19 found
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  1.  34
    From Bridge to Destination? Ethical Considerations Related to Withdrawal of ECMO Support over the Objections of Capacitated Patients.Andrew Childress, Trevor Bibler, Bryanna Moore, Ryan H. Nelson, Joelle Robertson-Preidler, Olivia Schuman & Janet Malek - 2022 - American Journal of Bioethics 23 (6):5-17.
    Extracorporeal membrane oxygenation (ECMO) is typically viewed as a time-limited intervention—a bridge to recovery or transplant—not a destination therapy. However, some patients with decision-making capacity request continued ECMO support despite a poor prognosis for recovery and lack of viability as a transplant candidate. In response, critical care teams have asked for guidance regarding the ethical permissibility of unilateral withdrawal over the objections of a capacitated patient. In this article, we evaluate several ethical arguments that have been made in favor of (...)
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  2.  37
    Bioethics and the Moral Authority of Experience.Ryan H. Nelson, Bryanna Moore, Holly Fernandez Lynch, Miranda R. Waggoner & Jennifer Blumenthal-Barby - 2022 - American Journal of Bioethics 23 (1):12-24.
    While experience often affords important knowledge and insight that is difficult to garner through observation or testimony alone, it also has the potential to generate conflicts of interest and unrepresentative perspectives. We call this tension the paradox of experience. In this paper, we first outline appeals to experience made in debates about access to unproven medical products and disability bioethics, as examples of how experience claims arise in bioethics and some of the challenges raised by these claims. We then motivate (...)
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  3.  50
    Two Minds, One Patient: Clearing up Confusion About “Ambivalence”.Bryanna Moore, Ryan H. Nelson, Peter A. Ubel & Jennifer Blumenthal-Barby - 2021 - American Journal of Bioethics 22 (6):37-47.
    Patients who experience difficulty making medical decisions are often referred to as “ambivalent.” However, the current lack of attention to the nuances between a cluster of phenomena that resemble...
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  4.  24
    Public views about quality of life and treatment withdrawal in infants: limitations and directions for future research.Ryan H. Nelson - 2020 - Journal of Medical Ethics 46 (1):20-21.
    Work done within the realm of what is sometimes called ‘descriptive ethics’ brings two questions readily to mind: How can empirical findings, in general, inform normative debates? and How can these empirical findings, in particular, inform the normative debate at hand? Brick et al 1 confront these questions in their novel investigation of public views about lives worth living and the permissibility of withdrawing life-sustaining treatment from critically ill infants. Mindful of the is-ought gap, the authors suggest modestly that their (...)
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  5.  22
    Moral Intimacy, Authority, and Discretion.Ryan H. Nelson & Bryanna Moore - 2020 - American Journal of Bioethics 20 (2):66-68.
    Volume 20, Issue 2, February 2020, Page 66-68.
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  6.  28
    Pediatric Authenticity: Hiding in Plain Sight.Ryan H. Nelson, Bryanna Moore & Jennifer Blumenthal-Barby - 2022 - Hastings Center Report 52 (1):42-50.
    Hastings Center Report, Volume 52, Issue 1, Page 42-50, January/February 2022.
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  7. A Critique of the Neurodiversity View.Ryan H. Nelson - 2021 - Journal of Applied Philosophy 38 (2):335-347.
    The neurodiversity view makes both a conceptual and a political claim. Conceptually, the neurodiversity view holds that certain neurocognitive differences currently classified as disorders—autism, most notably—are best understood as forms of diversity. Politically, it holds that, rather than being medicalized and ‘treated’, neurodiversity ought to be respected in the way other human differences—such as differences in race and sexual orientation—are respected. In this article, I challenge the arguments given in support of neurodiversity’s conceptual claim, while defending its political aims of (...)
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  8.  16
    Is Suffering a Useless Concept?Ryan H. Nelson, Brent Kious, Emily Largent, Bryanna Moore & Jennifer Blumenthal-Barby - forthcoming - American Journal of Bioethics:1-8.
    Abstract“Suffering” is a central concept within bioethics and often a crucial consideration in medical decision making. As used in practice, however, the concept risks being uninformative, ambiguous, or even misleading. In this paper, we consider a series of cases in which “suffering” is invoked and analyze them in light of prominent theories of suffering. We then outline ethical hazards that arise as a result of imprecise usage of the concept and offer practical recommendations for avoiding them. Appeals to suffering are (...)
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  9.  24
    Autism Advocacy Before and After DSM-5.Ryan H. Nelson - 2020 - American Journal of Bioethics 20 (4):48-50.
    Volume 20, Issue 4, May 2020, Page 48-50.
