)
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  9.  39
    Looking for Rules in a World of Exceptions: Reflections on Evidence-Based Practice.Ross E. G. Upshur - 2005 - Perspectives in Biology and Medicine 48 (4):477-489.
  10.  35
    Research Ethics Governance in Times of Ebola.Doris Schopper, Raffaella Ravinetto, Lisa Schwartz, Eunice Kamaara, Sunita Sheel, Michael J. Segelid, Aasim Ahmad, Angus Dawson, Jerome Singh, Amar Jesani & Ross Upshur - 2017 - Public Health Ethics 10 (1).
    The Médecins Sans Frontières ethics review board has been solicited in an unprecedented way to provide advice and review research protocols in an ‘emergency’ mode during the recent Ebola epidemic. Twenty-seven Ebola-related study protocols were reviewed between March 2014 and August 2015, ranging from epidemiological research, to behavioural research, infectivity studies and clinical trials with investigational products at early development stages. This article examines the MSF ERB’s experience addressing issues related to both the process of review and substantive ethical issues (...)
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  11.  49
    DNA Databanks and Consent: A Suggested Policy Option Involving an Authorization Model. [REVIEW]Timothy Caulfield, Ross Upshur & Abdallah Daar - 2003 - BMC Medical Ethics 4 (1):1-4.
    Background Genetic databases are becoming increasingly common as a means of determining the relationship between lifestyle, environmental exposures and genetic diseases. These databases rely on large numbers of research subjects contributing their genetic material to successfully explore the genetic basis of disease. However, as all possible research questions that can be posed of the data are unknown, an unresolved ethical issue is the status of informed consent for future research uses of genetic material. Discussion In this paper, we discuss the (...)
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  12. Your Liberty or Your Life: Reciprocity in the Use of Restrictive Measures in Contexts of Contagion. [REVIEW]A. M. Viens, Cécile M. Bensimon & Ross E. G. Upshur - 2009 - Journal of Bioethical Inquiry 6 (2):207-217.
    In this paper, we explore the role of reciprocity in the employment of restrictive measures in contexts of contagion. Reciprocity should be understood as a substantive value that governs the use, level and extent of restrictive measures. We also argue that independent of the role reciprocity plays in the legitimisation the use of restrictive measures, reciprocity can also motivate support and compliance with legitimate restrictive measures. The importance of reciprocity has implications for how restrictive measures should be undertaken when preparing (...)
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  13.  24
    Fair, Just and Compassionate: A Pilot for Making Allocation Decisions for Patients Requesting Experimental Drugs Outside of Clinical Trials.Arthur L. Caplan, J. Russell Teagarden, Lisa Kearns, Alison S. Bateman-House, Edith Mitchell, Thalia Arawi, Ross Upshur, Ilina Singh, Joanna Rozynska, Valerie Cwik & Sharon L. Gardner - 2018 - Journal of Medical Ethics 44 (11):761-767.
    Patients have received experimental pharmaceuticals outside of clinical trials for decades. There are no industry-wide best practices, and many companies that have granted compassionate use, or ‘preapproval’, access to their investigational products have done so without fanfare and without divulging the process or grounds on which decisions were made. The number of compassionate use requests has increased over time. Driving the demand are new treatments for serious unmet medical needs; patient advocacy groups pressing for access to emerging treatments; internet platforms (...)
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  14.  45
    Three Problems with Big Data and Artificial Intelligence in Medicine.Benjamin Chin-Yee & Ross Upshur - 2019 - Perspectives in Biology and Medicine 62 (2):237-256.
    We live in the Age of Big Data. In medicine, artificial intelligence and machine learning algorithms, fueled by big data, promise to change how physicians make diagnoses, determine prognoses, and develop new treatments. An exponential rise in articles on these topics is seen in the medical literature. Recent applications range from the use of deep learning neural networks to diagnose diabetic retinopathy and skin cancer from image databases, to the use of various machine learning algorithms for prognostication in cancer and (...)
