There are increasing pressures for bioethics to emphasise ‘translation’. Against this backdrop, we defend ‘speculative bioethics’. We explore speculation as an important tool and line of bioethical inquiry. Further, we examine the relationship between speculation and translational bioethics and posit that speculation can support translational work. First, speculative research might be conducted as ethical analysis of contemporary issues through a new lens, in which case it supports translational work. Second, speculation might be a first step (...) prior to translational work on a topic. Finally, speculative bioethics might constitute different content altogether, without translational objectives. For each conception of speculative bioethics, important methodological aspects determine whether it constitutes good bioethics research. We conclude that whether speculative bioethics is compatible with translational bioethics—and to what extent—depends on whether it is being employed as tool or content. Applying standards of impact uniformly across bioethics may inappropriately limit speculative bioethics. (shrink)

There are increasing pressures for bioethics research to have translational purposes. Against this backdrop, we argue in defense of speculative bioethics. We explore methods of speculation and their importance. Further, we examine the relationship between speculative bioethics and translational bioethics and posit that they are not dimorphous enterprises, but often support each other. First, speculative research might be conducted as ethical analysis of contemporary issues through a new lens, in which case it is (...) a means of conducting translational work. Second, speculative bioethics research might be a first step prior to translational work on a topic, in which case speculative bioethics is a necessary requirement for later translational work. Finally, speculative bioethics research might be a separate kind of bioethics altogether, in which case it does not have the same objectives of impact and translation as other bioethics work. For each type of work, important methodological aspects determine whether it constitutes good speculative bioethics research. We conclude that speculative bioethics is multipurpose, and whether it should have a translational dimension—and to what extent—depends on the issue. Applying standards of impact and translation as the gold standard across bioethics may inappropriately limit bioethics, particularly on emerging technologies. (shrink)

In the debate on the ethics of the non-medical use of pharmaceuticals for cognitive performance enhancement in healthy individuals there is a clear division between those who view “cognitive enhancement” as ethically unproblematic and those who see such practices as fraught with ethical problems. Yet another, more subtle issue, relates to the relevance and quality of the contribution of scholarly bioethics to this debate. More specifically, how have various forms of speculation, anticipatory ethics, and methods to predict scientific trends (...) and societal responses augmented or diminished this contribution? In this paper, we use the discussion of the ethics of cognitive enhancement to explore the positive and negative contribution of speculation in bioethics scholarship. First, we review and discuss how speculation has relied on different sets of assumptions regarding the non-medical use of stimulants, namely: terminology and framing; scientific aspects such as efficacy and safety; estimates of prevalence and consequent normalization; and the need for normative reflection and regulatory guidelines. Second, three methodological guideposts are proposed to alleviate some of the pitfalls of speculation: acknowledge assumptions more explicitly and identify the value attributed to assumptions; validate assumptions with interdisciplinary literature; and adopt a broad perspective to promote more comprehensive reflection. We conclude that, through the examination of the controversy about cognitive enhancement, we can employ these methodological guideposts to enhance the value of contributions from bioethics and minimize potential epistemic and practical pitfalls in this case and perhaps in other areas of bioethical debate. (shrink)

Chang-Rae Lee’s 2014 novel On Such a Full Sea uses the genre of speculative fiction to reflect on longstanding healthcare debates in the United States that have recently crystalized around the Affordable Care Act. The novel imagines the political economy of healthcare in a future America devastated by environmental illness. What kind of care is available and to whom? Who provides it? Who pays for it? What about distribution and access? The different healthcare systems governing each of three geo-social (...) zones in Lee's future society represent exaggerated versions of the scenarios participants in the ACA debate claim their opponents’ health policies would produce. The essay argues that Lee’s novel ultimately favors a version of universal government-funded care over a system based on supposed free-market principles, even as the novel also tries to make room for conservative Americans’ fears about the specter of so-called “socialized medicine.” More broadly, the essay contends that the health humanities should devote more attention to literary and artistic engagements with healthcare as a system: a complex set of financial models, public and private institutions, government policies, and actors whose roles range well beyond patient and care provider. (shrink)

In an April 2023 article in JAMA Pediatrics, ‘Life Support System for the Fetonate and the Ethics of Speculation’, authors De Bie, Flake and Feudtner critique bioethicists for practising what they call ‘speculative ethics’. The authors refer to a 2017 article that they published on the Extra-uterine Environment of Neonatal Development (EXTEND) system. This system was able to keep fetonatal (newborn, but in a fetal physiological state) lambs alive outside of the parent lamb’s womb for 4 weeks. The article (...) has been accessed almost 300 000 times and received significant media attention. It also resulted in an explosion in the bioethics literature about ‘the ethics of the artificial womb’. However, the authors bemoan, these ethics discussions focused largely on unrealistic use cases of the new technology—from elective shortening of pregnancies to complete ectogenesis. The authors dubbed these discussions as ‘a technically and developmentally naive, yet sensationally speculative, pipe dream’. The use case of the EXTEND technology that is most realistic involves supporting extremely premature newborns (23–24 weeks). Other probable uses include supporting infants in later gestational ages (25–28 weeks) with pathological conditions, potentially allowing for surgeries or other therapeutics to be delivered without imposing risks on pregnant patients. To …. (shrink)

In this essay, I examine the question of whether it is possible that the encounter with the other could be mediated such that the interval of distance would lose its determining power. I reflect on some instances of extraordinary corporeality, most particularly the phenomenon of conjoined twins, in order to problematize the relation between subjects as they are embodied. Where the normative body is supposedly marked out by the closed boundaries of the skin, the figuration of the anomalous body as (...) potentially leaky and contaminatory positions it as being of prime concern to both medical and cultural discourse. Within those paradigms there are of course many pressing bioethical issues to debate, but my intention is to draw back from a problem-based scenario in order to consider the threshold of ethics in the self/other relation itself. (shrink)

This brief essay proposes to reflect on what could be Latin American bioethics, speculating about possible identity characteristics and operational limits of the idea of what constitutes Latin America, outlined conceptually by geographical, historical and cultural aspects. This attempt does not assume the task of defining exactly or definitively what Latin American bioethics is, but rather limits itself to the purpose of causing controversy in order to stimulate reflection on this topic to assess its usefulness.

This article explores the ethical complexities of openly-expressed medical commentary using recent cancer diagnoses within the British monarchy as illustrative cases. Specifically, it examines tensions between public interest, personal privacy, and professional standards, underlining the adverse implications of conjectural discourse, alongside the role of physicians in enhancing wider medical understanding.

