In this article, we analyse the novel case of Phoenix, a non-binary adult requesting ongoing puberty suppression to permanently prevent the development of secondary sex characteristics, as a way of affirming their gender identity. We argue that the aim of OPS is consistent with the proper goals of medicine to promote well-being, and therefore could ethically be offered to non-binary adults in principle; there are additional equity-based reasons to offer OPS to non-binary adults as a group; and the ethical defensibility (...) of facilitating individual requests for OPS from non-binary adults also depends on other relevant considerations, including the balance of potential benefits over harms for that specific patient, and whether the patient’s request is substantially autonomous. Although the broadly principlist ethical approach we take can be used to analyse other cases of non-binary adults requesting OPS apart from the case we evaluate, we highlight that the outcome will necessarily depend on the individual’s context and values. However, such clinical provision of OPS should ideally be within the context of a properly designed research study with long-term follow-up and open publication of results. (shrink)

The sacred or holy is central to Heidegger’s later writings, “The Thing” and “Building Dwelling Thinking” taking it as their focus. This aspect of his philosophy is often viewed as lacking in coherence1 or an attempt to return to Ancient Greek religion.2 Heideggerian notions of the gods or the sacred have frequently been dismissed or neglected, with even sympathetic commentators like Julian Young playing down their importance.Heidegger’s later thought, however, represents one of the most radical attempts to critically rethink (...) divinity in Western thought, presenting the possibility of dialogue with the non-Western notions of divinity. Focusing on the Shinto notion of divinity,3 in this essay I will... (shrink)

This month's issue presents arguments on three longstanding ethical issues: prostitution, euthanasia and organ donation. It also addresses three issues perhaps more directly linked to daily practice across clinical care and research: resource allocation, consent, and, in an interesting pair of papers, how a clinician's own experiences might affect their ethical judgement and therefore clinical care.In a provocative article, Ole Martin Moen argues that our increasing acceptance of casual sex, that is, sexual encounters which do not involve an emotional connection, (...) render our assumption that prostitution is always harmful out of date. If one form of impersonal encounter is acceptable, then why not another? Naturally, prostitution involves some degree of risk of harm. However, he argues that many occupations we do accept are likewise risky, or are also subject to similar objections to prostitution. He allows there is one remaining harm, which is genuine today, but which is open to change: the legal and social stigma, which we impose on prostitution due to our mistaken beliefs .Our two invited commentators, Anderson and McDougall focus on the empirical evidence of harm. When a new drug is developed, a plausible theory as to its effects, mechanism and safety is required. We might test that in a computer model. But until it is tested in real life, we cannot know its real benefits or harms. The same might be true of ethical arguments. As McDougall says: "Moen presents a compelling argument that the exchange of sex for money need not be intrinsically harmful to the seller, but for the individuals actually involved in prostitution, does this conclusion really matter?"The reader might ask why a journal of medical ethics is publishing an article on prostitution. There are clearly potential and …. (shrink)

In a revolutionary new book, a theoretical physicist attacks the foundations of modern scientific theory, including the notion of time, as he shares evidence of ...

Brain organoid research raises ethical challenges not seen in other forms of stem cell research. Given that brain organoids partially recapitulate the development of the human brain, it is plausible that brain organoids could one day attain consciousness and perhaps even higher cognitive abilities. Brain organoid research therefore raises difficult questions about these organoids' moral status – questions that currently fall outside the scope of existing regulations and guidelines. This paper shows how these gaps can be addressed. We outline a (...) moral framework for brain organoid research that can address the relevant ethical concerns without unduly impeding this important area of research. (shrink)

In recent years, tech evangelists have made headlines predicting that in the future manual driving will be outlawed. This essay will investigate the question whether a ban of human driven cars can be defended on moral grounds in a future scenario in which autonomous cars are going to be significantly safer than manually driven cars. This article will argue that in such a future scenario manually driven cars, for moral reasons, indeed should be banned from participating in regular traffic. Since (...) the moral argument for outlawing manually driven cars will likely be met by resistance by car-aficionados, in the final part of the paper, we are devising a proposal for reconciling the strong moral case for a ban of manually driven cars with the widespread fondness of manual driving. (shrink)

