Biomedical Ethics

Edited by L. Syd M Johnson (SUNY Upstate Medical University)
Assistant editor: Tyler John (Rutgers University - New Brunswick)
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  1. Limits of Trust in Medical AI.Joshua James Hatherley - 2020 - Journal of Medical Ethics 46 (7):478-481.
    Artificial intelligence is expected to revolutionise the practice of medicine. Recent advancements in the field of deep learning have demonstrated success in variety of clinical tasks: detecting diabetic retinopathy from images, predicting hospital readmissions, aiding in the discovery of new drugs, etc. AI’s progress in medicine, however, has led to concerns regarding the potential effects of this technology on relationships of trust in clinical practice. In this paper, I will argue that there is merit to these concerns, since AI systems (...)
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  2. Ethical Issues in Text Mining for Mental Health.Joshua Skorburg & Phoebe Friesen - forthcoming - In M. Dehghani & R. Boyd (ed.), The Atlas of Language Analysis in Psychology.
    A recent systematic review of Machine Learning (ML) approaches to health data, containing over 100 studies, found that the most investigated problem was mental health (Yin et al., 2019). Relatedly, recent estimates suggest that between 165,000 and 325,000 health and wellness apps are now commercially available, with over 10,000 of those designed specifically for mental health (Carlo et al., 2019). In light of these trends, the present chapter has three aims: (1) provide an informative overview of some of the recent (...)
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  3. Review of Designing Babies. [REVIEW]Jonathan Anomaly - forthcoming - Bioethics.
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  4. Responsibility and the Limits of Patient Choice.Benjamin Davies - 2020 - Bioethics 34 (5):459-466.
    Patients are generally assumed to have the right to choices about treatment, including the right to refuse treatment, which is constrained by considerations of cost‐effectiveness. Independently, many people support the idea that patients who are responsible for their ill health should incur penalties that non‐responsible patients do not face. Surprisingly, these two areas have not received much joint attention. This paper considers whether restricting the scope of responsibility to pre‐treatment decisions can be justified, or whether a demand to hold people (...)
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  5. Autonomy, Consent, and the “Nonideal” Case.Hallvard Lillehammer - 2020 - Journal of Medicine and Philosophy 45 (3):297-311.
    According to one influential view, requirements to elicit consent for medical interventions and other interactions gain their rationale from the respect we owe to each other as autonomous, or self-governing, rational agents. Yet the popular presumption that consent has a central role to play in legitimate intervention extends beyond the domain of cases where autonomous agency is present to cases where far from fully autonomous agents make choices that, as likely as not, are going to be against their own best (...)
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  6. Willing Mothers: Ectogenesis and the Role of Gestational Motherhood.Susan Kennedy - 2020 - Journal of Medical Ethics 46 (5):320-327.
    While artificial womb technology is currently being studied for the purpose of improving neonatal care, I contend that this technology ought to be pursued as a means to address the unprecedented rate of unintended pregnancies. But ectogenesis, alongside other emerging reproductive technologies, is problematic insofar as it threatens to disrupt the natural link between procreation and parenthood that is normally thought to generate rights and responsibilities for biological parents. I argue that there remains only one potentially viable account of parenthood: (...)
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  7. ‘The Right Not to Know and the Obligation to Know’, Response to Commentaries.Ben Davies - 2020 - Journal of Medical Ethics 46 (5):309-310.
    I am grateful for these four incisive commentaries on my paper, ‘The right not to know and the obligation to know’ and regret that I cannot address every point made in these challenging responses to my work. Benjamin Berkman1 worries that I conflate medical information with medical action. I argue that patients sometimes have obligations to receive information, since medical decisions made with incomplete information may generate higher costs. As Berkman notes, though, information is no guarantee of action, and it (...)
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  8. The Right Not to Know and the Obligation to Know.Ben Davies - 2020 - Journal of Medical Ethics 46 (5):300-303.
    There is significant controversy over whether patients have a ‘right not to know’ information relevant to their health. Some arguments for limiting such a right appeal to potential burdens on others that a patient’s avoidable ignorance might generate. This paper develops this argument by extending it to cases where refusal of relevant information may generate greater demands on a publicly funded healthcare system. In such cases, patients may have an ‘obligation to know’. However, we cannot infer from the fact that (...)
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  9. Is Humane Slaughter Possible?Heather Browning & Walter Veit - 2020 - Animals 10 (5):799.
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  10. Book review. "Bird on an ethics wire: Battles about values in the culture wars." Margaret Somerville.Carlos Alberto Rosas Jimenez - 2019 - Cuadernos de Bioética 98 (30):95-97.
    Bird on an Ethics Wire es un libro sobre valores y cómo los entendemos como individuos y como sociedad. Es un libro que refleja un profundo respeto por la filosofía y la ética clásica como una subdisciplina de la filosofía moral; pero no está escrito para filósofos, sino más bien para una audiencia y escenarios distintos de la esfera pública, como una contribución en la búsqueda de los valores que podemos asumir en nuestras vidas. Por esta razón, la doctora Somerville (...)
