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  1. Reframing Consent for Clinical Research: A Function-Based Approach.Scott Y. H. Kim, David Wendler, Kevin P. Weinfurt, Robert Silbergleit, Rebecca D. Pentz, Franklin G. Miller, Bernard Lo, Steven Joffe, Christine Grady, Sara F. Goldkind, Nir Eyal & Neal W. Dickert - 2017 - American Journal of Bioethics 17 (12):3-11.
    Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...)
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  2. Informed consent.Nir Eyal - 2017 - In Peter Schaber & Andreas Müller (eds.), The Routledge Handbook of the Ethics of Consent. New York, NY: Routledge.
     
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  3. Using informed consent to save trust.Nir Eyal - 2014 - Journal of Medical Ethics 40 (7):437-444.
    Increasingly, bioethicists defend informed consent as a safeguard for trust in caretakers and medical institutions. This paper discusses an ‘ideal type’ of that move. What I call the trust-promotion argument for informed consent states:1. Social trust, especially trust in caretakers and medical institutions, is necessary so that, for example, people seek medical advice, comply with it, and participate in medical research.2. Therefore, it is usually wrong to jeopardise that trust.3. Coercion, deception, manipulation and other violations of standard informed consent requirements (...)
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  4. Why continuing uncertainties are no reason to postpone challenge trials for coronavirus vaccines.Robert Steel, Lara Buchak & Nir Eyal - 2020 - Journal of Medical Ethics 46 (12):808-812.
    To counter the pandemic caused by severe acute respiratory syndrome coronavirus 2, some have proposed accelerating SARS-CoV-2 vaccine development through controlled human infection trials. These trials would involve the deliberate exposure of relatively few young, healthy volunteers to SARS-CoV-2. We defend this proposal against the charge that there is still too much uncertainty surrounding the risks of COVID-19 to responsibly run such a trial.
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  5. ‘Perhaps the most important primary good’: self-respect and Rawls’s principles of justice.Nir Eyal - 2005 - Politics, Philosophy and Economics 4 (2):195-219.
    The article begins by reconstructing the just distribution of the social bases of self-respect, a principle of justice that is covert in Rawls’s writing. I argue that, for Rawls, justice mandates that each social basis for self-respect be equalized. Curiously, for Rawls, that principle ranks higher than Rawls’s two more famous principles of justice - equal liberty and the difference principle. I then recall Rawls’s well-known confusion between self-respect and another form of self-appraisal, namely, confidence in one’s determinate plans and (...)
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  6. Egalitarian justice and innocent choice.Nir Eyal - 2006 - Journal of Ethics and Social Philosophy 2 (1):1-19.
    This article argues that, in its standard formulation, luck-egalitarianism is false. In particular, I show that disadvantages that result from perfectly free choice can constitute egalitarian injustice. I also propose a modified formulation of luck-egalitarianism that would withstand my criticism. One merit of the modification is that it helps us to reconcile widespread intuitions about distributive justice with equally widespread intuitions about punitive justice.
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  7.  30
    Inequalities in Health: Concepts, Measures, and Ethics.Nir Eyal, Samia A. Hurst, Ole F. Norheim & Dan Wikler (eds.) - 2013 - Oxford University Press.
    Which inequalities in longevity and health among individuals, groups, and nations are unfair? And what priority should health policy attach to narrowing them? These essays by philosophers, economists, epidemiologists, and physicians attempt to determine how health inequalities should be conceptualized, measured, ranked, and evaluated.
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  8.  29
    The benefit/risk ratio challenge in clinical research, and the case of HIV cure: an introduction.Nir Eyal - 2017 - Journal of Medical Ethics 43 (2):65-66.
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  9.  49
    The Diverse Ethics of Translational Research.Neema Sofaer & Nir Eyal - 2010 - American Journal of Bioethics 10 (8):19-30.
    Commentators on the ethics of translational research find it morally problematic. Types of translational research are said to involve questionable benefits, special risks, additional barriers to informed consent, and severe conflicts of interest. Translational research conducted on the global poor is thought to exploit them and increase international disparities. Some commentators support especially stringent ethical review. However, such concerns are grounded only in pre-approval translational research (now called T1 ). Whether or not T1 has these features, translational research beyond approval (...)
