The prospect of using genome technologies to modify the human germline has raised profound moral disagreement but also emphasizes the need for wide-ranging discussion and a well-informed policy response. The Hinxton Group brought together scientists, ethicists, policymakers, and journal editors for an international, interdisciplinary meeting on this subject. This consensus statement formulated by the group calls for support of genome editing research and the development of a scientific roadmap for safety and efficacy; recognizes the ethical challenges involved in clinical reproductive (...) applications of genome editing but, importantly, rejects the idea that human reproductive germline modification is necessarily morally unacceptable; and highlights the importance of meaningful engagement in discussions of genome editing and the development of regulation and oversight mechanisms to govern future uses of such technologies. (shrink)

Moral enhancement is a topic that has sparked much current interest in the world of bioethics. The possibility of making people ‘better,’ not just in the conventional enhancement sense of improving health and other desirable qualities and capacities, but by making them somehow more moral, more decent, altogether better people, has attracted attention from both advocates 1 2 and sceptics 3 alike. The concept of moral enhancement, however, is fraught with difficult questions, theoretical and practical. What does it actually mean (...) to be ‘more moral’? How would moral enhancement be defined and would it necessarily, as some have claimed, make the world a better or safer place? How would or could such enhancement be achieved safely and without undue constraint on personal liberty and autonomy? On this subject, a recent paper by Crockett et al 4 investigating the effects of the neurotransmitter serotonin on moral decision-making provides an intriguing scientific basis for examining what might or might not constitute moral enhancement. The study involved treatment with citalopram, a drug that increases the action of serotonin in the brain, and subsequent analysis of participants' decision-making behaviour in two different situations involving moral dilemmas: the well-known ‘Trolley Problem’ 5 and the ‘Ultimatum Game’. 6 The researchers found that citalopram promoted what they call ‘prosocial behaviour’, increasing the participants' aversion to causing direct harm to others: in the first scenario, they were less likely to select the option that required killing one in order to save five, and in the second, less likely to reject unfair offers at the expense of others. The Crockett study is fascinating both for its insight into human behaviour and because it appears to demonstrate that, at least on some accounts of moral behaviour, serotonin may in fact be a …. (shrink)

John Harris has previously proposed that there is a moral duty to participate in scientific research. This concept has recently been challenged by Iain Brassington, who asserts that the principles cited by Harris in support of the duty to research fail to establish its existence. In this paper we address these criticisms and provide new arguments for the existence of a moral obligation to research participation. This obligation, we argue, arises from two separate but related principles. The principle of fairness (...) obliges us to support the social institutions which sustain us, of which research is one; while the principle of beneficence, or the duty of rescue, imposes upon us a duty to prevent harm to others, including by supporting potentially beneficial, even life-saving research. We argue that both these lines of argument support the duty to research, and explore further aspects of this duty, such as to whom it is owed and how it might be discharged. (shrink)

Animals, in the age of biotechnology, are the subjects of a myriad of scientific procedures, interventions, and modifications. They are created, altered, and experimented upon—often with highly beneficial outcomes for humans in terms of knowledge gained and applied, yet not without concern also for the effects upon the experimental subjects themselves: consideration of the use of animals in research remains an intensely debated topic. Concerns for animal welfare in scientific research have, however, been primarily directed at harm to and suffering (...) of animal subjects and their prevention. Little attention has been paid to the benefits research might potentially produce for animals themselves and the interests that some animals may therefore have in the furtherance of particular avenues of science. (shrink)

Recently, attention has been drawn to the basic principles governing the use of human embryos in research: specifically, the so-called fourteen-day rule. This rule stipulates that human embryos should not be allowed to grow in vitro past fourteen days of development. For years, the fourteen-day limit was largely theoretical, since culture techniques were not sufficient to maintain embryos up to this point. Yet in the past year, research has suggested that growing embryos beyond fourteen days might be feasible and scientifically (...) valuable. At the same time, work with pluripotent stem cells, including human PSCs, has shown that under certain conditions, they can form structures that recapitulate developmental features of the postimplantation embryo. This raises the possibility that PSCs could generate embryo-like structures in vitro, even “synthetic embryos,” that might provoke moral concern but would not fall under most current embryo research policies. In countries that permit embryo research, the fourteen-day rule has long been the linchpin of an effective policy compromise between what remain deeply divided moral positions on the human embryo's status. It has also, particularly in the United Kingdom, been influential in establishing a bioethics public-policy process. Any moves to change the rule must consider not just the implications for the use of embryos but also the potential impact of this model of bioethical governance of science. (shrink)