In lieu of an abstract, here is a brief excerpt of the content:President’s Council on BioethicsEdmund D. Pellegrino (bio) and F. Daniel Davis (bio)Approximately two weeks before what was to have been its final meeting, the White House dissolved the President’s Council on Bioethics by terminating the appointments of its 18 members. The letters of dismissal, dated 10 June 2009, informed the members that their service on the Council would end with the close of business the next day.The Council’s (...) term was set to expire on 30 September 2009. After President Obama’s election in November and during the transition, we were advised to proceed on the assumption that the Council would be permitted to cease on that date. Reasons for the abrupt move to disband the Council are unknown. We have accepted the fact that we Council members served at the pleasure of the President and that he simply exercised his rightful prerogative. No explanation is therefore required.Some observers have speculated that the action was retaliatory. They related to the fact that several members of the Council disagreed with the President’s stem cell policy in a signed statement published in the Hastings Center’s Bioethics Forum. Others have speculated that the move was pre-emptive. At its final meeting, scheduled for 25–26 June, the Council was set to sign-off on two of its final publications. One was a comprehensive report on the ethics of organ transplantation, and the other a white paper entitled Health Care and the Common Good. The aim was immediately to release the latter as a contribution to the intensifying debate about health care reform. Health Care and the Common Good could well have aided rather than impeded the President’s drive to better control health care costs and achieve universal coverage. The Council report attempted to ground both goals in the ethical framework of, as the title indicates, the common good of all Americans.In his letter terminating the members’ appointments, Assistant to the President for Presidential Personnel Don Gips said that the President “recognizes the values of having a commission of experts in bioethical issues to provide objective and non-ideological bioethics advice to his administration.” Gips went on to say that the President is “currently rethinking the purposes and goals of such a bioethics commission, and is carefully considering a revitalized mission and mandate.” And, [End Page 309] responding to media enquiries, White House press officer Reid Cherlin explained that the President’s Council was terminated because it was a “philosophically leaning advisory group” and, according to a New York Times account by Nicholas Wade, “because it favored discussion over developing a shared consensus.” As for the ultimate outcome of the President’s “rethinking,” Cherlin indicated that President Obama will appoint a new commission with the mandate of offering “practical policy options” in bioethics.In the light of our experiences with the Council, we leave it with hopes that certain questions of national importance will be addressed. In light of the nature of federal advisory commissions, what is or are the proper roles of a national bioethics commission? If the aim is to provide advice and counsel to the President or, perhaps to the U. S. Congress, is that advice best rendered as a group consensus or as an in-depth exploration of the inevitably conflicting ethical perspectives on a given issue? How should such a commission be constituted—with what sorts of individuals? And what is the nature of the expertise that they individually and collectively bring to the commission’s functions? If the commission is to promote public debate and discussion, how exactly should it go about that task? And how is the efficacy of a commission to be assessed? Such questions inevitably lead us deep into contested territory, as the experience of this Council has shown: into the intersections of politics, religion, and science and into the relations between practice and theory—between policy and what some seem to deride as “philosophy.” Indeed, policy without an underlying philosophy is an edifice without a foundation; philosophy without policy is a foundation without an edifice.At the last meeting of the Council in March 2009, we launched a discussion of these questions with the... (shrink)

Wexler and Specker Sullivan (2023) note that, “unbridled speculation can imperil the credibility of neuroethics, generate unrealistic expectations amongst different stakeholders, take up time that...

Teaching competency in bioethics has been a concern of the field since its start. In 1976, The Hastings Center published the first report on the teaching of contemporary bioethics. Graduate programs culminating in an MA or PhD were not needed at the time, concluded the report. “In the future, however,” the report speculated, “the development and/or changing social priorities may at some point allow, or even require, the creation of new academic structures for graduate education in bioethics.” (...) Although that future might be upon us, the creation of a terminal degree in bioethics has its detractors. Scholars have debated whether bioethics is a discipline with its own methods and theoretical grounding, a multidisciplinary field bringing various professional perspectives to bear on particular types of problems, a set of problem-solving skills to resolve moral disagreements, or something else entirely. Whether or not efforts to develop the methods and theory of bioethics have matured to the point that it is now a discipline in the strictest sense, new bioethics training programs have appeared at all postsecondary levels. In this essay, we examine the number and types of U.S. programs and degrees in this growing field. (shrink)

Feminist criticism of health care and ofbioethics has become increasingly rich andsophisticated in the last years of thetwentieth century. Nonetheless, this body ofwork remains quite marginalized. I believe thatthere are (at least) two reasons for this.First, many people are still confused aboutfeminism. Second, many people are unconvincedthat significant sexism still exists and aretherefore unreceptive to arguments that itshould be remedied if there is no largerbenefit. In this essay I argue for a thin,``core'' conception of feminism that is easy tounderstand and (...) difficult to reject. Corefeminism would render debate within feminismmore fruitful, clear the way for appropriaterecognition of differences among women andtheir circumstances, provide intellectuallycompelling reasons for current non-feminists toadopt a feminist outlook, and facilitatemutually beneficial cooperation betweenfeminism and other progressive socialmovements. This conception of feminism alsomakes it clear that feminism is part of alarger egalitarian moral and political agenda,and adopting it would help bioethics focus onthe most urgent moral priorities. In addition,integrating core feminism into bioethics wouldopen a gateway to the more speculative parts offeminist work where a wealth of creativethinking is occurring. Engaging with thisfeminist work would challenge and strengthenmainstream approaches; it should also motivatemainstream bioethicists to explore othercurrently marginalized parts of bioethics. (shrink)

New vaccines to prevent COVID-19 and malaria underscore the importance of scientific advances to promote public health globally. How is credit for such scientific discoveries attributed, and who benefits? The complex narrative of Amitav Ghosh’s _The Calcutta Chromosome_, both historical and speculative, demonstrates how medicine has come to value particular kinds of advances over others, prompting readers to question who controls access to resources and at what cost to global populations. In Ghosh’s imagined world, scientific discovery is evaluated and (...) rewarded—and ultimately deemed necessary—for its ability to serve communal, public health needs. (shrink)

The intersection of AI and neurotechnology has resulted in an increasing number of medical and non-medical applications and has sparked debate over the need for new human rights, or “neurorights,”...

