Book reviewed in this article: Not In Our Genes: Biology, Ideology, and Human Nature. By R. C. Lewontin, Steven Rose, and Leon J. Kamin.

: Some scientific research should not be published. The risks to national security and public health override the social benefits of disseminating scientific results openly. Unfortunately, scientists themselves are not in a position to know which studies to withhold from public view, as the National Research Council has proposed. Yet neither can government alone be trusted to balance the competing interests at stake.

Although many do not seem to recognize it, the half‐millenium‐old tradition of Catholic teachings on providing care at the end of life offers a nuanced, carefully balanced doctrine, centering on a finely tuned distinction between ordinary and extraordinary care. Given the significant Catholic contribution to the contemporary pluralist debate about end of life care, getting clear on that tradition is important.

The release of genetically engineered organisms into the shared environment raises scientific, ethical, and societal issues. Using some form of democratic deliberation to provide the public with a voice on the policies that govern these technologies is important, but there has not been enough attention to how we should connect public deliberation to the existing regulatory process. Drawing on lessons from previous public deliberative efforts by U.S. federal agencies, we identify several practical issues that will need to be addressed if (...) relevant federal agencies are to undertake public deliberative activities to inform decision‐making about gene editing in the wild. We argue that, while agencies may have institutional capacity to undertake public deliberative activities, there may not be sufficient political support for them to do so. Advocates of public deliberation need to make a stronger case to Congress about why federal agencies should be encouraged and supported to conduct public deliberations. (shrink)

Since 1980, the number of twin births in the United States has increased 76 percent, and the number of triplets or higher-order multiples has increased over 400 percent. These increases are due in part to increased maternal age, which is associated with spontaneous twinning. But the primary reason for these increases is that more and more people are undergoing fertility treatment. Despite an emerging (but not absolute) consensus in the medical literature that multiples, including twins, should be a far less (...) frequent outcome of fertility treatment, American clinicians currently practice fertility medicine in ways likely to result in twins and, occasionally, triplets-often, they tell us, at the request of their patients. At first blush, one might conclude that these practice patterns show that patients and their doctors have weighed the risks associated with twins against the benefits of swiftly completing their families and decided that the risks are worth taking. That is, their requests for twins must represent their free and informed choices. But there are reasons to be skeptical of this interpretation, including that the preferences of many patients seem to be very strongly shaped, if not sometimes completely constrained, by concerns about costs-costs that mainly result from the routine exclusion of in vitro fertilization from health insurance coverage. It is quite possible, we believe, that these cost concerns actually undermine the autonomy of fertility patients, pushing many of them to take risks with their health and the health of their hoped-for future children. [ABSTRACT FROM AUTHOR]. (shrink)

The Israeli Patient Rights Act attempts to accommodate personal autonomy within an avowedly paternalist communitarian state. Although Israel is still groping toward a solution, the legislation begins to show the different form a communitarian version of autonomy must take.

Medical ethics in times of war are fundamentally different from those in times of peace. War brings military and medical values into conflict, often overwhelming other moral obligations, such as a doctor's charge to relieve suffering, in the face of military necessity.

Medical ethics in times of war are fundamentally different from those in times of peace. War brings military and medical values into conflict, often overwhelming other moral obligations, such as a doctor's charge to relieve suffering, in the face of military necessity.

“Medicalized” weapons—those that rely on advances in neuroscience, physiology, and pharmacology—offer the prospect of reducing casualties and protecting civilians. They could be especially useful in modern asymmetric wars in which conventional states are pitted against guerrilla or insurgent forces. But may physicians and other medical workers participate in their development?

An international medical tribunal should be established with power to impose criminal sanctions against physicians who are guilty of crimes against humanity.

Many older people need external support for their daily living. A large minority of older adults with low or modest pension incomes face financial strains from the high cost of illness, and many older people in urban areas live in social isolation. Indeed, population aging has become a policy topic of concern. The policy debate since the end of the twentieth century about the future of public pensions and health and long‐term care programs has increasingly framed the growing numbers of (...) older people in alarmist terms. Unfounded claims about the unaffordability and unsustainability of social policies supporting older people have become common currency, often disguised as concerns about intergenerational justice. Such claims and concerns hinder clear thinking about proper social and fiscal policies, housing, health care, and labor markets to safeguard the well‐being of older people in aging societies. (shrink)

One central and unfortunately unavoidable characteristic of the aging process is its association with chronic physiological deterioration. Frailty, cognitive impairment, and physical conditions such as cardiovascular disease and vision and hearing loss are more frequent in this phase of life, and these conditions translate into an increasing need for care and support of multiple kinds. In traditional bioethical scholarship, these distinctive features of aging have been examined predominantly through a health‐focused lens. My main contention in this essay, however, is that (...) viewing aging within bioethics as primarily a health problem, to be addressed through frameworks for decision‐making or for resource allocation, is inadequate. My aim is to consider how the health conditions associated with aging affect older people’s lives in a much more expansive way than has typically been acknowledged. Just as importantly, I intend to show how shifting our bioethical imagination in this way raises different and challenging questions about what a good life in late life consists in and about what is owed to older people, in their personal and social lives, as a matter of justice. (shrink)

Gene editing in the environment must consider uncertainty about potential benefits and risks for different populations and under different conditions. There are disagreements about the weight and balance of harms and benefits. Deliberative and community‐led approaches offer the opportunity to engage and empower diverse publics to co‐create responses and solutions to controversial policy choices in a manner that is inclusive of diverse perspectives. Stories, understood as situated accounts that reflect a person's life experiences, can enable the articulation of nuanced perspectives, (...) diversify how perspectives are communicated, encourage wider participation, open dominant perspectives to challenge, and invite participants to assess appropriate empathy and precaution in collective positions. An emphasis on storytelling in deliberations on gene editing of organisms emphasizes carefully designed recruitment and facilitation to support hearing from a range of perspectives, including those that present a different set of assumptions than those that may be held by experts or other stakeholders, among these, consideration of how to understand our relationships to nature. (shrink)

The thought that human embryos could command moral respect yet also be acceptably used in medical research has struck some as incoherent. Given some assumptions about why they deserve respect, however, the thought is not objectionable, indeed not even unusual.

