ORCID Profile
0000-0003-2674-6225
Current Organisation
Deakin University - Geelong Campus at Waurn Ponds
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Bioethics (human and animal) | Applied Ethics | Historical Studies | Ethical Use of New Technology (e.g. Nanotechnology, Biotechnology) | Environmental Philosophy | Australian History (excl. Aboriginal and Torres Strait Islander History) | History and Philosophy of Medicine
Bioethics | Expanding Knowledge through Studies of Human Society | Technological Ethics | Environmental Ethics |
Publisher: Oxford University Press (OUP)
Date: 10-02-2022
DOI: 10.1093/SHM/HKAB133
Abstract: This article examines the emergence of bioethics at Monash University and Australia during the late-1970s and early-1980s. Unlike bioethics in the USA, which was born a decade earlier during policy debates over human experimentation and withdrawal of treatment, bioethics in Australia initially emerged in the university context via interactions among research scientists working at the forefront of reproductive medicine and philosophers seeking to address issues of public concern. These interactions occurred in a rapidly changing university sector that was moving towards research translation and a new global knowledge economy. Drawing on oral histories with philosophers and medical scientists involved in these events, as well as archival materials, this article uses a co-productionist analytic lens to critically examine how changing institutional norms encouraged mutually beneficial interactions between philosophers and scientists, which shaped the emergence of a new and distinctive field of bioethics in Australia.
Publisher: Wiley
Date: 12-2015
DOI: 10.1111/PHC3.12274
Publisher: Informa UK Limited
Date: 21-06-2016
Publisher: Springer Science and Business Media LLC
Date: 22-04-2016
DOI: 10.1007/S11019-016-9703-8
Abstract: Concerns over conflicts of interest (COI) in academic research and medical practice continue to provoke a great deal of discussion. What is most obvious in this discourse is that when COIs are declared, or perceived to exist in others, there is a focus on both the descriptive question of whether there is a COI and, subsequently, the normative question of whether it is good, bad or neutral. We contend, however, that in addition to the descriptive and normative, COI declarations and accusations can be understood as performatives. In this article, we apply J.L. Austin's performative speech-act theory to COI discourses and illustrate how this works using a contemporary case study of COI in biomedical publishing. We argue that using Austin's theory of performative speech-acts serves to highlight the social arrangements and role of authorities in COI discourse and so provides a rich framework to examine declarations, accusations and judgements of COI that often arise in the context of biomedical research and practice.
Publisher: Wiley
Date: 24-03-2015
DOI: 10.1002/9781118989463.WBECCS140
Abstract: Governmentality describes the practice of government that uses tactics, knowledges, and procedures to “conduct the conduct” of in iduals and populations. Foucault's analysis of neoliberal governmentality is especially relevant for examining consumer culture in relation to political economy. This entry outlines the significance of governmentality for the study of consumer culture, in particular consumption as production, consumption as responsibility, and consumption as security.
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.HEALTHPOL.2018.03.015
Abstract: "Sunshine" policy, aimed at making financial ties between health professionals and industry publicly transparent, has recently gone global. Given that transparency is not the sole means of managing conflict of interest, and is unlikely to be effective on its own, it is important to understand why disclosure has emerged as a predominant public policy solution, and what the effects of this focus on transparency might be. We used Carol Bacchi's problem-questioning approach to policy analysis to compare the Sunshine policies in three different jurisdictions, the United States, France and Australia. We found that transparency had emerged as a solution to several different problems including misuse of tax dollars, patient safety and public trust. Despite these differences in the origins of disclosure policies, all were underpinned by the questionable assumption that informed consumers could address conflicts of interest. We conclude that, while transparency reports have provided an unprecedented opportunity to understand the reach of industry within healthcare, policymakers should build upon these insights and begin to develop policy solutions that address systemic commercial influence.