This essay roughly sketches two major conceptions of autonomy in contemporary bioethics that promote the resourcification of human body parts: (1) a narrow conception of autonomy as self-determination; and (2) the conception of autonomy as dissociated from human dignity. In this paper I will argue that, on the one hand, these two conceptions are very different from that found in the modern European tradition of philosophical inquiry, because bioethics has concentrated on an external account of patient’s self-determination and (...) on dissociating dignity from internal human nature. However, on the other hand, they are consistent with more recent European philosophy. In this more recent tradition, human dignity has gradually been dissociated from contextual values, and human subjectivity has been dissociated from objectivity and absolutized as never to be objectified. In the concluding part, I will give a speculative sketch in which Kant’s internal inquiry of maxim of ends, causality and end, and dignity as irreplaceability is recombined with bioethics’ externalized one and used to support an extended human resourcification. (shrink)

Gerben Meynen (2019) invites us to consider the potential ethical implications of what he refers to as “thought apprehension” technology for psychiatric practice, that is, technologies that involve recording brain activity, and using this to infer what people are thinking (or intending, desiring, feeling, etc.). His article is wide-ranging, covering several different ethical principles, various situations psychiatrists might encounter in therapeutic, legal and correctional contexts, and a range of potential incarnations of this technology, some more speculative than others. Although (...) Meynen’s article raises some highly relevant potential implications of some “thought apprehension”-based neurotechnologies, which are certainly worthy of further exploration, I suggest that Meynen’s analysis is beset by two problems. First, some of the technologies that form the focus of his discussion are too speculative, and second, due to the many issues under consideration, some problems are not adequately characterized, relevant ethical principles are misidentified, and valuable literature is not sufficiently engaged with. Consideration of these weaknesses might allow us to better see how to conduct a fruitful analysis of speculative neurotechnologies. (shrink)

In this age of DIY Health—a present that has been described as a time of “ludic capitalism”—one is constantly confronted with the injunction to manage risk by means of making healthy choices and of informed participation in various self-surveillant technologies of bioinformatics. Neoliberal governmentality has been redacted by poststructuralist scholars of bioethics as defined by the two-fold emergence of, on the one hand, populations and on the other, the self-determining individual—as biopolitical entities. In this article, we provide a genealogical-phenomenological (...) schematization (GPS analysis) of the narration of cancer in relation to “sexual minority populations.” Canonical discourses concerning minority sexualities are articulated by means of a logic of “inclusion and reification” that organizes the interiorization of norms of embodied relationality, and a positive liaison with biomedical technologies and techniques in the taking up of a rhetorical style of biographical compliance. Neoliberal DIY Health logics conflate participation with agency, and institute norms of recognition that constrain visibility to: citizens who make healthy choices and manage risk, heroic cancer stories, stories of the reconstruction of states of normalcy, or of survival against all odds. Alternatively, we trace the performative articulations of queer narrative practices that constitute an ephemeral, nomadic praxiology—a doing of knowledge in cancer’s queer narration. Queer cancer narrative practices represent a relationship to health and embodiment that is predicated, not on normalcy, but predicated on troubling norms, on artful failure, and on engaging in a kind of affective mapping that might be thought constitutive of a speculative bioethical relation to the self as other. (shrink)

This addendum expands upon the arguments made in the author’s 2020 essay, “Legal Personhood for Artificial Intelligence: Citizenship as the Exception to the Rule”, in an effort to display the significance human augmentation technologies will have on (feasibly) inadvertently providing legal protections to artificial intelligence systems (AIS)—a topic only briefly addressed in that work. It will also further discuss the impacts popular media have on imprinting notions of computerised behaviour and its subsequent consequences on the attribution of legal protections to (...) AIS and on speculative technological advancement that would aid the sophistication of AIS. (shrink)

This essay examines the fantasy of life extension enabled through the transfer of one’s consciousness to new, cloned bodies in the event of disease, accident, or old age. This vision has recently been dramatized in both fiction and film, bearing witness to the power of this imaginary scenario. This eventuality would raise wide-ranging ethical issues, which speculative bioethics should begin to contemplate. Interestingly, it is young adult fiction that has recently provided an extensive and consistent cluster of novels (...) dealing not only with this topic but also with the interrelated notion of clones purposely grown to replace a loved one, with a concomitant array of further ethical concerns. These and related topics will be examined here through the lens of fiction and recent theoretical work on future biotechnological scenarios. (shrink)

Ce texte offre quelques réflexions épistémologiques et méthodologiques en réponse au texte d’Antoine Boudreau LeBlanc qui plaide pour une bioéthique renouvelée, capable de faire le lien entre science et politique afin de relever les défis majeurs auxquels l’humanité est actuellement confrontée. Cette proposition apparait nécessaire, compte tenu du paradoxe qui émerge du fait que l’expertise et la spécialisation grandissante ne se traduisent pas toujours par des solutions aux problèmes complexes qui affligent l’humanité. Il apparaît nécessaire de réfléchir à la nature (...) même de ces problèmes et de reconnaitre qu’ils se situent à une échelle qui dépasse l’individu. De même, il apparait nécessaire de considérer la dimension pratique de mise en oeuvre des solutions proposées. L’ouverture épistémique de la bioéthique semble être un atout important à cet égard. Toutefois, on peut se demander si le potentiel d’hybridation entre les savoirs défendu par Boudreau LeBlanc risque d’être atténué par la professionnalisation et la centralisation de la médiation entre ceux-ci. De même, il importe de préserver le caractère distinctif de la bioéthique. (shrink)

Over the past few years the use of stimulants such as methylphenidate and modafinil among the student population has attracted considerable debate in the pages of bioethics journals. Under the rubric of cognitive enhancement, bioethicists have discussed this use of stimulants—along with future technologies of enhancement—and have launched a sometimes forceful debate of such practices. In the following paper, it is argued that even if we focus solely upon current practices, the term cognitive enhancement encompasses a wide range of (...) ethical considerations that can usefully be addressed without the need for speculation. In taking this position it is suggested that we divide cognitive enhancement into a series of empirically-constructed frameworks—medical risks and benefits, self-medication and under-prescription, prescription drug abuse and over-medication, and finally, the intention to cognitively enhance. These are not mutually exclusive frameworks, but provide a way in which to identify the scope of the issue at hand and particular ethical and medical questions that may be relevant to enhancement. By a process of elimination it is suggested that we can indeed talk of cognitive enhancement as an observable set of practices. However, in doing so we should be aware of how academic commentaries and discussion may be seen as both capturing reality and reifying cognitive enhancement as an entity. (shrink)