Advocates of paid living kidney donation frequently argue that kidney sellers would benefit from paid donation under a properly regulated kidney market. The poor outcomes experienced by participants in existing markets are often entirely attributed to harmful black-market practices. This article reviews the medical and anthropological literature on the physical, psychological, social, and financial harms experienced by vendors under Iran's regulated system of donor compensation and black markets throughout the world and argues that this body of research not only documents (...) significant harms to vendors, but also provides reasons to believe that such harms would persist under a regulated system. This does not settle the question of whether or not a regulated market should be introduced, but it does strengthen the case against markets in kidneys while suggesting that those advocating such a system cannot appeal to the purported benefits to vendors to support their case. (shrink)

It may soon be possible to generate human organs inside of human-pig chimeras via a process called interspecies blastocyst complementation. This paper discusses what arguably the central ethical concern is raised by this potential source of transplantable organs: that farming human-pig chimeras for their organs risks perpetrating a serious moral wrong because the moral status of human-pig chimeras is uncertain, and potentially significant. Those who raise this concern usually take it to be unique to the creation of chimeric animals with (...) ‘humanised’ brains. In this paper, we show how that the same style of argument can be used to critique current uses of non-chimeric pigs in agriculture. This reveals an important tension between two common moral views: that farming human-pig chimeras for their organs is ethically concerning, and that farming non-chimeric pigs for food or research is ethically benign. At least one of these views stands in need of revision. (shrink)

The precautionary principle aims to influence decision‐making in contexts where some activity poses uncertain but potentially grave threats. This perfectly describes the controversy surrounding germline gene editing. This article considers whether the precautionary principle should influence how we weigh the risks and benefits of human germline interventions, focusing especially on the possible threats to the health of future generations. We distinguish between several existing forms of the precautionary principle, assess their plausibility and consider their implications for the ethics of germline (...) modification. We also offer a novel form of the precautionary principle: the sufficientarian precautionary principle. Some plausible versions of the precautionary principle recommend placing somewhat greater weight on avoiding threats to future generations than on achieving short‐term benefits. However, no plausible versions of the precautionary principle entail that we should outright reject the use germline gene editing in human reproduction and some, such as the sufficientarian version, might endorse its use. (shrink)

Human‐animal chimeras—creatures composed of a mix of animal and human cells—have come to play an important role in biomedical research, and they raise ethical questions. This article focuses on one particularly difficult set of questions—those related to the moral status of human‐animal chimeras with brains that are partly or wholly composed of human cells. Given the uncertain effects of human‐animal chimera research on chimeric animals’ cognition, it would be prudent to ensure we do not overlook or underestimate their moral status. (...) However, to assess moral status, we first need to determine what kinds of capacities are morally relevant. The standard view holds that it matters, morally, if chimeric animals develop uniquely human cognitive capacities. I argue that this view is mistaken, highlighting three problems with it: that we can think of examples of uniquely human cognitive capacities that are not morally significant, that we can think of examples of morally significant cognitive capacities that are not uniquely human, and that evidence that some cognitive capacity is shared with nonhuman animals does not undermine claims that this capacity is morally significant. We need a better framework for thinking about the moral status of part‐human beings. (shrink)

Even though human smuggling is one of the central topics of contention in the political discourse about immigration, it has received virtually no attention from moral philosophy. This article aims...

At the University of Pretoria the author, a practical theologian, experiences a fruitful soil for the development of an interdisciplinary process. He referred to concrete examples of cooperation, but used the article to reflect on best practices for the interdisciplinary dialogue. He came to the conclusion that it probably made more sense to talk of Practical-theological alternatives rather than to describe the subject in a single fixed manner of understanding and action. Our goal should rather be to open up the (...) boundaries between Practical Theology, Human, Social and Natural Sciences. (shrink)

Mary Shelley’sFrankensteinhas captured the public imagination ever since it was first published over 200 years ago. While the narrative reflected 19th-century anxieties about the emerging scientific revolution, it also suggested some clear moral lessons that remain relevant today. In a sense,Frankensteinwas a work of bioethics written a century and a half before the discipline came to exist. This paper revisits the lessons ofFrankensteinregarding the creation and manipulation of life in the light of recent developments in stem cell and neurobiological research. (...) It argues that these lessons are becoming more relevant than ever. (shrink)

AI researchers have developed sophisticated language models capable of generating paragraphs of 'synthetic text' on topics specified by the user. While AI text generation has legitimate benefits, it could also be misused, potentially to grave effect. For example, AI text generators could be used to automate the production of convincing fake news, or to inundate social media platforms with machine-generated disinformation. This paper argues that AI text generators should be conceptualised as a dual-use technology, outlines some relevant lessons from earlier (...) debates on dual-use life sciences research, and calls for closer collaboration between ethicists and the machine learning community to address AI language models’ dual-use implications. (shrink)