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  11. The Ethics of Ectogenesis.Joona Räsänen & Anna Smajdor - 2020 - Bioethics 34 (4):328-330.
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  12. Neonatal Incubator or Artificial Womb? Distinguishing Ectogestation and Ectogenesis Using the Metaphysics of Pregnancy.Elselijn Kingma & Suki Finn - 2020 - Bioethics 34 (4):354-363.
    A 2017 Nature report was widely touted as hailing the arrival of the artificial womb. But the scientists involved claim their technology is merely an improvement in neonatal care. This raises an under-considered question: what differentiates neonatal incubation from artificial womb technology? Considering the nature of gestation—or metaphysics of pregnancy—(a) identifies more profound differences between fetuses and neonates/babies than their location (in or outside the maternal body) alone: fetuses and neonates have different physiological and physical characteristics; (b) characterizes birth as (...)
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  13. Resolved and Unresolved Bioethical Authenticity Problems.Jesper Ahlin Marceta - 2020 - Monash Bioethics Review 38 (1):1-14.
    Respect for autonomy is a central moral principle in bioethics. It is sometimes argued that authenticity, i.e., being “real,” “genuine,” “true to oneself,” or similar, is crucial to a person’s autonomy. Patients sometimes make what appears to be inauthentic decisions, such as when anorexia nervosa patients refuse treatment to avoid gaining weight, despite that the risk of harm is very high. If such decisions are inauthentic, and therefore non-autonomous, it may be the case they should be overridden for paternalist reasons. (...)
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  14. Sheep Complexity Outside the Laboratory.C. E. Abbate - 2019 - Animal Sentience 233:1-3.
    Marino & Merskin’s review shows that sheep are intelligent and highly social but their methodology has some shortcomings. I describe five problems with reviewing only the academic and scientific literature and suggest how one might provide an even more compelling case for the complexity of sheep minds.
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  15. Not the Doctor’s Business: Privacy, Personal Responsibility and Data Rights in Medical Settings.Carissa Véliz - forthcoming - Bioethics.
    This paper argues that assessing personal responsibility in healthcare settings for the allocation of medical resources would be too privacy-invasive to be morally justifiable. In addition to being an inappropriate and moralizing intrusion into the private lives of patients, it would put patients’ sensitive data at risk, making data subjects vulnerable to a variety of privacy-related harms. Even though we allow privacy-invasive investigations to take place in legal trials, the justice and healthcare systems are not analogous. The duty of doctors (...)
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  16. Applying the Narrative Coherence Standard in Non-Medical Assessments of Capacity.Tyler Gibb, Madison Irene Hybels & Khadijah Hussain - 2020 - American Journal of Bioethics Neuroscience 1 (11):31-33.
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  17. Against the Impairment Argument: A Reply to Hendricks.Joona Räsänen - forthcoming - Bioethics.
    In an article of this journal, Perry Hendricks makes a novel argument for the immorality of abortion. According to his impairment argument, abortion is immoral because: (a) it is wrong to impair a fetus to the nth degree, such as causing the fetus to have fetal alcohol syndrome (FAS); (b) it is wrong to impair a fetus to the n+1 degree (to cause the fetus to be more impaired than to have FAS); (c) killing the fetus impairs the fetus to (...)
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  18. Book review. "Compassion and moral guidance". Steve Bein.Carlos Alberto Rosas Jimenez - 2014 - Persona y Bioética 2 (18):254-262.
    Compassion and Moral Guidance es el título de la tesis doctoral del profesor Steve Bein de la Universidad de Hawai, publicada en el 2013 por la Society for Asian and Comparative Philosophy como su monografía No. 23. En este texto el autor nos pone frente a un término utilizado muy frecuentemente pero muchas veces am-biguo o que conduce a equívocos.
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  19. Value Theory, Beneficence, and Medical Decision-Making.David DeGrazia - 2020 - American Journal of Bioethics 20 (3):71-73.
    Volume 20, Issue 3, March 2020, Page 71-73.
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  20. Sugar, Taxes, & Choice.Carissa Véliz, Hannah Maslen, Michael Essman, Lindsey Smith Taillie & Julian Savulescu - 2019 - Hastings Center Report 49 (6):22-31.
    Population obesity and associated morbidities pose significant public health and economic burdens in the United Kingdom, United States, and globally. As a response, public health initiatives often seek to change individuals’ unhealthy behavior, with the dual aims of improving their health and conserving health care resources. One such initiative—taxes on sugar‐sweetened beverages (SSB)—has sparked considerable ethical debate. Prominent in the debate are arguments seeking to demonstrate the supposed impermissibility of SSB taxes and similar policies on the grounds that they interfere (...)