The rapid advancement of artificial (computer) intelligence systems (CIS) has generated a means whereby assistive bionic prosthetics can become both more effective and practical for the patients who rely upon the use of such machines in their daily lives. However, de lege lata remains relatively unspoken as to the legal status of patients whose devices contain self-learning CIS that can interface directly with the peripheral nervous system. As a means to reconcile for this lack of legal foresight, this article approaches (...) the topic of CIS-nervous system interaction and the impacts it may have on the legal definition of “persons” under the law. While other literature of this nature centres upon notions of transhumanism or self-enhancement, the approach herein approached is designed to focus solely upon the legal nature of independent CIS actions when operating alongside human subjects. To this end, it is hoped that further discussion on the topic can be garnered outside of transhumanist discourse to expedite legal consideration for how these emerging relationships ought to be received by law-generating bodies internationally. (shrink)

Clinical bioethics is big business. There are now hundreds of people who bioethics in community and university hospitals, nursing homes, rehabilitation and home care settings, and some who play the role of clinical ethics consultant to transplant teams, managed care companies, and genetic testing firms. Still, there is as much speculation about what clinically active bioethicists actually do as there was ten years ago. Various commentators have pondered the need for training standards, credentials, exams, and malpractice insurance for (...) ethicists engaged in clinical consultation. Much of the discussion seems to accept an implicit presumption that all clinical ethics consultation practices look pretty much alike. But is this accurate? What do clinical ethicists do, how and where do they do it, and what kind of clinical ethics is useful in the hospital and in other settings? (shrink)

Although germline editing has been the subject of debate ever since the 1980s, it tended to be based rather on speculative assumptions until April 2015, when CRISPR/Cas9 technology was used to modify human embryos for the first time. This article combines knowledge about the technical and scientific state of the art, economic considerations, the legal framework and aspects of clinical reality. A scenario will be elaborated as a means of identifying key ethical implications of CRISPR/Cas9 genome editing in humans (...) and possible ways of dealing with them. Unlike most other discussions of CRISPR/Cas9 germline editing, which are generally based on deontological arguments, the focus in this case will be on a consequentialistic argument against certain applications of germline and somatic editing that takes not only the potential benefits and risks but also socioeconomic issues into consideration. The practical need for an indication catalogue, guidelines for clinical trials, and for funding of basic research will be pointed out. It will be argued that this need for regulatory action and discussion does not stem primarily from the fact that CRISPR/Cas9 germline editing is revolutionary in terms of its ethical implications and potential for human therapy, although this is the prevailing view in the current discussion. Understanding the value and interest dependency of arguments put forward by different stakeholders and learning from past debates related to similar technologies might prove a fruitful method of reaching judgments and decisions that come closer to a consensus upon which society as a whole can agree - which after all should be the true goal of an ethical debate and of bioethics. (shrink)

Research on human-animal chimeras have elicited alarms and prompted debates. Those involving the generation of chimeric brains, in which human brain cells become anatomically and functionally intertwined with their animal counterparts in varying ratios, either via xenografts or embryonic co-development, have been considered the most problematic. The moral issues stem from a potential for “humanization” of the animal brain, as well as speculative changes to the host animals’ consciousness or sentience, with consequential alteration in the animal hosts’ moral status. (...) However, critical background knowledge appears to be missing to resolve these debates. Firstly, there is no consensus on animal sentience vis-à-vis that of humans, and no established methodology that would allow a wholesome and objective assessment of changes in animal sentience resulting from the introduction of human brain cells. Knowledge in interspecies comparative neuropsychology that could allow effective demarcation of a state of “humanization” is also lacking. Secondly, moral status as a philosophical construct has no scientific and objective points of reference. Either changes in sentience or humanization effects would remain unclear unless there are some neuroscientific research grounding. For a bioethical stance based on moral status of human-animal brain chimera to make meaningful contributions to regulatory policies, it might first need to be adequately informed by, and with its arguments constructed, in a manner that are factually in line with the science. In may be prudent for approved research projects involving the generation of human-animal brain chimera to have a mandatory component of assessing plausible changes in sentience. (shrink)

Background: The bioethics literature contains speculation but little data about sociodemographic differences between patients for whom ethics committees (EC) are consulted for conflict about life-sustaining treatment (LST) and the broader hospital population that these committees serve. To provide an empirical context for this discussion, we examined differences in five sociodemographic factors between patients for whom an EC was consulted for conflict over LST and the general inpatient population, hypothesizing that nonwhite patients were most likely to be disproportionately represented. Methods: (...) This was a retrospective cohort study comparing self-reported race/ethnicity, household income, insurance status, primary language, and religious affiliation between patients involved in EC consultations for conflict over LST and the general adult inpatient population at a large academic hospital from January 1, 2007, through December 31, 2013. Results: There were 169 EC consultations involving conflict over LST and 243,197 adult inpatient admissions over the study period. On bivariate analysis, patients for whom the EC was consulted for conflict over LST were more likely to be nonwhite, low-income, and to speak a primary language other than English. They were not more likely to be underinsured or to report a religious affiliation. On multivariate analysis, patients for whom the EC was consulted for conflict over LST were more likely to be nonwhite (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.7–3.7; p <.001). They were also more likely to be low income (OR, 1.8; 95% CI, 1.1–3.0; p =.02). They were not more likely to speak a primary language other than English (OR, 1.4; 95% CI, 0.9–2.1; p =.17). None of the assessed variables were associated with conflict over LST requiring additional meetings beyond the first EC consultation. Conclusions: Nonwhite and low-income status patients are disproportionately represented in EC committee consultation for conflict over LST compared to the general inpatient population. (shrink)

This highly speculative paper seeks to discern where the discipline of Bioethics may be heading in the next decade or two. It is clear that the rapid pace of scientific discovery and technological innovation will not slacken, and, as a result, fresh moral issues, for which there are no precedents in currently accepted moral wisdom, will rapidly emerge. This mushrooming of ethical problems will be taking place at a time of increasing moral pluralism, when common moral values become (...) harder to establish, and powerful subgroups embrace moral dogmatism, whether religious or secular in character.Faced with such complexity and confusion, governments and industrial groups will increasingly seek guidance from bioethics "experts", through paid consultancies, advisory panels and commissioned reports on specific topics. But Bioethics itself is currently in a stage of flux: 1. Certain research areas in Bioethics have 'bolted' (in the horticultural sense), because of a rich injection of funds - notably genetics and stem cell research - while other areas are relatively under-researched. 2. Inter-disciplinarity has become de rigueur, largely under funder pressure, and, allied to this, an insistence on empirical work has created conceptual confusions. 3. There is a continuing ferment in bioethical theory, with little sign of productive co-operation between rival camps. Indeed theoretical enrichment seems to lag far behind the constant demand for relevance and 'applied ethics'.So what of the future? I detect certain trends, some to be deplored and discouraged, others to be applauded and nurtured. On my 'black list' are: the commercialisation of Bioethics; and the dumbing down of several critical disciplines in the name of relevance. On my 'white list' are: further adventures in theory; inter-disciplinarity come of age; and the future envisioned in today's young minds. (shrink)

