Carnegie Mellon University

Alex John London

Alex John London

Clara L. West Professor of Ethics and Philosophy

  • Baker Hall 150A
  • 412.268.4938

Bio

Alex John London is the Clara L. West Professor of Ethics and Philosophy and Director of the Center for Ethics and Policy at Carnegie Mellon University. Professor London is an elected Fellow of the Hastings Center whose work focuses on ethical and policy issues surrounding the development and deployment of novel technologies in medicine, biotechnology and artificial intelligence, methodological issues in theoretical and practical ethics, and cross-national issues of justice and fairness. His papers have appeared in Mind, Science, The Lancet, PLoS Medicine, Statistics In Medicine, The Hastings Center Report, and numerous other journals and collections and he is co-editor of Ethical Issues in Modern Medicine, one of the most widely used textbooks in medical ethics.

Policy Work in Research Ethics and Oversight.  Biomedical research is one of the most productive areas for the development of novel technologies.  Professor London has helped to shape key ethical guidelines for the oversight of research with human participants for over a decade.  From 2012-2016 he was a member of the Working Group on the Revision of CIOMS 2002 International Ethical Guidelines for Biomedical Research Involving Human Subjects.  Prior to that he was an expert commentator at three World Medical Association meetings for the revision of the 2013 Declaration of Helsinki.  Since 2007 he has been a member of the ethics working group of the U.S. HIV Prevention Trials Network where he was part of the group that drafted the HIV Prevention Trials Network Ethics Guidance for Research.  From 2016-2017 he was part of the U.S. National Academy of Medicine Committee on Clinical Trials During the 2014-15 Ebola Outbreak and in 2016 he was appointed to the U.S. Health and Human Services Advisory Committee on Blood and Tissue Safety and Availability. He has served as an ethics expert in consultations with numerous national and international organizations including U.S. National Institutes of Health, the World Health Organization (here, and here), the World Medical Association (here, and here) and the World Bank.

Ethical Foundations of Trial Design.  Professor London has written widely on foundational issues in the ethics and design of research with human subjects.  His work on clinical equipoise and the “integrative approach” to risk assessment provides clear operational content to the requirement that risks in research be reasonable and that research should be designed to produce valuable information. His work on the ethics of international research has helped to shape the debate about the requirements of justice, responsiveness to host community health needs, post-trial access, how to define the standard of care and how to use the concept of clinical equipoise in cross-national research.

Ethics of Regulation and Oversight.  Professor London has articulated a non-paternalistic foundation for the ethical oversight of research involving human subjects.  With colleagues, he has written a series of papers articulating a model for understanding clinical translation that identifies key benchmarks for assessing the ethical and scientific merits of proposals to reform research practice.  This work emphasizes the role of incentives in aligning the parochial interests of stakeholders with the social mission of producing valid, reliable, and relevant scientific information.

Autonomous systems, surveillance and other novel technologies.  Professor London’s work extends to novel technologies outside of biomedical research.  He has active research interests in ethical and policy issues related to the development and deployment of autonomous systems, such as self-driving cars.  He has also worked on ethical issues surrounding real-time video surveillance and the use of DNA technologies to identify remains in the aftermath of conflict or disaster.

Foundational Ethical Issues.  In addition to his work on practical ethical and policy issues, Professor London maintains an active research program on foundational ethical and methodological issues in theoretical and practical ethics.  He has explored the value of dignity in Kantian moral frameworks and the challenges this concept poses for rational decision making, in both group and individual choice settings.  He has also written about methodological issues in practical ethics.

Honors and Awards.  Professor London received the Elliott Dunlap Smith Award for Distinguished Teaching and Educational Service in the Dietrich College of Humanities and Social Sciences at Carnegie Mellon University.  He received the Distinguished Service Award from the American Society of Bioethics and Humanities (ASBH) and a New Directions Fellowship from the Andrew W. Mellon Foundation.

Professor London is an affiliated faculty member of the Center for Bioethics and Health Law at the University of Pittsburgh and was previously a Visiting Scholar at the Harvard University Program in Ethics and Health. Before joining Carnegie Mellon in 2000, he was a post-doctoral fellow at the University of Minnesota's Center for Bioethics and he received his Ph.D. in Philosophy from the University of Virginia.

