About

Andrew Flescher is a professor whose research focuses on Medical Humanities, bioethics and disability studies, literature and ethics, ethics and narratives of the problem of evil, comparative religious ethics, George Bernard Shaw, ethics and health care policy, ethics of organ donation, compassion and altruism, health care justice, normative ethics, moral theory, religion and culture, literature and film. His work explores the ethical dimensions of health care and the intersection of literature, religion, and moral philosophy, contributing to the understanding of ethical issues in medical and cultural contexts.

Research topics

• Medicine
• Law
• Political Science
• Surgery
• Computer Science
• Data science
• Cardiology
• Intensive care medicine
• Physical therapy

Selected publications

• Now Is the Time for Ethical Analysis in Organ Transplantation

  Current Transplantation Reports · 2025-04-01 · 1 citations

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Ethical and Practical Considerations for Research in the Comatose Patient

  SSRN Electronic Journal · 2025-01-01

  preprintOpen access
  PublisherDOI

• Advancing Precision Medicine in PDAC: An Ethical Scoping Review and Call to Action for IHC Implementation

  Cancers · 2025-06-06 · 1 citations

  reviewOpen access

  Pancreatic ductal adenocarcinoma (PDAC) presents significant challenges in diagnosis, prevention, and treatment. Predictive biomarkers offer the potential to revolutionize clinical management, particularly in the preoperative setting, but their implementation requires careful consideration of ethical implications. This scoping review analyzes the ethical landscape of using immunohistochemistry (IHC) for molecular subtyping in PDAC, focusing on its utility, accessibility, and potential impact on patient care. We conducted a systematic literature search in the PubMed, Scopus and Google Scholar databases (2015-2025) using COVIDENCE, which identified 130 references. Of these, 79 were reviewed in a full-text format, and 9 ultimately met the inclusion criteria for our analysis. IHC offers several advantages as a companion diagnostic tool. It is relatively inexpensive, widely available in most pathology laboratories, and can be readily integrated into existing clinical workflows. This contrasts with more complex molecular subtyping methods, such as gene expression profiling, which can be costly, require specialized equipment and expertise, and may not be readily accessible in all clinical settings. Furthermore, accurate analysis of gene expression requires the localized targeting of individual cells; therefore, digesting the sample for bulk analysis would be less informative than using spatial localization techniques such as IHC. Because biomarker regulation can occur at the level of transcription or translation, protein-level assessment via IHC is often more accurate than mRNA analysis. Standardized IHC protocols for biomarker assessment are therefore essential for translating the molecular subtyping of PDAC into clinically actionable treatment strategies, especially for aggressive subtypes like basal-like tumors. This readily deployable IHC-based approach can optimize therapy selection, maximizing patient benefits and minimizing exposure to ineffective and potentially toxic treatments. This review critically analyzes the ethical dimensions of this method, grounded in the principles of autonomy, beneficence, non-maleficence, and justice. The review urges the medical community to fully utilize the potential of IHC-driven molecular subtyping to improve outcomes in PDAC, while ensuring equitable and responsible access to the benefits of precision oncology for all patients.

  PublisherOA PDFDOI

• Living Donation, Identity Formation, and the Virtue of Cost-Neutrality

  2025-10-21

  book-chapter1st authorCorresponding
  PublisherDOI

• An Ethical Analysis of Allocating Organs Out of Sequence

  Current Transplantation Reports · 2025-08-05

  articleOpen accessSenior author

  Recently, in response to the problem of underutilization of organs available for transplant, there has been an increase in organs allocated out of sequence (AOOS). AOOS occurs when Organ Procurement Organizations and/or transplant programs deviate from the calculated rank-order list of potential recipients on the national organ waiting list. While AOOS attempts to decrease organ nonuse and improve organ placement efficiency, this practice raises questions about fairness and public trust. To address these concerns, the Organ Procurement and Transplant Network Ethics Committee undertook an ethical analysis of AOOS, a condensed version of which we present here. While AOOS represents a tempting solution to nonuse, we argue it is not fully justified by utility, as the data remain unclear whether AOOS has a significant positive impact on organ nonuse. There are further concerns regarding the ethical principles of respect for persons, transparency, and equity. We conclude that AOOS should not come to be regarded as the prevailing solution to mounting pressure placed on the transplant community precipitated by nonuse, and that the transplant community should strive to develop system-wide solutions to organ waste though the development of a more transparent and comprehensive policy framework.

