Austin Horn 2017-09-13T13:01:38+00:00

Project Description

RESEARCH AREAS:

  • Medical Ethics

  • Research Ethics

  • Clinical Trials

CONTACT:

AUSTIN HORN

Doctoral Student;
Department of Philosophy, Western University

Austin Horn is currently a doctoral student in philosophy at Western University. His academic interests centre on the ethics of medical research. Austin received his B.A. Honours (with distinction) in philosophy from the University of Victoria. He pursued an independent undergraduate research project on moral psychology, investigating the implications of recent studies in neuroscience, cognitive psychology, and evolutionary biology for moral philosophy. Working as a research assistant for the Eco-Research Chair in Environmental Law and Policy, Prof. M’Gonigle, Austin conducted the research for a book chapter on “Green Legal Theory,” a critique of environmental law as an effective regulatory mechanism for environmental protections. Austin received his Master’s in philosophy at Western. He worked as a graduate research assistant on the “Ethics of Neuroimaging After Serious Brain Injury,” a project that investigates the ethical issues of neuroimaging in behaviourally nonresponsive patients. Supervised by Prof. Charles Weijer, Austin wrote his Master’s research paper on an important ethical concept in research ethics, called “clinical equipoise.” The paper explores the history, debate, contemporary applications, and global implications of clinical equipoise. Austin’s current doctoral research explores the ethical challenges that arise in the context pragmatic comparative effectiveness randomized controlled trials. He also works as a graduate research assistant on the ethics of pragmatic clinical trials.

I am interested in the ethics of medical research. More specifically, my research explores the ethical challenges that arise in the context of pragmatic comparative effectiveness randomized controlled trials (ceRCTs), such as cluster randomized trials of policy interventions involving healthcare professionals.

Pragmatic ceRCTs evaluate the head-to-head effectiveness of two (or more) interventions under real-world clinical conditions. ceRCTs are critical for the production of evidence regarding the most effective, least harmful, and most cost-effective treatments, thereby providing information policy makers, physicians and patients urgently require for healthcare decision-making. But, ceRCTs present difficult ethical challenges because they intermingle interventions routinely used in practice with research, and this belies a clear research-practice distinction. The lack of guidance on interpreting internationally accepted research ethics principles in the context of ceRCTs, has left researchers and research ethics committees without a unified and systematic method of ethical analysis for these important trials. This has inevitably led to controversies in the wake of a few ceRCTs, resulting in unnecessary and costly delays. The absence of clear ethical guidance for ceRCTs therefore poses a practical threat to the conduct of this socially valuable research.

My doctoral research project aims to develop a novel ethical framework for the design and conduct of pragmatic ceRCTs. I will apply this framework to a recently funded Ontario-wide ceRCT, called the FLUID trial. As a graduate research assistant, I am also working with a new international and interdisciplinary research team on the ethics of pragmatic trials. The team spans five countries (Canada, U.S., U.K., Australia, and France) and consists of philosophers, ethicists, trialists, statisticians, social scientists, and experts in knowledge translation. By combining ethical analysis with empirical methodologies, the project seeks to address a broad range of ethical challenges that arise in pragmatic trials, including those in health services research, cluster randomized trials, stepped wedge trials, and comparative effectiveness trials. The project will culminate in an international consensus guidance process to aid researchers and research ethics committees conduct and review pragmatic trials. My doctoral research project is an important component of this larger project.

Edited Journals (published, submitted, and in preparation)

Horn AR, Weijer C. Clinical Equipoise. Encyclopedia of Global Bioethics, (1): 1-11. (Published 2015).

Horn AR, Weijer C, Grimshaw JM, Brehaut JC, Fergusson D, Goldstein CE, Taljaard M. An ethical analysis of the SUPPORT trial: addressing challenges posed by pragmatic comparative effectiveness randomized controlled trials with interventions routinely used in medical practice.” Kennedy Institute of Ethics Journal. (Submitted 2016).

Goldstein CE, Brehaut J, Fergusson D, Grimshaw J, Horn AR, Taljaard M, Weijer C. Ethical issues in pragmatic randomized controlled trials: a review of the literature identifies gaps in ethical argumentation. BMJ Quality and Safety. (Submitted 2016).

Horn AR, Goldstein CE, Weijer C. Thinking clearly about the FIRST trial: addressing ethical challenges in cluster randomized trials of policy interventions involving health providers or trainees. (In preparation).

Goldstein CE, Horn AR, Weijer C. An ethical analysis of the PADIT trial. (In progress).

Invited Talks

Fergusson D, McIntyre L, Taljaard M, Horn AR, Weijer C. Ethical challenges in pragmatic comparative effectiveness trials (Invited panel). Society for Clinical Trials. Montreal, QC. (May 15, 2016).

Conference presentations

Horn AR, Taljaard M, Weijer C. An ethical analysis of the SUPPORT study: addressing challenges posed by a randomized controlled trial comparing standard treatments used in medical practice (Oral presentation). American Society for Bioethics and Humanities. Washington, DC. (October 10, 2016).

Horn AR, Taljaard M, Weijer C. An ethical analysis of the SUPPORT study: addressing challenges posed by a randomized controlled trial comparing standard treatments used in medical practice (Oral presentation). International Association of Bioethics. Edinburgh, UK. (June 15, 2016).

Horn AR, Taljaard M, Weijer C. An ethical analysis of the SUPPORT study: addressing challenges posed by a randomized controlled trial comparing standard treatments used in medical practice (Oral presentation). Society for Clinical Trials. Montreal, QC. (May 17, 2016).

Horn AR, Taljaard M, Weijer C. An ethical analysis of the SUPPORT study: addressing challenges posed by a randomized controlled trial comparing standard treatments used in medical practice (Oral presentation). Canadian Bioethics Society. Toronto, ON. (May 27, 2016).

Horn AR, Naci L, Weijer C, Owen AM. The master of suspense: using movies and fMRI to decode the phenomenology of conscious experience in vegetative state patients (Poster presentation). International Neuroethics Society. Chicago, IL. 2015. (June 1, 2015).

Horn AR, Naci L, Weijer C, Owen AM. Decoding phenomenal experience in vegetative state patients (Poster presentation). Canadian Association for Neuroscience. Vancouver, British Columbia. (May 24, 2015).

Horn AR, Naci L, Weijer C, Owen AM. The master of suspense: using movies and fMRI to decode the phenomenology of conscious experience in vegetative state patients (Poster presentation). Montreal Neuroethics Conference for Young Researchers. Montreal, QC. (April 17, 2015).

Horn AR. The foundations of morality: a descriptive or normative enterprise? (Poster presentation). Jamie Cassels Undergraduate Research Fair. Victoria, BC. (March 5, 2014).

Winter, 2017, “Ethics for Digital World,” Western University (Teaching Assistant, Grader).

Fall, 2016, “Research Ethics,” Western University (Guest Lecturer).

Fall, 2016, “Business Ethics,” Western University (Teaching Assistant, Grader).

Winter, 2016, “Health Care Ethics,” Western University (Guest Lecturer, Teaching Assistant, Grader).

Winter, 2015, “Health Care Ethics,” Western University (Teaching Assistant, Grader).

Fall, 2015, “Media Ethics,” Western University (Teaching Assistant, Grader).