Publisher: Springer Science and Business Media LLC
Date: 28-10-2009
Publisher: Informa UK Limited
Date: 11-2017
DOI: 10.1080/14647273.2017.1390266
Abstract: In Australia, the growing assisted reproductive technologies (ART) industry has recently received some public criticism. Much of this criticism centres on the concern that doctors are increasingly motivated by profit, rather than patient interests. These concerns appear to suggest that the growing business of ART generates conflicts of interest (COI) for clinicians. While media reports may be rhetorically compelling, claims that ART practice is distorted by COI must be supported by empirical evidence. This preliminary study sought to engage with people involved with the ART industry and map out their concerns related to COI in ART. A small convenience s le of eight professionals was interviewed. Here, we present the major themes uncovered, including a richer understanding of the 'interests' of various parties involved in Australian ART. We then propose a strategy for how this topic could be constructively explored.
Publisher: Springer Science and Business Media LLC
Date: 02-12-2022
DOI: 10.1007/S11673-021-10146-8
Abstract: I have been invited to reflect on "Discourse communities and the discourses of experience" a paper co-authored by Little, Jordens, and Sayers and discuss how their analysis of discourse communities has influenced the development of bioethics and consider its influence now and potential effects in the future. Their paper examines the way different discourse communities are shaped by different experiences and desires. The shared language and experiences can provide a sense of belonging and familiarity. These can be positive aspects of a discourse community, but there are also risks restricting the voices and experiences that can be heard and recognized. In this essay I hope to weave together three threads: an analysis of Little, Jordens, and Sayer's research on discourse communities the narrative interview I conducted with Little about his own experiences in establishing a bioethics centre and my own experience of the bioethical discourse community established by Little.
Publisher: Springer Science and Business Media LLC
Date: 03-2021
Publisher: Springer Science and Business Media LLC
Date: 12-2015
DOI: 10.1007/S11673-015-9670-4
Abstract: Public health advocates, government agencies, and commercial organizations increasingly use nutritional science to guide food choice and diet as a way of promoting health, preventing disease, or marketing products. We argue that in many instances such references to nutritional science can be characterized as nutritional scientism. We examine three manifestations of nutritional scientism: (1) the simplification of complex science to increase the persuasiveness of dietary guidance, (2) superficial and honorific references to science in order to justify cultural or ideological views about food and health, and (3) the presumption that nutrition is the primary value of food. This paper examines these forms of nutritional scientism in the context of biopolitics to address bioethical concerns related to the misuse of scientific evidence to make claims regarding the effect of diet on health. We argue that nutritional scientism has ethical implications (i) for in idual responsibility and freedom, (ii) concerning iatrogenic harm, and (iii) for well-being.
Publisher: Informa UK Limited
Date: 03-04-2015
Publisher: Springer Science and Business Media LLC
Date: 03-09-2014
DOI: 10.1057/STH.2014.12
Publisher: Springer Science and Business Media LLC
Date: 11-03-2020
Publisher: Wiley
Date: 03-11-2018
DOI: 10.1111/JEP.12843
Abstract: This paper reports on the findings from 6 focus groups conducted with Australian medical students. The focus groups sought students' perspectives on how the influence of commercial interests on medical practice and education could be managed. We conducted 6 focus groups with medical students in New South Wales, Australia. Participants were recruited via student-run medical society and faculty e-mail lists. Forty-nine students from 6 medical schools in New South Wales participated. The research team reflected on the extent to which students uncritically appealed to science in the abstract as a management solution for conflicts of interest. Data analysis was largely inductive, looking for uses of scientific terminology, EBM, and appeals to "science" in the management of COI and applied theoretical analyses of scientism. The students in our study suggested that science and evidence-based medicine, rather than ethics or professionalism, were the best tools to deal with undue influence and bias. This paper uses philosophy of science literature to critically examine these scientistic appeals to science and EBM as a means of managing the influence of pharmaceutical reps and commercial interests. We argue that a scientistic style of reasoning is reinforced through medical curricula and that students need to be made aware of the epistemological assumptions that underpin science, medicine, and EBM to address the ethical challenges associated with commercialised health care. More work is needed to structure medical curricula to reflect the complexities of practice and realities of science. However, curricula change alone will not sufficiently address issues associated with commercial interests in medicine. For real change to occur, there needs to be a broader social and professional debate about the ways in which medicine and industry interact, and structural changes that restrict or mitigate commercial influences in educational, research, and policy settings.
