ORCID Profile
0000-0002-5817-7488
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In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Applied Ethics | Bioethics (human and animal) | Law and Society | Ethical Theory | Professional Ethics (incl. police and research ethics) | Feminist Theory
Bioethics | Public Health (excl. Specific Population Health) not elsewhere classified | Social Ethics | Law, Politics and Community Services not elsewhere classified | Expanding Knowledge in Philosophy and Religious Studies |
Publisher: Informa UK Limited
Date: 28-05-2019
Publisher: Springer Science and Business Media LLC
Date: 23-10-2014
Publisher: University of Toronto Press Inc. (UTPress)
Date: 02-2017
Abstract: This paper draws attention to gendered dimensions of surgical device failure, focusing on two case studies—hernia repair mesh for pelvic organ prolapse, and metal-on-metal hip implants. We explore possible reasons for higher rates of harms to women, including systematic biases in health research and device regulation. Given that these factors are readily identifiable, we look to feminist scholarship to understand what might maintain them, including the role of cultural factors within surgery, such as gendered communication patterns and sexism. We then canvas potential measures to mitigate the increased risk of harms faced by women who use implanted devices.
Publisher: Springer Science and Business Media LLC
Date: 08-06-2016
DOI: 10.1007/S10728-016-0323-5
Abstract: Patient or public involvement (PPI) in health research is increasingly expected as a matter of policy. In theory, PPI can contribute both to the epistemic aims intrinsic to research (generating knowledge), and to extrinsically valued features of research such as social inclusion and transparency. In practice, the aims of PPI have not always been clear, although there has been a tendency to encourage the involvement of so-called ordinary people who are regarded as representative of an assumed patient perspective. In this paper we focus on the epistemic potential of PPI, using theoretical work in epistemology to develop a nuanced account of patients' experiential knowledge and how this might contribute directly to conceptual development, hypothesis generation and data interpretation. We also consider how some features of health research pose barriers to this kind of epistemic contribution. Drawing on Miranda Fricker's idea of testimonial injustice, we explore how disciplinary indicators of credibility in clinical and academic health research contexts might be wrongly applied to those involved in PPI, undermining their potential to contribute. Finally we argue for a range of strategies to maximize opportunities for patients to engage with research teams and make epistemologically significant contributions to research.
Publisher: AMPCo
Date: 07-2017
DOI: 10.5694/MJA16.00916
Publisher: Springer Netherlands
Date: 06-06-2015
Publisher: Wiley
Date: 21-09-2012
DOI: 10.1111/J.1365-2753.2012.01905.X
Abstract: This paper raises questions about the epistemological foundations of evidence-based medicine (EBM). We argue that EBM is based upon reliabilist epistemological assumptions, and that this is appropriate - we should focus on identifying the most reliable processes for generating and collecting medical knowledge. However, we note that this should not be reduced to narrow questions about which research methodologies are the best for gathering evidence. Reliable processes for generating medical evidence might lie outside of formal research methods. We also question the notion of the knower that is assumed by EBM. We argue that EBM assumes an enlightenment conception of knowers as autonomous, substitutable in iduals. This conception is troubled by the way that clinicians learn the role of anecdote in health care and the role of patient choice, all of which bring into play features of clinicians and patients as situated in iduals with particular backgrounds and experiences. EBM's enlightenment conception of the knower is also troubled by aspects of the way evidence is produced. Given these limitations, we argue that EBM should retain its reliabilist bent, but should look beyond formal research methodologies in identifying processes that yield reliable evidence for clinical practice. We suggest looking to feminist epistemology, with its focus on the standpoints of in idual situated knowers, and the role of social context in determining what counts as knowledge.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2014
Publisher: BMJ
Date: 04-07-2018
DOI: 10.1136/MEDETHICS-2018-104804
Abstract: Despite concerns about the relationships between health professionals and the medical device industry, the issue has received relatively little attention. Prevalence data are lacking however, qualitative and survey research suggest device industry representatives, who are commonly present in clinical settings, play a key role in these relationships. Representatives, who are technical product specialists and not necessarily medically trained, may attend surgeries on a daily basis and be available to health professionals 24 hours a day, 7 days a week, to provide advice. However, device representatives have a dual role: functioning as commissioned sales representatives at the same time as providing advice on approaches to treatment. This duality raises the concern that clinical decision-making may be unduly influenced by commercial imperatives. In this paper, we identify three key ethical concerns raised by the relationship between device representatives and health professionals: (1) impacts on healthcare costs, (2) the outsourcing of expertise and (3) issues of accountability and informed consent. These ethical concerns can be addressed in part through clarifying the boundary between the support and sales aspects of the roles of device representatives and developing clear guidelines for device representatives providing support in clinical spaces. We suggest several policy options including hospital provision of expert support, formalising clinician conduct to eschew receipt of meals and payments from industry and establishing device registries.
