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Xavier Symons
Australian Catholic University
  1. Why Should HCWs Receive Priority Access to Vaccines in a Pandemic?Xavier Symons, Steve Matthews & Bernadette Tobin - 2021 - BMC Medical Ethics 22 (1):1-9.
    BackgroundViral pandemics present a range of ethical challenges for policy makers, not the least among which are difficult decisions about how to allocate scarce healthcare resources. One important question is whether healthcare workers should receive priority access to a vaccine in the event that an effective vaccine becomes available. This question is especially relevant in the coronavirus pandemic with governments and health authorities currently facing questions of distribution of COVID-19 vaccines.Main textIn this article, we critically evaluate the most common ethical (...)
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  2.  9
    Pellegrino, MacIntyre, and the Internal Morality of Clinical Medicine.Xavier Symons - 2019 - Theoretical Medicine and Bioethics 40 (3):243-251.
    There has been significant debate about whether the moral norms of medical practice arise from some feature or set of features internal to the discipline of medicine. In this article, I analyze Edmund Pellegrino’s conception of the internal morality of medicine, and situate it in the context of Alasdair MacIntyre’s influential account of “practice.” Building upon MacIntyre, Pellegrino argued that medicine is a social practice with its own unique goals—namely, the medical, human, and spiritual good of the patient—and that the (...)
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  3.  16
    Strengthening the Ethical Distinction Between Euthanasia, Palliative Opioid Use and Palliative Sedation.Xavier Symons - 2020 - Journal of Medical Ethics 46 (1):57-58.
    Thomas Riisfeldt’s essay1 is a valuable contribution to the literature on palliative sedation, appropriately titrated administration of opioids and euthanasia. In this response, I will not deal with the author’s empirical claim about the relationship between opioid use, palliative sedation and survival time. Rather, I will briefly critique the author’s discussion of doctrine of double effect and its application to palliative sedation and opioid use at the end of life. That is, I will focus on the ethical claims made by (...)
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  4.  35
    Persuasion, Not Coercion or Incentivisation, is the Best Means of Promoting COVID-19 Vaccination.Susan Pennings & Xavier Symons - 2021 - Journal of Medical Ethics 47 (10):709-711.
    Savulescu argues that it may be ethically acceptable for governments to require citizens be vaccinated against COVID-19. He also recommends that governments consider providing monetary or in-kind incentives to citizens to increase vaccination rates. In this response, we argue against mandatory vaccination and vaccine incentivisation, and instead suggest that targeted public health messaging and a greater responsiveness to the concerns of vaccine-hesitant individuals would be the best strategy to address low vaccination rates.
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  5.  5
    Conscientious Objection in Health Care: Why the Professional Duty Argument is Unconvincing.Xavier Symons - 2022 - Journal of Medicine and Philosophy 47 (4):549-557.
    The past decade has seen a burgeoning of scholarly interest in conscientious objection in health care. Specifically, several commentators have discussed the implications that conscientious objection has for the delivery of timely, efficient, and nondiscriminatory medical care. In this paper, I discuss the main argument put forward by the most prominent critics of conscientious objection—what I call the Professional Duty Argument or PDA. According to proponents of PDA, doctors should place patients’ well-being and rights at the center of their professional (...)
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  6.  9
    Rationing, Responsibility and Blameworthiness: An Ethical Evaluation of Responsibility-Sensitive Policies for Healthcare Rationing.Xavier Symons & Reginald Chua - 2021 - Kennedy Institute of Ethics Journal 31 (1):53-76.
    Several ethicists have defended the use of responsibility-based criteria in healthcare rationing. Yet in this article we outline two challenges to the implementation of responsibility-based healthcare rationing policies. These two challenges are, namely, that responsibility for past behavior can diminish as an agent changes, and that blame can come apart from responsibility. These challenges suggest that it is more difficult to hold someone responsible for health related actions than proponents of responsibility-sensitive healthcare policies suggest. We close by discussing public health (...)
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  7.  27
    ‘Alive by Default’: An Exploration of Velleman’s Unfair Burdens Argument Against State Sanctioned Euthanasia.Xavier Symons & Reginald Chua - 2020 - Bioethics 34 (3):288-294.
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  8. Response to Tomasz Zuradzki's Preimplantation Genetic Diagnosis and Rational Choice Under Risk or Uncertainty.Xavier Symons - 2014 - Journal of Medical Ethics 40 (11):779-779.
  9.  11
    Organismal Death, the Dead-Donor Rule and the Ethics of Vital Organ Procurement.Xavier Symons & Reginald Mary Chua - 2018 - Journal of Medical Ethics 44 (12):868-871.
    Several bioethicists have recently discussed the complexity of defining human death, and considered in particular how our definition of death affects our understanding of the ethics of vital organ procurement. In this brief paper, we challenge the mainstream medical definition of human death—namely, that death is equivalent to total brain failure—and argue with Nair-Collins and Miller that integrated biological functions can continue even after total brain failure has occurred. We discuss the implications of Nair-Collins and Miller’s argument and suggest that (...)
