This book is the latest in the WIRED series of publications ‘reporting on the emerging trends, ideas and technologies shaping our world.’ Genomics, which is rather more than genome sequencing, cert...

The belief that genomics requires rethinking the ‘social contract’ to realize its potential has received backing from leading figures within bioethics. The case for a new social contract is anchored in notions of solidarity, altruism or the common good. But national genome sequencing is playing out against a backdrop of greatly increased involvement, and investment, of governments in their life science sectors – creating a sort of international race to drive innovation, stimulate growth, and create the most competitive life science (...) sectors. Recent developments in the UK suggest this agenda is detrimental to openness and transparency, as well as independent oversight, and meaningful public consultation. These aspects of governance, I argue, should be reconceived as part of the requirements of good governance. Further, a new social contract should involve a commitment by government, and industry, to educate the public about life science – and should be extended to life science more generally. (shrink)

Our ability to generate genomic data is currently well ahead of our ability to understand what they mean, raising challenges about how best to engage with them. This article considers ethical aspects of work with such data, focussing on research contexts that are intertwined with clinical care. We discuss the identifying nature of genomic data, the medical information intrinsic within them, and their linking of people within a biological family. We go on to consider what this means for consent, the (...) importance of thoughtful sharing of genomic data, the challenge of constructing meaningful findings, and the legacy of unequal representation in genomic datasets. We argue that the ongoing success of genomic data research relies on public trust in the enterprise: to justify this trust, we need to ensure robust stewarding, and wide engagement about the ethical issues inherent in such practices. (shrink)

The Covid-19 pandemic has demonstrated the potential of genomic technologies for the detection and surveillance of infectious diseases. Pathogen genomics is likely to play a major role in the future of research and clinical implementation of genomic technologies. However, unlike human genetics, the specific ethical and social challenges associated with the implementation of infectious disease genomics has received comparatively little attention. In this paper, we contribute to this literature, focusing on the potential consequences for individuals and communities of the use (...) of these technologies. We concentrate on areas of challenges related to privacy, stigma, discrimination and the return of results in the cases of the surveillance of known pathogens, metagenomics and host genomics. (shrink)

Amidst a plethora of books about human genome engineering (HGE), this one by John H Evans, a professor of sociology in the United States, stands out with its original and interesting take on how th...

As a psychologist and an ethicist, we have explored empirically newborn screening consent and communication processes. In this paper we consider the impact on families if newborn screening uses whole genome sequencing. We frame this within the World Health Organization’s definition of health and contend that proposals to use whole genome sequencing in newborn screening take into account the ethical, practical and psychological impact of such screening. We argue that the important psychological processes occurring in the neonatal phase necessitate a (...) clear justification that providing risk information at this stage provides a health benefit. We illustrate how research on current newborn screening can inform whole genome sequencing debates, whilst highlighting important gaps. Obtaining explicit, voluntary, and sufficiently informed consent for newborn screening is challenging, however we stress that such consent is ethically and legally appropriate and psychologically and practically important. We conclude by outling how this might be done. (shrink)

2023 marks twenty years since the formal completion of the Human Genome Project (HGP). As many readers will know, this monumental international collaboration to determine the sequence of all three...

Charles Camosy’s Losing Our Dignity is a concise and disturbing account of how our long held understanding of human equality, largely inherited from Christianity, is gradually being undermined by t...

One of the primary concerns in animal research is ensuring the welfare of laboratory animals. Modern views on animal welfare emphasize the role of animal sentience, i.e. the capacity to experience subjective states such as pleasure or suffering, as a central component of welfare. The increasing official recognition of animal sentience has had large effects on laboratory animal research. The Cambridge Declaration on Consciousness (Low et al., University of Cambridge, 2012) marked an official scientific recognition of the presence of sentience (...) in mammals, birds, and cephalopods. Animal sentience has furthermore been recognized in legislation in the European Union, UK, New Zealand and parts of Australia, with discussions underway in other parts of the world to follow suit. In this paper, we analyze this shift towards recognition of sentience in the regulation and practice in the treatment of laboratory animals and its effects on animal welfare and use. (shrink)