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  10.  27
    COVID-19 controlled human infection studies: worries about local community impact and demands for local engagement.Kyungdo Lee & Nir Eyal - 2021 - Journal of Medical Ethics 47 (8):539-542.
    In spring, summer and autumn 2020, one abiding argument against controlled human infection studies of SARS-CoV-2 vaccines has been their impact on local communities. Leading scientists and bioethicists expressed concern about undue usage of local residents’ direly needed scarce resources at a time of great need and even about their unintended infection. They recommended either avoiding CHI trials or engaging local communities before conducting any CHIs. Similar recommendations were not made for the alternative—standard phase III field trials of these same (...)
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  11. Making Fair Choices on the Path to Universal Health Coverage.Ole Frithjof Norheim, Trygve Ottersen, Bona Chitah, Richard Cookson, Norman Daniels, Nir Eyal, Walter Flores, Axel Gosseries, Daniel Hausman, Samia Hurst, Lydia Kapiriri, Toby Ord, Shlomi Segall, Frehiwot Defaye, Alex Voorhoeve & Alicia Yamin - 2014 - World Health Organisation.
    This report by the WHO Consultative Group on Equity and Universal Health Coverage addresses how countries can make fair progress towards the goal of universal coverage. It explains the relevant tradeoffs between different desirable ends and offers guidance on how to make these tradeoffs.
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  12.  56
    How to keep high-risk studies ethical: classifying candidate solutions.Nir Eyal - 2017 - Journal of Medical Ethics 43 (2):74-77.
  13.  36
    Input and output in distributive theory.Nir Eyal & Anders Herlitz - 2023 - Noûs 57 (1):3-25.
    Distributive theories evaluate distributions of goods based on candidate recipients’ characteristics, e.g. how well off candidates are, how deserving they are, and whether they fare below sufficiency. But such characteristics vary across possible worlds, so distributive theories may differ in terms of the world which for them settles candidates’ characteristics. This paper examines how distributive theories differ in terms of whether candidate recipients’ relevant characteristics are grounded in the possible world that would take place if the distributor does not intervene (...)
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  14.  41
    Can Rationing through Inconvenience Be Ethical?Nir Eyal, Paul L. Romain & Christopher Robertson - 2018 - Hastings Center Report 48 (1):10-22.
    In this article, we provide a comprehensive analysis and a normative assessment of rationing through inconvenience as a form of rationing. By “rationing through inconvenience” in the health sphere, we refer to a nonfinancial burden that is either intended to cause or has the effect of causing patients or clinicians to choose an option for health-related consumption that is preferred by the health system for its fairness, efficiency, or other distributive desiderata beyond assisting the immediate patient. We argue that under (...)
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  15.  22
    Do coronavirus vaccine challenge trials have a distinctive generalisability problem?Nir Eyal & Tobias Gerhard - 2022 - Journal of Medical Ethics 48 (9):586-589.
    Notwithstanding the success of conventional field trials for vaccines against COVID-19, human challenge trials that could obtain more information about these and about other vaccines and further strategies against it are about to start in the UK. One critique of COVID-19 HCTs is their distinct paucity of information on crucial population groups. For safety reasons, these HCTs will exclude candidate participants of advanced age or with comorbidities that worsen COVID-19, yet a vaccine should protect such populations. We turn this cliché (...)
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  16. Is the Body Special? Review of Cécile Fabre, Whose Body is it Anyway? Justice and the Integrity of the Person: Nir Eyal.Nir Eyal - 2009 - Utilitas 21 (2):233-245.
    Both left libertarians, who support the redistribution of income and wealth through taxation, and right libertarians, who oppose redistributive taxation, share an important view: that, looming catastrophes aside, the state must never redistribute any part of our body or our person without our consent. Cécile Fabre rejects that view. For her, just as the undeservedly poor have a just claim to money from their fellow citizens in order to lead a minimally flourishing life, the undeservedly ‘medically poor’ have a just (...)
