29 found
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  1.  39
    Three Arguments Against Institutional Conscientious Objection, and Why They Are (Metaphysically) Unconvincing.Xavier Symons & Reginald Mary Chua - 2024 - Journal of Medicine and Philosophy 49 (3):298-312.
    The past decade has seen a burgeoning of scholarly interest in conscientious objection in healthcare. While the literature to date has focused primarily on individual healthcare practitioners who object to participation in morally controversial procedures, in this article we consider a different albeit related issue, namely, whether publicly funded healthcare institutions should be required to provide morally controversial services such as abortions, emergency contraception, voluntary sterilizations, and voluntary euthanasia. Substantive debates about institutional responsibility have remained largely at the level of (...)
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  2.  25
    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.  54
    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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  4.  28
    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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  5.  22
    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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  6.  22
    An Ethical Examination of Donor Anonymity and a Defence of a Legal Ban on Anonymous Donation and the Establishment of a Central Register.Xavier Symons & Henry Kha - 2024 - Journal of Bioethical Inquiry 21 (1):105-115.
    Many if not most sperm donors in the early years of IVF donated under conditions of anonymity. There is, however, a growing awareness of the ethical cost of withholding identifying parental information from donor children. Today, anonymous donation is illegal in many jurisdictions, and some jurisdictions have gone as far as retrospectively invalidating contracts whereby donors were guaranteed anonymity. This article provides a critical evaluation of the ethics and legality of anonymous donation. We defend Australian and British legislation that has (...)
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  7. 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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  8.  51
    ‘Alive by default’: An exploration of Velleman’s unfair burdens argument against state sanctioned euthanasia.Xavier Symons & Reginald Chua - 2019 - Bioethics 34 (3):288-294.
    In this article we critically evaluate an argument against state‐sanctioned euthanasia made by David Velleman in his 1992 paper ‘Against the right to die’. In that article, Velleman argues that legalizing euthanasia is morally problematic as it will deprive eligible patients of the opportunity of staying ‘alive by default’. That is to say, those patients who are rendered eligible for euthanasia as a result of legislative reform will face the burden of having to justify their continued existence to their epistemic (...)
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  9.  23
    Why Conscience Matters: A Theory of Conscience and Its Relevance to Conscientious Objection in Medicine.Xavier Symons - 2023 - Res Publica 29 (1):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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  10.  31
    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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  11.  26
    What We Owe to the Future, written by William MacAskill.Xavier Symons - 2024 - Journal of Moral Philosophy 21 (1-2):207-209.
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  12.  26
    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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  13. 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.
  14.  11
    Genetic disenhancement and xenotransplantation: diminishing pigs’ capacity to experience suffering through genetic engineering.Daniel Rodger, Daniel J. Hurst, Christopher A. Bobier & Xavier Symons - forthcoming - Journal of Medical Ethics.
    One objection to xenotransplantation is that it will require the large-scale breeding, raising and killing of genetically modified pigs. The pigs will need to be raised in designated pathogen-free facilities and undergo a range of medical tests before having their organs removed and being euthanised. As a result, they will have significantly shortened life expectancies, will experience pain and suffering and be subject to a degree of social and environmental deprivation. To minimise the impact of these factors, we propose the (...)
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  15.  16
    Two conceptions of conscience and the problem of conscientious objection.Xavier Symons - 2017 - Journal of Medical Ethics 43 (4):245-247.
    Schuklenk and Smalling argue that it is practically impossible for civic institutions to meet the conditions necessary to ensure that conscientious objection does not conflict with the core principles of liberal democracies. In this response, I propose an alternative definition of conscience to that offered by Schuklenk and Smalling. I discuss what I call the ‘traditional’ notion of conscience, and contrast this with the existentialist conception of conscience (which I take to be a close cousin of the view targeted by (...)
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  16.  22
    Abortion, euthanasia, and the limits of principlism.Brieann Rigby & Xavier Symons - 2023 - Medicine, Health Care and Philosophy 26 (4):549-556.
    Principlism is an ethical framework that has dominated bioethical discourse for the past 50 years. There are differing perspectives on its proper scope and limits. In this article, we consider to what extent principlism provides guidance for the abortion and euthanasia debates. We argue that whilst principlism may be considered a useful framework for structuring bioethical discourse, it does not in itself allow for the resolution of these neuralgic policy discussions. Scholars have attempted to use principlism to analyse the ethics (...)
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  17.  13
    Correction: Abortion, euthanasia, and the limits of principlism.Brieann Rigby & Xavier Symons - 2023 - Medicine, Health Care and Philosophy 26 (4):557-557.
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  18.  45
    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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  19.  19
    How Then Should We Die? Two Opposing Responses to the Challenges of Suffering and Death.Xavier Symons - 2023 - The New Bioethics 29 (2):193-194.
    Kay Toombs is an influential ethicist and disability scholar. In a new edition of her book How Then Should We Die? Two Opposing Responses to the Challenges of Suffering and Death, she critiques soc...
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  20.  14
    Moral Distress as Critique: Going beyond ‘Illegitimate Institutional Constraints’.Kate Jackson-Meyer, Xavier Symons & Charlotte Duffee - 2023 - American Journal of Bioethics 23 (4):79-82.
    Kolbe and de Melo-Martin (2023) raise important concerns about the limited usefulness of measures of moral distress. They propose that moral distress is best measured in terms of “illegitimate inst...
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  21.  25
    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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  22.  25
    First among equals? Adaptive preferences and the limits of autonomy in medical ethics.Susan Pennings & Xavier Symons - 2024 - Journal of Medical Ethics 50 (3):212-218.
    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, (...)
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  23.  18
    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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  24.  7
    On the importance of consistency: a response to Giubilini et al.Xavier Symons - 2024 - Journal of Medical Ethics 50 (5):347-348.
    Giubiliniet aloffer some helpful reflections on the conscientious provision of medical care and whether and in what circumstances professional associations ought to support the conscientious provision of abortion in circumstances where abortion is banned or heavily restricted. I have several reservations, however, about the argument developed in the article. First, the essay makes questionable use of the case of Savita Halappanavar to justify its central argument about conscientious provision. Second, there is an apparent inconsistency between this article and the authors’ (...)
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  25.  14
    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). CLF states that we should prioritise the needs of individuals who have had less opportunity to experience the events that characterise a complete life. Persadet alargue 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 we (...)
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  26.  27
    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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  27.  14
    Shlomi Segall. Why Inequality Matters: Luck Egalitarianism, Its Meaning and Value.Xavier Symons - 2021 - Journal of Moral Philosophy 18 (4):425-428.
  28.  13
    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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  29.  9
    Why conscience matters: a defence of conscientious objection in healthcare.Xavier Symons - 2022 - 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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