Publisher: MDPI AG
Date: 20-09-2022
DOI: 10.3390/NU14193884
Abstract: (1) Background: Albeit the main focus remains largely on mothers, in recent years Developmental Origins of Health and Disease (DOHaD) scientists, including epigeneticists, have started to examine how a father’s environment affects disease risk in children and argued that more attention needs to be given to father’s health-related behaviors for their influence on offspring at preconception (i.e., sperm health) as well as paternal lifestyle influences over the first 1000 days. This research ushers in a new paternal origins of health and disease (POHaD) paradigm and is considered a welcome equalization to the overemphasis on maternal influences. Epigeneticists are excited by the possibilities of the POHaD paradigm but are also cautious about how to interpret data and avoid biased impression of socio-biological reality. (2) Methods: We review sociological and historical literatures on the intersection of gender, food and diet across different social and historical contexts to enrich our understanding of the father (3) Results: Sociological and historical research on family food practices and diet show that there are no “fathers” in the abstract or vacuum, but they are differently classed, racialized and exist in socially stratified situations where choices may be constrained or unavailable. This confirms that epigeneticists researching POHaD need to be cautious in interpreting paternal and maternal dietary influences on offspring health (4) Conclusions: We suggest that interdisciplinary approach to this new paradigm, which draws on sociology, history and public health, can help provide the social and historical context for interpreting and critically understanding paternal lifestyles and influences on offspring health.
Publisher: Informa UK Limited
Date: 02-10-2022
Publisher: Springer Science and Business Media LLC
Date: 07-03-2012
Publisher: WHO Press
Date: 05-02-2018
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: Hindawi Limited
Date: 24-02-2015
DOI: 10.1111/IJCP.12609
Publisher: Springer Netherlands
Date: 2014
Publisher: Routledge
Date: 07-2016
Publisher: Springer Science and Business Media LLC
Date: 02-2016
DOI: 10.1007/S11017-016-9353-0
Abstract: Social, political, and economic environments play an active role in nurturing professional virtue. Yet, these environments can also lead to the erosion of virtue. As such, professional virtue is fragile and vulnerable to environmental shifts. While physicians are often considered to be among the most virtuous of professional groups, concern has also always existed about the impact of commercial arrangements on physicians' willingness and capacity to enact their professional virtues. This article examines the ways in which commercial arrangements have been negotiated to secure medical virtue from real or perceived threats of erosion. In particular, we focus on the concern surrounding conflicts of interest arising from commercial arrangements that have developed as a result of neoliberal economic and social policies. The deregulation of medical markets and privatization of services have produced new commercial relationships that are often misunderstood by patients, publics, and physicians themselves. 'Conflicts of interest' policies have been introduced in an attempt to safeguard ethical conduct and medical practice. However, a number of virtue ethicists have critiqued these policies as inadequate for securing virtue. We examine the ways in which commercial arrangements have been seen to impact upon medical virtue, both historically and in the context of modern medicine (using the ex le of fertility services in Australia). We then describe and critique current efforts to restore clinical virtue through both conflict of interest policies and through virtue ethics. Finally, we suggest some possible ways of addressing the corrosive effects of neoliberalism on medical virtue.
