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Dive into the research topics where Angus Dawson is active.

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Featured researches published by Angus Dawson.


Vaccine | 2008

The ethics of mandatory vaccination against influenza for health care workers.

J.J.M. van Delden; Richard Ashcroft; Angus Dawson; Georg Marckmann; Ross Upshur; Marcel Verweij

Vaccination of health care workers (HCW) in long-term care results in indirect protection of patients who are at high-risk for influenza. The voluntary uptake of influenza vaccination among HCW is generally low. We argue that institutions caring for frail elderly have the responsibility to implement voluntary programmes for vaccination against influenza of HCW. When uptake falls short a mandatory programme may be justified. The main justification stems from the duty of care givers not to harm ones patient when one knows there is a significant risk of harm and the intervention to reduce this chance has a favourable balance of benefit over burdens and risks.


Bioethics | 2010

The Future of Bioethics: Three Dogmas and a Cup of Hemlock

Angus Dawson

In this paper I argue that bioethics is in crisis and that it will not have a future unless it begins to embrace a more Socratic approach to its leading assumptions. The absence of a critical and sceptical spirit has resulted in little more than a dominant ideology. I focus on three key issues. First, that too often bioethics collapses into medical ethics. Second, that medical ethics itself is beset by a lack of self-reflection that I characterize here as a commitment to three dogmas. Third, I offer a more positive perspective by suggesting how bioethics may benefit from looking towards public health ethics as a new source of inspiration and direction.


Journal of Medical Ethics | 2006

In defence of moral imperialism: four equal and universal prima facie principles

Angus Dawson; E Garrard

Raanan Gillon is a noted defender of the four principles approach to healthcare ethics. His general position has always been that these principles are to be considered to be both universal and prima facie in nature. In recent work, however, he has made two claims that seem to present difficulties for this view. His first claim is that one of these four principles, respect for autonomy, has a special position in relation to the others: he holds that it is first among equals. We argue that this claim makes little sense if the principles are to retain their prima facie nature. His second claim is that cultural variation can play an independent normative role in the construction of our moral judgments. This, he argues, enables us to occupy a middle ground between what he sees as the twin pitfalls of moral relativism and (what he calls) moral imperialism. We argue that there is no such middle ground, and while Gillon ultimately seems committed to relativism, it is some form of moral imperialism (in the form of moral objectivism) that will provide the only satisfactory construal of the four principles as prima facie universal moral principles.


Public health reviews | 2012

The Place of Solidarity in Public Health Ethics

Angus Dawson; Bruce Jennings

When we consider the literature that has been produced exploring approaches to public health ethics, it is rare to find any mention of solidarity. One obvious conclusion is that solidarity is a meaningless or superfluous consideration. We suggest that this is not the right conclusion to draw, and that we must first understand what solidarity is and then consider what difference it might make to thinking about issues in public health ethics. In this paper we, first, outline some of the existing approaches to public health ethics and suggest that they often involve a set of questionable assumptions about the nature of social relations as well as a clear commitment to particular values. A failure of imagination in relation to solidarity is not, however, an argument against taking the concept seriously. Second, we propose a particular account of solidarity, suggest reasons why it is important for thinking about ethical issues in public health, and suggest how it relates to other relevant values. We argue that it is essential to engage with the issue of where we ought to place solidarity within our debates and frameworks for public health ethics.


American Journal of Public Health | 2012

Informed consent and cluster-randomized trials.

Julius Sim; Angus Dawson

We argue that cluster-randomized trials are an important methodology, essential to the evaluation of many public health interventions. However, in the case of at least some cluster-randomized trials, it is not possible, or is incompatible with the aims of the study, to obtain individual informed consent. This should not necessarily be seen as an impediment to ethical approval, providing that sufficient justification is given for this omission. We further argue that it should be the institutional review boards task to evaluate whether the protocol is sufficiently justified to proceed without consent and that this is preferable to any reliance on community consent or other means of proxy consent.


Journal of Medical Ethics | 2015

Ebola: what it tells us about medical ethics

Angus Dawson

Good medical ethics needs to look more to the resources of public health ethics and use more societal, population or community values and perspectives, rather than defaulting to the individualistic values that currently dominate discussion. In this paper I argue that we can use the recent response to Ebola as an example of a major failure of the global community in three ways. First, the focus has been on the treatment of individuals rather than seeing that the priority ought to be public health measures. Second, the advisory committee on experimental interventions set up by the WHO has focused on ethical issues related to individuals and their guidance has been unclear. Third, the Ebola issue can be seen as a symptom of a massive failure of the global community to take sufficient notice of global injustice.