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  10.  25
    Disability and Contingency Care.Ryan H. Nelson, Bharath Ram & Mary Anderlik Majumder - 2020 - American Journal of Bioethics 20 (7):190-192.
    Volume 20, Issue 7, July 2020, Page 190-192.
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  11.  21
    Clinical Ethics Expertise: Beyond Justified Normative Recommendations?Janet Malek & Ryan H. Nelson - 2019 - American Journal of Bioethics 19 (11):82-84.
    Volume 19, Issue 11, November 2019, Page 82-84.
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  12.  8
    Ethical Complexities in Utilizing Artificial Intelligence for Surrogate Decision Making.Jennifer Blumenthal-Barby, Faith E. Fletcher, Lauren Taylor, Ryan H. Nelson, Bryanna Moore, Brendan Saloner & Peter A. Ubel - 2024 - American Journal of Bioethics 24 (7):1-2.
    Ms. P. is in the ICU with respiratory failure and sepsis. She has been on a ventilator for almost a week, and now has impending kidney failure. Her children, who have been taking turns at the bedsi...
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  13.  34
    Social Reproductive Labor, Gender, and Health Justice.John Macintosh & Ryan H. Nelson - 2018 - American Journal of Bioethics 18 (10):26-28.
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  14.  19
    Consistently Inconsistent: Does Inconsistency Really Indicate Incapacity?Bryanna Moore, Ryan H. Nelson, Nicole Meredyth & Nekee Pandya - 2023 - HEC Forum 35 (3):215-222.
    While it is not explicitly included in capacity assessment tools, “consistency” has come to feature as a central concern when assessing patients’ capacity. In order to determine whether inconsistency indicates incapacity, clinicians must determine the source of the inconsistency with respect to the process or content of a patient’s decision-making. In this paper, we outline common types of inconsistency and analyze them against widely accepted elements of capacity. We explore the question of whether inconsistency necessarily entails a deficiency in a (...)
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  15.  20
    Building Effective Mentoring Relationships During Clinical Ethics Fellowships: Pedagogy, Programs, and People.Trevor M. Bibler, Ryan H. Nelson, Bryanna Moore, Janet Malek & Mary A. Majumder - 2024 - HEC Forum 36 (1):1-29.
    How should clinical ethicists be trained? Scholars have stated that clinical ethics fellowships create well-trained, competent ethicists. While this appears intuitive, few features of fellowship programs have been publicly discussed, let alone debated. In this paper, we examine how fellowships can foster effective mentoring relationships. These relationships provide the foundation for the fellow’s transition from novice to competent professional. In this essay, we begin by discussing our pedagogical commitments. Next, we describe the structures our program has created to assist our (...)
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  16.  14
    Consistently Inconsistent: Does Inconsistency Really Indicate Incapacity?Bryanna Moore, Ryan H. Nelson, Nicole Meredyth & Nekee Pandya - 2021 - HEC Forum 35 (3):1-8.
    While it is not explicitly included in capacity assessment tools, “consistency” has come to feature as a central concern when assessing patients’ capacity. In order to determine whether inconsistency indicates incapacity, clinicians must determine the source of the inconsistency with respect to the process or content of a patient’s decision-making. In this paper, we outline common types of inconsistency and analyze them against widely accepted elements of capacity. We explore the question of whether inconsistency necessarily entails a deficiency in a (...)
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  17.  28
    Justice and Intellectual Disability In A Pandemic.Ryan H. Nelson & Leslie P. Francis - 2020 - Kennedy Institute of Ethics Journal 30 (3):319-338.
    If the COVID-19 crisis has brought any benefits, one is the increased attention paid to persons with disabilities in the contexts of clinical medicine and public health. There has been a great deal of insightful discussion since the outbreak about controversial disability issues the pandemic has brought to light. For a population often overlooked in both academic circles and the public square, mere visibility is a victory. There are at least two important respects in which the discussion remains underdeveloped, however.First, (...)
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  18.  2
    Navigating Tensions Between Law and Ethics in Surrogate Decision Making.Ryan H. Nelson - 2024 - American Journal of Bioethics 24 (7):127-128.
    One way of thinking about the tension this case presents is as a simple conflict between law and ethics: Does the team follow the patient’s legally authorized surrogate, or the surrogate who is bet...
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  19.  26
    Review of Matthew L. Baum, The Neuroethics of Biomarkers: What the Development of Bioprediction Means for Moral Responsibility, Justice, and the Nature of Mental Disorder1. [REVIEW]Ryan H. Nelson - 2016 - American Journal of Bioethics 16 (12):20-22.