Publisher: Springer Science and Business Media LLC
Date: 11-09-2014
Publisher: Springer Science and Business Media LLC
Date: 03-01-2017
DOI: 10.1007/S11673-016-9764-7
Abstract: The pharmaceutical industry plays an increasingly dominant role in healthcare, raising concerns about "conflicts of interest" (COI) on the part of the medical professionals who interact with the industry. However, there is considerable disagreement over the extent to which COI is a problem and how it should be managed. Participants in debates about COI have become entrenched in their views, which is both unproductive and deeply confusing for the majority of medical professionals trying to work in an increasingly commercialized environment. We used a modified meta-narrative review method to analyse debates about COI in the academic and grey literature. We found two Discourse Models: The Critical Discourse Model sees COI in health and biomedicine as a major problem that both can and should be addressed, while the Defensive Discourse Model argues that current efforts to control COIs are at best unnecessary and at worst harmful. Each model is underpinned by profoundly differing views about how society should be organized-in particular whether market forces should be encouraged or curtailed-and how the dangers associated with market forces should be managed. In order to make any headway, academics and policymakers must recognize that these debates are underpinned by profoundly differing worldviews.
Publisher: Springer Nature Singapore
Date: 2022
DOI: 10.1007/978-981-19-3155-0_12
Abstract: Consumer food ethics has re-emerged over the past 30 years as a popular form of activism to address concerns with the dominance of corporate interests in the global food system. Proponents of consumer ethics contend that informing consumers about injustices in the food system via labels or awareness c aigns will lead to collective rejection of unethical food corporations and the embrace of ethical products. This approach has been criticized on a variety of grounds, including its reliance on and eventual co-optation by market mechanisms. In response to these criticisms, food activists and scholars have promoted a consumer ethic that embraces local and alternative food systems, thereby producing an alternative consumer ethic purportedly outside of market logics. While these alternative practices have much to commend them, we argue that alternative food systems are invariably oriented towards consumer interests and thereby run into similar problems faced by earlier iterations of consumer-based ethics. We argue against the persistent focus on consumer ethics as means of substantially disrupting food systems, whether global, local or alternative.
Publisher: Springer Science and Business Media LLC
Date: 06-01-2021
Publisher: Oxford University Press
Date: 21-11-2012
DOI: 10.1093/OBO/9780199756797-0029
Abstract: Public health has made enormous contributions to global health through policies and interventions. However, public health measures have also increased human suffering through policies of forced sterilization, mandatory screening of vulnerable populations, detention of people with infectious diseases, and the quarantine and social isolation of “sick” people or communities. Until the early 21st century, the values and ethics that public health is based on have been assumed to be “good” and have not been subject to critical analysis. Since the first decade of the 21st century, however, bioethics has shifted its attention from the clinic to the public sphere, and many of the ethical issues raised by public health have become the focus both of philosophical and empirical study. Bioethics in public health addresses the tension between local and global health needs the role of the community in decision making the duties, obligations, and limitations of the state in relation to the provision of health care the targeting of vulnerable populations by interventions aimed at preventing disease and the nature and importance of ethical principles and rights in health care. This article provides a collection of resources that address the ethical theories, theoretical frameworks, key concepts, and practices of public health.
Publisher: Wiley
Date: 09-2014
DOI: 10.5694/MJA14.01191
Abstract: The current outbreak of Ebola virus disease in West Africa is the worst so far. The unprecedented extent of mortality and morbidity in this outbreak has followed more from imposition of neoliberal economic policies on the countries affected than from the biological virulence of Ebola virus. The lack of vaccines and medications for Ebola virus disease is evidence that markets cannot reliably supply treatments for epidemic diseases. We attribute the current difficulties in containment chiefly to the erosion or non-development of the health and medical infrastructure needed to respond effectively, as a direct result of market-privileging policies imposed in the interests of wealthy nations. These events and responses hold lessons for public health priorities in Australia.