Selected Publications

The PDFs of these papers are intended for personal academic use only and should not be distributed in any way.

Textbook

book cover Ethical Issues In Modern Medicine, 8th edition. Bonnie Steinbock, Alex John London, John D. Arras. McGraw Hill, 2012.

Ethics and Autonomous Systems

David Danks & Alex John London (forthcoming). Algorithmic Bias in Autonomous Systems. Proceedings of the 26th International Joint Conference on Artificial Intelligence (IJCAI 2017). (preprint)
IEEE Intelligent Systems David Danks and Alex John London (2017). Regulating Autonomous Systems: Beyond Standards. IEEE Intelligent Systems.


Formal Methods in Ethics

Philosopher's Imprint Adam Bjorndahl, Alex John London, Kevin J.S. Zollman (2017) Kantian Decision Making Under Uncertainty: Dignity, Price, and Consistency. The Philosopher’s Imprint. APRIL 2017, VOLUME 17, NO. 7, PP. 1-22
Mind Cover Athanasiou E, London AJ, Zollman KJS. (2015) "Dignity and the Value of Rejecting Profitable but Insulting Offers." Mind.

Kestigian, A. and London, A. J. (2016), Adversaries at the Bedside: Advance Care Plans and Future Welfare. Bioethics. doi: 10.1111/bioe.12263


London AJ and Zollman K.Z. (2010). Research at the Auction Block: Problems for the Fair Benefits Approach to International Research. The Hastings Center Report 40(4):34-45.
[PDF]
Appendices
Hoss F, London AJ. (2015) Assessing the Moral Coherence and Moral Robustness of Social Systems: Proof of Concept for a Graphical Models Approach. Science and Engineering Ethics (online first 21 December) DOI 10.1007/s11948-015-9743-0.

Ethics of Research in Crisis Situations

London, Alex John (2009) "Clinical Research in a Public Health Crisis: The Integrative Approach to Managing Uncertainty and Mitigating Conflict," Seton Hall Law Review: Vol. 39: Iss. 4, Article 4.  Available at: http://scholarship.shu.edu/shlr/vol39/iss4/4
Threats to the Common Good: Biochemical Weapons and Human Subjects Research. Alex John London (2003). The Hastings Center Report 33(5): 17-25.
[PDF]
Science Magazine Cover DNA Identification After Conflict or Disaster. Alex John London, Lisa S. Parker, Jay D. Aronson. Science 13 September 2013: Vol. 341 no. 6151 pp. 1178-1179 DOI: 10.1126/science.1238085
[
Summary]
[Reprint]
[Full Text]
[Podcast]


Ethical and Scientific Issues in Research Regulation and Oversight

JAMA London AJ (2017) Equipoise in Research: Integrating Ethics and Science in Human Research. JAMA. 2017;317(5):525-526. doi:10.1001/jama.2017.0016
Jonathan Kimmelman and Alex John London, “The Structure of Clinical Translation: Efficiency, Information, and Ethics,” Hastings Center Report 45 (2015): 1–7. DOI: 10.1002/hast.433.
[Abstract]

Alex John London and Jonathan Kimmelman. (2016) Accelerated Drug Approval and Health InequalityJAMA Intern Med. Published online June 13, 2016. doi:10.1001/jamainternmed.2016.2534