Hastings Center Report, Volume 52, Issue 5, Page 42-43, September–October 2022.

The U.S. Food and Drug Administration's drug advisory committees provide expert assessments of the safety and efficacy of new therapies considered for approval. A committee hears from a variety of speakers, from six groups, including voting members of the committee, FDA staff members, employees of the pharmaceutical company seeking approval of a therapy, patient and consumer representatives, expert speakers invited by the company, and public participants. The committees convene at the request of the FDA when the risks and harms of (...) novel products are not immediately clear, and their final decisions carry significant weight, as most therapies that receive advisory committee approval are subsequently approved by the FDA. In recent years, across a series of diverse publications, the financial conflicts of interest of each category of participants in the meetings have been investigated. Here, we summarize these findings and their ethical implications, focusing on the FDA Oncologic Drugs Advisory Committee, and we suggest ways to move toward more transparent and impartial advisory committee meetings. (shrink)

In recent years a number of books have been published that offer short autobiographical essays of academics, focusing on their research and how their life history affected their scholarly development. These could be labeled as "intellectual journey narratives." Some volumes focus on philosophers and their religious faith or lack thereof (e.g., Clark, 1997, Antony, 2007). Psychology has its own version of the intellectual journey narrative, in T. S. Krawiec's (1972, 1974, 1978) multivolume set of autobiographical essays by contemporary psychologists. In (...) 1987, Rosemary Pilkington edited her first volume of essays entitled Men and Women of Parapsychology: Personal Reflections, Esprit Volume 1. It contains autobiographical essays by Jule Eisenbud, Montague Ullman, Jan Ehrenwald, Eileen Coly, Joseph H. Rush, Gertrude R. Schmeidler, Emilio Servadio, Renée Haynes, Hans Bender, Karlis Osis, George Zorab and Bernard Grad. The second (2013) volume contains autobiographical essays by Mary Rose Barrington, Eberhard Bauer, William Braud (now deceased), Stephen Braude, Richard S. Broughton, Larry Dossey, Sally Rhine Feather, Erlendur Haraldsson, Arthur Hastings, Stanley Krippner, Lawrence LeShan, Roger Nelson, John Palmer, Guy Leon Playfair, William G. Roll (now deceased), Serena Roney-Dougal, Stephan A. Schwartz, Rex G. Stanford, Russell Targ, Charles T. Tart, and Walter von Lucadou. Between the two volumes almost every significant contemporary parapsychologist is represented, with the major exceptions being the late John Beloff and the late Ian Stevenson. (shrink)

Insofar as many older adults fit some definition of disability, disability studies and gerontology would seem to have common interests and goals. However, there has been little discussion between these fields. The aim of this paper is to open up the insights of disability studies as well as philosophy of disability to discussions in gerontology. In doing so, I hope to contribute to thinking about the good life in late life by more critically reflecting upon the meaning of the body, (...) ability, and the variability of each. My central argument is that we should conceptualize age‐associated bodily variations and abilities not in terms of individual capacity, but in terms of what I call “the extended body.” It is in light of the meaning of embodiment and ability in general that we must think differently and more capaciously about the meaning of late life in particular. (shrink)

When Jonathan Swift published “A Modest Proposal for Preventing the Children of Poor People of Being a Burden on their Country or Parents, and for Making Them Beneficial to the Publick” in 1729, many early readers were shocked and repulsed. Yet if a similar proposal were published today in a reputable academic journal, we could not be sure of its satirical character: it might well be entirely sincere. In late February this year, the Journal of Medical Ethics prepublished online a (...) paper that can be seen as a modernized bioethical version of Swift's “Modest Proposal.” All the authors had done is present a “well reasoned argument based on widely accepted premises” that allowed them to “proceed logically” from those premises to the conclusions. (shrink)

The possibility of moral bioenhancement, and the alleged need for it, have been widely discussed both in ethics journals and the media since this type of enhancement was first proposed in the Journal of Medical Ethics in 2008. Most prominently, Ingmar Persson and Julian Savulescu have argued that humans in their current condition are simply not good enough to deal effectively with the global problems we face today and that, if we want to have any hope of saving the world (...) from “ultimate harm,” we need to find ways to morally enhance people, using psychopharmaceuticals, neurostimulation, gene editing, or whatever other biological method we can think of that might do the trick. Persson and Savulescu's 2012 book on the subject, Unfit for the Future: The Need for Moral Enhancement, has very much determined the direction of the debate. However, what remains contentious is the question of whether the kind of enhancement that Persson and Savulescu envisage is really desirable and actually feasible. Earlier in 2016, two books on moral bioenhancement were published, namely John Harris's How to Be Good: The Possibility of Moral Enhancement and Harris Wiseman's The Myth of the Moral Brain: The Limits of Moral Enhancement. Harris's book focuses on the desirability of moral bioenhancement, and Wiseman's primarily on its feasibility. Both reject Persson and Savulescu's proposal and approach, but for very different reasons. (shrink)