Leonard M. Fleck
University Distinguished Professor
Center for Bioethics and Social Justice
Department of Philosophy
- C-202 East Fee Hall
- (517) 355-7552
- 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.
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
- Webinar: Precision Medicine and Distributive Justice: Wicked Problems for Democratic Deliberation
- If Whole Genome Sequencing is So Cheap and Quick, Why Shouldn’t Everyone Have It Done?
- Religious Coercion of Physicians: Whose Conscience Is It Anyway?
- Health Care and Social Justice: Just Take Two Aspirin for Your Tumor If You Cannot Afford Your Cancer Care
- Medicare For All: This Is Going to Hurt
- Greed Is God: The Divine Right to Avaricious Drug Pricing
- Gene Editing: God's Will or God's Won't
- Charlie Gard: An Unnecessary Tragedy?
- No More Death Panels; Politically-Assisted Suicide Instead
- Medicare Part "Q": Fantasy or Fantastic?
- Precision Medicine/Ambiguous Ethics?
- The Ethical Challenges Raised by Hepatitis C Drugs
- Misconceptions: Ethics and the Rejection of Reproductive Roulette
- Should Women Pay More for Health Insurance?
- Just Caring: Meeting the Health Care Needs of the Elderly (and Everyone Else)
- Podcast: Why I Left the U.S. for My Surgical Procedure: Fleck and Fluegel - Episode 21
- Podcast: Ethics and Policy Issues of Targeted Cancer Therapies: Fleck and Mackenzie - Episode 16
- Podcast: Ethical Implications of Gene-Editing Human Embryos: Eijkholt and Fleck – Episode 13
- Podcast: Reflecting on Early Bioethics: Fleck and Tomlinson - Episode 9
- Podcast: Organ Donation Models: Eijkholt and Fleck - Episode 8
- Podcast: The Medical Ethics Resource Network of Michigan: a History - Episode 3
- Webinar: Personalized Genomic Medicine: Rough Justice, Ragged Edges, Rugged Moral Terrain
- Webinar: Whoopie Pies, Super-Size Fries: "Just" Snacks? "Just" Des(s)erts?
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