After reading Savulescu and colleagues,1 one ought to be in no doubt that human heritable genome editing is a ‘moral imperative’: to cure disease, reduce inequalities, improve public health and protect future generations. They make this argument repeatedly and in no uncertain terms. Yet are they right to do so? I am certainly not against developing HGE or exploring its possibilities. Instead, I aim to sound a cautionary note in relation to claims about its technological potential and how we frame (...) arguments on this basis. The ‘moral imperative’ argument has been made many times, since well before the advent of genome editing, by the present authors and others. It generally rests on a number of preconditions, implicit or explicit: that HGE will be safe, effective, cost-efficient and equitably available. Now, many bioethicists would take no issue with, indeed have supported,5 the proposition that, once all of these conditions are satisfied, HGE is something we have good moral reasons to pursue. At this pivotal moment for global science, ethics and governance, however, we need equally to be concerned with the technology’s immediate future trajectory: whether and how we can reach the point of satisfying these conditions. In this context, the MIA is something of a distraction; at worst, it may even be corrosive and damaging. Consider first the argument from evolutionary fitness, that HGE is morally required to counteract the supposed ‘genetic deterioration’ produced by medically enabled ‘survival of the weak’, that makes …. (shrink)

This book examines, through a multi-disciplinary lens, the possibilities offered by relationships and family forms that challenge the nuclear family ideal, and some of the arguments that recommend or disqualify these as legitimate units in our societies. That children should be conceived naturally, born to and raised by their two young, heterosexual, married to each other, genetic parents; that this relationship between parents is also the ideal relationship between romantic or sexual partners; and that romance and sexual intimacy ought to (...) be at the core of our closest personal relationships - all these elements converge towards the ideal of the nuclear family. The authors consider a range of relationship and family structures that depart from this ideal: polyamory and polygamy, single and polyparenting, parenting by gay and lesbian couples, as well as families created through current and prospective modes of assisted human reproduction such as surrogate motherhood, donor insemination, and reproductive cloning. (shrink)

From reason to practice in bioethics brings together original contributions from some of the world's leading scholars in the field of bioethics. With a particular focus on, and critical engagement with, the influential work of Professor John Harris, the book provides a detailed exploration of some of the most interesting and challenging philosophical and practical questions raised in bioethics.

The United Kingdom is the first and so far only country to pass explicit legislation allowing for the licensed use of the new reproductive technology known as mitochondrial replacement therapy. The techniques used in this technology may prevent the transmission of mitochondrial DNA diseases, but they are controversial because they involve the manipulation of oocytes or embryos and the transfer of genetic material. Some commentators have even suggested that MRT constitutes germline genome modification. All eyes were on the United Kingdom (...) as the most likely location for the first MRT birth, so it was a shock when, on September 27, 2016, an announcement went out that the first baby to result from use of the intervention had already been born. In New York City, United States-based scientist John Zhang used maternal spindle transfer to generate five embryos for a woman carrying oocytes with deleterious mutations of the mitochondrial DNA. Zhang then shipped the only euploid embryo to Mexico, where it was transferred to the mother's uterus. Zhang's team's travel across international borders to carry out experimental procedures represents a form of scientific tourism that has not been properly ethically explored; it can, however, have seriously detrimental effects for developing countries. (shrink)

