Browsing by Author "Hawkins, Jennifer"
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Item Open Access Death is Nothing! A Defense of Epicureanism(2020) Burkhardt, TimDeath can be terrible for the survivors of the deceased, but can it be bad for the deceased themselves? Epicurus argued that it could not be, apparently because there is no temporal overlap between death and the deceased person—no time at which both are present. This argument has received a great deal of philosophical attention in recent decades, but few philosophers of death find it convincing. Most believe that death can be bad for the deceased and some fear that grave moral implications would follow if it could not be. This dissertation argues otherwise. It begins by defending Epicurus’ argument against a host of the most promising contemporary objections to it. Finding that these objections fail, it concludes that the prevailing philosophical consensus is unjustified: although death may be a great misfortune for the survivors of the deceased, it cannot be bad for the deceased themselves. The dissertation then examines the implications of this conclusion for some other issues in ethics, arguing that these implications are not as unpleasant as is sometimes believed. In doing so, it hopes to establish a foothold for the larger project of showing that Epicureanism, deeply important though it is, does not wreak havoc upon the moral landscape.
Item Open Access Pharmaceutical Progress for Neglected Diseases: Using Non-Traditional Development Models to Overcome Market Deficiencies(2015) Rahman, Samir ZinnatTechnological advancements and developments in public and private sector medical research capacities have ushered an era of novel therapies and hopes against illness and disease at an unprecedented rate. However, not all diseases have fared similarly in this era of progress. Neglected diseases, those that afflict large numbers of the impoverished, continue to impart significant morbidity, mortality, and economic damage, largely unchecked, due to persistent deficiencies in treatment options. Inadequacies in pharmaceutical development comprise a major component of the problem, due to exorbitant costs associated with the drug approval process, combined with financial inabilities of the target clientele. Despite this market failure, in certain cases, drugs have in fact been developed and approved for use against neglected diseases. However, given the unique economic circumstances, such developments have often been funded, supported, and catalyzed through nontraditional means. The innovation and development policy mechanisms that yielded such progress against difficult odds can serve as models upon which to build and promote future pharmaceutical development for neglected diseases, if these mechanisms are explicitly characterized and common trends associated with successful drug production are identified. This thesis performs exactly such an analysis, by identifying relevant instances of approvals of drugs for neglected diseases, exploring their development histories, characterizing such histories into broad categories, and evaluating those broad categories against one another. In an examination of eighteen such approvals that occurred between 1989 and 2014, this thesis finds that six broad categories of development incentive policies were employed: (1) product development partnerships, (2) private pharmaceutical industry development, (3) corporate philanthropy, (4) military development, (5) priority review voucher issuance, and (6) intellectual property transfer. Of these policies, the product development partnership mechanism accounted for the most drug approvals, across a diverse array of diseases and jurisdictions, which suggests a particular robustness of this policy mechanism. As such, this thesis will contend that this particular policy mechanism theoretically, as well as empirically, represents the most propitious policy option for future endeavors to reduce the societally detrimental effects of the persistence of neglected diseases.
Item Open Access The Ethics of Innovation in the Medical Device Industry: A Complex Interaction between Multiple Actors and a Search for a Novel Approach(2014-12-30) Fawley, David WilliamEthics are inexorably linked to innovation and the release of new technology in the medical device industry. This thesis explores the ethical responsibilities of the actors within the industry, and questions the effectiveness of Premarket Notification [510(k)] regulation to adequately and ethically regulate the release of medical devices. Revision or redefinition of 510(k) policy is strongly suggested to properly address concerns of safety and efficacy in the ethical release of innovation to the public.Item Open Access The Ethics of the Rule of Rescue: Guidelines for Use in the Medical Setting(2019-04-16) Flynn, SpencerThe “rule of rescue” (RR) is the human impulse to rescue an identifiable person facing imminent threat, regardless of associated costs. For example, no price is spared to save trapped miners, even though instituting improved mine safety protocols may be more cost-effective by preventing mine disasters in the first place. In healthcare institutions, the rule of rescue is controversial primarily because of the frequent conflict between the impulse to rescue versus cost-effective healthcare allocation, and secondarily because of the occasional conflict between the impulse to rescue versus fairness and equity concerns. Consider the issue of allocating ventilators in a flu pandemic—in the face of scarcity, should we attempt to rescue each victim as they come, or adhere to a cost-effectiveness scheme in distributing resources? Further, should we attempt to rescue each victim as they come if wealthy, insured patients disproportionately present for help, or should we enact more generalized policies to ensure fair outcomes at a population level? Here, I present the first full ethical treatment of the RR, including an analysis of the moral psychology of rescue and the RR as considered from both consequentialist and deontological lenses. Regarding psychology at the individual level, I conclude that the impulse to rescue does not track morally salient considerations, but instead is influenced primarily by heuristics and errors in processing statistics. At a societal level, I conclude that following the RR plays an important role in building social trust and motivating altruism. Further, I show that the RR is compatible with each major ethical theory, albeit only insofar as it is necessary for social cohesion and wellbeing. I end by presenting a summary checklist of the relevant considerations around employing the RR in healthcare institutional decision-making, as well as a few suggestions for future research programs.