In 2017 and 2019, two research teams claimed ‘proof of principle’ for artificial womb technology (AWT). AWT has long been a subject of speculation in bioethical literature, with broad consensus that it is a welcome development. Despite this, little attention is afforded to more immediate ethical problems in the development of AWT, particularly as an alternative to neonatal intensive care. To start this conversation, I consider whether experimental AWT is innovative treatment or medical research. The research–treatment distinction, pervasive in regulation (...) worldwide, is intended to isolate research activities and subject them to a greater degree of oversight. I argue that there is a tendency in the literature to conceptualize AWT for partial ectogenesis as innovative treatment. However, there are sufficiently serious ethical concerns with experimental AWT that mean that it must not be first used on humans on the basis that it is a ‘beneficial treatment’. First, I outline the prospects for translation of AWT animal studies into treatment for human preterms. Second, I challenge the conceptualizations of experimental AWT as innovative treatment. It must be considered medical research to reflect the investigatory nature of the process and guarantee sufficient protections for subjects. Identifying that AWT is research is crucial in formulating further ethico‐legal questions regarding the experimental use of AWT. Third, I demonstrate that clinical trials will be a necessary part of the clinical translation of AWT because of requirements laid out by regulators. I consider the justification for clinical trials and highlight some of the crucial ethical questions about the conditions under which they should proceed. (shrink)

The long ongoing and partly heated debate on the concept of disease has not led to any consensus on the status of this apparently essential concept for modern health care. The arguments range from claims that the disease concept is vague, slippery, elusive, or complex, and to statements that the concept is indefinable and unnecessary. The unsettled status of the concept of disease is challenging not only to health care where diagnosing, treating, and curing disease are core aims, but also (...) to the branch of philosophy that tries to clarify concepts. This article discusses three claims about the concept of disease: that it is vague, complex, and that it is indefinable. It investigates what is meant by these claims, what their implications are, and whether the claims are sound or not. It is argued that some of the arguments are flawed and miss important points about concept analysis. This does not mean, however, that disease is a clear concept with a crisp definition. It only rules out speculative claims that disease necessarily is vague, complex, and indefinable. It appears at least as hard to show that disease is indefinable as it is to define it. (shrink)

While neuroethics is generally thought to be a modern addition to the broader field of bioethics, this subdiscipline has existed in clinical practice throughout the course of the 20th century. In this essay, Fins describes an older tradition of clinical neuroethics that featured such physician-humanists as Sir William Osler, Wilder Penfield, and Fred Plum, whose work and legacy exploring disorders of consciousness is highlighted. Their normative work was clinically grounded and focused on the needs of patients, in contrast to (...) modern neuroethics, which is more speculative and distant from the lived reality of the clinic. Using recent developments in the diagnosis and treatment of disorders of consciousness, and the history of the vegetative and minimally conscious states, Fins asks why modern neuroethics has taken this turn and what can be done to restore clinical neuroethics to a more proportionate place in the field. (shrink)

: This response to Lynn Jansen's critique of clinical pragmatism concentrates on two themes: (1) contrasting approaches to moral epistemology and (2) the connection between theory and practice in clinical ethics. Particular attention is paid to the status of principles and the role of consensus, with some closing speculations on how Dewey might view the current state of bioethics.

Dispositions and potentialities seem importantly similar. To talk about what something has the potential or disposition to do is to make a claim about a future possibilitythe "threats and promises" that fill the world (Goodman 1983, 41). In recent years, dispositions have been the subject of much conceptual analysis and metaphysical speculation. The inspiration for this essay is the hope that that work can shed some light on discussions of potentiality. I compare the concepts of disposition and potentiality, consider whether (...) accounts of these concepts are subject to similar difficulties, and whether having a disposition or a potentiality can depend on extrinsic factors. The concept of a disposition I am working with is drawn from the recent literature in metaphysics and philosophy of science that focuses on the analysis of dispositional concepts and their role in a broader ontology. The concept of a potentiality is drawn from the bioethics literature that focuses on the moral relevance of potentialities that subjects of medical decisions mayor may not possess. Some preliminary conclusions I draw are the following: I. Potentialities are dispositions; 2. Due to problematic cases, potentiality ascriptions, like disposition ascriptions, are not reducible to counterfactual statements; and 3. Like dispositions, some potentialities can be extrinsic. Here I do not aim to draw any conclusions about the moral relevance of potentialities but rather to outline conceptual and metaphysical options available to those who seek to employ this concept. However, to the extent that these options are relevant to answering moral questions, I am skeptical about the prospects of finding a value-neutral way to choose between them. I have tried to outline a number of options regarding the nature of potentialities for those who would like that notion to play some role in their theorizing in bioethics, or elsewhere. There still are a number of decisions to make about how to explicate the concept of potentiality that is most relevant for one's purposes. How should one flesh out the associated counterfactuals, regardless of whether they hope to reduce potentiality claims to counterfactual conditionals? How should one circumscribe the relevant possible circumstances of manifestation for a given potentiality? Are the circumstances necessary for the actualization of a given potentiality to be counted circumstances of possession or circumstances of manifestation? Is the kind of which something is potentially a member a natural kind or a class whose membership is determined by convention? My anticipation, and perhaps my worry, is that these questions do not have answers that can be determined independently from the conclusions about the moral relevance of potentiality that a given theorist aims to establish. (shrink)

Three arguments of Habermas against “liberal eugenics”—the arguments from consent, responsibility, and instrumentalization—are critically evaluated and explicated in the light of his discourse ethics and social theory. It is argued that these arguments move partly at a too deep level and are in part too individualistic and psychological to sufficiently counter the liberal position that he sets out to criticize. This is also due to limitations that prevent discourse ethics from connecting effectively to the moral and political domains, e.g., through (...) a discussion of justice. In spite of these weaknesses, Habermas’s thesis is of major relevance and brings up neglected issues in the discussion about eugenic reproductive practices. This relevance has not been duly recognized in bioethics, largely because of the depth of his speculations of philosophical anthropology. It is argued that Habermas’s notion of the colonization of the lifeworld could provide the analytical tool needed to build that bridge to the moral and political domain. (shrink)