London AJ and Kimmelman J. (2015) Why Clinical Translation Cannot Succeed Without Failing. eLife 2015;4:e12844. DOI: 10.7554/eLife.12844.
Benjamin Carlisle , Nadine Demko, Georgina Freeman, Amanda Hakala, Nathalie MacKinnon, Tim Ramsay, Spencer Hey, Alex John London, Jonathan Kimmelman. (2015) Benefit, Risk and Outcomes in Drug Development: A Systematic Review of Sunitinib. JNCI: Journal of the National Cancer Institute. 108 (1): djv292 doi: 10.1093/jnci/djv292
Danielle Marie Wenner, Jonathan Kimmelman, and Alex John London. (2015). Patient-Funded Trials: Opportunity or Liability? Cell Stem Cell 
World Medical Journal Cover London AJ. (2013) Justification, Coherence and Consistency of Provisions in the Revised Declaration of Helsinki. World Medical Journal 59(5): 188-192.
[PDF]
Law, Medicine & Ethics Cover London AJ. 2012. A Non-Paternalistic Model of Research Ethics and Oversight:Assessing the Benefits of Prospective Review. Journal of Law, Medicine, and Ethics 40(4):930-944. DOI: 10.1111/j.1748-720X.2012.00722.x
[Link]
Science Magazine Cover Rethinking Research Ethics: The Case of Postmarketing Trials. Alex John London, Jonathan Kimmelman, Benjamin Carlisle. Science 4 May 2012: Vol. 336 no. 6081 pp. 544-545 DOI: 10.1126/science.1216086
[PDF]
Beyond Access vs. Protection in Trials of Innovative Therapies. Alex John London, Jonathan Kimmelman, and Marina Elena Emborg
Science 14 May 2010: 829-830.
[PDF]
London AJ, Borasky DA Jr, Bhan A, for the Ethics Working Group of the HIV Prevention Trials Network (2012) Improving Ethical Review of Research Involving Incentives for Health Promotion. PLoS Med 9(3):
e1001193. doi:10.1371/journal.pmed.1001193 [PDF]
Kimmelman J, London AJ (2011) Predicting Harms and Benefits in Translational Trials: Ethics, Evidence, and Uncertainty. PLoS Med 8(3): e1001010. doi:10.1371/journal.pmed.1001010 [PDF]
StatMed Reasonable Risks In Clinical Research: A Critique and a Proposal for the Integrative Approach. Alex John London (2006) Statistics In Medicine 25:2869-2885. DOI: 10.1002/sim.2634.
[PDF of published article from Wiley InterScience]
[PDF of unpaginated pre-print]
JMP Two Dogmas of Research Ethics and the Integrative Approach to Human-Subjects Research. Alex John London (2007) Journal of Medicine and Philosophy 32 (2): 99-116. DOI:10.1080/03605310701255727
[PDF]
OUP Clinical Equipoise: Foundational Requirement or Fundamental Error? Alex John London (2007) in Bonnie Steinbock (ed.) The Oxford Handbook of Bioethics. New York: Oxford University Press: 571-596.
[PDF]
JLME Equipoise and the Criteria for Reasonable Action. Evans EL & London AJ. (2006) Journal of Law Medicine and Ethics 34 (2): 441-450.
[PDF]
The Moral Foundations of Equipoise and Its Role in International Research. Alex John London (2006) The American Journal of Bioethics 6(4):48-50.
[PDF]
Threats to the Common Good: Biochemical Weapons and Human Subjects Research. Alex John London (2003). The Hastings Center Report 33(5): 17-25.
[PDF]


Ethics of International Research

London AJ and Zollman K.Z. (2010). Research at the Auction Block: Problems for the Fair Benefits Approach to International Research. The Hastings Center Report 40(4):34-45.
[PDF]
Appendices
lancet London AJ and Kimmelman J. (2008). Justice in Translation: From Bench to Bedside in the Developing World. The Lancet 372 (9632): 82-85.
[PDF]
ResearchEthics London AJ. (2008). Responsiveness to Host Community Health Needs. in Ezekiel J. Emanuel, Christine Grady, Robert Crouch, Reidar Lie, Franklin Miller, and David Wendler eds., The Oxford Textbook of Clinical Research Ethics. (New York: Oxford University Press) pp. 737-744.
[PDF]
HCR London AJ. (2005). Justice and the Human Development Approach to International Research. The Hastings Center Report 35(1): 24-37.
[PDF]
Bioethics London AJ. (2001). "Equipoise and International Human-Subjects Research." Bioethics 15(4) 4: 312-332.
[PDF]
JMP London AJ. (2000). "The Ambiguity and the Exigency: Clarifying 'Standard of Care' Arguments in International Research."Journal of Medicine and Philosophy 25(4): 379-397.
[PDF]
Vaccine Cover "Placebo use in vaccine trials: Recommendations of a WHO expert panel” (2014) Annette Rid, Abha Saxena, Abdhullah H. Baqui, Anant Bhan, Julie Bines, Marie-Charlotte Bouesseau, Arthur Caplan, James Colgrove, Ames Dhai, Rita Gomez-Diaz, Shane K. Green, Gagandeep Kang, Rosanna Lagos, Patricia Loh, Alex John London, Kim Mulholland, Pieter Neels, Punee Pitisuttithum, Samba Cor Sarr, Michael Selgelid, Mark Sheehan, et al. Vaccine 32(37): 4708-4712 (PDF)