On November 26, 2018, the world awoke to the news that genome editing had for the first time been used to create genetically modified human beings. He Jiankui, a scientist then employed by Southern University of Science and Technology of China, Shenzhen, announced via social media and the popular press that he had performed genome editing on embryos with the aim of disrupting the CCR5 gene in order to induce immunity to HIV, implanted the embryos, and that twin girls had (...) been born.In the wake of this announcement, arguments, claims, and accusations flew. Most commentators declared He's actions "irresponsible," pointing to various statements by scientific organizations agreeing that human embryo genome editing was... (shrink)

In recent years, discourses around “personalized,” “stratified,” and “precision” medicine have proliferated. These concepts broadly refer to the translational potential carried by new data-intensive biomedical research modes. Each describes expectations about the future of medicine and healthcare that data-intensive innovation promises to bring forth. The definitions and uses of the concepts are, however, plural, contested and characterized by diverse ideas about the kinds of futures that are desired and desirable. In this paper, we unpack key disputes around the “personalized,” “stratified,” (...) and “precision” terms, and map the epistemic, political and economic contexts that structure them as well as the different roles attributed to patients and citizens in competing future imaginaries. We show the ethical and value baggage embedded within the promises that are manufactured through terminological choices and argue that the context and future-oriented nature of these choices helps to understanding how data-intensive biomedical innovations are made socially meaningful. (shrink)

New health technologies are rapidly emerging from various areas of bioscience research, such as gene editing, regenerative medicine and synthetic biology. These technologies raise promising medical possibilities but also a range of ethical considerations. Apart from the issues involved in considering whether novel health technologies can or should become part of mainstream medical treatment once established, the process of research translation to develop such therapies itself entails particular ethical concerns. In this paper I use synthetic biology as an example of (...) a new and largely unexplored area of health technology to consider the ways in which novel health technologies are likely to emerge and the ethical challenges these will present. I argue that such developments require us to rethink conventional attitudes towards clinical research, the roles of doctors/researchers and patients/participants with respect to research, and the relationship between science and society; and that a broader framework is required to address the plurality of stakeholder roles and interests involved in the development of treatments based on novel technologies. (shrink)

The legitimacy of embryo research, use, and destruction is among the most important issues facing contemporary bioethics. In the preceding paper, Ingmar Persson and Julian Savulescu took up an argument of John Harris and tried to find some new ways of avoiding its dramatic consequences. They noted that: “John Harris has argued that if … it is morally permissible to engage in reproduction … despite knowledge that a large number of embryos will fail to implant and quickly die, then … (...) it is morally permissible to produce embryos for other purposes that involve killing them, for instance, to harvest stem cells” and suggest that this argument fails. (shrink)

Recent ethical and legal challenges have arisen concerning the rights of individuals over their IVF embryos, leading to questions about how, when the wishes of parents regarding their embryos conflict, such situations ought to be resolved. A notion commonly invoked in relation to frozen embryo disputes is that of reproductive rights: a right to have (or not to have) children. This has sometimes been interpreted to mean a right to have, or not to have, one's own genetic children. But can (...) such rights legitimately be asserted to give rise to claims over embryos? We examine the question of property in genetic material as applied to gametes and embryos, and whether rights over genetic information extend to grant control over IVF embryos. In particular we consider the purported right not to have one's own genetically related children from a property-based perspective. We argue that even if we concede that such (property) rights do exist, those rights become limited in scope and application upon engaging in reproduction. We want to show that once an IVF embryo is created for the purpose of reproduction, any right not to have genetically-related children that may be based in property rights over genetic information is ceded. There is thus no right to prevent one's IVF embryos from being brought to birth on the basis of a right to avoid having one's own genetic children. Although there may be reproductive rights over gametes and embryos, these are not grounded in genetic information. (shrink)

Biomedical research involving human participants is highly regulated and subject to stringent ethical requirements. Clinical research ethics, regulation and policy have tended to focus almost exclusively on the protection of participants' interests against harms that might result from taking part in research. Less consideration, however, has been given to the interests that patients may themselves have in research participation, even in trials that may be beyond the bounds of current clinical research practice. In this paper, we consider the case of (...) a suggested extension to clinical trial protocols to explore the ethics of participation in ‘risky’ research. We argue that patients may have a strong interest in taking part in research, and that even when greater-than-usual risks may be present, such research can be both ethically and scientifically justified. Finally, we suggest that there might be scope in some cases to assert a right to participate in research, and that the possibility of such a right merits further consideration. (shrink)