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  15.  19
    Reciprocity and Ethical Tuberculosis Treatment and Control.Diego S. Silva, Angus Dawson & Ross E. G. Upshur - 2016 - Journal of Bioethical Inquiry 13 (1):75-86.
    This paper explores the notion of reciprocity in the context of active pulmonary and laryngeal tuberculosis treatment and related control policies and practices. We seek to do three things: First, we sketch the background to contemporary global TB care and suggest that poverty is a key feature when considering the treatment of TB patients. We use two examples from TB care to explore the role of reciprocity: isolation and the use of novel TB drugs. Second, we explore alternative means of (...)
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  16.  22
    On Pandemics and the Duty to Care: Whose Duty? Who Cares?Carly Ruderman, C. Shawn Tracy, Cécile M. Bensimon, Mark Bernstein, Laura Hawryluck, Randi Z. Shaul & Ross E. G. Upshur - 2006 - BMC Medical Ethics 7 (1):5.
    BackgroundAs a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many were exposed (...)
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  17.  35
    If Not Evidence, Then What? Or Does Medicine Really Need a Base?Ross E. G. Upshur - 2002 - Journal of Evaluation in Clinical Practice 8 (2):113-119.
  18.  42
    On Pandemics and the Duty to Care: Whose Duty? Who Cares? [REVIEW]Carly Ruderman, C. Tracy, Cécile Bensimon, Mark Bernstein, Laura Hawryluck, Randi Zlotnik Shaul & Ross Upshur - 2006 - BMC Medical Ethics 7 (1):1-6.
    Background As a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals (HCPs) and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many (...)
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  19.  89
    Global Health Ethics for Students.Andrew D. Pinto & Ross E. G. Upshur - 2009 - Developing World Bioethics 9 (1):1-10.
    As a result of increased interest in global health, more and more medical students and trainees from the.
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  20.  23
    Can Academic and Clinical Journals Be in Financial Conflict of Interest Situations? The Case of Evidence‐Based Incorporated.Ross Upshur, Stephen Buetow, Michael Loughlin & Andrew Miles - 2006 - Journal of Evaluation in Clinical Practice 12 (4):405-409.
  21.  49
    Innovations in Research Ethics Governance in Humanitarian Settings.Doris Schopper, Angus Dawson, Ross Upshur, Aasim Ahmad, Amar Jesani, Raffaella Ravinetto, Michael J. Segelid, Sunita Sheel & Jerome Singh - 2015 - BMC Medical Ethics 16 (1):10.
    Médecins Sans Frontières is one of the world’s leading humanitarian medical organizations. The increased emphasis in MSF on research led to the creation of an ethics review board in 2001. The ERB has encouraged innovation in the review of proposals and the interaction between the ERB and the organization. This has led to some of the advances in ethics governance described in this paper.
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  22.  19
    Taking Tissue Seriously Means Taking Communities Seriously.Ross EG Upshur, James V. Lavery & Paulina O. Tindana - 2007 - BMC Medical Ethics 8 (1):11.
    Health research is increasingly being conducted on a global scale, particularly in the developing world to address leading causes of morbidity and mortality. While research interest has increased, building scientific capacity in the developing world has not kept pace. This often leads to the export of human tissue (defined broadly) from the developing to the developed world for analysis. These practices raise a number of important ethical issues that require attention.
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  23.  16
    What Makes Public Health Studies Ethical? Dissolving the Boundary Between Research and Practice.Donald J. Willison, Nancy Ondrusek, Angus Dawson, Claudia Emerson, Lorraine E. Ferris, Raphael Saginur, Heather Sampson & Ross Upshur - 2014 - BMC Medical Ethics 15 (1):61.
    The generation of evidence is integral to the work of public health and health service providers. Traditionally, ethics has been addressed differently in research projects, compared with other forms of evidence generation, such as quality improvement, program evaluation, and surveillance, with review of non-research activities falling outside the purview of the research ethics board. However, the boundaries between research and these other evaluative activities are not distinct. Efforts to delineate a boundary – whether on grounds of primary purpose, temporality, underlying (...)