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  17.  56
    Inequality in Political Philosophy and in Epidemiology: A Remarriage.Nir Eyal - 2018 - Journal of Applied Philosophy.
    In political philosophy and in economics, unfair inequality is usually assessed between individuals, nowadays often on luck-egalitarian grounds. You have more than I do and that's unfair. By contrast, in epidemiology and sociology, unfair inequality is traditionally assessed between groups. More is concentrated among people of your class or race than among people of mine, and that's unfair. I shall call this difference the egalitarian ‘divorce’. Epidemiologists, and their ‘divorce lawyers’ Paula Braveman, Norman Daniels, and Iris Marion Young, explain that (...)
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  18. The Ethics of Human Challenge Trials Using Emerging SARS-CoV-2 Virus Variants.Abie Rohrig & Nir Eyal - manuscript
    The world’s first COVID-19 human challenge trial using the D614G strain of SARS-CoV-2 is underway in the United Kingdom. The Wellcome Trust is funding challenge stock preparation of the Beta variant (B.1.351) for a follow-up human challenge trial, and researchers at Imperial College London are considering conducting that trial. However, little has been written thus far about the ethical justifiability of human challenge trials with SARS-CoV-2 variants of concern. While vaccine resistance as such does not increase risks for volunteers in (...)
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  19.  46
    Precommitting to Serve the Underserved.Nir Eyal & Till Bärnighausen - 2012 - American Journal of Bioethics 12 (5):23-34.
    In many countries worldwide, especially in Sub-Saharan Africa, a shortage of physicians limits the provision of lifesaving interventions. One existing strategy to increase the number of physicians in areas of critical shortage is conditioning medical school scholarships on a precommitment to work in medically underserved areas later. Current practice is usually to demand only one year of service for each year of funded studies. We show the effectiveness of scholarships conditional on such precommitment for increasing physician supplies in underserved areas. (...)
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  20.  34
    Is There an Ethical Upper Limit on Risks to Study Participants?Nir Eyal - 2020 - Public Health Ethics 13 (2):143-156.
    Are some risks to study participants too much, no matter how valuable the study is for society? This article answers in the negative.
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  21. Physician brain drain: Can nothing be done?Nir Eyal & Samia A. Hurst - 2008 - Public Health Ethics 1 (2):180-192.
    Next SectionAccess to medicines, vaccination and care in resource-poor settings is threatened by the emigration of physicians and other health workers. In entire regions of the developing world, low physician density exacerbates child and maternal mortality and hinders treatment of HIV/AIDS. This article invites philosophers to help identify ethical and effective responses to medical brain drain. It reviews existing proposals and their limitations. It makes a case that, in resource-poor countries, ’locally relevant medical training’—teaching primarily locally endemic diseases and practice (...)
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  22.  1
    Incommensurability and democratic deliberation in bioethics.Nir Eyal - 2024 - Philosophical Studies 181 (12):3367-3393.
    Often, a health resource distribution (or, more generally, a health policy) ranks higher than another on one value, say, on promoting total population health; and lower on another, say, on promoting that of the worst off. Then, some opine, there need not be a rational determination as to which of the multiple distributions that partially fulfill both one ought to choose. Sometimes, reason determines only partially, intransitively, or contentiously which of the many “compromises” between these two values is best or (...)
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  23.  33
    Vaccine testing for emerging infections: the case for individual randomisation.Nir Eyal & Marc Lipsitch - 2017 - Journal of Medical Ethics 43 (9):625-631.
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  24. Three Case Studies in Making Fair Choices on the Path to Universal Health Coverage.Alex Voorhoeve, Tessa Edejer, Kapiriri Lydia, Ole Frithjof Norheim, James Snowden, Olivier Basenya, Dorjsuren Bayarsaikhan, Ikram Chentaf, Nir Eyal, Amanda Folsom, Rozita Halina Tun Hussein, Cristian Morales, Florian Ostmann, Trygve Ottersen, Phusit Prakongsai & Carla Saenz - 2016 - Health and Human Rights 18 (2):11-22.
