Leonard M. Fleck

Leonard Fleck photo



Center for Bioethics and Social Justice

Department of Philosophy

C-202 East Fee Hall
(517) 355-7552
fleck @ msu.edu
Pronouns: he/him/his

PhD 1975 St. Louis University
BA 1966 Loyola University

Curriculum Vitae
MSU Scholars Profile
Research Gate Profile


Leonard Fleck's interests focus on medical ethics, health care policy, priority-setting and rationing, and reproductive decision-making. He explores the role of community dialogue (rational democratic deliberation) in addressing controversial issues of ethics and public policy related to emerging genetic technologies. More recently, he has been working on a book-length manuscript that addresses a number of ethical and policy issues related to precision medicine, primarily in a cancer treatment context.

Selected Publications

Danis M, Hurst SA, Fleck L, Forde R, Slowther A, eds. Fair Resource Allocation and Rationing at the Bedside. 1 ed: Oxford University Press; 2014. This volume is comprised of over twenty essays addressing various aspects of the issue of bedside rationing from both European and American perspectives. Dr. Fleck also contributed “Just Caring: The Ethical Challenges of Bedside Rationing,” Chapter 10, 171-203.

Fleck L. Just Caring: Health Care Rationing and Democratic Deliberation. Oxford University Press; 2009.

Fleck LM. Healthcare Priority-Setting: Chat-Ting Is Not Enough; Comment on “Swiss-CHAT: Citizens Discuss Priorities for Swiss Health Insurance Coverage”. International Journal of Health Policy and Management. October 2018;7(10):961-963. Available online July 28, 2018. PMID: 30316250. PMCID: PMC6186469. DOI: 10.15171/ijhpm.2018.66.

Fleck LM. Precision QALYs, Precisely Unjust. Cambridge Quarterly of Healthcare Ethics. July 2019;28(3):439-449. DOI: 10.1017/S0963180119000367.

Fleck L. Ethical Considerations Related to Obesity Intervention. In: Davies HD, Fitzgerald HE, Silk KJ, eds. Obesity in Childhood and Adolescence, 2nd Edition. Vol 2: Praeger; November 2018:3-35.

Fleck LM. Controlling Healthcare Costs: Just Cost Effectiveness or “Just” Cost Effectiveness? Cambridge Quarterly of Healthcare Ethics. April 2018;27(2):271-283. Available online March 6, 2018. PMID: 29509125. DOI: 10.1017/S0963180117000603.

Fleck LM, Murphy TF. First Come, First Served in the Intensive Care Unit: Always? Cambridge Quarterly of Healthcare Ethics. January 2018;27(1):52-61. PMID: 29214960. DOI: 10.1017/S0963180117000391.

Fleck LM. Just caring: Do we need philosophical foundations? Ethics, Medicine and Public Health. Available online June 9 2017. April-June 2017;3(2):221-232. This is the official journal for the International Academy of Medical Ethics and Public Health, jointly sponsored by the Sorbonne and Université René Descartes.

Fleck LM. Just Caring: Precision Medicine, Cancer Biomarkers and Ethical Ambiguity. In: Blanchard A, Strand R, eds. Cancer Biomarkers: Ethics, Economics and Society. Kokstad: Megaloceros Press; 2017:73-94.

Fleck LM, Danis M. How Should Therapeutic Decisions about Expensive Drugs Be Made in Imperfect Environments? AMA Journal of Ethics. February 2017;19(2):147-156.

Fleck LM. Choosing Wisely: Is Parsimonious Care Just Rationing? Cambridge Quarterly of Healthcare Ethics. July 2016;25(3):366-376.

Fleck L. Critical Care Limits: What Is the Right Balance? American Journal of Bioethics. Jan 2016;16(1):48-50.

Fleck LM. Just Caring: The Insufficiency of the Sufficiency Principle in Health Care. In: Fourie C, Rid A, eds. What Is Enough? Sufficiency, Justice, and Health: Oxford University Press; 2016:223-243.

Fleck L. Just Solidarity: The Key to Fair Health Care Rationing. Diametros. 2015;43(March 2015):44-54; an online European Philosophy journal.

Fleck L. Just Caring: Fair Innings and Priority Setting. In: Nagel E, Lauerer M, eds. Prioritization in Medicine: An International Dialogue: Springer International Publishing; 2016.

Fleck L. Just Caring: Do the Indolent, the Inebriated and the Irresponsible Deserve Equal Access to Needed Health Care? Indiana Health Law Review. July 2014;11(2):553-587.

Fleck L. Pharmacogenomics and Personalized Medicine: Wicked Problems, Ragged Edges, Ethical Precipices. New Biotechnology. Sept 2012(special issue “Personalized Medicine and Diagnostics"):757-768.

Fleck L. Liberty and the Individual Mandate. In: Kronenfeld J, Parmet W, Zezza M, eds. Debates on U.S. Health Care: Sage Publications; 2012:132-145.

Fleck L. Just Caring: In Defense of the Role of Rational Democratic Deliberation in Health Care Rationing and Priority Setting. In: den Exter A, Buijsen M, eds. Rationing Healthcare: Hard Choices and Unavoidable Trade-offs. Antwerp: Maklu Press; 2012:19-36.

Fleck L. Just Caring: Health Care Rationing, Terminal Illness, and the Medically Least Well Off. Journal of Law, Medicine, and Ethics. Summer 2011;39:156-171.

Fleck L. Just Caring: Defining a Basic Benefit Package. Journal of Medicine and Philosophy. Dec 2011;36:589-611.

Work in Progress:

Precision Medicine/Ethical Ambiguity? Wicked Problems, Ragged Edges, Rough Justice. Oxford University Press, (late 2020).

The Liberalism Problem, Public Reason, and Health Care Justice. Cambridge University Press, 2021 (anticipated).

Selected Achievements and Awards

  • Elected Fellow of the Brocher Foundation (Geneva), 2011
  • University Distinguished Faculty Award, 2003
  • Distinguished Faculty Award, College of Human Medicine, 2003
  • Elected Fellow of The Hastings Center, June 2002