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  24.  37
    Access and Use of Human Tissues From the Developing World: Ethical Challenges and a Way Forward Using a Tissue Trust.Claudia I. Emerson, Peter A. Singer & Ross Eg Upshur - 2011 - BMC Medical Ethics 12 (1):2.
    BackgroundScientists engaged in global health research are increasingly faced with barriers to access and use of human tissues from the developing world communities where much of their research is targeted. In part, the problem can be traced to distrust of researchers from affluent countries, given the history of 'scientific-imperialism' and 'biocolonialism' reflected in past well publicized cases of exploitation of research participants from low to middle income countries.DiscussionTo a considerable extent, the failure to adequately engage host communities, the opacity of (...)
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  25.  13
    Fast and Frugal Decision Trees: How Can the Patient Come Last in a Patient-Centred World?Ross E. G. Upshur - 2018 - Journal of Evaluation in Clinical Practice 24 (5):1259-1261.
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  26.  15
    Clinical Judgement in the Era of Big Data and Predictive Analytics.Benjamin Chin-Yee & Ross Upshur - 2018 - Journal of Evaluation in Clinical Practice 24 (3):638-645.
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  27.  21
    Ebola and Learning Lessons From Moral Failures: Who Cares About Ethics?Maxwell J. Smith & Ross E. G. Upshur - 2015 - Public Health Ethics 8 (3):305-318.
    The exercise of identifying lessons in the aftermath of a major public health emergency is of immense importance for the improvement of global public health emergency preparedness and response. Despite the persistence of the Ebola Virus Disease outbreak in West Africa, it seems that the Ebola ‘lessons learned’ exercise is now in full swing. On our assessment, a significant shortcoming plagues recent articulations of lessons learned, particularly among those emerging from organizational reflections. In this article we argue that, despite not (...)
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  28.  46
    Seven Characteristics of Medical Evidence.Ross E. G. Upshur - 2000 - Journal of Evaluation in Clinical Practice 6 (2):93-97.
  29.  61
    Explanation, Understanding, Objectivity and Experience.Michael Loughlin, Robyn Bluhm, Drozdstoj S. Stoyanov, Stephen Buetow, Ross E. G. Upshur, Kirstin Borgerson, Maya J. Goldenberg & Elselijn Kingma - 2013 - Journal of Evaluation in Clinical Practice 19 (3):415-421.
  30.  18
    Ebola Virus in West Africa: Waiting for the Owl of Minerva.Ross E. G. Upshur - 2014 - Journal of Bioethical Inquiry 11 (4):421-423.
    The evolving Ebola epidemic in West Africa is unprecedented in its size and scope, requiring the rapid mobilization of resources. It is too early to determine all of the ethical challenges associated with the outbreak, but these should be monitored closely. Two issues that can be discussed are the decision to implement and evaluate unregistered agents to determine therapeutic or prophylactic safety and efficacy and the justification behind this decision. In this paper, I argue that it is not compassionate use (...)
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  31.  97
    Virtue, Progress and Practice.Michael Loughlin, Robyn Bluhm, Stephen Buetow, Ross E. G. Upshur, Maya J. Goldenberg, Kirstin Borgerson & Vikki Entwistle - 2011 - Journal of Evaluation in Clinical Practice 17 (5):839-846.
  32.  37
    The Political and Ethical Challenge of Multi-Drug Resistant Tuberculosis.Ross Upshur, Ian Kerridge, Wendy Lipworth, Christopher Mayes & Chris Degeling - 2015 - Journal of Bioethical Inquiry 12 (1):107-113.
    This article critically examines current responses to multi-drug resistant tuberculosis and argues that bioethics needs to be willing to engage in a more radical critique of the problem than is currently offered. In particular, we need to focus not simply on market-driven models of innovation and anti-microbial solutions to emergent and re-emergent infections such as TB. The global community also needs to address poverty and the structural factors that entrench inequalities—thus moving beyond the orthodox medical/public health frame of reference.
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  33.  35
    Making the Grade: Assuring Trustworthiness in Evidence.Ross Upshur - 2009 - Perspectives in Biology and Medicine 52 (2):264-275.
