The ethics of synthetic DNA.

In this paper, we discuss the ethical concerns that may arise from the synthesis of human DNA. To date, only small stretches of DNA have been constructed, but the prospect of generating human genomes is becoming feasible. At the same time, the significance of genes for identity, health and reproduction is coming under increased scrutiny.

How not to talk about passive euthanasia: A lesson from India.

The 2011 Shanbaug case has proved to be very important in shaping the debates about end-of-life care and assisted dying in India. Ostensibly dealing with the question of whether it was permissible to withdraw treatment from a patient in a persistent vegetative state, it became a case about the legality of passive euthanasia, which is how it was treated by the Law Commission of India in 2012, and by the Supreme Court bench considering the Common Cause case in 2018. However, questions about the legality of passive euthanasia depend on whether we have a coherent definition of "passive euthanasia".

What passive euthanasia is.

Background: Euthanasia can be thought of as being either active or passive; but the precise definition of "passive euthanasia" is not always clear. Though all passive euthanasia involves the withholding of life-sustaining treatment, there would appear to be some disagreement about whether all such withholding should be seen as passive euthanasia.

Main Text: At the core of the disagreement is the question of the importance of an intention to bring about death: must one intend to bring about the death of the patient in order for withholding treatment to count as passive euthanasia, as some sources would indicate, or does withholding in which death is merely foreseen belong to that category? We may expect that this unclarity would be important in medical practice, in law, and in policy.

An Ethics Framework for Big Data in Health and Research.

Ethical decision-making frameworks assist in identifying the issues at stake in a particular setting and thinking through, in a methodical manner, the ethical issues that require consideration as well as the values that need to be considered and promoted. Decisions made about the use, sharing, and re-use of big data are complex and laden with values. This paper sets out an developed by a working group convened by the (SHAPES) It presents the aim and rationale for this framework supported by the underlying ethical concerns that relate to all health and research contexts.

What a drag it is getting old: a response to Räsänen.

In this brief response to Joona Räsänen's argument for the coherence and desirability of being able legally to change one's age, I outline a couple of reasons for thinking that the case he makes is deeply flawed. As such, I contend that we have no reason to think that age should be the kind of thing that one should be able to change legally. Moreover, we have at least one good reason for thinking that legal age change would be positively undesirable.

Perchance to Dream: Pathology, Pharmacology, and Politics in a 24-Hour Economy.

The lack of sleep is a significant problem in the modern world. The structure of the economy means that 24 hour working is required from some of us, sometimes because we are expected to be able to respond to share-price fluctuations on the other side of the planet, sometimes because we are expected to serve kebabs to people leaving nightclubs, and sometimes because lives depend on it. The immediate effect is that we feel groggy; but there may be much more sinister long-term effects of persistent sleep deprivation and disruption, the evidence for which is significant, and worth taking seriously.

On the Relationship between Medical Ethics and the Law.

In his comments on Bland, Lord Justice Hoffmann stated that 'I would expect medical ethics to be formed by the law rather than the reverse'. But what judges expect, and what they have a right to expect, are different things; I shall use Hoffmann LJ's statement as a way into looking at the relationship between ethics and law, and argue that it is partially correct insofar as that it makes a prediction about that relationship. Professional ethics and codes of ethics are shaped by law; but law is shaped by those codes to some extent, and both are influenced by 'philosophical ethics'.

The ethics of reporting all the results of clinical trials.

Introduction Or Background: The terms 'publication bias' and 'reporting bias' describe aspects of a phenomenon by which data from trials are not publicized, and so remain inaccessible. This may generate a false impression about the world; but those facts may have important implications for clinical decisions. Thus, the bias may leave patients worse off than they might be.

Genetic information: making a just world strange.