The pelvic exam is used to assess the health of female reproductive organs and so involves digital penetration by a physician. However, it is common practice for medical students to acquire experience in administering pelvic exams by performing them on unconscious patients without prior authorization. In this article, we argue that such unauthorized pelvic exams (UPEs) are sexual assault. Our argument is simple: in any other circumstance, unauthorized digital penetration amounts to sexual assault. Since there are no morally significant differences (...) between UPEs and other instances of digital penetration, UPEs are sexual assault. So, insofar as one is against sexual assault, one should be against UPEs. (shrink)

This paper looks at the ethics of opt-in vs. opt-out of organ donation as Scotland has transitioned its systems to promote greater organ availability. We first analyse studies that compare the donation rates in other regions due to such a system switch and find that organ increase is inconclusive and modest at best. This is due to a lack of explicit opt-out choices resulting in greater resistance and family override unless there are infrastructures and greater awareness to support such change. (...) The paper then looks at the difference between informed consent of the opt-in vs. presumed consent in the opt-out approaches. Patient autonomy and dignity are better reflected with informed consent. Eighteen months have passed since the new organ donation policy has come into effect, this paper recommends more research into organ donors’ psychological motivations to help governments and the healthcare profession obtain more organs for transplantation. (shrink)

McMillan, a Lecturer in Law at Edinburgh University, has written this book which is part of a wider research project conducted at Edinburgh Law School funded by the Wellcome Trust, entitled ‘Confro...

The Ethics of Generating Posthumans is a multi-disciplinary anthology edited by Calum MacKellar, director of research at the Scottish Council on Human Bioethics, and Trevor Stammers, editor-in-chie...

Curing Mad Truths, a short collection of essays and lectures, is Rémi Brague's plea for ‘some sort of return to the Middle Ages’ (p. 5) in the teeth of the ideology of Modernity which, he posits, t...

Many people believe the morality of abortion stands or falls on the moral status of the fetus, with abortion opponents arguing fetuses are persons with a right to life. Judith Jarvis Thomson bypasses this debate, arguing that even if we assume fetuses have a right to life, this is not a right to use other people’s bodies. Recently Perry Hendricks attempts to bypass discussion of rights, assuming that if he can show that some people have a right to use other’s (...) bodies, then we ought to restrict abortion (and perhaps compel organ donation, charity, etc.). Hendricks attempts to illustrate this by way of a Feinberg-style cabin case. I argue Hendricks’ restrictivist argument fails. (shrink)

In this new book in the Routledge Critical Approaches to Health series, Anna Westin (Honorary Visiting Lecturer at University of Kent and Honorary Visiting Fellow at St. Mary’s University, Centre f...

This issue provides an end of year feast with something for everyone. Browning and Veit note how, since the presence of sentience in mammals, birds and cephalopods received official scientific reco...

There is a regulatory option for conscientious objection in health care that has yet to be systematically examined by ethicists and policymakers: granting a liberty to request exemption from prescribed work tasks without a companion guarantee that the request is accommodated. For the right-holder, the liberty’s value lies in the ability to seek exemption without duty-violation and a tangible prospect of reassignment. Arguing that such a liberty is too unreliable to qualify as a right to conscientious objection leads to the (...) problem of consistently distinguishing its effects from those of a right to conscientious objection that is made conditional on an individual assessment of the objector’s motivation. These properties require that we distinguish the liberty to request exemption from more restrictive policy choices, and that we subject it to greater scrutiny in the wider moral discourse as a possible variant of a right to conscientious objection. (shrink)

This paper considers the number of speeches which treat central topics in the House of Lords second reading of the ‘Assisted Dying Bill’ (October 22, 2021). It summarizes some of the principal arguments for and against the Bill according to the main categories of discussion. These were compassion; palliative care; autonomy, choice and control; legal and social effects. In summarizing the arguments thematically, it is possible to see the current state of the debate and how concerns are shared on either (...) side, even if approaches to and proposed solutions for those problems are different. The paper concludes that the essential source of disagreement lies outside of the arguments raised, and therefore that any change in the law is not likely to arise from political consensus. (shrink)

This paper examines the problem of dying alone in the context of no-visitors hospital policy during the COVID-19 pandemic. It critically analyses a rights-based solution, offering a democratized vi...

Decriminalising Abortion in the UK. What would it Mean, edited by Sally Sheldon and Kaye Wellings (Profess...

A careful observation of the phenomenon of human life allows us to understand that from the beginning of the human life cycle until its destruction, the existence of each subject is deeply marked b...

