Merle Spriggs PhD
Professional Work Experience
- Senior Tutor, (Distance Education) Master of Bioethics and Graduate Diploma of Bioethics, Monash University, Clayton, Vic.
- Assistant Editor Monash Bioethics Review
- Sessional Lecturer in the graduate program in Ethics in Aged Services Management and Ethics in Dementia Care and Service Victoria University.
Research Interests
In contemporary bioethics discussions, standard theories of autonomy rely on the idea that people have some kind of life plan, or at least a stable set of values. When someone receives a devastating diagnosis they may act in ways that could be interpreted as a departure from a previously held life-plan or stable values. In my master's thesis I looked at examples of people who were to some extent self-determining despite having suffered a traumatic life-event. Now, I am exploring some of the issues more systematically. I am trying to work out what we are really referring to when we talk of autonomy.
I have begun by tracing the history of the development of the contemporary idea and by looking closely at the ideas of Rousseau, Kant and Mill. I have also traced the way in which the principle of respect for autonomy got into contemporary American bioethics via The Belmont Report. Also, because of the wide influence of Beauchamp and Childress's Principles of Biomedical Ethics in the field of bioethics, I look at the changes that take place in their chapter on autonomy. This shows us how many in the field view the concept of autonomy.
In contemporary discussions it seems that when we speak of autonomy there are quite different ideas that we may be referring to. Modern theorists invariably appeal to Kant but do they really understand Kant? Is the notion of autonomy they use one that is true to Kant? If it is not, what kind of concept or concepts are they using?
Finally I will try to work out if there is a useful idea of autonomy for the clinical context - one which can deal with traumatic events such as a devastating diagnosis.
Masters Thesis
"Autonomy and Shattered Assumptions" (1995)
Abstract : Existing well developed accounts of autonomy do not seem to apply to situations other than those in which a person's life goes along on a reasonably settled path. My concern is with instances in the clinical context where a person has to make a decision in the face of dramatically changed circumstances - when a person's life-plan or fundamental assumptions have been shattered.
I argue that the emphasis given to life-plans in some accounts of autonomy detracts from the importance of the present by over valuing the future. What is more, the life-plans referred to in discussions of autonomy do not readily admit the possibility that bad things can happen to a person. In the clinical context bad things do happen to people and the essence of such traumatic events is the disintegration of a person's life-plan. I consider examples of people who are to some extent self-determining despite their having suffered a traumatic life event.
Recent Publications
Refereed Journal Articles
- Ethical implications of women's underrepresentation in clinical trials (ethics committee supplement) in Monash Bioethics Review 1999; 18(2): 11-20.
- "Autonomy in the face of a devastating diagnosis' in Journal of Medical Ethics,1998; 24: 123-26.
- Women's participation in clinical trials in Alternative Law Journal 1998; 23(6)/ Health Issues 57 (Dec 1998) 273-5, 294.
- "Human subjects research: Review of the NH&MRC National Statement on Ethical Conduct in Research Involving Humans' in Ethics Committee Supplement Monash Bioethics Review, Vol.18, No.4, October 1999, pp.5-13.
- "The World Medical Association's proposed changes to the Declaration of Helsinki: Report from a Melbourne symposium' Ethics Committee Supplement Monash Bioethics Review, Vol.18, No.4, October 1999, pp.24-28.
Book Reviews and Booknotes
- Informative Paternalism: Studies in the Ethics of Promoting and Predicting Health by Nina Nikku, Linkopings Studies in Arts and Science, Linkoping, Sweden, in Bioethics 1998; 12: 259.
- Autonomy and Intervention: Parentalism in the Caring Life, by John Kultgen in Bioethics, Vol.10, No.4, Oct. 1996. Pp.344-346.
- Challenging Medicine (ed.) Jonathan Gabe, David Kelleher and Gareth Williams, Routledge, London, 1994 in Health Issues , 50. March 1997, pp.30-31.
- Philosophy of Medicine and Bioethics: A Twenty-Year Retrospective and Critical Appraisal, edited by Ronald A. Carson and Chester R. Burns, Dordrecht, The Netherlands, Kluwer Academic Publishers 1997 in Bioethics (forthcoming)
Other Journal Contributions
- Contemporary muddle in concepts of autonomy. in: Conference Proceedings (What is this thing called 'Bioethics'? ), 6th Annual Australia Bioethics Association Conference. (in press)
- "Health Consumer Information Needs and Participation in Medical Decision-Making' in Health Issues, 49, December 1996, pp.21-22.
- "The Role of Ethics Committees - Finding the Balance' in Health Issues, 48, September, 1996, pp.10-11.
- Report - "General Practice Evaluation Conference' for Health Issues, 48, September 1996, pp.8-9.
Memberships
- Health Issues Centre Editorial Committee. Health Issues Centre is an independent policy/research institution.
- Southern Health Care Network Dandenong Human Research and Ethics Committee.
- Australian Bioethics Association
- Research Ethics Committee Wesley Central Mission
- Australian Institute of Health, Law and Ethics.