The scarcity of vital organs has prompted several calls to either modify the dead donor rule or interpret it more broadly. Given its symbolic importance, however, the rule should be changed only cautiously.

Safe and effective methods of preconception gender selection through flow cytometric separation of X- and Y-bearing sperm could greatly increase the use of gender selection by couples contemplating reproduction. Such a development raises ethical, legal, and social issues about the impact of such practices on offspring, on sex ratio imbalances, and on sexism and the status of women. This paper analyzes the competing interests in preconception gender selection, and concludes that its use to increase gender variety in a family, and (...) possibly for selecting the gender of firstborn, might in many instances be ethically acceptable. (shrink)

: Embryonic stem cells, which have the potential to save many lives, must be recovered from aborted fetuses or live embryos. Although tissue from aborted fetuses can be used without moral complicity in the underlying abortion, obtaining stem cells from embryos necessarily kills them, thus raising difficult questions about the use of embryonic human material to save others. This article draws on previous controversies over embryo research and distinctions between intrinsic and symbolic moral status to analyze these issues. It argues (...) that stem cell research with spare embryos produced during infertility treatment, or even embryos created specifically for research or therapeutic purposes, is ethically acceptable and should receive federal funding. (shrink)

The idea of splitting off cells from embryos to clone human beings sounds so bizarre and dangerous that one would think the practice should not be permitted. A closer look reveals its ethical acceptability.

Advance directives such as living wills are attractive in that they give us a sense of control over our futures. But they also tend to obscure conflicts between a patient's competent wishes and later, incompetent interests. They allow caregivers to avoid evaluating quality of life in assessing the best interests of incompetent patients.

Ethical and legal traditions recognize prenatal duties to avoid harm to offspring. However, applying the harm principle to pregnancy requires a careful balancing of a baby's welfare with a pregnant woman's interest in liberty and bodily integrity. In the case of maternal PKU the mother can prevent harm to her baby by returning to the admittedly unpleasant diet that prevented her from being retarded. Informing, counseling, and access to medical care should be the primary policy. Seizures and forced treatment cannot (...) be justified in this case, and only rarely in other situations. (shrink)

Embryonic stem cell research has been a source of ethical, legal, and social controversy since the first successful culturing of human ESCs in the laboratory in 1998. The controversy has slowed the pace of stem cell science and shaped many aspects of its subsequent development. This paper assesses the main issues that have bedeviled stem cell progress and identifies the ethical fault lines that are likely to continue.The time is appropriate for such an assessment because the field is poised for (...) a period of rapid development. President Obama has removed the Bush administration’s restrictions on federal funding. A huge influx of federal research funds is in the offing and presumably a more rapid maturing of the science will take place. Stem cell science is also moving into the clinical realm. In March 2009, the Food and Drug Administration approved the first clinical trial with an ESC-derived therapy for spinal cord injuries, an important first step — though by no means a final or a sure one — in moving ESC research out of the laboratory into clinical medicine. Finally, recent work with induced pluripotent stem cells suggests that non-embryonic sources of pluripotent stem cells may one day be routinely available. Such a development will lessen the temperature of the ethical debate while raising other issues. (shrink)

: Pharmacogenetics offers the prospect of an era of safer and more effective drugs, as well as more individualized use of drug therapies. Before the benefits of pharmacogenetics can be realized, the ethical issues that arise in research and clinical application of pharmacogenetic technologies must be addressed. The ethical issues raised by pharmacogenetics can be addressed under six headings: regulatory oversight, confidentiality and privacy, informed consent, availability of drugs, access, and clinicians' changing responsibilities in the era of pharmacogenetic medicine. We (...) analyze each of these categories of ethical issues and provide policy approaches for addressing them. (shrink)

A couple may have a child to provide stem cells for another child. They may also use preimplantation testing—even, troubling though it is, prenatal testing and selective abortion—to ensure a close tissue match.

First published in 1905, this reissued edition of The Philosophical Works of Francis Bacon is an edited collection based upon the definitive seven volume edition of 1857, translated and prefaced by Robert Leslie Ellis and James Spedding. Of great historical, philosophical and scientific interest, this collection brings together translations of Bacon’s most important works, including the Novum Organum , the De Augmentis Scientarium , the Parasceve , and the De Principiis atque Originibus, as well as works originally written in English, (...) such as the Valerius Terminus and the Filum Labyrinthi . The reissue offers a comprehensive and provocative collection of the key writings of the man we now consider to be the father of Empiricism who popularised inductive methodologies for scientific inquiry. All works include prefaces by Robert Leslie Ellis and James Spedding, and the collection includes an introductory note from the editor John M. Robertson. (shrink)

The Child Abuse Amendments of 1984 established the norms for treating disabled newborns, but they did not address the treatment of premature babies. Parents and physicians need a framework for decisionmaking. A decision handed down recently by the Texas Supreme Court is a step forward.

Recent reports of “switched” embryos and gametes place already fragile couples in unfortunate circumstances, raise vexing questions regarding such fundamental concepts as parenthood and reproduction, and cast a shadow on the integrity of the infertility industry.

The President's Council on Bioethics (PCB) has deepened ethical and policy debates with its more conservative slant on bioethical issues. In the process it has elicited both brickbats and exasperat...

If preembryos are not persons, as Professor Richard A. McCormick recently argued in an article in this journal, then a variety of actions with preembryos should be permitted to follow. These actions include discard, freezing, research, and preimplantation genetic analysis.

This introduction explores the history of the 18th-century Enlightenment movement. Considering its intellectual commitments, Robertson then turns to their impact on society, and the ways in which Enlightenment thinkers sought to further the goal of human betterment, by promoting economic improvement and civil and political justice.

The Pittsburgh protocol is ethically and legally acceptable as written, but more research is needed to determine if it can be implemented in ways that will observe the procedures that make it ethically acceptable. If so, its desirability as public policy will depend on the number of organs it is likely to generate and its effects on public attitudes toward organ donation generally. In the final analysis, the controversial aspects of this protocol concern symbolic issues about respect for the dead (...) and near dead, rather than substantive concerns that real patient interests will be harmed. (shrink)

In vitro fertilization is now a well-established practice in the field of assisted reproduction. In 1995, over 41,000 IVF cycles were done in the United States, at a cost of more than $300 million. The overall success rate has risen to 22.8 deliveries per 100 egg-retrieval procedures. As the field has matured, the attention of policy-makers has shifted from questions about the ethical and legal status of human embryos to concerns about providing access and protecting consumers.Three such concerns have emerged. (...) One is the danger that IVF programs will disseminate misleading information about their success rates in order to attract patients. This problem, however, may be alleviated by the publication in late 1997 of the first of annual national and clinic specific reports, based on randomly audited data, by the Centers for Disease Control and Prevention, the American Society of Reproductive Medicine, the Society for Assisted Reproductive Technology, and RESOLVE, pursuant to the federal 1992 Fertility Clinic Success Rate and Laboratory Certification Act. (shrink)