A range of views on the morality of synthetic biology and its place in public policy and political discourse.

Human cloning raises the most profound questions about human nature, our faith in ourselves, and our ability to make decisions that could significantly alter the character of humanity. In this exciting and accessible book, Gregory Pence offers a candid and sometimes humorous look at the arguments for and against human cloning. Originating a human being by cloning, Pence boldly argues, should not strike fear in our hearts but should be examined as a reasonable reproductive option for couples. Pence considers (...) how popular culture has influenced the way we think about cloning, and he presents a lucid and non-technical examination of the scientific research and relevant moral issues in the cloning debate. This book is a must-read for anyone who is concerned about the impact of technology on human life and for those with interests in medical ethics, sociology, and public policy. (shrink)

: A comparison of casuistry with the strain of particularism developed by John McDowell and David Wiggins suggests that casuistry is susceptible to two very different mistakes. First, as sometimes developed, casuistry tends toward an implausible rigidity and systematization of moral knowledge. Particularism offers a corrective to this error. Second, however, casuistry tends sometimes to present moral knowledge as insufficiently systematized: It often appears to hold that moral deliberation is merely a kind of perception. Such a perceptual model of deliberation (...) cannot offer a convincing account of the possibility of moral progress. This second problem is one to which particularism is itself prone. To redress it, other aspects of casuistry must be exploited: Casuistry contains an account of presumptive generalizations that explains how moral deliberation might be structured by rules while also depending at critical junctures on perception. (shrink)

A majority opinion seems to have emerged in scholarly analysis of the assortment of technologies that have been given the label “synthetic biology.” According to this view, society should allow the technology to proceed and even provide it some financial support, while monitor­ing its progress and attempting to ensure that the development leads to good outcomes. The near‐consensus is captured by the U.S. Presidential Commission for the Study of Bioethical Issues in its report New Directions: The Ethics of Synthetic Biology (...) and Emerging Technologies, which arguably marked the end of a preliminary round of analysis about the ethical and policy questions raised by synthetic bi­ology. Like a number of other, earlier documents issued by various groups around the world, the re­port called attention to questions about how the technology will be used; whether it might be mis­used; what sorts of accidents might happen along the way; the economic, environmental, and social impacts of the eventual applications; whether the very idea of “synthetic biology” should be trou­bling; and how the debate over all of these ques­tions will be conducted. Also like most similar documents, however, while it called for careful monitoring and oversight of technology, it did not recommend any significant new constraints on its development and use. The commission's stance was that it would be “imprudent either to declare a moratorium on synthetic biology until all risks can be determined and mitigated, or to simply ‘let science rip,’ regardless of the likely risks.”In this report, we will take stock of the current consensus, comment on some of the major points of disagreement, and identify the next steps for the debate. In part I, we offer a brief overview of the research and applications commonly grouped together under the heading of synthetic biology, partly in order to set the stage for the rest of the discussion and partly because we want to highlight some conceptual problems that attend the very la­bel given this field. In parts II, III, and IV, we take up, respectively, three broad classes of concerns that arise in the context of synthetic biology: con­cerns about the intrinsic or inherent value of do­ing synthetic biology, concerns about the concrete harms and benefits of doing synthetic biology, and concerns about justice. Addressing these concerns requires a method for bringing the public's values to bear on policy‐making concerning emerging biotechnologies; in part V, we discuss the chal­lenges in developing such a method. (shrink)

Much work in bioethics tries to sidestep bedrock questions about moral values. This is fine if we agree on our values; arguments about human enhancement suggest we do not. One bedrock question underlying these arguments concerns the role of emotion in morality: worries about enhancement are derided as emotional and thus irrational. In fact, both emotion and reason are integral to all moral judgment.

This rich collection, popular among teachers and students alike, provides an in-depth look at major cases that have shaped the field of medical ethics. The book presents each famous (or infamous) case using extensive historical and contextual background, and then proceeds to illuminate it by careful discussion of pertinent philosophical theories and legal and ethical issues.

Now in its twentieth year of publication, this rich collection, popular among teachers and students alike, provides an in-depth look at major cases that have shaped the field of medical ethics. The book presents each famous (or infamous) case using extensive historical and contextual background, and then proceeds to illuminate it by careful discussion of pertinent philosophical theories and legal and ethical issues.