    The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies (...)
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  25. Measuring the Global Burden of Disease: Philosophical Dimensions.Nir Eyal, Samia A. Hurst, Christopher J. L. Murray, S. Andrew Schroeder & Daniel Wikler (eds.) - 2020 - New York, USA: Oup Usa.
    The Global Burden of Disease Study is one of the largest-scale research collaborations in global health, producing critical data for researchers, policy-makers, and health workers about more than 350 diseases, injuries, and risk factors. Such an undertaking is, of course, extremely complex from an empirical perspective. But it also raises complex ethical and philosophical questions. In this volume, a group of leading philosophers, economists, epidemiologists, and policy scholars identify and discuss these philosophical questions. Better appreciating the philosophical dimensions of a (...)
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  26. Ethical and legal race‐responsive vaccine allocation.Bastian Steuwer & Nir Eyal - 2023 - Bioethics 37 (8):814-821.
    In many countries, the COVID‐19 pandemic varied starkly between different racial and ethnic groups. Before vaccines were approved, some considered assigning priority access to worse‐hit racial groups. That debate can inform rationing in future pandemics and in some of the many areas outside COVID‐19 that admit of racial health disparities. However, concerns were raised that “race‐responsive” prioritizations would be ruled unlawful for allegedly constituting wrongful discrimination. This legal argument relies on an understanding of discrimination law as demanding color‐blindness. We argue (...)
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  27.  24
    Symposium on risks to bystanders in clinical research: An introduction.Nir Eyal & Lisa Holtzman - 2020 - Bioethics 34 (9):879-882.
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  28.  62
    Adding Lithium to Drinking Water for Suicide Prevention—The Ethics.Jared Ng, Manne Sjöstrand & Nir Eyal - 2019 - Public Health Ethics 12 (3):274-286.
    Recent observations associate naturally occurring trace levels of Lithium in ground water with significantly lower suicide rates. It has been suggested that adding trace Lithium to drinking water could be a safe and effective way to reduce suicide. This article discusses the many ethical implications of such population-wide Lithium medication. It compares this policy to more targeted solutions that introduce trace amounts of Lithium to groups at higher risk of suicide or lower risk of adverse effects. The question of mass (...)
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  29.  61
    Informed consent, the value of trust, and hedons.Nir Eyal - 2014 - Journal of Medical Ethics 40 (7):447-447.
    Sissela Bok's1 and Torbjörn Tännsjö's2 writings on trust and informed consent were sources of inspiration for my article.3 It is gratifying to have a chance to respond to their thoughtful comments.Bok concurs with my scepticism that the ‘trust-promotion argument for informed consent’ can successfully generate commonsense morality's full set of informed consent norms. But she finds that argument even more wanting, perhaps so wanting as to be unworthy of critical attention. What she seems to find particularly objectionable is the fact (...)
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  30.  54
    Paternalism, French fries and the weak-willed Witness.Nir Eyal - 2014 - Journal of Medical Ethics 40 (5):353-354.
    Most books on ethics are boring. Against Autonomy 1 is fun to read because its helpful and profound points are made without a fuss. Author Sarah Conly is right that “when individuals engage in behavior that undercuts their own chances of happiness, state interference may be justified”.In what follows I argue that Conly misinterprets that thesis in three ways. First, she says that her paternalism seeks to “help people get where they want to go... live the lives they truly want (...)
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  31.  62
    Nudges and Noodges: The Ethics of Health Promotion—New York Style.Daniel Wikler & Nir Eyal - 2013 - Public Health Ethics 6 (3):pht033.
    Michael Bloomberg's three terms in New York City's mayoral office are coming to a close. His model of governance for public health influenced cities and governments around the world. What should we make of that model? This essay introduces a symposium in which ethicists Sarah Conly, Roger Brownsword and Alex Rajczi discuss that legacy.
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  32.  59
    Inequalities in HIV Care: Chances Versus Outcomes.Nir Eyal & Alex Voorhoeve - 2011 - American Journal of Bioethics 11 (12):42-44.