  34.  52
    What Does Public Health Ethics Tell (Or Not Tell) Us About Intervening in Non-Communicable Diseases?Ross Upshur - 2013 - Journal of Bioethical Inquiry 10 (1):19-28.
    Obesity has been described as pandemic and a public health crisis. It has been argued that concerted research efforts are needed to enhance our understanding and develop effective interventions for the complex and multiple dimensions of the health challenges posed by obesity. This would provide a secure evidence base in order to justify clinical interventions and public policy. This paper critically examines these claims through the examination of models of public health and public health ethics. I argue that the concept (...)
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  35.  27
    Critical Thinking in Clinical Medicine: What is It?Mona Gupta & Ross Upshur - 2012 - Journal of Evaluation in Clinical Practice 18 (5):938-944.
  36.  6
    Critical Reflections on Evidence, Ethics and Effectiveness in the Management of Tuberculosis: Public Health and Global Perspectives.Geetika Verma, Ross E. G. Upshur, Elizabeth Rea & Solomon R. Benatar - 2004 - BMC Medical Ethics 5 (1):2.
    Background Tuberculosis is a major cause of morbidity and mortality globally. Recent scholarly attention to public health ethics provides an opportunity to analyze several ethical issues raised by the global tuberculosis pandemic. Discussion Recently articulated frameworks for public health ethics emphasize the importance of effectiveness in the justification of public health action. This paper critically reviews the relationship between these frameworks and the published evidence of effectiveness of tuberculosis interventions, with a specific focus on the controversies engendered by the endorsement (...)
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  37.  29
    Re-Evaluating Concepts of Biological Function in Clinical Medicine: Towards a New Naturalistic Theory of Disease.Benjamin Chin-Yee & Ross E. G. Upshur - 2017 - Theoretical Medicine and Bioethics 38 (4):245-264.
    Naturalistic theories of disease appeal to concepts of biological function, and use the notion of dysfunction as the basis of their definitions. Debates in the philosophy of biology demonstrate how attributing functions in organisms and establishing the function-dysfunction distinction is by no means straightforward. This problematization of functional ascription has undermined naturalistic theories and led some authors to abandon the concept of dysfunction, favoring instead definitions based in normative criteria or phenomenological approaches. Although this work has enhanced our understanding of (...)
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  38.  10
    The Complex, the Exhausted and the Personal: Reflections on the Relationship Between Evidence-Based Medicine and Casuistry. Commentary on Tonelli (2006), Integrating Evidence Into Clinical Practice: An Alternative to Evidence-Based Approaches. Journal Of.Ross E. G. Upshur - 2006 - Journal of Evaluation in Clinical Practice 12 (3):281-288.
  39. Philosophy, Medicine and Health Care – Where We Have Come From and Where We Are Going.Michael Loughlin, Robyn Bluhm, Jonathan Fuller, Stephen Buetow, Ross E. G. Upshur, Kirstin Borgerson, Maya J. Goldenberg & Elselijn Kingma - 2014 - Journal of Evaluation in Clinical Practice 20 (6):902-907.
  40.  7
    A Failure in Solidarity: Ethical Challenges in the Development and Implementation of New Tuberculosis Technologies.Ana Komparic, Angus Dawson, Renaud F. Boulanger, Ross E. G. Upshur & Diego S. Silva - 2019 - Bioethics 33 (5):557-567.
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  41.  14
    Historical Thinking in Clinical Medicine: Lessons From R.G. Collingwood's Philosophy of History.Benjamin H. Chin-Yee & Ross E. G. Upshur - 2015 - Journal of Evaluation in Clinical Practice 21 (3):448-454.
  42. Certainty, Probability and Abduction: Why We Should Look to C.S. Peirce Rather Than Gödel for a Theory of Clinical Reasoning.Ross Upshur - 1997 - Journal of Evaluation in Clinical Practice 3 (3):201-206.