The emergence of de‐extinction is a study in technological optimism. What has already been accomplished in recovering ancient genomes, recreating them, and reproducing animals with engineered genomes is amazing but also has a long ways to go to achieve “de‐extinction” as most people would understand that term. Still, with some caveats in place, creating a functional replacement for an extinct species may sometimes be doable, and given the right goals, might sometimes make sense. The International Union for Conservation of Nature (...) guidelines for de‐extinction do a reasonable job of keeping the caveats in place and clarifying the goals. In fact, given the right caveats about what de‐extinction can accomplish, we should pay a lot of attention to the technology and should think carefully about the goals. Not only has the technology been advancing, but our environmental standards have been getting looser and more flexible, providing less guidance for implementing the technology. The guiding ideals for conservation are often explained as a choice between John Muir, founder of The Sierra Club, and Gifford Pinchot, who helped create the U.S. Forest Service. Muir argued for preserving some places in the world in their natural state because of their great value and beauty. Pinchot, by contrast, was bluntly utilitarian. He argued for trying to keep some natural places more or less undamaged so that we could use them later. There has long been dissatisfaction with this choice, and in the last couple of decades, a number of prominent voices have proposed a “gardening ethic” as a new standard that combines elements of Muir and Pinchot. A gardening ethic is supposed to both celebrate the land and declare that it must now be managed. But what would good gardening mean when it comes to de‐extinction? (shrink)

The COVID-19 pandemic has affected every human being on the planet and forced us all to reflect on the bioethical issues it raises. In this timely book, Gregory Pence examines a number of relevant issues, including the fair allocation of scarce medical resources, immunity passports, tradeoffs between protecting senior citizens and allowing children to flourish, discrimination against minorities and the disabled, and the myriad issues raised by vaccines.

Richard Dawkins’s best argument against the existence of God aims to show that the universe fits better with atheism than with theism. The fact that complex life developed gradually over a long period of time is required by an atheistic view but is not required by a theistic view. This fact, then, supports the atheistic view. This argument does raise the probability of atheism. I discuss four analogous arguments that point towards theism. I conclude that Dawkins’s argument lends some support (...) for atheism, but his strategy suggests sufficient arguments to see that the total case points in the opposite direction. (shrink)

Flesh of My Flesh is a collection of articles by today's most respected scientists, philosophers, bioethicists, theologians, and law professors about whether we should allow human cloning. It includes historical pieces to provide background for the current debate. Religious, philosophical, and legal points of view are all represented.

As the #1 topic in bioethics, cloning has made big news since Dolly's announced birth in 1998. In a new book building on his classic Who's Afraid of Human Cloning?, pioneering bioethicist Gregory E. Pence continues to advocate a reasoned view of cloning. Beginning with his surreal experiences as an expert witness before Congressional and California legislative committees, Pence analyzes the astounding recent progress in animal cloning; the coming surprises about human cloning; the links between animal, stem cell, and (...) human cloning; embryo politics; and other hot topics like artificial wombs and transgenic animals. -/- Pence rebuts the growing chorus of naysayers headed by Leon Kass, chairman of the President's Council on Bioethics, who attack the biomedical sciences, and explains why cloning will save endangered species and beloved pets, and help future children and people with degenerative diseases. (shrink)

This issue of the Hastings Center Report features three articles exploring aspects of decision-making for others. In the first two, the focus is on the limits of surrogate decision-makers’ authority when the surrogates’ judgments about a patient's treatment conflict with the physicians’. If a physician decides that a patient will not benefit from CPR, for example, but the patient's surrogate insists on it, is the physician obliged to proceed with the procedure? Or can the physician, pointing to a duty to (...) provide good care to the patient and not to cause the patient to suffer, get a do-not-resuscitate order for the patient—even in the face of the surrogate's objections? These are the questions that animate the first article, in which a group of authors report on a policy implemented at Massachusetts General Hospital to help doctors who face this dilemma. The second article, by physician Jeffrey Berger, flips the questions. If a physician decides that a patient's intractable suffering requires palliative sedation, may the surrogate prevent it anyway? Or can the physician, pointing to a duty to alleviate the suffering, administer palliative sedation even in the face of the surrogate's objections? Such circumstances, says Berger, show the need for conceptual work delineating the limits of surrogates’ authority and practical work on mechanisms for doing so—protecting patients and giving physicians a clear route to follow. (shrink)

Much work in bioethics tries to sidestep bedrock questions about moral values. This is fine if we agree on our values; arguments about human enhancement suggest we do not. One bedrock question underlying these arguments concerns the role of emotion in morality: worries about enhancement are derided as emotional and thus irrational. In fact, both emotion and reason are integral to all moral judgment.