Publisher: Wiley
Date: 07-2017
DOI: 10.1111/IMJ.13471
Abstract: Conflicts of interest (COI) are considered ubiquitous in many healthcare arrangements,
Publisher: Springer Science and Business Media LLC
Date: 28-10-2023
DOI: 10.1007/S41055-022-00111-5
Abstract: The challenges to designing and implementing ethically and politically meaningful eating policies are many and complex. This article provides a brief overview of Anne Barnhill and Matteo Bonotti’s Healthy Eating Policy and Political Philosophy: A Public Reason Approach while also critically engaging with the place of racial justice, global interconnectedness, and debates over science in thinking about ethics and politics of public health nutrition and policy. I do not aim to burden Barnhill and Bonotti with the responsibility to fully address these issues, but considering the interconnection of these issues and the ever pressing effects of climate change on local and global food systems, we collectively need to turn to these difficult and pressing questions about what a just food system looks like, what concerns are centred, and who is left out. I group these engagements with Barnhill and Bonotti under three headings: racial liberalism, global food system, and contested nutrition science. I conclude with some remarks about locality.
Publisher: Routledge
Date: 22-12-2015
Publisher: Elsevier BV
Date: 04-2020
DOI: 10.1016/J.JCLINEPI.2019.12.014
Abstract: The aim of the study was to identify the range of issues labeled as "non-financial conflicts of interest" in biomedicine, articulate the associated concerns, and analyze the implications of defining these issues as conflicts of interest. This was a qualitative study, triangulating data from three purposively s led sources: (1) literature, (2) policies, and (3) interviews. Participants were corresponding authors of s led literature (December 2017 to January 2019). A critical, interpretive approach served as the analytic strategy. A total of 99 articles provided the s ling frame we recruited 16 participants and s led 20 policies. Participants labeled a wide range of personal attributes, social relationships, professional experiences, intellectual endeavors, and financial interests as "non-financial conflicts of interest." Despite a lack of consensus regarding the nature of the problem, many "non-financial" interests are currently subject to policy action. The term serves as ethical shorthand to describe the ways that (1) "strong beliefs," (2) "predetermined views," (3) experiences, and (4) relationships shape evidence-led processes. Expansion of the definition of conflict of interest to include non-financial interests may have unintended consequences, including exclusion of erse perspectives. Problems labeled "non-financial conflicts of interest" should be defined in terms of what they are rather than what they are not (i.e., "non"-financial). We suggest instead, preventing financial conflicts of interest and ensuring inclusive and equitable representation within evidence-based processes.
Publisher: Wiley
Date: 19-11-2019
DOI: 10.1002/9781405165518.WBEOSL049.PUB2
Abstract: Lifestyle has been of interest to sociologists since the emergence of consumer capitalism in the mid‐nineteenth century. The mass production and distribution of consumer goods, increased speed of transportation and communication, and fragmenting of traditional sources of authority and social cohesion contributed to the conditions that enabled in iduals to style their life to reflect a particular identity and social status. Sociologists such as Max Weber (1864–1920), Thorstein Veblen (1857–1929), and Georg Simmel (1858–1918) were central to initial analyses of the social and economic changes that gave rise to practices of self‐formation and the styling of life. Lifestyle endures as a sociological topic of study, including sociological analyses of new practices of styling life, countercultures, and how other fields (e.g., healthcare, sport) engage with the concept.
Publisher: Wiley
Date: 31-07-2017
DOI: 10.1111/MEDU.13383
Abstract: Conflicts of interest (CoIs) are considered to be ubiquitous in health care and biomedicine. The disclosure of relevant interests is a first step in managing conflicts, although its usefulness is contested. Although several countries have mandated the public disclosure of doctors' financial relationships with the pharmaceutical industry, little is known about medical students' understanding of mandatory public disclosure. Six 90-minute focus groups were conducted with medical students in New South Wales, Australia. Participants ranged from first- to final-year students. Students were asked about their understanding and experiences of CoIs and, more specifically, for their views on and experiences of disclosure in medical education, mandatory disclosure and public registers. Qualitative data analysis was based on a framework approach. Participants were generally not supportive of mandatory public disclosure of financial relationships with industry, principally because of concerns about privacy, control over disclosure, and others' (mis)interpretations of disclosures. Further, they did not know how to assess the disclosures presented to them as part of their medical education and described a wide range of reactions to disclosed information. This study suggests that students are currently not well prepared for mandatory public disclosure of CoIs. The subsequent discussion draws on Bourdieu's doxa to highlight assumptions of altruism in medicine, assumptions that are potentially in tension with recent events that have exposed doctors to moral scrutiny by the public. Medical students could be better prepared for future obligations by encouraging disclosures, and contextualising and helping students to interpret them. Disclosure as a box-ticking exercise is unlikely to achieve goals implied by transparency, but a more reflective approach may assist both scrutinisers and the scrutinised.