  PublisherOA PDFDOI

• COLONOSCOPY OUTSHINES FECAL IMMUNOCHEMICAL TEST IN REDUCING COLORECTAL ADENOCARCINOMA MORTALITY: LESSONS FROM 1.75 MILLION PATIENTS

  Gastrointestinal Endoscopy · 2025-05-01

  article
  PublisherDOI

• NRP Possibly Violates “Do No Harm” and Is Not Worth Risking the Perception That It Does

  The American Journal of Bioethics · 2024-06-02 · 2 citations

  article1st authorCorresponding
  PublisherDOI

• How Well Do Religious Exemptions Apply to Mandates for COVID-19 Vaccines?

  Religions · 2023-04-24 · 3 citations

  articleOpen access1st authorCorresponding

  In the United States, religious exemptions to health-driven mandates enjoy, and should enjoy, protected status in medical ethics and healthcare law. Religious exemptions are defined as seriously professed exceptions to state or federal laws, which appeal to Title VII of the Civil Rights Act of 1964, allowing workers to request an exception to a job requirement, including a health-protective mandate, if it “conflicts with their sincerely held religious beliefs, practices, or observances”. In medical ethics, such religious exceptions are usually justified on the basis of the principle of autonomy, where personally held convictions, reflected in scripture or established religious norms, are safeguarded on the basis of the first amendment, thereby constituting an important area in which societal good must yield to individual liberty. Acknowledging the longstanding category of “religious exemptions”, and referencing some examples that adhere to its parameters in good faith (e.g., objections made by some institutions to HPV vaccines), I argue that, to date, no coherent basis for religious exemptions to COVID-19 vaccines has been offered through appeal to the principle of autonomy, or, in a healthcare context, to “medical freedom”. Indeed, proponents of characterizing these exemptions as legitimate misconstrue autonomy and abuse the reputation of the religious traditions they invoke in defense of their endeavors to opt out. The upshot is not only an error in interpreting the principle of autonomy, whereby it is issued a “blank check”, but also a dishonesty in itself whereby a contested political position becomes deliberately disguised as a protected religious value. “Sincerely held beliefs”, I conclude, appear no longer to constitute the standard for religious accommodation in the era of COVID-19. Individual declaration, seemingly free of any reasonable constraint, does. This is a shift that has serious consequences for public health and, more broadly, the public good.

  PublisherOA PDFDOI

• Looking at the Impact of COVID-19 on Religious Practice and the Impact of Religious Practice on COVID-19

  Religions · 2023-07-19 · 1 citations

  articleOpen accessSenior author

  As this collection of essays on the manner in which religion and public health policy have impacted one another in the COVID-19 era goes to press, both the United States’ Centers for Disease Control (CDC) and the United Nations’ World Health Organization (WHO) have recently declared the end to the pandemic (CDC 2023b; UN 2023b; Williams 2023; Siddiqui et al [...]

  PublisherOA PDFDOI

• Organ Procurement Using Normothermic Regional Perfusion—Reply

  JAMA · 2023-10-10

  letter

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  PublisherDOI

Frequent coauthors

• Jun Ying

  Shanghai Jiao Tong University

  16 shared

• Margaret K. Formica

  SUNY Upstate Medical University

  16 shared

• Charles C. Branas

  University of Otago

  16 shared

• Nils Hennig

  Icahn School of Medicine at Mount Sinai

  16 shared

• Karen D. Liller

  University of South Florida

  16 shared

• Sandro Galea

  Boston University

  16 shared

• Andrew S. Park

  16 shared

• Hala Madanat

  San Diego State University

  16 shared

Education

• Ph.D., English

  University of California, Berkeley

  1996

• M.A., English

  University of California, Berkeley

  1992

• B.A., English

  University of California, Santa Barbara

  1989

Awards & honors

• Winner of the Choice Award for The Altruistic Species (2007)
• Winner of the Prose Award for Moral Evil (2013)
• Winner of Prose Award for Moral Evil (2013)
• Choice Award for The Altruistic Species (2007)