    We analyse three moral dilemmas involving resource allocation in care for HIV-positive patients. Ole Norheim and Kjell Arne Johansson have argued that these cases reveal a tension between egalitarian concerns and concerns for better population health. We argue, by contrast, that these cases reveal a tension between, on the one hand, a concern for equal *chances*, and, on the other hand, both a concern for better health and an egalitarian concern for equal *outcomes*. We conclude that, in these cases, there (...)
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  33.  39
    What can the lived experience of participating in risky HIV cure-related studies establish?Nir Eyal - 2018 - Journal of Medical Ethics:medethics-2017-104593.
    This response to Gail Henderson et al argues that they were right that interviewees’ appraisals of cure study participation should inform protocol review decisions, but wrong to take these appraisals at face value.
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  34.  43
    Dependence on Digital Medicine in Resource-Limited Settings.Jeffrey I. Campbell, Jessica Haberer, Angella Musiimenta & Nir Eyal - 2018 - American Journal of Bioethics 18 (9):54-56.
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  35.  47
    Reconciling informed consent with prescription drug requirements.Nir Eyal - 2012 - Journal of Medical Ethics 38 (10):589-591.
  36.  23
    Future pandemics and the urge to ‘do something’.Adam Lerner & Nir Eyal - forthcoming - Journal of Medical Ethics.
    Research with enhanced potential pandemic pathogens (ePPP) makes pathogens substantially more lethal, communicable, immunosuppressive or otherwise capable of triggering a pandemic. We briefly relay an existing argument that the benefits of ePPP research do not outweigh its risks and then consider why proponents of these arguments continue to confidently endorse them. We argue that these endorsements may well be the product of common cognitive biases—in which case they would provide no challenge to the argument against ePPP research. If the case (...)
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  37.  25
    Paying for antiretroviral adherence: is it unethical when the patient is an adolescent?Justin Healy, Rebecca Hope, Jacqueline Bhabha & Nir Eyal - 2017 - Journal of Medical Ethics 43 (3):145-149.
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  38.  59
    Incommensurability and Trade.Nir Eyal & Emma Tieffenbach - 2016 - The Monist 99 (4):387-405.
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  39. Cómo tomar decisiones justas en el camino hacia la cobertura universal de salud.Ole Frithjof Norheim, Trygve Ottersen, Bona Chitah, Richard Cookson, Norman Daniels, Frehiwot Defaye, Nir Eyal, Walter Flores, Axel Gosseries, Daniel Hausman, Samia Hurst, Lydia Kapiriri, Toby Ord, Shlomi Segall, Gita Sen, Alex Voorhoeve, Tessa T. T. Edejer, Andreas Reis, Ritu Sadana, Carla Saenz, Alicia Yamin & Daniel Wikler - 2015 - Pan-American Health Organization (PAHO).
    La cobertura universal de salud está en el centro de la acción actual para fortalecer los sistemas de salud y mejorar el nivel y la distribución de la salud y los servicios de salud. Este documento es el informe fi nal del Grupo Consultivo de la OMS sobre la Equidad y Cobertura Universal de Salud. Aquí se abordan los temas clave de la justicia (fairness) y la equidad que surgen en el camino hacia la cobertura universal de salud. Por lo (...)
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  40.  20
    When offering a patient beneficial treatment undermines public health.Nir Eyal & Bridget Williams - 2023 - Bioethics 37 (9):846-853.
    Sometimes, offering someone beneficial care is likely to thwart the similar or more serious medical needs of more people. For example, when acute shortage is strongly predicted to persist, providing the long period on scarce intensive care that a certain COVID‐19 patient needs is sometimes projected to block several future COVID‐19 patients from receiving the shorter periods on intensive care that they will need. Expected utility is typically higher if the former is denied intensive care. A tempting initial account of (...)
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  41.  34
    Paired Publication: A Way to Lower One Barrier between Philosophical Insight and Bioethics.Bastian Steuwer, Nir Eyal & Monica Magalhães - 2022 - American Journal of Bioethics 22 (12):33-35.