In line with their vast expansion over the last few decades, the brain sciences — including neurobiology, psychopharmacology, biological psychiatry, and brain imaging — are becoming increasingly prominent in a variety of cultural formations, from self-help guides and the arts to advertising and public health programmes. This article, which introduces the special issue of History of the Human Science on ‘Neuroscience, Power and Culture’, considers the ways that social and historical research can, through empirical investigations grounded in the observation of (...) what is actually happening and has already happened in the sciences of mind and brain, complement speculative discussions of the possible social implications of neuroscience that now appear regularly in the media and in philosophical bioethics. It suggests that the neurosciences are best understood in terms of their lineage within the ‘psy’-disciplines, and that, accordingly, our analyses of them will be strengthened by drawing on existing literatures on the history and politics of psychology — particularly those that analyze formations of knowledge, power and subjectivity associated with the discipline and its practical applications. Additionally, it argues against taking today’s neuroscientific facts and brain-targetting technologies as starting points for analysis, and for greater recognition of the ways that these are shaped by historical, cultural and political-economic forces. (shrink)

Genome editing, for instance by CRISPR-Cas, is a major advancement of the last 10 years in medicine but questions ethically our practices. In particular, human embryo heritable genome editing is a source of great controversy. We explored how this ethical question was debated in the literature from PubMed database, in a period of 4 years (2016–2020) around the announcement of the ‘CRISPR babies’ Chinese experiment in November 2018. We evaluated the weight of the arguments for and against this topic, through (...) an analysis of reviews published on this question. The most important arguments come from the technical perspective: safety issues and benefits, putative long-term effects on the future generations and the need to assess this aspect. Next, foreseeable clinical benefits and the alternatives to these methods are discussed. The number of people that would benefit from such techniques is also considered. However, social and anthropological issues are addressed in a more disparate way. Parenthood and desire for children are sometimes overlooked. Few authors mention social justice, stigmatisation and equality of access. Consent and information are more clearly addressed, as well as the question of the relationship between generations. Finally, the effects on the nature of humankind or human species are far from being consensual; the risks of enhancement, eugenics and transhumanism are raised. We conclude that the risks associated with the immaturity of the technique were at the forefront of the ethical debate on human embryo heritable genome editing. Their consequences were seen as more immediate and easier to handle than those of sociological or anthropological projections, which are more speculative in nature. (shrink)

Different beliefs about the nature and justification of bioethics may reflect different assumptions in moral epistemology. Two alternative views (put forward by David Seedhouse and Michael H Kottow) are analysed and some speculative conclusions formed. The foundational questions raised here are by no means settled and deserve further attention.

A prominent critique of cognitive or athletic enhancement claims that certain performance‐improving drugs or technologies may ‘cheapen’ resulting achievements. Considerably less attention has been paid to the impact of enhancement on the value of moral achievements. Would the use of moral enhancement (bio)technologies, rather than (solely) ‘traditional’ means of moral development like schooling and socialization, cheapen the ‘achievement’ of morally improving oneself? We argue that, to the extent that the ‘cheapened achievement’ objection succeeds in the domains of cognitive or athletic (...) enhancement, it could plausibly also succeed in the domain of moral enhancement—but only regarding certain forms. Specifically, although the value of moral self‐improvement may be diminished by some of the more speculative and impractical forms of moral enhancement proposed in the literature, this worry has less force when applied to more plausibly viable forms of moral enhancement: forms in which drugs or technologies play an adjunctive or facilitative, rather than a determinative, role in moral improvement. We illustrate this idea with three examples from recent literature: the possible use of psychedelic drugs in certain moral‐learning contexts, ‘Socratic Al’ (a proposed Al‐driven moral enhancer) and empathy enhancement through virtual reality (VR). We argue that if one assumes that these technologies work roughly as advertised, the ‘cheapened achievement’ objection loses much of its bite. The takeaway lesson is that moral enhancement in its most promising and practical forms ultimately evades a leading critique of cognitive and athletic enhancement. We end by reflecting on the potential upshot of our analysis for enhancement debates more widely. (shrink)

This qualitative social scientific study explores professional texts of healthcare ethics to understand the ways in which ethical professionalism in medicine and nursing are culturally constructed in Finland. Two books in ethics, published by Finnish national professional organizations—one for nurses and one for physicians—were analyzed with the method of critical discourse analysis. Codes of ethics for each profession were also scrutinized. Analysis of the texts sought to reveal what is taken for granted in the texts as well as to speculate (...) what appeared to be relegated to the margins of the texts or left entirely invisible. Physicians’ ethics was discovered to emphasize objectivity and strong group membership as a basis for ethical professionalism. The discourses identified in the physicians’ ethics guidebook were universal ethics, reductionism, non-subjectivity, and threat. Nursing ethics was discovered to highlight reflectivity as its central focus. This idea of reflectivity was echoed in the identified discourses: local ethics, enlightenment, and moral agency. The analysis exposes a cultural gap between the ethics discourses of medicine and nursing. More work is needed to bridge ethics discourses in Finland in a way that can support healthcare professionals to find common ground and to foster inclusivity in ethical dialogue. Further development of bioethical practices is suggested as a potential way forward. (shrink)

This section welcomes submissions addressing literature as a means to explore ethical issues arising in healthcare. “Literature” will be understood broadly, including fiction and creative nonfiction, illness narratives, drama, and poetry; film studies might be considered if the films are adaptations from a literary work. Topics include in-depth analysis of literary works as well as theoretical contributions, discussions, and commentary about narrative approaches to disease and medicine, the way literature shapes the relationship between patients and healthcare professionals, the role of (...) speculative fiction as a testing ground for future scenarios in healthcare, and so on. Articles discussing the uses of literature for bioethics education and outreach will be particularly appreciated. Research on literature not originally written in English will be considered as long as it has also been published in translation. Submissions should include an abstract and should conform to theCQGuidelines for Contributors. To submit an article or discuss a suitable topic, write to Antonio Casado da Rocha [email protected].:This article proposes a concept of narrative autonomy to supplement existing accounts in healthcare ethics. This is done by means of a comparison between three end-of-life scenarios: Tolstoy’sThe Death of Ivan Ilyichand two related contemporary stories by Lorrie Moore and Bernhard Schlink, which explore some problems arising when extremely individualistic notions of patient autonomy are put into practice. It is argued that the best model for palliative care is a cooperative one in which patient autonomy is understood as essentially social, and that involves decisional, executive, informational, and narrative dimensions. (shrink)