Publisher: Informa UK Limited
Date: 02-07-2020
Publisher: Oxford University Press (OUP)
Date: 19-06-2014
DOI: 10.1093/PHE/PHU013
Publisher: Wiley
Date: 24-03-2015
DOI: 10.1111/BIOE.12089
Abstract: Debate concerning the social impact of obesity has been ongoing since at least the 1980s. Bioethicists, however, have been relatively silent. If obesity is addressed it tends to be in the context of resource allocation or clinical procedures such as bariatric surgery. However, prominent bioethicists Peter Singer and Dan Callahan have recently entered the obesity debate to argue that obesity is not simply a clinical or personal issue but an ethical issue with social and political consequences. This article critically examines two problematic aspects of Singer and Callahan's respective approaches. First, there is an uncritical assumption that in iduals are autonomous agents responsible for health-related effects associated with food choices. In their view, in iduals are obese because they choose certain foods or refrain from physical activity. However, this view alone does not justify intervention. Both Singer and Callahan recognize that in iduals are free to make foolish choices so long as they do not harm others. It is at this point that the second problematic aspect arises. To interfere legitimately in the liberty of in iduals, they invoke the harm principle. I contend, however, that in making this move both Singer and Callahan rely on superficial readings of public health research to lify the harm caused by obese in iduals and ignore pertinent epidemiological research on the social determinants of obesity. I argue that the mobilization of the harm principle and corresponding focus on in idual behaviours without careful consideration of the empirical research is itself a form of harm that needs to be taken seriously.
Publisher: Informa UK Limited
Date: 02-01-2017
Publisher: Informa UK Limited
Date: 02-01-2020
Publisher: Springer Science and Business Media LLC
Date: 14-09-2017
DOI: 10.1007/S11673-017-9804-Y
Abstract: Conflicts of interest, stemming from relationships between health professionals and the pharmaceutical industry, remain a highly isive and inflammatory issue in healthcare. Given that most jurisdictions rely on industry to self-regulate with respect to its interactions with health professionals, it is surprising that little research has explored industry leaders' understandings of conflicts of interest. Drawing from in-depth interviews with ten pharmaceutical industry leaders based in Australia, we explore the normalized and structural management of conflicts of interest within pharmaceutical companies. We contrast this with participants' unanimous belief that the antidote to conflicts of interest with health professionals were "informed consumers." It is, thus, unlikely that a self-regulatory approach will be successful in ensuring ethical interactions with health professionals. However, the pharmaceutical industry's routine and accepted practices for disclosing and managing employees' conflicts of interest could, paradoxically, serve as an excellent model for healthcare.
Publisher: Springer Science and Business Media LLC
Date: 29-01-2015
DOI: 10.1007/S11673-014-9595-3
Abstract: This article critically examines current responses to multi-drug resistant tuberculosis (MDR-TB) 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 ublic health frame of reference.
Publisher: Informa UK Limited
Date: 06-07-2017
Location: Australia
Start Date: 2019
End Date: 2024
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2022
End Date: 2024
Funder: Australian Research Council
View Funded ActivityStart Date: 07-2017
End Date: 07-2021
Amount: $356,808.00
Funder: Australian Research Council
View Funded ActivityStart Date: 07-2022
End Date: 06-2025
Amount: $630,000.00
Funder: Australian Research Council
View Funded Activity