Publisher: Oxford University Press (OUP)
Date: 06-04-2017
Abstract: For many years, ethical debate about pacemakers has focused on whether and under what circumstances they may be turned off in end of life care. Several other important ethical issues have been neglected, perhaps because the dilemmas they pose for cardiologists are not so immediate. These include: potential conflicts of interest, particularly those arising from the role of industry employed allied professionals (IEAPs) in pacemaker care unanticipated impacts of commercial competition and the device improvement cycle risks associated with remotely accessible software equity in access to healthcare and questions about reuse of explanted pacemakers in low and middle income countries. This paper analyses these issues in order to facilitate a more comprehensive approach to ethics and the cardiac pacemaker. Cardiologists should be aware of all of these issues and contribute to ongoing discussions about how they are resolved.
Publisher: Springer Netherlands
Date: 2017
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2019
Publisher: AMPCo
Date: 24-11-2020
DOI: 10.5694/MJA2.50426
Publisher: Wiley
Date: 11-0001
DOI: 10.1002/HAST.644
Abstract: One day soon it may be possible to replace a failing heart, liver, or kidney with a long‐lasting mechanical replacement or perhaps even with a 3‐D printed version based on the patient's own tissue. Such artificial organs could make transplant waiting lists and immunosuppression a thing of the past. Supposing that this happens, what will the ongoing care of people with these implants involve? In particular, how will the need to maintain the functioning of artificial organs over an extended period affect patients and their doctors and the responsibilities of those who manufacture such devices? Drawing on lessons from the history of the cardiac pacemaker, this article offers an initial survey of the ethical issues posed by the need to maintain and service artificial organs. We briefly outline the nature and history of cardiac pacemakers, with a particular focus on the need for technical support, maintenance, and replacement of these devices. Drawing on the existing medical literature and on our conversations and correspondence with cardiologists, regulators, and manufacturers, we describe five sources of ethical issues associated with pacemaker maintenance: the location of the devices inside the human body, such that maintenance generates surgical risks the complexity of the devices, which increases the risk of harms to patients as well as introducing potential injustices in access to treatment the role of software—particularly software that can be remotely accessed—in the functioning of the devices, which generates privacy and security issues the impact of continual development and improvement of the device and the influence of commercial interests in the context of a medical device market in which there are several competing products. Finally, we offer some initial suggestions as to how these questions should be answered.
Publisher: Informa UK Limited
Date: 29-07-2021
DOI: 10.1080/21507740.2021.1949404
Abstract: ABSTRACTThis paper examines potential ethical and legal issues arising during the research, development and clinical use of a proposed strategy in personalized medicine (PM): using human induced pluripotent stem cell (iPSC)-derived tissue cultures as predictive models of in idual patients to inform treatment decisions. We focus on epilepsy treatment as a likely early application of this strategy, for which early-stage stage research is underway. In relation to the research process, we examine issues associated with biological s les data health vulnerable populations neural organoids and what level of accuracy justifies using the iPSC-derived neural tissue system. In relation to clinical use, we examine potential uses in pre-natal screening, and effects on clinical decision-making. Although our focus is providing recommendations for researchers developing work in this area, we identify the novel issue of deciding on an acceptable accuracy level for the system. We also emphasize an issue thus far neglected in the ethics of PM: PM tends to represent treatment decisions as though they should be directed solely by biomedical information, but this in itself could be detrimental to best personalizing treatment decisions in the clinic.
Publisher: Wiley
Date: 12-02-2016
DOI: 10.1111/BIOE.12252
Abstract: Surgical innovation promises improvements in healthcare, but it also raises ethical issues including risks of harm to patients, conflicts of interest and increased injustice in access to health care. In this article, we focus on risks of injustice, and use a case study of robotic prostatectomy to identify features of surgical innovation that risk introducing or exacerbating injustices. Interpreting justice as encompassing matters of both efficiency and equity, we first examine questions relating to government decisions about whether to publicly fund access to innovative treatments. Here the case of robotic prostatectomy exemplifies the difficulty of accommodating healthcare priorities such as improving the health of marginalized groups. It also illustrates challenges with estimating the likely long-term costs and benefits of a new intervention, the difficulty of comparing outcomes of an innovative treatment to those of established treatments, and the further complexity associated with patient and surgeon preferences. Once the decision has been made to fund a new procedure, separate issues of justice arise at the level of providing care to in idual patients. Here, the case of robotic prostatectomy exemplifies how features of surgical innovation, such as surgeon learning curves and the need for an adequate volume of cases at a treatment centre, can exacerbate injustices associated with treatment cost and the logistics of travelling for treatment. Drawing on our analysis, we conclude by making a number of recommendations for the just introduction of surgical innovations.