Immanuel Kant is widely recognised as one of the most important Western philosophers since Aristotle. His thought has had, and continues to have, a profound effect on every branch of philosophy, including aesthetics, ethics, metaphysics, epistemology, political philosophy, and philosophy of religion. This Lexicon contains detailed and original entries by 130 leading Kant scholars, covering Kant's most important concepts as well as each of his writings. Part I covers Kant's notoriously difficult philosophical concepts, providing entries on these individual 'trees' of (...) Kant's philosophical system. Part II, by contrast, provides an overview of the 'forest' of Kant's philosophy, with entries on each of his published works and on each of his sets of lectures and personal reflections. This part is arranged chronologically, revealing not only the broad sweep of Kant's thought but also its development over time. Professors, graduate students, and undergraduates will value this landmark volume. (shrink)

In the wake of ChatGPT’s release, academics and journal editors have begun making important decisions about whether and how to integrate generative artificial intelligence (AI) into academic publishing. Some argue that AI outputs in scholarly works constitute plagiarism, and so should be disallowed by academic journals. Others suggest that it is acceptable to integrate AI output into academic papers, provided that its contributions are transparently disclosed. By drawing on Taylor’s work on academic norms, this paper argues against both views. Unlike (...) “traditional” forms of plagiarism, use of generative AI can be consistent with the norms that should underlie academic research. In these cases, its use should neither be prohibited nor required to be disclosed. However, some careless uses of generative AI do threaten to undermine the quality of academic research by mischaracterizing existing literature. This, not “AI plagiarism,” is the real concern raised by ChatGPT and related technologies. (shrink)

DNA databases have significant commercial value. Direct-to-consumer genetic testing companies have built databanks using samples and information voluntarily provided by customers. As the price of genetic analysis falls, there is growing interest in building such databases by paying individuals for their DNA and personal data. This paper maps the ethical issues associated with private companies paying for DNA. We outline the benefits of building better genomic databases and describe possible concerns about crowding out, undue inducement, exploitation, and commodification. While certain (...) objections deserve more empirical and philosophical investigation, we argue that none currently provide decisive reasons against using financial incentives to secure DNA samples. (shrink)

We do not always benefit from the expansion of our choice sets. This is because some options change the context in which we must make decisions in ways that render us worse off than we would have been otherwise. One promising argument against paid living kidney donation holds that having the option of selling a ‘spare’ kidney would impact people facing financial pressures in precisely this way. I defend this argument from two related criticisms: first, that having the option to (...) sell one’s kidney would only be harmful if one is pressured or coerced to take this specific course of action; and second, that such forms of pressure are unlikely to feature in a legal market. (shrink)

A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight general problems (...) with this style of argument, and particular problems with its use in specific cases. We conclude that the burden ultimately falls on decision-makers to choose the policy supported by the best reasons. (shrink)

In Markets Without Limits and a series of related papers, Jason Brennan and Peter Jaworski argue that it is morally permissible to buy and sell anything that it is morally permissible to possess and exchange outside of the market. Accordingly, we should open markets in “contested commodities” including blood, gametes, surrogacy services, and transplantable organs. This paper clarifies some important aspects of the case for market boundaries and in so doing shows why there are in fact moral limits to the (...) market. I argue that the case for restricting the scope of the market does not turn on the idea that some things are constitutively non-market goods; it turns instead on the idea that treating some things according to market norms would threaten the realization of particular kinds of human interests. (shrink)

Genomic research can reveal ‘unsolicited’ or ‘incidental’ findings that are of potential health or reproductive significance to participants. It is widely thought that researchers have a moral obligation, grounded in the duty of easy rescue, to return certain kinds of unsolicited findings to research participants. It is less widely thought that researchers have a moral obligation to actively look for health-related findings. This paper examines whether there is a moral obligation, grounded in the duty of easy rescue, to actively hunt (...) for genomic secondary findings. We begin by showing how the duty to disclose individual research findings can be grounded in the duty of easy rescue. Next, we describe a parallel moral duty, also grounded in the duty of easy rescue, to actively hunt for such information. We then consider six possible objections to our argument, each of which we find unsuccessful. Some of these objections provide reason to limit the scope of the duty to look for secondary findings, but none provide reason to reject this duty outright. We argue that under a certain range of circumstances, researchers are morally required to hunt for these kinds of secondary findings. Although these circumstances may not currently obtain, genomic researchers will likely acquire an obligation to hunt for secondary findings as the field of genomics continues to evolve. (shrink)