The ethics of psychiatry The ethics of psychiatry is one of the areas of medical ethics where the overlap between medical ethics and philosophy of medicine is largest. This is illustrated by two papers in the current issue of the JME. Charlotte Blease discusses whether it is “… ever right to prescribe placebos to patients in clinical practice?” in the context of prescribing for patients with severe depression . Would such prescriptions for instance amount to morally problematic deception? In an (...) intricate analysis she points out that the answer to the question depends on a range of complex conceptual distinctions that will be familiar to scholars in philosophy of medicine. One very significant issue that is raised is that well-being is not synonymous with a realistic assessment of oneself or one's circumstances. Most of us who are not depressed have positive illusions about ourselves and this may even …. (shrink)

Population-level biomedical research offers new opportunities to improve population health, but also raises new challenges to traditional systems of research governance and ethical oversight. Partly in response to these challenges, various models of public involvement in research are being introduced. Yet, the ways in which public involvement should meet governance challenges are not well understood. We conducted a qualitative study with 36 experts and stakeholders using the World Café method to identify key governance challenges and explore how public involvement can (...) meet these challenges. This brief report discusses four cross-cutting themes from the study: the need to move beyond individual consent; issues in benefit and data sharing; the challenge of delineating and understanding publics; and the goal of clarifying justifications for public involvement. The report aims to provide a starting point for making sense of the relationship between public involvement and the governance of population-level biomedical research, showing connections, potential solutions and issues arising at their intersection. We suggest that, in population-level biomedical research, there is a pressing need for a shift away from conventional governance frameworks focused on the individual and towards a focus on collectives, as well as to foreground ethical issues around social justice and develop ways to address cultural diversity, value pluralism and competing stakeholder interests. There are many unresolved questions around how this shift could be realised, but these unresolved questions should form the basis for developing justificatory accounts and frameworks for suitable collective models of public involvement in population-level biomedical research governance. (shrink)

Many of our most important goals require months or even years of effort to achieve, and some never get achieved at all. As social psychologists have lately emphasized, success in pursuing such goals requires the capacity for perseverance, or "grit." Philosophers have had little to say about grit, however, insofar as it differs from more familiar notions of willpower or continence. This leaves us ill-equipped to assess the social and moral implications of promoting grit. We propose that grit has an (...) important epistemic component, in that failures of perseverance are often caused by a significant loss of confidence that one will succeed if one continues to try. Correspondingly, successful exercises of grit often involve a kind of epistemic resilience in the face of failure, injury, rejection, and other setbacks that constitute genuine evidence that success is not forthcoming. Given this, we discuss whether and to what extent displays of grit can be epistemically as well as practically rational. We conclude that they can be (although many are not), and that the rationality of grit will depend partly on features of the context the agent normally finds herself in. In particular, grit-friendly norms of deliberation might be irrational to use in contexts of severe material scarcity or oppression. (shrink)

Book synopis: A collection of more than 30 specially commissioned essays, this volume surveys the work of the 17th-century philosopher-scientist commonly regarded as the founder of modern philosophy, while integrating unique essays detailing the context and impact of his work. Covers the full range of historical and philosophical perspectives on the work of Descartes Discusses his seminal contributions to our understanding of skepticism, mind-body dualism, self-knowledge, innate ideas, substance, causality, God, and the nature of animals Explores the philosophical significance of (...) his contributions to mathematics and science Concludes with a section on the impact of Descartes's work on subsequent philosophers. (shrink)