Publisher: Springer Science and Business Media LLC
Date: 15-02-2019
DOI: 10.1007/S11017-019-09482-Z
Abstract: Personalised medicine (PM) has been discussed as a medical paradigm shift that will improve health while reducing inefficiency and waste. At the same time, it raises new practical, regulatory, and ethical challenges. In this paper, we examine PM strategies epistemologically in order to develop capacities to address these challenges, focusing on a recently proposed strategy for developing patient-specific models from induced pluripotent stem cells (iPSCs) so as to make in idualised treatment predictions. We compare this strategy to two main PM strategies-stratified medicine and computational models. Drawing on epistemological work in the philosophy of medicine, we explain why these two methods, while powerful, are neither truly personalised nor, epistemologically speaking, novel strategies. Both are forms of correlational black box. We then argue that the iPSC models would count as a new kind of black box. They would not rely entirely on mechanistic knowledge, and they would utilise correlational evidence in a different way from other strategies-a way that would enable personalised predictions. In arguing that the iPSC models would present a novel method of gaining evidence for clinical practice, we provide an epistemic analysis that can help to inform the practical, regulatory, and ethical challenges of developing an iPSC system.
Publisher: Springer International Publishing
Date: 2023
Publisher: Springer Science and Business Media LLC
Date: 23-03-2022
DOI: 10.1186/S12910-022-00771-2
Abstract: The development and deployment of medical devices, along with most areas of healthcare, has been significantly impacted by the COVID-19 pandemic. This has had variable ethical implications, two of which we will focus on here. First, medical device regulations have been rapidly amended to expedite approvals of devices ranging from face masks to ventilators. Although some regulators have issued cessation dates, there is inadequate discussion of triggers for exiting these crisis standards, and evidence that this may not be feasible. Given the relatively low evidence standards currently required for regulatory approval of devices, this further indefinite reduction in standards raises serious ethical issues. Second, the pandemic has disrupted the usual operations of device representatives in hospitals, providing an opportunity to examine and refine this potentially ethically problematic practice. In this paper we explain and critically analyse the ethical implications of these two pandemic-related impacts on medical devices and propose suggestions for their management. These include an endpoint for pandemic-related adjustments to device regulation or a mechanism for continued refinement over time, together with a review of device research conducted under crisis conditions, support for the removal and replacement of emergency approved devices, and a review of device representative credentialling.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2015
Publisher: Oxford University Press
Date: 19-04-2018
DOI: 10.1093/OSO/9780190609610.001.0001
Abstract: Philosophical theorizing about moral responsibility has recently taken a “social” turn, marking a shift in focus from traditional metaphysical concerns about free will and determinism. Yet despite this social turn, the implications of structural injustice and inequalities of power for theorizing about moral responsibility remain surprisingly neglected in philosophical literature. Recent theories have attended to the interpersonal dynamics at the heart of moral responsibility practices, and the role of the moral environment in scaffolding agential capacities. However, they assume an overly idealized conception of agency and of our moral responsibility practices as reciprocal exchanges between equally empowered and situated agents. The essays in this volume systematically challenge this assumption. Leading theorists of moral responsibility, including Michael McKenna, Marina Oshana, and Manuel Vargas, consider the implications of oppression and structural inequality for their respective theories. Neil Levy urges the need to refocus our analyses of the epistemic and control conditions for moral responsibility from in idual to socially extended agents. Leading theorists of relational autonomy, including Catriona Mackenzie, Natalie Stoljar, and Andrea Westlund develop new insights into the topic of moral responsibility. Other contributors bring debates about moral responsibility into dialogue with recent work in feminist philosophy, and topics such as epistemic injustice, implicit bias and blame. Collectively, the essays in this volume reorient philosophical debates about moral responsibility in important new directions.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-07-2021
No related organisations have been discovered for Katrina Hutchison.
Start Date: 2020
End Date: 01-2025
Amount: $426,023.00
Funder: Australian Research Council
View Funded ActivityStart Date: 03-2020
End Date: 03-2025
Amount: $311,000.00
Funder: Australian Research Council
View Funded Activity