In this paper, we offer the spanish translation with notes of three treatises of Ramon Llull : Artificium electionis personarum, the chapter XXIV of book II from Llibre d’Evast, d’Aloma e de Blaquerna named «En qual manera Natana fo eleta a abadessa» and De arte electionis. These three texts show a new election technique supported on the Ars magna methods. The translations are preceded by a short introduction explaining the place that such texts occupy in the whole lullian opus and (...) the advances of recents investigations. (shrink)

In this research I propose to bring to light the meaning of "Venus" in the invocation of Lucretius´s De rerum natura. This paper is divided into six parts. In the first, I give an account of the various interpretations of the invocation and I systematize them. In the second I analyze and discuss three incategorizable investigations. In the third and fourth parts I expose the epicurean concepts of pleasure and divinity respectively. In the fifth I look for the terms, by (...) way of epithets, that the poet uses to refer to the goddess, bringing to light the nuances that light up them alternately in various instances of the invocation. In the sixth, finally, I give mine interpretation of vv 44-49 explaining why they should be included in the invocation. (shrink)

An innovative program recently initiated at the University of California, Los Angeles Medical Center allows people to donate a kidney in exchange for a voucher that a loved one can redeem for a kidney if and when needed. As a relatively new practice, the ethical implications of advanced kidney donation have not yet been widely discussed. This paper reflects on some of the bioethical issues at stake in this new donation program, as well as some broader philosophical issues related to (...) the meaning and moral salience of commodification. I first consider whether the literature on commercial markets in organs––a longstanding topic of bioethical debate––can meaningfully inform ethical analysis of kidney voucher programs. Specifically, I consider whether and to what extent common objections to the exchange of kidneys for cash also apply to the exchange of kidneys for “kidney vouchers.” Second, I argue that the contrast between the ethical issues raised by these two practices highlights the need to understand commodification as existing on a continuum, with different degrees of commodification giving rise to different ethical issues. Doing so can help sharpen our understanding of commodification as a moral concept, as well as its relevance to broader debates about the moral limits of markets. (shrink)

Discrimination is typically understood to be a comparative phenomenon: S is discriminated against on the basis of trait T if she would not have been treated in the same way if she did not possess T. But the comparative test for discrimination may hide from view some important cases: associational discrimination and stereotype policing. These cases show more clearly what is true of discrimination in general: that it involves a vicarious wrong, that is, an action which wrongs someone other than (...) the primary object of disregard. This suggests why philosophers disagree whether discrimination is wrong because it causes harm or because it expresses disrespect. Paradigmatic cases of discrimination involve both harm and disrespect, but direct the harm and the disrespect towards different targets by treating the harmed individual as a mere representative of the targeted group. Discrimination is dehumanizing, and morally distinctive, precisely because of this fact. (shrink)

ABSTRACTTo whom is a duty owed? Contractualism answers with an interest theory of direction. As such, it faces three challenges. The Conceptual Challenge requires acknowledgment that a duty is conceptually distinct from an interest. The Extensional Challenge requires an account of cases in which one who is owed a duty does not take an interest in the duty, or does not take as much of an interest as someone who is not owed the duty. The Positivist Challenge requires explanation of (...) the great flexibility of law and other social practices in positing duties that do not reflect the landscape of moral interests. Contractualism can be shown to meet these challenges once we acknowledge the centrality of the idea of a generic interest. Focusing on generic interests also illuminates the distinctive form of respect involved in directedness. (shrink)

One common objection to establishing regulated live donor organ markets is that such markets would be exploitative. Perhaps surprisingly, exploitation arguments against organ markets have been widely rejected in the philosophical literature on the subject. It is often argued that concerns about exploitation should be addressed by increasing the price paid to organ sellers, not by banning the trade outright. I argue that this analysis rests on a particular conception of exploitation, and outline two additional ways that the charge of (...) exploitation can be understood. I argue that while increasing payments to organ sellers may mitigate or eliminate fair benefits exploitation, such measures will not necessarily address fair process exploitation or complicity in injustice. I further argue that each of these three forms of wrongdoing is relevant to the ethics of paid living organ donation, as well as the design of public policy more generally. (shrink)