    Blumenthal-Barby et al. (2022) are right. Philosophers should pay greater attention to bioethics and bioethicists should pay greater attention to insights from philosophy. This commentary extends t...
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  42.  42
    Research ethics and public trust in vaccines: the case of COVID-19 challenge trials.Nir Eyal - 2024 - Journal of Medical Ethics 50 (4):278-284.
    Despite their clearly demonstrated safety and effectiveness, approved vaccines against COVID-19 are commonly mistrusted. Nations should find and implement effective ways to boost vaccine confidence. But the implications for ethical vaccine development are less straightforward than some have assumed. Opponents of COVID-19 vaccine challenge trials, in particular, made speculative or empirically implausible warnings on this matter, some of which, if applied consistently, would have ruled out most COVID-19 vaccine trials and many non-pharmaceutical responses.
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  43.  68
    Making Fair Choices on the Path to Universal Health Coverage: Applying Principles to Difficult Cases.Alex Voorhoeve, Tessa T.-T. Edejer, Lydia Kapiriri, Ole Frithjof Norheim, James Snowden, Olivier Basenya, Dorjsuren Bayarsaikhan, Ikram Chentaf, Nir Eyal, Amanda Folsom, Rozita Halina Tun Hussein, Cristian Morales, Florian Ostmann, Trygve Ottersen, Phusit Prakongsai & Carla Saenz - 2017 - Health Systems and Reform 3 (4):1-12.
    Progress towards Universal Health Coverage (UHC) requires making difficult trade-offs. In this journal, Dr. Margaret Chan, the WHO Director-General, has endorsed the principles for making such decisions put forward by the WHO Consultative Group on Equity and UHC. These principles include maximizing population health, priority for the worse off, and shielding people from health-related financial risks. But how should one apply these principles in particular cases and how should one adjudicate between them when their demands conflict? This paper by some (...)
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  44.  28
    Obamacare and Conscientious Objection.Nir Eyal & Axel Gosseries - 2013 - Ethical Perspectives 20 (1):109-117.
  45. Faire Des Choix Justes Pour Une Couverture Sanitaire Universelle.Ole Frithjof Norheim, Trygve Ottersen, Bona Chitah, Richard Cookson, Norman Daniels, Frehiwot Defaye, Nir Eyal, Walter Flores, Axel Gosseries, Daniel Hausman, Samia Hurst, Lydia Kapiriri, Toby Ord, Shlomi Segall, Gita Sen, Alex Voorhoeve, Daniel Wikler, Alicia Yamin, Tessa T. T. Edejer, Andreas Reis, Ritu Sadana & Carla Saenz - 2015 - World Health Organization.
    This report from the WHO Consultative Group on Equity and Universal Health Coverage offers advice on how to make progress fairly towards universal health coverage.
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  46. Shlomi Segall.Dan Brock, Eric Cavallero, Norman Daniels, Nir Eyal, Iwao Hirose, Adi Koplovitz, Martin McIvor, David Miller, Ole Norheim & Daniel Schwartz - 2011 - In Carl Knight & Zofia Stemplowska (eds.), Responsibility and distributive justice. New York: Oxford University Press.
     
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  47.  34
    Afterword: returning to philosophical foundations in research ethics.Nir Eyal - 2017 - Journal of Medical Ethics 43 (2):132-133.
  48.  14
    All research that might result in a pandemic must undergo external review.Nir Eyal - 2023 - Bioethics 37 (3):223-225.
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  49.  44
    Coercion in the fight against medical brain drain.Nir Eyal & Samia Hurst - unknown
    Several contributions in this book tell of doctors' increasing emigration from developing countries where they are in critical shortage, especially from the underserved rural and public sectors of countries in sub-Saharan Africa (SSA) and South Asia. They point out the severe harm from that migration to some of the world's poorest and sickest populations who have no other doctors to turn to, and gain little from their emigration. Since significant harm to the badly off is bad, decline in that migration (...)
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  50.  38
    Non-Consequentialist Utilitarianism.Nir Eyal - 2014 - Ethics and Economics 11 (2).
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