  43.  33
    Reporting of Informed Consent, Standard of Care and Post-Trial Obligations in Global Randomized Intervention Trials: A Systematic Survey of Registered Trials.Emma R. M. Cohen, Jennifer M. O'neill, Michel Joffres, Ross E. G. Upshur & Edward Mills - 2009 - Developing World Bioethics 9 (2):74-80.
    Objective: Ethical guidelines are designed to ensure benefits, protection and respect of participants in clinical research. Clinical trials must now be registered on open-access databases and provide details on ethical considerations. This systematic survey aimed to determine the extent to which recently registered clinical trials report the use of standard of care and post-trial obligations in trial registries, and whether trial characteristics vary according to setting. Methods: We selected global randomized trials registered on http://www.clinicaltrials.gov and http://www.controlled-trials.com. We searched for intervention (...)
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  44.  22
    Overdose Education and Naloxone Distribution Programmes and the Ethics of Task Shifting.Daniel Z. Buchman, Aaron M. Orkin, Carol Strike & Ross E. G. Upshur - 2018 - Public Health Ethics 11 (2):151-164.
    North America is in the grips of an epidemic of opioid-related poisonings. Overdose education and naloxone distribution programmes emerged as an option for structurally vulnerable populations who could not or would not access mainstream emergency medical services in the event of an overdose. These task shifting programmes utilize lay persons to deliver opioid resuscitation in the context of longstanding stigmatization and marginalization from mainstream healthcare services. OEND programmes exist at the intersection of harm reduction and emergency services. One goal of (...)
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  45.  5
    Developing and Implementing New TB Technologies: Key Informants’ Perspectives on the Ethical Challenges.Renaud F. Boulanger, Ana Komparic, Angus Dawson, Ross E. G. Upshur & Diego S. Silva - 2020 - Journal of Bioethical Inquiry 17 (1):65-73.
    ObjectiveTo identify the ethical challenges associated with the development and implementation of new tuberculosis drugs and diagnostics.MethodsTwenty-three semi-structured qualitative interviews conducted between December 2015 and September 2016 with programme administrators, healthcare workers, advocates, policymakers, and funders based in the Americas, Europe, and Africa. Interviews were analysed using thematic analysis.ResultsDivergent interests and responsibilities, coupled with power imbalances, are a primary source of ethical challenges; the uncertain risk profiles of new drugs present an additional one. Although this challenge can be partially mitigated (...)
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  46.  17
    A Short Note on Probability in Clinical Medicine.Ross E. G. Upshur - 2013 - Journal of Evaluation in Clinical Practice 19 (3):463-466.
  47.  17
    Much Ado About Omics: Welcome to ‘the Permutome’.Spencer G. Livingstone, Maxwell J. Smith, Diego S. Silva & Ross E. G. Upshur - 2015 - Journal of Evaluation in Clinical Practice 21 (6):1018-1021.
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  48.  8
    Ebola and Learning Lessons From Moral Failures: Who Cares About Ethics?: Table 1.Maxwell J. Smith & Ross E. G. Upshur - 2015 - Public Health Ethics:phv028.
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  49.  4
    Re-Evaluating Concepts of Biological Function in Clinical Medicine: Towards a New Naturalistic Theory of Disease.Benjamin Chin-Yee & Ross E. G. Upshur - 2017 - Theoretical Medicine and Bioethics: Philosophy of Medical Research and Practice 38 (4):245-264.
    Naturalistic theories of disease appeal to concepts of biological function, and use the notion of dysfunction as the basis of their definitions. Debates in the philosophy of biology demonstrate how attributing functions in organisms and establishing the function-dysfunction distinction is by no means straightforward. This problematization of functional ascription has undermined naturalistic theories and led some authors to abandon the concept of dysfunction, favoring instead definitions based in normative criteria or phenomenological approaches. Although this work has enhanced our understanding of (...)
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  50.  9
    Conventions or Foundations? A Response to Miles Little's Ex Nihilo Nihil Fit? Medicine Rests on Solid Foundations.Ross E. G. Upshur - 2014 - Journal of Evaluation in Clinical Practice 20 (6):988-990.
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