Leonard M. Fleck

(517) 355-7552

C-202 East Fee Hall


University Distinguished Professor
Medical Ethics; Social and Political Philosophy; Deliberative Democracy; Health Care Policy

Curriculum Vitae


Professor Fleck has published over 160 articles and book chapters  on a broad range of topics in health care ethics, especially issues related to health care justice, health care rationing, and health care policy. More recently he has published a number of articles on ethical issues related to emerging genetic technologies, this in connection with his role as co-principal investigator for two three-year NIH ELSI grants. These grants explored the role of community dialogue (rational democratic deliberation) in addressing controversial issues of ethics and policy related to genetics and reproductive decision making. Some of the work in those community dialogue projects was captured in a book he authored for Oxford University Press in 2009 under the title Just Caring: Health Care Rationing and Democratic Deliberation. Subsequently, he was co-editor for a volume that addressed ethical issues related to the problem of bedside rationing. That volume was also published by Oxford University Press in 2015 under the title Fair Resource Allocation and Rationing at the Bedside.

Currently (2022) he has completed another volume for Oxford University Press under the title Precision Medicine and Distributive Justice: Wicked Problems for Democratic Deliberation.  This volume addresses a number of emerging ethics issues, especially problems of health care justice, related to what is referred to as “precision” or “personalized” medicine, most especially in connection with targeted cancer therapies and immunotherapy.

Professor Fleck has also completed work on another volume for Cambridge University Press (2022) with the title  Bioethics, Public Reason, and Religion: The Liberalism Problem . This volume addresses a number of issues related to emerging medical technologies that are regarded by many religious advocates as being ethically controversial, such as pre-implantation genetic diagnosis or gene-editing of human embryos aimed at minimizing the birth of children with life-threatening genetic disorders.

Professor Fleck has served as chair of the Philosophy and Medicine Committee of the American Philosophical Association. He is a Fellow of the Hastings Center as well as the Brocher Foundation (Geneva). He has been the recipient of a University Distinguished Faculty Award (2003) as well as a Distinguished Faculty Award from the College of Human Medicine (2003).

Please see Prof. Fleck’s page at the Center for Bioethics and Social Justice for additional information: http://bioethics.msu.edu/73-people/86-fleck


1.      “The Dobbs Decision: Can It be Justified by Public Reason?” Cambridge Quarterly of Healthcare Ethics 32 (July 2023), forthcoming 40 pp. in manuscript.

2.      “Abortion and ‘Zombie’ Laws: Who is Accountable?”  Cambridge Quarterly of Healthcare Ethics 32 (July 2023), forthcoming 5 pp. in manuscript.

3.      “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, March, 2022), pp. 205-34.

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

5.       “Precision Medicine and the Fragmentation of Solidarity (and justice).”  Medicine, Health Care, and Philosophy: A European Journal.  June 2022;26: 191-206.

6.      “Ultimate Price: The Value We Place on Human Life,” [Book review, Thomas Friedman, author]. Public Health Ethics 14 (2) (Oct. 2021), 218-20. 

7.      “Alzheimer’s and Aducanumab: Unjust Profits and False Hopes,” Hastings Center Report 51 (July/August, 2021), 9-11.

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

9.      “Altruistic Organ Donation: On Giving a Kidney to a Stranger,” Cambridge Quarterly of Healthcare Ethics 31 (July, 2022): 395-99.

10.  “Just Caring: Screening Needs Limits,” Journal of Medical Ethics 46 (2020): 253-54.

11.  “Medical Ethics: A Distinctive Species of Ethics,” Cambridge Quarterly of Healthcare Ethics 29 (July, 2020): 421-25

12.  “Just Caring: Do We Need Philosophical Foundations?” paper for Ethics, Medicine and Public Health 3(June, 2017), pp. 221-32.  This is the official journal for the International Academy of Medical Ethics and Public Health, jointly sponsored by the Sorbonne and Universite Rene Descartes.

13.  “Health Care Priority-Setting: CHAT-ting is Not Enough,” International Journal of Health Policy and Management 7 (Oct., 2018), 961-63 

14.  “Precision QALYs, Precisely Unjust,” Cambridge Quarterly of Health Care Ethics 27  (July, 2019): 439-49.

15.  “Ethical Considerations Related to Obesity Intervention,” chapter in Obesity in Childhood and Adolescence, Vol. 2 edited by Hiram Fitzgerald and Dele Davies. Praeger, Nov. 2018, pp. 1-38.

16.  “Controlling Health Care Costs: Just Cost-effectiveness or ‘Just’ Cost-effectiveness?” Cambridge Quarterly of Healthcare Ethics, special issue on Justice, Health Care, and Well-Being, edited by Tuija Takala, 27 (April, 2018): 271-83.

17.  “First Come, First Served in the Intensive Care Unit, Always?” [with Tim Murphy], Cambridge Quarterly of Healthcare Ethics, 27 (Jan. 2018): 52-61.

18.  Review of “Understanding Health Inequalities and Justice: New Conversations Across the Disciplines,” edited by Mara Buchbinder et al.  Hastings Center Report (Oct. 2017).

19.  “Just Caring: Precision Medicine, Cancer Biomarkers, and Ethical Ambiguity,” chapter in Social and Economic Aspects of Cancer Biomarkers, edited by Anne Bremer and

Roger Strand (Megaloceros Press, 2017), chapter 5, 73-94.

20.  “How Should Therapeutic Decisions About Expensive Drugs Be Made in Imperfect Environments?”  AMA Journal of Ethics.  19 (Feb., 2017): 147-56. (with Marion Danis MD as second author).

21.  “Just Caring: Parsimonious Care in Certain Uncertain Circumstances.”  30-page paper

            Prepared for Western Michigan University Bioethics conference (March, 2016);

            Archived as epub at: http://scholarworks.wmich.edu

22.   “Choosing Wisely: Is Parsimonious Care ‘Just’ Rationing?” Cambridge Quarterly of Healthcare Ethics 25 (2016): 366-76.

23.  “Critical Care Limits: What is the Right Balance?” American Journal of Bioethics 16 (2016): 48-50.

24.  “Just Rationing in the ICU: What Benefits Count?”  Newsletter of the Philosophy and Medicine Committee of the American Philosophical Association (Spring 2016), 6-10 .

University News

Philosopher and Medical Ethicist Leonard M. Fleck Named University Distinguished Professor
Published August 9, 2023 in College of Arts & Letters
Close-up portrait of person smiling into camera in front of a brown background.
Leonard M. Fleck has been named University Distinguished Professor, one of the highest honors bestowed upon faculty members by Michigan State University. Fleck, who is appointed in both the Center…Read now »
Leonard Fleck: OP-Ed: Sacrificing Public Health for the Sake of the Economy
Published March 30, 2020 in College of Arts & Letters
profile of a man wearing a black sweater and a white collared shirt underneath
(Leonard Fleck, Professor of Philosophy and a faculty member in MSU’s Center for Ethics and Humanities in the Life Sciences, is among the foremost experts on the ethical…Read now »