What should readers expect of a journal, not primarily of ethics nor of bioethics, but of medical ethics? The ‘Disclaimer’ on this journal’s inside front cover states that it is ‘intended for medical professionals’. That perhaps narrows the field: but what interests ‘medical professionals’? Writing in 1796, the young Samuel Taylor Coleridge, poet, polymath and professional patient, declared that ‘Physicians… are shallow animals: having always employed their minds about Body and Gut, they imagine that in the whole system of (...) things there is nothing but Gut and Body’. Very soon he would have to revise this opinion, as a growing number of medical professionals became his friends and collaborators, exploring together the heady mix of scientific discovery and metaphysical speculation that made the intellectual world of the early nineteenth century so exciting, and so available. It was still possible for a physician, possessed of a reasonable general education, to keep abreast not only of the latest developments in the emerging sciences but also of what was new in the arts and humanities. In the early twenty-first century, by contrast, that may be more difficult. The sciences have greatly multiplied, and often become so specialised that even other scientists may have difficulty in fully comprehending the intricacies and implications of developments in disciplines not their own; and similar difficulties may arise not only between scientists and practitioners of the arts and humanities, but also between scholars working in different branches of the arts and humanities. Gifted communicators, skilled popularisers and interdisciplinary journals of course, can and do go …. (shrink)

Cimatti and Salzani have put together a rich collection of essays on animal studies that provides an exhaustive overview of how Italian contemporary philosophers are engaging with animal ethics, antispeciesism, posthumanism, ecofeminism, and biopolitics. This edited volume represents an important development in the “animal turn” in the humanities, particularly because it is published in English, allowing for a more efficient dialogue between “Italian theory” and philosophers around the world. This is, in fact, the first collection that will give an international (...) audience access to the rich and varied contribution of Italian contemporary philosophy in the burgeoning field of animal studies. It is also important to point out that all the authors—who are either well-established erudite thinkers or bright and innovative new voices in the panorama of Italian philosophy—effectively engage with recent and prominent scholarship in the fields of animal studies, posthumanism, and biopolitics, such as the work of Zizek, Esposito, Hardt, Calarco, Braidotti, and Wolfe.The volume is clearly intended for an academic audience: professors, scholars, and graduate students studying not only philosophy, Italian studies, environmental humanities, and animal ethics, but also political science, ethology, comparative literature, art history, and religious studies. In addition, the book could also find an audience in animal rights and environmental activists who are interested in the philosophical aspects and ethical and political implications of their actions.The division of the book into three sections (“Animality in the Italian Tradition,” “Animality in Perspective,” and “Fragments of a Contemporary Debate”) provides the reader a clear trajectory from the Italian philosophical tradition to the current debate on “animality.” In the first section, in fact, the authors engage with the rich and complex tradition of both Italian animal philosophy and advocacy. In the three essays that make up this section, the authors provide a compelling historical perspective of the anti-Cartesian and antidualistic aspects of Italian thought, tracing its pre-Cartesian origin and post-Cartesian developments through the work of Francis of Assisi, Dante Alighieri, Giordano Bruno, Giambattista Vico, and Giacomo Leopardi, among others. This section also includes essays outlining the development of animal bioethics in Italy, which emerged from the work of animal advocacy pioneer Aldo Capitini and continued to have an important impact on Italian culture thanks to the antispeciesist movement and debate, of which the third essay of this section provides an exhaustive intellectual history.The second section of the volume, comprised of six essays, provides an overall view of the ongoing philosophical debate on animality that traverses Italian posthumanism, feminism, theology, biopolitics, environmental ethics, and Marxist thought. Here the authors engage with some of the prominent voices in the contemporary Italian philosophical landscape, such as Giorgio Agamben, Roberto Esposito, Roberto Marchesini, Antonio Negri, Maria Turchetto, Adriana Caravero, Luisa Muraro, and Paolo De Benedetti. As pointed out by the editors in their introduction, this section does not intend to offer a complete account of the extensive and heterogenous exchanges occurring inside the Italian biological turn, but instead aims at investigating its most compelling approaches and effectively links them to the ongoing transnational debate.The rich historiography and analysis of the first two sections is complemented, in the third section of the volume, by the speculative approach that strongly characterizes all five final essays. Here we can find some of the most exciting and original developments in Italian scholarship on animal philosophy. This section is, therefore, the most effective in presenting the distinctive approach of contemporary Italian philosophers in rethinking animality and the human-animal interplay, in particular inside the historical and epistemological frame of the Anthropocene. For instance, Massimo Filippi explores how slaughterhouses have become exemplary spaces to investigate the calculation that adds, subtracts, multiplies, and divides humans and animals, which removes animality and excises the other, which forcefully bans any imagining of the monstrously other, of the other-than-human, and that produces, among others and besides It-Self, the Woman, the Homosexual, the Abnormal, the Migrant, the Criminal, and the Animal. (p. 225)Structuring his argument on the real and metaphorical “mathematics of sacrifice” at work in the slaughterhouse (p. 226), Filippi engages with the processes that enable human ontological privilege, with intraspecific and interspecific mechanisms of discrimination, and with philosophical, political, and ethical implications of meat production.For a second and final example, ethologist Roberto Marchesini—one of the most original and prominent voices in animal studies—focuses on redefining the paradigm of “animality.” In his essay, Marchesini questions behaviorism and the automatism of learning, key aspects that have been prominent in defining animality in many fields, from biology to philosophy. Building from his groundbreaking and extensive work in ethology and zooanthropology, he argues for an “elaborative model” of animality (animal as subject) against the fallacy of the “automatism-based model” (animal as mechanism): Subjectivity is the implicit condition of the animal being, an expressive dimension that may also be unconscious but that precedes from (i) a constructivist conception of behavior, which we could explain by considering it a work in progress, always open and never predetermined, but equally never imposed and nonetheless always co-factorial to external contributions, and (ii) a propositional view of the individual, or rather from being supported by verbal structures such as to delight, to fear, to want, which join themselves to modal predicates declined according to context, but which likewise render the individual the protagonist. (p. 247)Animal studies has established itself as one of the most exciting areas of research inside the biological turn of the humanities worldwide and, by collecting such a large number of compelling and provocative theories from Italian contemporary philosophy, the impact of Cimatti and Salzani's volume will be twofold: It will enrich and expand a developing discussion in the environmental humanities and in animal studies while establishing the centrality of Italian thought in such an important and, in the Anthropocene era, necessary debate. (shrink)