Ethical Issues in Innovation: Surgery and Movement Disorders

Movement Disorders Journal Cover Kimmelman J, London AJ, Ravina B, Ramsay T, Bernstein M, Fine A, Stahnisch F, Emborg ME. (2009). "Launching Invasive, First-in-Human Trials Against Parkinson’s Disease: Ethical Considerations". Movement Disorders. [Abstract]
CuttingToTheCore London AJ. (2006). "Sham Surgery and Reasonable Risk" in David Benatar ed. Cutting to the Core: Exploring the Ethics of Contested Surgeries. New York: Rowman & Littlefield Publishers, Inc. 211-228.
[PDF]
Surgery London AJ. (2006).“Cutting Surgical Practice at the Joints: Individuating and Assessing Surgical Procedures.” in Angelique M. Rietsma and Jonathan D. Moreno eds., Ethical Guidelines for Innovative Surgery.  (Hagerstown, MD: University Publishing Group) 19-52.
[PDF]
StatMedRes London AJ, Kadane JB. (2002). "Placebos That Harm: Sham Surgery Controls in Clinical Trials." Statistical Methods in Medical Research 11(5): 413-428.
[PDF]

(This paper was a finalist for the 2002 Mark S. Ehrenreich Prize in health care ethics.)
London AJ, Kadane JB (2003). “Sham Surgery and Genuine Standards of Care: Can the Two be Reconciled?” The American Journal of Bioethics 3 (4): 61-64.
[PDF] from Project Muse
London AJ. (2001). "The Maltese Conjoined Twins: Two Views of Their Separation." The Hastings Center Report 31; 1: 48-52.
[PDF]


Ethics and Advertising Health Services

American Journal of Bioethics Cover Schenker Y, Arnold R, London AJ. 2014. "The Ethics of Advertising for Healthcare Services." American Journal of Bioethics 14 (3): 34-43. (Link)
JAMA Cover Schenker Y, London AJ. Risks of Imbalanced Information on US Hospital Websites. JAMA Intern Med. Published online January 12, 2015. doi:10.1001/jamainternmed.2014.7400


Methodology and Moral Psychology in Theoretical and Applied Ethics

metaphysics London AJ. (2001). "Moral Knowledge and the Acquisition of Virtue in Aristotle's Nicomachean and Eudemian Ethics." The Review of Metaphysics 54(3): 500-531.
[PDF]
theoretical London AJ. (2001). "The Independence of Practical Ethics." Theoretical Medicine and Bioethics 22(2): 87-105.
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KIEJ London AJ. (2000). "Amenable to Reason: Aristotle's Rhetoric and the Moral Psychology of Practical Ethics." Kennedy Institute of Ethics Journal 10(4): 287-305.
[PDF]
STP London AJ. (1998). "Virtue and Consequences: Hobbes on the Value of the Moral Virtues." Social Theory and Practice 24; 1:1-23.
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Selected Past Lectures