This paper develops and tests a new conceptual model incorporating the indirect impact of two ethical ideologies (idealism and relativism) on Chinese consumers’ ethical judgments under four ethically problematic consumption situations (active benefit, passive benefit, deceptive practice, and no/indirect harm) through two cultural values (integration and moral discipline). Data from a large-scale online consumer survey in five major Chinese cities (_N_ = 1046) support most hypotheses. The findings are consistent with the postulated global impact of ethical ideology on forming an (...) individual’s beliefs and values and highlight the importance of a thorough understanding of the significant determinants of consumer ethics to promote ethically responsible consumption behaviors. This study also uses an emic approach to conceptualize and measure Chinese cultural values by using cultural constructs and measures that are designed explicitly in the Chinese context. (shrink)

This chapter highlights the common practice of appealing to lay intuitions as evidence for philosophical theories of free will. These arguments often seem to assume that the purported intuitions in question are not results of error, and the purported intuitions are generalizable to some interesting extent. Some empirical investigations of these two assumptions, including some studies that revealed intra‐personal variation in compatibilist intuitions are reviewed. The chapter examines two popular error theories, the affect Hypothesis and the Bypassing Hypothesis, which take (...) these findings to challenges. With new empirical results, it argues instead that both compatibilist and incompatibilist intuitions genuinely reflect how people think about free will and moral responsibility. A pluralistic approach of theorizing about free will that allows one to embrace either compatibilism or incompatibilism in different contexts is proposed. (shrink)

Ten years after the Human Genome Project’s completion the life sciences stand in a moment of uncertainty, transition, and contestation. The postgenomic era has seen rapid shifts in research methodology, funding, scientific labor, and disciplinary structures. Postgenomics is transforming our understanding of disease and health, our environment, and the categories of race, class, and gender. At the same time, the gene retains its centrality and power in biological and popular discourse. The contributors to Postgenomics analyze these ruptures and continuities and (...) place them in historical, social, and political context. Postgenomics, they argue, forces a rethinking of the genome itself, and opens new territory for conversations between the social sciences, humanities, and life sciences. Contributors. Russ Altman, Rachel A. Ankeny, Catherine Bliss, John Dupré, Michael Fortun, Evelyn Fox Keller, Sabina Leonelli, Adrian Mackenzie, Margot Moinester, Aaron Panofsky, Sarah S. Richardson, Sara Shostak, Hallam Stevens. (shrink)

Since the very beginning, Confucianism has been troubled by a serious gap between its political ideals and the reality of societal circumstances. Contemporary Confucians must develop a viable method of governance that can retain the spirit of the Confucian ideal while tackling problems arising from nonideal modern situations. The best way to meet this challenge, Joseph Chan argues, is to adopt liberal democratic institutions that are shaped by the Confucian conception of the good rather than the liberal conception of (...) the right.Confucian Perfectionism examines and reconstructs both Confucian political thought and liberal democratic institutions, blending them to form a new Confucian political philosophy. Chan decouples liberal democratic institutions from their popular liberal philosophical foundations in fundamental moral rights, such as popular sovereignty, political equality, and individual sovereignty. Instead, he grounds them on Confucian principles and redefines their roles and functions, thus mixing Confucianism with liberal democratic institutions in a way that strengthens both. Then he explores the implications of this new yet traditional political philosophy for fundamental issues in modern politics, including authority, democracy, human rights, civil liberties, and social justice.Confucian Perfectionism critically reconfigures the Confucian political philosophy of the classical period for the contemporary era. (shrink)

This book provides much new thinking on the phenomenon of whole person education, a phenomenon which features strongly in East Asian universities, and which aims to develop students intellectually, spiritually, and ethically, to master critical thinking skills, to explore ethical challenges in the surrounding community and to acquire a broad based foundation of knowledge in humanities, society and nature. The book considers different approaches to whole person education, including Confucian, Buddhist, and Chinese perspectives, Western philosophy and religion and interdisciplinary approaches. (...) Overall, the book provides a comprehensive overview of whole person education, why it matters and how to implement it. Moreover, although the examples in the book are from East Asia, the discussion and the values involved are universal, important for the whole world. (shrink)