BackgroundDespite the recognition that developing artificial intelligence (AI) that is trustworthy is necessary for public acceptability and the successful implementation of AI in healthcare contexts, perspectives from key stakeholders are often absent from discourse on the ethical design, development, and deployment of AI. This study explores the perspectives of birth parents and mothers on the introduction of AI-based cardiotocography (CTG) in the context of intrapartum care, focusing on issues pertaining to trust and trustworthiness.MethodsSeventeen semi-structured interviews were conducted with birth parents (...) and mothers based on a speculative case study. Interviewees were based in England and were pregnant and/or had given birth in the last two years. Thematic analysis was used to analyze transcribed interviews with the use of NVivo. Major recurring themes acted as the basis for identifying the values most important to this population group for evaluating the trustworthiness of AI.ResultsThree themes pertaining to the perceived trustworthiness of AI emerged from interviews: (1) trustworthy AI-developing institutions, (2) trustworthy data from which AI is built, and (3) trustworthy decisions made with the assistance of AI. We found that birth parents and mothers trusted public institutions over private companies to develop AI, that they evaluated the trustworthiness of data by how representative it is of all population groups, and that they perceived trustworthy decisions as being mediated by humans even when supported by AI.ConclusionsThe ethical values that underscore birth parents and mothers’ perceptions of trustworthy AI include fairness and reliability, as well as practices like patient-centered care, the promotion of publicly funded healthcare, holistic care, and personalized medicine. Ultimately, these are also the ethical values that people want to protect in the healthcare system. Therefore, trustworthy AI is best understood not as a list of design features but in relation to how it undermines or promotes the ethical values that matter most to its end users. An ethical commitment to these values when creating AI in healthcare contexts opens up new challenges and possibilities for the design and deployment of AI. (shrink)

It has already become a commonplace to discuss postbiological evolution in various contexts of futures studies, bioethics, cognitive sciences, philosophical anthropology, or even economics and SETI studies. The assumption is that technological/cultural evolution will soon entirely substitute for the biological processes which underlie human existence – and, by analogy, the existence of other independently evolved intelligent beings, if any. Various modes of postbiological evolution of humans have been envisioned in both fictional and discursive contexts. Little thought has been devoted (...) so far to the question whether these postbiological modes are truly final in both logical and conceptual terms. What lies beyond the postbiological realm? Clearly, only a few radical speculations on the topic can be offered. In this paper, it is argued that in a sufficiently broad subset of scenarios for postbiological evolution there will be a kind of reverse trend: the one of reintegration with the biological universe, by that point understood in a much wider and more inclusive sense. The argument for such reintegration could be understood through the metaphor of expanding Klein bottle as a symbolic image of the post-postbiological evolutionary trajectories. This kind of trajectory will lead to the state in which products of culture are indistinguishable from the natural environment, suggesting practical consequences for our SETI efforts. (shrink)

New technologies facilitate the enhancement of a wide range of human dispositions, capacities, or abilities. While it is argued that we need to set limits to human enhancement, it is unclear where we should find resources to set such limits. Traditional routes for setting limits, such as referring to nature, the therapy-enhancement distinction, and the health-disease distinction, turn out to have some shortcomings. However, upon closer scrutiny the concept of enhancement is based on vague conceptions of what is to be (...) enhanced. Explaining why it is better to become older, stronger, and more intelligent presupposes a clear conception of goodness, which is seldom provided. In particular, the qualitative better is frequently confused with the quantitative more. We may therefore not need “external” measures for setting its limits – they are available in the concept of enhancement itself. While there may be shortcomings in traditional sources of limit setting to human enhancement, such as nature, therapy, and disease, such approaches may not be necessary. The specification-of-betterment problem inherent in the conception of human enhancement itself provides means to restrict its unwarranted proliferation. We only need to demand clear, sustainable, obtainable goals for enhancement that are based on evidence, and not on lofty speculations, hypes, analogies, or weak associations. Human enhancements that specify what will become better, and provide adequate evidence, are good and should be pursued. Others should not be accepted. (shrink)

The Arab and Islamic world is in cultural, political and ethical flux. Pressures of globalisation contend with ancient ideas and concepts that permeate cultural frameworks. Health professionals are among the many groups battling to accommodate the rapidly changing conditions. In many predominantly Muslim countries intense debates are underway among clinicians about the impact of the forces of change on their practices. To help understand these forces we conducted a study of the experiences of clinicians in the Hashemite Kingdom of Jordan, (...) a Middle Eastern nation state where the overwhelming majority of the population is Muslim. The sample contained 508 doctors and doctors-in-training, of whom 63% were male and 80% were younger than 40 years of age. It included both a quantitative survey, covering a wide range of issues, and qualitative, free-text written responses. Our results demonstrated high levels of disquiet related to the overall organisation and administration of the health care system, the specific content of ethical decisionmaking, and the impact of changing social, cultural and religious factors. Concerns included overcrowding, widespread corruption and hierarchical, non- democratic, management practices, and tensions relating to traditional and modern approaches to ethics, especially in relation to consent, organ donation, confidentiality, privacy, abortion, and the role of women. The roles of religion and religious authorities, the relative importance of the family, and community and tribal obligations were also areas of contention. The study exposes profound divisions and widely differing perspectives among Jordanian doctors and an abiding sense of uncertainty and instability within the profession. Many doctors express ambivalence in relation to both modern trends and traditional precepts. Three main axes of ethical contention were demonstrated, relating to the tensions between: "conservative" and "pragmatic" styles of decision-making; "traditional" approaches and internationalised standards of ethics; and the role of Islam and pressures to disengage ethical decision- making from religious authority. We speculate that these issues and divisions, and the deep sense of disquiet revealed by our data reflect large-scale forces to which Jordanian society is exposed and to a substantial degree may provide a way to understand the ethical predicament of many other countries in the contemporary Arab world. (shrink)

A pertinent concern in the human enhancement debate is that human enhancement technologies (HET) are intrinsically bad and, hence, morally impermissible. This article evaluates the related claims about the intrinsic badness of HET by looking into philosophical theories of intrinsic value. It investigates how well-established conceptions of intrinsic value map onto typical bioconservative arguments about HET's intrinsic badness. Three predominant variants of these arguments are explored and found wanting: (i) HET are intrinsically bad owing to their unnaturalness; (ii) the pursuit (...) of HET reveals intrinsically bad character (“the desire for mastery”); and (iii) HET will necessarily undermine intrinsically valuable things (e.g., human dignity). My analysis shows that the debate on intrinsic value places serious constraints on claims about the intrinsic badness of HET. More specifically, the analysis shows that bioconservative arguments are, for the most part, inconsistent, misconceived, and overly speculative. Enhancement interventions cannot be bearers of intrinsic value on any of its plausible understandings, and, even if we could grant such a possibility, there are no compelling reasons to presume that the intrinsic value of HET would be necessarily negative. As a result, claims regarding their moral impermissibility are unwarranted. (shrink)