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  10.  28
    On the Univocity of Rationality: A Response to Nigel Biggar’s ‘Why Religion Deserves a Place in Secular Medicine’.Xavier Symons - 2015 - Journal of Medical Ethics 41 (11):870-872.
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  11.  5
    An Ethical Defense of a Mandated Choice Consent Procedure for Deceased Organ Donation.Xavier Symons & Billy Poulden - 2022 - Asian Bioethics Review 14 (3):259-270.
    Organ transplant shortages are ubiquitous in healthcare systems around the world. In response, several commentators have argued for the adoption of an opt-out policy for organ transplantation, whereby individuals would by default be registered as organ donors unless they informed authorities of their desire to opt-out. This may potentially lead to an increase in donation rates. An opt-out system, however, presumes consent even when it is evident that a significant minority are resistant to organ donation. In this article, we defend (...)
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  12.  15
    Respect for Persons and the Allocation of Lifesaving Healthcare Resources.Xavier Symons - 2021 - Bioethics 35 (5):392-399.
    Many ethicists argue that we should respect persons when we distribute resources. Yet it is unclear what this means in practice. For some, the idea of respect for persons is synonymous with the idea of respect for autonomy. Yet a principle of respect for autonomy provides limited guidance for how we should distribute scarce medical interventions. In this article, however, I sketch an alternative conception of respect for persons—one that is based on an ethic of mutual accountability. I draw in (...)
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  13.  4
    The Way of Medicine: Ethics and the Healing Profession.Xavier Symons - 2022 - The New Bioethics 28 (1):90-93.
    This book is centred around a traditional, vocational account of medical ethics – what is sometimes called a Hippocratic medical ethics but what Curlin and Tollefsen label ‘The Way of Medicine’. Th...
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  14.  1
    Why Conscience Matters: A Defence of Conscientious Objection in Healthcare.Xavier Symons - 2023 - New York: Routledge, Taylor & Francis Group.
    The book provides a detailed introduction to a major debate in bioethics, as well as a rigorous account of the role of conscience in professional decision-making. Exploring the role of conscience in healthcare practice, this book offers fresh counterpoints to recent calls to ban or severely restrict conscience objection. It provides a detailed philosophical account of the nature and moral import of conscience, and defends a prima facie right to conscientious objection for healthcare professionals. The book also has relevance to (...)
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  15.  3
    First Among Equals? Adaptive Preferences and the Limits of Autonomy in Medical Ethics.Susan Pennings & Xavier Symons - forthcoming - Journal of Medical Ethics.
    Respect for patient autonomy is a central principle of medical ethics. However, there are important unresolved questions about the characteristics of an autonomous decision, and whether some autonomous preferences should be subject to more scrutiny than others.In this paper, we consider whether inappropriately adaptive preferences—preferences that are based on and that may perpetuate social injustice—should be categorised as autonomous in a way that gives them normative authority. Some philosophers have argued that inappropriately adaptive preferences do not have normative authority, because (...)
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  16.  2
    Why Conscience Matters: A Theory of Conscience and Its Relevance to Conscientious Objection in Medicine.Xavier Symons - forthcoming - Res Publica:1-21.
    Conscience is an idea that has significant currency in liberal democratic societies. Yet contemporary moral philosophical scholarship on conscience is surprisingly sparse. This paper seeks to offer a rigorous philosophical account of the role of conscience in moral life with a view to informing debates about the ethics of conscientious objection in medicine. I argue that conscience is concerned with a commitment to moral integrity and that restrictions on freedom of conscience prevent agents from living a moral life. In section (...)
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  17.  1
    Shlomi Segall. Why Inequality Matters: Luck Egalitarianism, Its Meaning and Value.Xavier Symons - 2021 - Journal of Moral Philosophy 18 (4):425-428.
  18.  10
    Two Conceptions of Conscience and the Problem of Conscientious Objection.Xavier Symons - 2017 - Journal of Medical Ethics 43 (4):245-247.
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  19.  8
    Does the Doctrine of Double Effect Apply to the Prescription of Barbiturates? Syme Vs the Medical Board of Australia.Xavier Symons - 2017 - Journal of Medical Ethics:medethics-2017-104230.
    The doctrine of double effect is a principle of crucial importance in law and medicine. In medicine, the principle is generally accepted to apply in cases where the treatment necessary to relieve pain and physical suffering runs the risk of hastening the patient’s death. More controversially, it has also been used as a justification for withdrawal of treatment from living individuals and physician-assisted suicide. In this paper, I will critique the findings of the controversial Victorian Civil and Administrative Tribunal hearing (...)
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  20.  3
    Reflective Disequilibrium: A Critical Evaluation of the Complete Lives Framework for Healthcare Rationing.Xavier Symons - 2021 - Journal of Medical Ethics 47 (2):108-112.
    One prominent view in recent literature on resource allocation is Persad, Emanuel and Wertheimer’s complete lives framework for the rationing of lifesaving healthcare interventions. CLF states that we should prioritise the needs of individuals who have had less opportunity to experience the events that characterise a complete life. Persad et al argue that their system is the product of a successful process of reflective equilibrium—a philosophical methodology whereby theories, principles and considered judgements are balanced with each other and revised until (...)
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