How strong is the argument for requiring public deliberation by very large publics—at national or even global levels—before moving forward with efforts to use gene editing on wild populations of plants or animals? Should there be a general moratorium on any such efforts until such broad public deliberation has been successfully carried out? This article works toward recommendations about the need for and general framing of broad public deliberation. It finds that broad public deliberation is highly desirable but not flatly (...) necessary before moving forward with any local cases of gene editing in the wild. It also finds that broad public deliberation would be most helpful in generating very general guidance and is unlikely to be appropriate for specific cases. Broad public deliberation is most helpful for cases that involve higher levels of uncertainty and moral ambiguity, but separating out a distinct class of cases for deliberation is not yet possible. (shrink)

Can we make wise policy decisions about still‐emerging technologies—decisions that are grounded in facts yet anticipate unknowns and promote the public's preferences and values? There is a widespread feeling that we should try. There also seems to be widespread agreement that the central element in wise decisions is the assessment of benefits and costs, understood as a process that consists, at least in part, in measuring, tallying, and comparing how different outcomes would affect the public interest. But how benefits and (...) costs are best weighed when making decisions about whether to move forward with an emerging technology is not clear. Many commentators feel that the weighing is often inadequate or inappropriate. Those who argue for a “precautionary” approach to the weighing do so precisely because they feel the need for a restraint on the dominant decision‐making tools and processes for assessing outcomes.This Hastings Center special report examines those tools and processes, taking the method known as cost‐benefit analysis as a starting point. In U.S. governance, CBA, sometimes informed by risk assessment, is the most widely used and extensively studied method, and authoritative reports on genetic and reproductive technologies often use language suggestive of cost‐benefit analysis. There is also a long‐running debate about the role of values in CBA and other formal impact assessment mechanisms—and about how those mechanisms compare to the precautionary principle. The guiding idea in the report is to engage in a close examination of the strengths and limits of CBA for ensuring that emerging technologies are used in ways that square with the public's values, drawing on applications of synthetic biology to illustrate and sharpen the analysis and then considering corrections to CBA and some alternative methodologies that handle values differently. (shrink)

In How to Build a Better Human, prominent bioethicist Gregory E. Pence argues if, we are careful and ethical, we can use genetics, biotechnology, and medicine in safe ethical ways for human enhancement. He looks at the innovations and challenges that have occurred since the birth of bioethics almost 50 years ago and considers the ethical implications of the technological advances that are just around the corner.

This chapter contains sections titled: * Introduction * Shrinking Gaps? * Strengthening Supernatural Arguments * Note * References * Further Reading.

In a recent issue of this journal, Kevin Corcoran has argued that the metaphysical theory one holds to about the nature of human persons is irrelevant to the sort of ethical questions that occupy bioethicists as well as the general public. Specifically, he argues that whether one holds a constitution view of human persons, an animalist view, or a substance dualist view, the real work in one’s ethical reasoning is done by certain moral principles rather than by metaphysical ones. I (...) raise objections to his analysis and propose that it is a combination of ethical principles and metaphysical principles that does the work in our judgements about the morality of abortion and other actions. (shrink)