International Invited Talks

  • “Social Value, Reasonable Risk, and Research in a Public Health Crisis” Matariki 2017 Research Ethics Workshop, England.
  • “Equipoise and Vaccine Research in an Epidemic Context” “Ethical Design of Vaccine Trials in Emerging Infections Workshop” Oxford University 7/17/17.
  • “Ethical and Methodological Considerations for Pharmacovigilance with Accelerated Release of Medicines” Opening Keynote, Uppsala Forum of the Uppsala Monitoring Center, 30 June, 2016.
  • “Beyond Protection: The Integrity of Science as a Fundamental Ethical Concern” Opening Keynote Plenary, 15th Annual Meeting of the International Society of Pharmacovigilance. Prague, Czech Republic, Oct 28, 2015.
  • “Research and Global Health: Some Considerations of Justice” Annual Ethics Oration for the International Continence Society, Rio de Janeiro Brazil, 10/22/14.
  • “Mitigating Social Tension in Pandemic Research” and “Comments on the 2009 WHO Report on Research Ethics in International Epidemic Response” presented at Regulating Experimental Medicine During a Pandemic, London England 6/6- 7/14.
  • “Benefit Sharing in the Context of Biomedical Research: The Human Development Model” CIOMS International Workshop on Considerations on Benefit Sharing, Geneva, Switzerland Nov. 20, 2013.
  • “Integrity & Social Trust: Securing the Future of Identification of the Missing” The Missing: An Agenda for the Future, The Hague, Netherlands Oct. 31, 2013.
  • “Expert Consultation on Use of Placebo in Vaccine Trials: Pneumococcal Vaccine Case Study” World Health Organization (WHO) Expert Consultation on Use of Placebo in Vaccine Trials, Annecy France, Jan 17, 2013.
  • “Post-Trial Access to Investigational Interventions in International Settings,” The World Medical Association Expert Conference on the Revision of the Declaration of Helsinki, Cape Town, South Africa, Dec 6, 2012.
  • “Improving the Ethical Assessment of Incentives in Research,” and “Beyond Risk and Consent: Safeguarding the Integrity of Research as a Unique Social Good” for the training program in Buenos Aires, Argentina of the Fogarty International Center of the National institutes of Health 5/22-24/2012.
  • “Responsiveness, Access, and Partnerships for Inquiry,” Conference on Post Trial Access to Trial Drugs: Legal, Ethical, and Practical Issues, Broucher Foundation, Geneva Switzerland, 12/15/2011.
  • “Ethical Issues and Institutions of DNA Identification,” International Commission on Missing Persons (ICMP), Steering Committee on Forensic Sciences Programs, Sarajevo, Bosnia Herzegovina 10/25/11.
  • “The Integrative Approach to Clinical Trials of Charged Particle Radiotherapy” Institute for Science and Ethics and the Particle Therapy Cancer Research Institute, Oxford University 7/24/11.
  • “Fair Benefits and Placebo Controls” The World Medical Association Expert Conference on The Ethics of Placebo Controls in Clinical Trials, Sao Paulo, Brazil, 7/15/2011.
  • “Research vs. Surveillance and Other Public Health Practices: Definitions and Respective Ethical and Procedural Implications.” World Health Organization, Geneva Switzerland, 6/10/09.
  • “Reasonable Risk in Clinical Research” and “The Responsiveness to Host Community Health Needs Requirement” for the training program in Buenos Aires, Argentina of the Fogarty International Center of the National institutes of Health 11/7-8/06.

Invited Plenary Talks

  • “Ethics and AI” Vision Monday, New York City, 3/29/17.
  • “The ‘Standard of Prevention’ in HIV Prevention Research” plenary panel presentation at the HIV Vaccine Trials Network Annual Meeting, Washington D.C. 5/6/15.
  • “IRBs, What Are They Good For? Absolutely Nothing? Individual Integrity vs. Institutional Design” Lehman Lecture in Medical Ethics, Allegheny College March 12, 2014.
  • “Ethical Challenges in Research Involving Financial Incentives In Resource Scarce Environments,” Invited Plenary, U.S. Government Evidence Summit: Enhancing Provision and Use of Maternal Health Services through Financial Incentives, Washington, DC, 4/25/12.
  • “Ethical Issues in Behavioral Economics and Combination Prevention” Invited Plenary, HIV Prevention Trials Network Annual Meeting, Washington DC. 6/6/11.
  • “Is Research Morally Special: Justice, Respect, and Reasonable Regulation.” Invited Plenary, Public Responsibility In Medicine and Research (PRIMR) annual meeting, 11/14/09. (I gave 3 additional talks at this meeting as well).