In an article recently published in this journal, I raised a puzzle about the control of genetic information, suggesting a situation in which it might turn out that we have a duty to remain in ignorance about at least some aspects of our own genome. In this article, I propose a way that would make sense of how the puzzle arises, and offer a way to resolve it and similar puzzles in future: in essence, we would consider genetic information to be something the distribution of which may be more or less just. We would not know in advance what a just distribution would be, though, and in some cases there might still be a justice-based reason to deny a person genetic information about himself.

The case for a duty to research: not yet proven.

In this commentary on 'Why participating in (certain) scientific research is a moral duty', I take issue with a number of Stjernschantz Forsberg et al's claims. Though abiding by the terms of a contract might be obligatory, this won't show that those terms themselves indicate a duty--even allowing that there's a contract to begin with. Meanwhile, though we might have reasons to participate, not all reasons are moral reasons, and the paper does not establish that the reasons here are moral in character.

What's the point of philosophical bioethics?

Many people working in bioethics take pride in the subject's embrace of a wide range of disciplines. This invites questions of what in particular is added by each. In this paper, I focus on the role of philosophy within the field: what, if anything, is its unique contribution to bioethics? I sketch out a claim that philosophy is central to bioethics because of its particular analytic abilities, and defend its place within bioethics from a range of sceptical attacks.

The topsy-turvy cloning law.

In debates about human cloning, a distinction is frequently drawn between therapeutic and reproductive uses of the technology. Naturally enough, this distinction influences the way that the law is framed. The general consensus is that therapeutic cloning is less morally problematic than reproductive cloning--one can hold this position while holding that both are morally unacceptable--and the law frequently leaves the way open for some cloning for the sake of research into new therapeutic techniques while banning it for reproductive purposes.

What's wrong with the brain drain (?).

One of the characteristics of the relationship between the developed and developing worlds is the 'brain drain'- the phenomenon by which expertise moves towards richer countries, thereby condemning poorer countries to continued comparative and absolute poverty. It is tempting to see the phenomenon as a moral problem in its own right, such that there is a moral imperative to end it, that is separate from (and additional to) any moral imperative to relieve the burden of poverty. However, it is not clear why this should be so - why, that is, there is a moral reason to stem the flow of expertise in addition to seeking to improve welfare.

Is there a duty to remain in ignorance?

Questions about information inform many debates in bioethics. One of the reasons for this is that at least some level of information is taken by many to be a prerequisite of valid consent. For others, autonomy in the widest sense presupposes information, because one cannot be in control of one's life without at least some insight into what it could turn out to contain.

Defending the duty to research?

In 2005, John Harris published a paper in the Journal of Medical Ethics in which he claimed that there was a duty to support scientific research. With Sarah Chan, he defended his claims against criticisms in this journal in 2008. In this paper I examine the defence, and claim that it is not powerful.

Enhancing evolution and enhancing evolution.

It has been claimed in several places that the new genetic technologies allow humanity to achieve in a generation or two what might take natural selection hundreds of millennia in respect of the elimination of certain diseases and an increase in traits such as intelligence. More radically, it has been suggested that those same technologies could be used to instil characteristics that we might reasonably expect never to appear due to natural selection alone. John Harris, a proponent of this genomic optimism, claims in his book Enhancing Evolution that we not only have it in our power to enhance evolution, but that we also have a duty to do so.

John Harris' argument for a duty to research.

John Harris suggests that partcipation in or support research, particularly medical research, is a moral duty. One kind of defence of this position rests on an appeal to the past, and produces two arguments. The first of these arguments is that it is unfair to accept the benefits of research without contributing something back in the form of support for, or participation in, research.

On Heidegger, medicine, and the modernity of modern medical technology.

This paper examines medicine's use of technology in a manner from a standpoint inspired by Heidegger's thinking on technology. In the first part of the paper, I shall suggest an interpretation of Heidegger's thinking on the topic, and attempt to show why he associates modern technology with danger. However, I shall also claim that there is little evidence that medicine's appropriation of modern technology is dangerous in Heidegger's sense, although there is no prima facie reason why it mightn't be.