How should we think about synthetic biology—about the potential benefits and risks of these applications as well as the very idea of designed, extensively genetically modi­fied organisms? The lead article in this report sets out our thinking, but the article is rounded out with nine commentaries that sometimes expand on and sometimes argue with our perspective. Jonathan Wolff, a philosopher at the University College of London and a member of the Nuffield Council on Bioethics, and Mark Bedau, a philosopher at (...) Reed College and a participant in several projects aimed at de­veloping artificial cells, discuss the potential consequences of synthetic biology and suggest some reasons for a precau­tionary approach to deliberating about the consequences. Jane Calvert, reader in science, technology, and innovation studies at the University of Edinburgh and a member of the Nuffield Council on Bioethics working party on emerging biotechnologies, recommends, however, that deliberation about the governance of emerging technologies focus less on consequences than on aims and purposes.Gigi Gronvall, senior associate at the Center for Health Security in the University of Pittsburgh Medical Center, and David Relman, a microbiologist and immunologist at the Stanford School of Medicine, offer contrasting per­spectives about a question we raise concerning “the eth­ics of knowledge”—the values at stake in generating and disseminating potentially dangerous information. Gaymon Bennett offers some ruminations on the questions we raise about how synthetic biology might change the human re­lationship to nature in morally significant ways. He argues, too, that we can think about the ethics of synthetic biology more effectively by getting “upstream” in another way—by sitting next to the bioengineers doing the work and study­ing their “everyday practice” rather than by paying attention only to what is thought and said about their work. Colleen Grogan, professor at the University of Chicago's School of Social Administration and an expert on democratic partici­patory processes in governance, builds on our comments about the challenge of creating a meaningful public dialog about synthetic biology. Jim Thomas, a researcher with the ETC Group, challenges our view of how the public debate about synthetic biology is trending. And Sarah Carter, a policy analyst with the J. Craig Venter Institute, puts our discussion about synthetic biology in the context of debates about other new products and technologies. (shrink)

This book gather's thirty-five of Pence's most influential, groundbreaking, and personal essays into one broad-ranging volume. It included essays on cloning, AIDS, dignified death,and test-tube babies.

The use of information raises a perplexing new set of questions in bioethics. One familiar subset of these has to do with the goal of improving medical practice by collecting information about it, in effect integrating practice and research. This topic was discussed in the January‐February 2013 issue of the Report and in this issue is taken up again in Policy and Politics, where Michelle Meyer connects the issue to the evidence‐based medicine movement. A somewhat less familiar set has to (...) do with potentially dangerous information. In the lead article in this issue, David Resnik discusses the publication last year of two articles that described how researchers had developed new and more dangerous forms of H5N1, also known as bird flu, which has produced an extraordinary death rate when it has infected people but has not so far evolved into a form that can be easily transmitted from one person to another. Yet another set has to do with sharing clinical medical information using newly developed tools such as electronic health records. In an essay in this issue, Kyle Galbraith argues that these technologies also need to be usable for patients, but that “those who have the most to gain from increased access to their health information are often unlikely to be able to decipher that information and respond in a meaningful way.”. (shrink)

We introduce several new editorial developments in this issue aimed at increasing the conversational give‐and‐take that appears in our pages. First, we are moving our editorial, Another Voice, to a spot following the article it addresses, which allows us to experiment with it a bit, letting it run longer and soliciting multiple editorials–“Other Voices.” Second, our letters section has been rebranded “Exchange” to acknowledge the short essay section that, over the years, it has grown to be. And finally, this issue (...) includes, as a supplement, a guest‐edited Special Report that takes up the idea of a “learning health care system.” It is our hope and plan that this will be the first in an occasional series of externally sponsored Special Reports, and we welcome proposals for additional installments in the series. (shrink)

It has been a couple of years now since debate erupted over the study known as the Surfactant, Positive Pressure, and Oxygenation Randomized Trial, which sought to gauge the risks and benefits of different blood oxygen levels currently targeted in the care of premature infants. Both articles in this issue of the Hastings Center Report try to take the debate to a new level, but as expressed in the title of one of three commentaries on the articles, the controversy shows (...) no signs of abating. (shrink)

One of the foundational thoughts in bioethics is that professional roles can generate special ethical obligations. Bioethics first emerged as an effort to understand the special ethical obligations of physicians and researchers. But bioethics now finds itself subject to a converse thought. Bioethicists engaged in clinical ethics consultations‐discussing patient care and decision‐making with physicians and others‐have a special ethical obligation toward patients and coworkers, and that obligation has generated a professional role, as it were. Clinical ethicists bear the obligation of (...) ensuring that ethical standards for patient care are upheld, and since this work requires special skills and knowledge, clinical ethicists can be asked to demonstrate that they have what it takes and can bring it effectively to bear in consultations. The evolution of clinical ethical consultation is the topic of the lead article in this issue of the Report. The second article in this issue returns to that ur‐topic‐the ethical obligations of physicians and researchers. (shrink)