Hastings Center Report | 2015

Solidarity in the Moral Imagination of Bioethics

Bruce Jennings; Angus Dawson

How important is the concept of solidarity in our societys calculus of consent as regards the legitimacy and ethical and political support for public health, health policy, and health services? By the term “calculus of consent,” we refer to the answer that people give to rationalize and justify their obedience to laws, rules, and policies that benefit others. The calculus of consent answers questions such as, Why should I care? Why should I help? Why should I contribute to the public provision of others? Consent here does not have to be a deliberate, explicit act of informed agreement. And a calculus does not have to be a quantifiable, quasimathematical operation; more often, such a calculus takes narrative form in stories that a society tells about itself and that individuals tell about their place in it. One vital function of bioethics is to inform and shape those stories. Bioethics has the potential to offer society a keener insight into and perception of what is ethically at stake in controversies concerning health, science, and society. This insight is what we shall refer to as a “moral imagination,” by which we do not mean make-believe or fantasy but, rather, the capacity to take a critical distance from the given, to think reality otherwise. The moral imagination enables one to see connections between factors at work in history, in large social and communal structures, and in the shape of ones own life, thoughts, and feelings. Here we are especially concerned with the contribution that the concept of solidarity can make to the moral imagination of bioethics. We contend that solidarity must become more widely active and explicit in bioethics analysis and argumentation as it endeavors to shape reasons for obeying norms and rules of common benefit in an open, diverse society.


BMC Medical Ethics | 2014

What makes public health studies ethical? Dissolving the boundary between research and practice

Donald J. Willison; Nancy Ondrusek; Angus Dawson; Claudia Emerson; Lorraine E. Ferris; Raphael Saginur; Heather Sampson; Ross Upshur

BackgroundThe generation of evidence is integral to the work of public health and health service providers. Traditionally, ethics has been addressed differently in research projects, compared with other forms of evidence generation, such as quality improvement, program evaluation, and surveillance, with review of non-research activities falling outside the purview of the research ethics board. However, the boundaries between research and these other evaluative activities are not distinct. Efforts to delineate a boundary – whether on grounds of primary purpose, temporality, underlying legal authority, departure from usual practice, or direct benefits to participants – have been unsatisfactory.Public Health Ontario has eschewed this distinction between research and other evaluative activities, choosing to adopt a common framework and process to guide ethical reflection on all public health evaluative projects throughout their lifecycle – from initial planning through to knowledge exchange.DiscussionThe Public Health Ontario framework was developed by a working group of public health and ethics professionals and scholars, in consultation with individuals representing a wide range of public health roles. The first part of the framework interprets the existing Canadian research ethics policy statement (commonly known as the TCPS 2) through a public health lens. The second part consists of ten questions that guide the investigator in the application of the core ethical principles to public health initiatives.The framework is intended for use by those designing and executing public health evaluations, as well as those charged with ethics review of projects. The goal is to move toward a culture of ethical integrity among investigators, reviewers and decision-makers, rather than mere compliance with rules. The framework is consonant with the perspective of the learning organization and is generalizable to other public health organizations, to health services organizations, and beyond.SummaryPublic Health Ontario has developed an ethics framework that is applicable to any evidence-generating activity, regardless of whether it is labelled research. While developed in a public health context, it is readily adaptable to other health services organizations and beyond.


BMC Medical Ethics | 2015

Innovations in research ethics governance in humanitarian settings

Doris Schopper; Angus Dawson; Ross Upshur; Aasim Ahmad; Amar. Jesani; Raffaella Ravinetto; Michael J. Segelid; Sunita. Sheel; Jerome Amir Singh

BackgroundMédecins Sans Frontières (MSF) is one of the world’s leading humanitarian medical organizations. The increased emphasis in MSF on research led to the creation of an ethics review board (ERB) in 2001. The ERB has encouraged innovation in the review of proposals and the interaction between the ERB and the organization. This has led to some of the advances in ethics governance described in this paper.DiscussionWe first update our previous work from 2009 describing ERB performance and then highlight five innovative practices:• A new framework to guide ethics review• The introduction of a policy exempting a posteriori analysis of routinely collected data• The preapproval of “emergency” protocols• General ethical approval of “routine surveys”• Evaluating the impact of approved studiesThe new framework encourages a conversation about ethical issues, rather than imposing quasi-legalistic rules, is more engaged with the specific MSF research context and gives greater prominence to certain values and principles. Some of the innovations implemented by the ERB, such as review exemption or approval of generic protocols, may run counter to many standard operating procedures. We argue that much standard practice in research ethics review ought to be open to challenge and revision. Continued interaction between MSF researchers and independent ERB members has allowed for progressive innovations based on a trustful and respectful partnership between the ERB and the researchers. In the future, three areas merit particular attention. First, the impact of the new framework should be assessed. Second, the impact of research needs to be defined more precisely as a first step towards being meaningfully assessed, including changes of impact over time. Finally, the dialogue between the MSF ERB and the ethics committees in the study countries should be enhanced.SummaryWe hope that the innovations in research ethics governance described may be relevant for other organisations carrying out research in fragile contexts and for ethics committees reviewing such research.


Health Affairs | 2011

The Moral Case For The Routine Vaccination Of Children In Developed And Developing Countries

Angus Dawson

In developed countries some parents have decided not to provide routine vaccinations for their children, while in many developing countries there are inadequate rates of vaccination for various reasons. The consequences for children, and members of the community in which they live, can be significant and even tragic. Although some parents may worry that vaccines will harm their child, there is a broader moral case for vaccination that parents and policy makers should consider. This case has four components: benefits and harms, best interests, community benefits, and justice. This moral case should be central to deliberations about vaccination by parents and policy makers.

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Marcel Verweij

Wageningen University and Research Centre

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Richard Ashcroft

Queen Mary University of London

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Heather Draper

University of Birmingham

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Lucy Frith

University of Liverpool

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