Genomic sequencing technologies (GS) pose novel challenges not seen in older genetic technologies, making traditional standards for fully informed consent difficult or impossible to meet. This is due to factors including the complexity of the test and the broad range of results it may identify. Meaningful informed consent is even more challenging to secure in contexts involving significant time constraints and emotional distress, such as when rapid genomic testing (RGS) is performed in neonatal intensive care units. In this article, we (...) propose that informed consent matters not for its own sake, but because obtaining it furthers a range of morally important goals, such as promoting autonomy, well‐being, and trust in medicine. These goals form the basis of a new framework [PROmoting Morally Important Consent Ends (PROMICE)] for assessing the ethical appropriateness of various informed consent models. We illustrate this framework with two examples: (a) a tiered and layered consent model for obtaining consent for GS, and (b) consent for RGS in critically ill newborns. We conclude that appropriately—rather than fully—informed consent provides the correct standard for genomic medicine and research. (shrink)

Drawing on a wide range of Kant's recorded thought beyond his Groundwork for the Metaphysics of Morals, this essay presents an overview of Kant's account of practical agency as embodied practical agency and argues against the intellectualized interpretations of Kant's account of practical agency presented by Christine Korsgaard and Henry Sidgwick. In both Kant's empirical-psychological and metaphysical descriptions of practical agency, he presents a recognizably human practical agent that is broader and deeper than the faculty of reason alone. This agent (...) chooses action from a reflective distance, but not from the complete affective distance of reason. We choose neither as reason alone, nor even as the sum of all of our ‘higher’ faculties, of cognition (including reason), feeling, and desire, in Kant's view. Instead, we choose as an agent that also has ‘lower’, ‘sensible’ faculties, of cognition (including sense), feeling, and desire, which together comprise our ‘sensibility’. These mental states of sensibility are not merely confused versions of our higher cognitions, feelings, or desires, and so different from them in degree only, but are instead distinct from our higher states in kind also; and these distinct sensible states are not dependent on our higher states and so on a commitment to the value of humanity, for example. For this reason, a choice in favour of sensible states and in opposition to the moral law need in no way undermine its own foundations and thus be incoherent, as Korsgaard and Sidgwick argue, but instead only immoral. Because Kant does not reduce the problem of immoral choice to one of insufficient reflection and ensuing confusion, he does not view moral progress in cognitive terms alone, whether in the form of a clearer understanding of the moral law, improved judgment in applying it, or deeper insight into our own nature as practical agents. Kant instead recognizes the crucial importance of cultivating our feelings and desires over the course of a lifetime both as a way to make ourselves worthy of the humanity within us directly and also as a way to facilitate future moral choices. (shrink)

Luke Semrau argues that the documented harms of existing organ markets do not undermine the case for establishing regulated systems of paid kidney donation. He offers two arguments in support of this conclusion. First, Semrau argues that the harms of kidney selling are straightforwardly amenable to regulatory solution. Second, Semrau argues that even in existing black markets, sellers would likely have experienced greater harm if the option of selling a kidney were not available. This commentary challenges both of Semrau’s claims. (...) I argue that there is no reason to believe that kidney sellers benefit from the current black market trade in organs, and highlight a number of potential issues regarding the effectiveness and feasibility of Semrau’s proposed market regulations. (shrink)

What is the meaning of life? It is a question that has intrigued the great philosophers--and has been hilariously lampooned by Monty Python. Indeed, the whole idea strikes many of us as vaguely pompous, a little absurd. Is there one profound and mysterious meaning to life, a single ultimate purpose behind human existence? In What's It All About?, Julian Baggini says no, there is no single meaning. Instead, Baggini argues meaning can be found in a variety of ways, in (...) this life. He succinctly breaks down six answers people commonly suggest when considering what life is all about--helping others, serving humanity, being happy, becoming successful, enjoying each day as if it were your last, and "freeing your mind." By reducing the vague, mysterious question of meaning to a series of more specific (if thoroughly unmysterious) questions about what gives life purpose and value, he shows that the quest for meaning can be personal, empowering, and uplifting. If the meaning of life is not a mystery, if leading meaningful lives is within the power of us all, then we can look around us and see the many ways in which life can have purpose. We can see the value of happiness while accepting it is not everything. We can see the value of success, without interpreting that too narrowly. We can see the value of seizing the day as well as helping others lead meaningful lives. We can recognize the value of love, as perhaps the most powerful motivator of all. Illustrating his argument with the thoughts of many of the great philosophers and examples drawn from everyday life, Baggini convincingly shows that the search for meaning is personal and within the power of each of us to find. (shrink)

Greely’s target article outlines six categories of ethical issues associated with human brain surrogate research. Some of these issues are familiar from other research contexts; others, less...