This article is an examination of the doctor–woman patient encounter through a vulnerability lens. This relationship has been traditionally been critiqued as a paternalistic encounter in which the...

Gender dysphoria is a persistent distress about one’s assigned gender. Referrals regarding gender dysphoria have recently greatly increased, often of a form that is rapid in onset. The sex ratio ha...

The right to informed consent, as established in the Supreme Court judgment in Montgomery v Lanarkshire Health Board [2015] UKSC 11, I claim involves a ‘journey of love’ between clinicians and...

Abortion pill reversal treatment aims to halt an initiated medical abortion, wherein a pregnant woman takes progesterone after having taken the first of the two consecutive abortion pills, ty...

Can we speak of a feminine approach to caring for the body? If there is such an approach, how does culture influence or even construct it? Do we need a new culture of care in the medical field? Wha...

In 2017, The New Bioethics published its first special-themed issue on the topic of personalized medicine. It proved highly popular, especially Gyawali and Sullivan’s paper ‘Economics of Can...

Opponents of abortion are commonly said to be inconsistent in their beliefs or actions, and to fail in their obligations to prevent the deaths of embryos and fetuses from causes other than induced...

Elective egg freezing for fertility preservation - commonly referred to as social egg freezing or non-medical egg freezing, will be permitted in Singapore from 2023. There...

Bryan Hall is dean of the College of Contemporary Liberal Studies and Professor of Liberal Arts at Regis University, USA. An Ethical Guidebook to the Zombie Apocalypse, his first foray into fiction...

Cryopreservation presents the possibility of circumventing irreversible death through the body’s extreme cooling. Once cooled, this ‘cryon’ is then stored at sub-zero temperatures until medical kno...

Central to this essay is the understanding that varied communities may have an inherent and unrecognised culture of their own and this culture may be detrimental to their core. Bioethics constitutes one such community and is embedded in norms and values comprising its own culture. I use exclusion of religion or simply ‘irreligion’ as an example of a cultural element that may be established and so shape the culture of bioethics. Irreligious bioethics includes both overt religious preclusion and the more (...) pervasive form of religious marginalisation. This norm is narrated into the culture of bioethics with justifications sustaining it. Irreligious bioethics is inadmissible as it claims illegitimate neutrality, is a misuse of expertise and results in a variety of harms. As bioethics is influential in society, those engaged should be critically reflective and aware of harmful cultural elements whilst also possessing the honesty, courage and capacity to change them. (shrink)

There has been a significant growth in the literature on nudging and behavioural economics, since Richard Thaler and Cass Sunstein published their well-known book Nudge: Improving Decisions about H...

Could it be that if a fetus is not a person abortion is still immoral? One affirmative answer comes in the form of ‘The Impairment Argument’, which utilizes ‘The Impairment Principle’ to argue that abortion is immoral even if fetuses lack personhood. I argue ‘The Impairment Argument’ fails. It is not adequately defended from objections, and abortion is, in fact, a counterexample to the impairment principle. Furthermore, it explains neither what the wrong-making features of abortion are nor what features of (...) fetuses ground their supposed moral significance. By presupposing the fetus lacks personhood and providing no alternate account of the basis of fetuses’ moral significance, there is nothing to constitute abortion’s wrongness. Attempts to modify it fail for the same reasons. Thus, the impairment argument fails to show abortion is immoral. (shrink)

Arising from a research project from the Faraday Institute for Science and Religion in Cambridge, UK, this primer on gene editing is written by a postdoctoral researcher in the Faculty of Divinity...

‘There is a tide in the affairs of men.Which, taken at the flood, leads on to fortune;’Those who edit academic journals rarely seek fortune in finan...

This essay discusses sentient robot research through the lens of suffering. First three kinds of suffering are considered: physical, psychological, and existential. Physical pain is shown to b...

A COVID-19 vaccine mandate is being introduced for health and social care workers in England, and those refusing to comply will either be redeployed or have their employment terminated. We argue th...

Restraint has been used within health care settings for many centuries. Initially physical restraint was the method of choice, in present times. Within critical care units PR and chemical rest...

Covid-19 and arguments related to abortion – these two topics between them take up the majority of the pages of this issue. That the first of these should do so, is no surprise. Over two years on f...

This book is centred around a traditional, vocational account of medical ethics – what is sometimes called a Hippocratic medical ethics but what Curlin and Tollefsen label ‘The Way of Medicine’. Th...