Abstract

In the late 1980s, an Institute of Medical Ethics working party on the teaching of medical ethics defined the subject as follows.1 Medical Ethics, it stated, has ‘two meanings’: ‘traditionally’ it ‘has referred to the standards of professional competence and conduct which the medical profession requires of its members’; ‘increasingly’, it ‘refers to the study of ethical or moral problems raised by the practice of medicine’. Thirty years on, teaching, learning and research in medical ethics retains this dual emphasis on the normative as well as the problematic. In the same vein, most papers in this issue of the Journal raise ethically problematic questions which have practical moral implications for what eventually ought, or ought not to be done, to or by individuals or populations in the context of healthcare. The urgent need for a well-argued medical ethics was acknowledged by the IME working party when it observed that many of the problems now ‘increasingly’ raised by the practice of medicine ‘cannot be resolved simply by appealing to professional codes, or to science, religion, the law or even common sense’. Such problems, the report added, ‘often arise… when principles previously accepted begin to be questioned, or are understood imperfectly or even misrepresented’. That these categories remain relevant, again is illustrated by papers in this issue. At the most fundamental, if also perhaps the most speculative level, are questions previously asked about the moral status of consciousness in animals or in non-communicating brain-injured patients for example, but now also being asked in relation to cerebral organoids or ‘mini-brains’. As Lavazza and Massimini explain in their ground-breaking paper on the subject organoids are ‘three-dimensional biological structures grown in vitro from different kinds of stem-cells that self-organise mimicking real organs with specific cell-types’: these now …