Abstract

Here I critique the approach often seen in bioethics, termed "Chicken Little bioethics," which emphasizes only the potential risks of novel therapies, using fecal microbiota transplant (FMT) as a case study. I argue that, instead of cataloging hypothetical risks, bioethicists should focus on establishing an ethical framework for FMT based on justice, beneficence, nonmaleficence, and autonomy. The essay advocates for empirical risk-benefit analysis through initiatives like the FMT registry, which tracks patient outcomes to better assess the actual risks and benefits compared to antibiotic alternatives. Additionally, I address challenges related to informed consent, donor selection, and access to FMT, underscoring the need for balanced policies that consider both patient safety and the equitable availability of this promising therapy. In the end, I call for a regulatory approach that fosters responsible innovation while allowing FMT and similar bacteriotherapies to be integrated safely and effectively into medical practice.