When we define something as a crime, we generally thereby criminalize the attempt to commit that crime. However, it is a vexing puzzle to specify what must be the case in order for a criminal attempt to have occurred, given that the results element of the crime fails to come about. I argue that the philosophy of action can assist the criminal law in clarifying what kinds of events are properly categorized as criminal attempts. A natural thought is that this (...) project should take the form of specifying what it is in general to attempt or try to perform an action, and then to define criminal attempts as attempts to commit crimes. Focusing on Gideon Yaffe's resourceful work in Attempts (Oxford University Press, 2010) as an example of this strategy, I argue that it results in a view that is overly inclusive: one will count as trying to commit a crime even in the far remote preparatory stages that we in fact have good reason not to criminalize. I offer an alternative proposal to distinguish between mere preparations and genuine attempts that has its basis not in trying, but doing: a criminal attempt is underway once what the agent is doing is a crime. Working out the details of this schema turns out to have important implications for action theory. A recently burgeoning view known as Naive Action Theory holds that all action can be explained by appeal to some further thing that the agent is doing, and that that the same explanatory nexus is at work even when we appeal to what the agent is intending, trying, or preparing to do -- these notions do explanatory work because they too refer to actions that are in progress, albeit in their infancy. If this is right, than the notion of 'doing' will also be too inclusive for the purposes of the criminal law. I argue that we should draw the reverse conclusion: the distinctions between pure intending, trying, preparing, and doing serve an important purpose in the criminal law, and this fact lends support to the view that they are genuine metaphysical and explanatory distinctions. (shrink)

This book provides a compositional, truth-conditional, crosslinguistic semantics for evidentiality, the linguistic encoding of the source of information on which a statement is based. Central to the proposed theory is the distinction between what propositional content is at-issue and what content is not-at-issue. Evidentials contribute not-at-issue content, and can affect the level of commitment a sentence makes to the main proposition, contributed by sentential mood. In this volume, Sarah Murray builds on recent work in the formal semantics of evidentials (...) and related phenomena, and proposes a semantics that does not appeal to separate dimensions of illocutionary meaning. Instead, she argues that all sentences make three contributions: at-issue content, not-at-issue content, and an illocutionary relation. At-issue content is presented and made available for subsequent anaphora, but is not directly added to the common ground; not-at-issue content directly updates the common ground; and the illocutionary relation uses the at-issue content to impose structure on the common ground, which, depending on the clause type, can trigger further updates. 0The analysis is supported by extensive empirical data from Cheyenne, drawn from the author's own fieldwork, as well as from English and a variety of other languages. (shrink)

After offering an opening consideration of the hazards of neoliberalism, I address the general shape of the crisis of care that has evolved under its auspices. Two aspects of this crisis require greater attention: the moral precarity of caregivers and the relational harms of neoliberal capitalism. Thus, I first consider the moral precarity that caregivers experience by drawing on a concept that originates in scholarly work on the experiences of healthcare workers and combat veterans, namely, moral injury. Through this concept, (...) we can see how caregivers in late-stage capitalism face a seemingly unavoidable violation of their own significant moral beliefs. Second, I examine how the crisis of care results not only in individual harms of moral injury but also in harms to relationships themselves, as I continue to track the impact of moral injury on our intrapersonal and interpersonal lives. Ultimately, I argue that an important facet of the crisis of care is how it operates as a crisis of relationality in which our intrapersonal and interpersonal connections are placed under practical and moral strain. In taking a broader view, we can see how the fraying of particular intrapersonal and interpersonal connections can accumulate, resulting in the unraveling of wider webs of interdependency, just when we need them most. Throughout the paper, I zero in on the moral implications of the crisis of care driven by neoliberalism, featuring the damages that caregivers and their relationships sustain when situated in morally precarious ways. In doing so, I drive home the point that the crisis of care under neoliberalism is as much a moral and relational crisis as it is a political and economic one. (shrink)

This volume is an interdisciplinary attempt to insert a broader, historically informed perspective into current political and academic debates on the issue of evidence and the reliability of scientific knowledge. Evidence in Action is the perfect resource for all those interested in the relationship between science, technology, and the role of knowledge in society.