Leonard M. Fleck

Leonard Fleck photo


University Distinguished Professor

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


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 completed a book-length manuscript that addresses a number of ethical and policy issues related to precision medicine, primarily in a cancer treatment context. He also completed another book that addresses several contemporary issues related to bioethics and religion from a Rawlsian public reason perspective.

Selected Publications

Fleck LM. Bioethics, Public Reason, and Religion. Cambridge University Press, 2022. DOI: 10.1017/9781009086684.

Fleck LM. Precision Medicine and Distributive Justice: Wicked Problems for Democratic Deliberation. Oxford University Press, 2022.

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. Full Reciprocity: An Essential Element for a Fair Opt-Out Organ Transplantation Policy. Cambridge Quarterly of Healthcare Ethics. July 2022;31(3): 310-20.

Fleck LM. Precision Medicine and the Fragmentation of solidarity (and justice). Medicine, Health Care, and Philosophy: A European Journal. June 2022;26: 191-206.

Fleck LM. Precision Health and Ethical Ambiguity: How Much Cancer Can WE Afford to Prevent? In Precision Oncology and Cancer Biomarkers: Issues at Stake and Matters of Concern, edited by Anne Bremer and Roger Strand (Springer, 2022), 205-34.

Fleck LM. Ultimate Price: The Value We Place on Human Life. [Book review, Thomas Friedman, author]. Public Health Ethics. October 2021;14 (2): 218-20.

Fleck LM. Alzheimer’s and Aducanumab: Unjust Profits and False Hopes. Hastings Center Report. July/August 2021;51: 9-11.

Fleck LM. Should Whole Genome Sequencing be Publicly Funded for Everyone as a Matter of Health Care Justice? (with Leslie Francis) Cambridge Quarterly of HealthCare Ethics. Jan. 2022;31 (1): 5-15.

Eli Adashi, Burgess M, Burall S, Cohen IG, Fleck LM, Harris J, Holm S, LaFont C, Moreno JD, Neblo MA, and seven others. Heritable Human Genome Editing: The Public Engagement Imperative. The CRISPR Journal. 2020;3 (6): 434-39.

Fleck LM. Just Caring: Screening Needs Limits. Journal of Medical Ethics. 2020;46: 253-54.

Fleck LM. Medical Ethics: A Distinctive Species of Ethics. Cambridge Quarterly of Healthcare Ethics. July 2020;29: 421-25.

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.

More Items on the Web

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.

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