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  21. Responding to Objections to Gatekeeping for Hormone Replacement Therapy.Toni C. Saad, Daniel Rodger & Bruce Philip Blackshaw - 2019 - Journal of Medical Ethics 45 (12):828-829.
    Florence Ashley has responded to our response to ‘Gatekeeping hormone replacement therapy for transgender patients is dehumanising.’ Ashley criticises some of our objections to their view that patients seeking hormone replacement therapy (HRT) for gender dysphoria should not have to undergo a prior psychological assessment. Here we clarify our objections, most importantly that concerning the parity between cosmetic surgery and the sort of intervention Ashley has in mind. Firstly, we show Ashley’s criticism of our comparison is insubstantial. We then examine (...)
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  22. Context is Needed When Assessing Fair Subject Selection.G. Owen Schaefer - 2020 - American Journal of Bioethics 20 (2):20-22.
    Volume 20, Issue 2, February 2020, Page 20-22.
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  23. Consent’s Dominion: Dementia and Prior Consent to Sexual Relations.Samuel Director - 2019 - Bioethics 33 (9):1065-1071.
    In this paper, I answer the following question: suppose that two individuals, C and D, have been in a long-term committed relationship, and D now has dementia, while C is competent; if D agrees to have sex with C, is it permissible for C to have sex with D? Ultimately, I defend the view that, under certain conditions, D can give valid consent to sex with C, rendering sex between them permissible. Specifically, I argue there is compelling reason to endorse (...)
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  24. Sex Selection in India: Why a Ban is Not Justified.Aksel Braanen Sterri - forthcoming - Developing World Bioethics.
    When widespread use of sex‐selective abortion and sex selection through assisted reproduction lead to severe harms to third parties and perpetuate discrimination, should these practices be banned? In this paper I focus on India and show why a common argument for a ban on sex selection fails even in these circumstances. I set aside a common objection to the argument, namely that women have a right to procreative autonomy that trumps the state's interest in protecting other parties from harm, and (...)
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  25. Authenticity in Bioethics: Bridging the Gap Between Theory and Practice.Jesper Ahlin Marceta - 2019 - Dissertation, KTH Royal Institute of Technology
    The aim of this doctoral thesis is to bridge the gap between theoretical ideals of authenticity and practical authenticity-related problems in healthcare. In this context, authenticity means being "genuine," "real," "true to oneself," or similar, and is assumed to be closely connected to the autonomy of persons. The thesis includes an introduction and four articles related to authenticity. The first article collects various theories intended to explain the distinction between authenticity and inauthenticity in a taxonomy that enables oversight and analysis. (...)
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  26. The Truth Behind Conscientious Objection in Medicine: A Reply to Clarke, Emmerich, Minerva and Saad.Nir Ben-Moshe - 2019 - Journal of Medical Ethics 45 (10):681-683.
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  27. Credibility Excess and Social Support Criterion.John Beverley & Hollen N. Reischer - 2019 - American Journal of Bioethics 19 (11):32-34.
    Volume 19, Issue 11, November 2019, Page 32-34.
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  28. Social Support Is Not the Only Problematic Criterion, But If Used at All, “Lack of Social Support” Should Count in Favor of Listing, Not Against.Maura Priest - 2019 - American Journal of Bioethics 19 (11):35-37.
    Berry, Daniels, and Ladin make a strong argument for discontinuing the use of, “lack of social support,” as an organ transplantation listing criterion. This argument, however, actually leads to conclusions much stronger than those that the authors’ propose: The argument works equally well against using, (1) any “psychosocial” factors at all as a listing criterion, and, (2) any criteria other than factors that directly relate to empirically established medical need, and/or empirically established survival rate. Moreover, while the authors rightly point (...)
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  29. The Limits of the Rights to Free Thought and Expression.Barrett Emerick - forthcoming - Kennedy Institute of Ethics Journal.
    It is often held that people have a moral right to believe and say whatever they want. For instance, one might claim that they have a right to believe racist things as long as they keep those thoughts to themselves. Or, one might claim that they have a right to pursue any philosophical question they want as long as they do so with a civil tone. In this paper I object to those claims and argue that no one has such (...)
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  30. Why a Right to Life Rules Out Infanticide: A Final Reply to Räsänen.Bruce P. Blackshaw & Daniel Rodger - 2019 - Bioethics 33 (8):965-967.
    Joona Räsänen has argued that pro‐life arguments against the permissibility of infanticide are not persuasive, and fail to show it to be immoral. We responded to Räsänen’s arguments, concluding that his critique of pro‐life arguments was misplaced. Räsänen has recently replied in ‘Why pro‐life arguments still are not convincing: A reply to my critics’, providing some additional arguments as to why he does not find pro‐life arguments against infanticide convincing. Here, we respond briefly to Räsänen’s critique of the substance view, (...)
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  31. A Non-Ideal Authenticity-Based Conceptualization of Personal Autonomy.Jesper Ahlin Marceta - 2019 - Medicine, Health Care and Philosophy 22 (3):387-395.
    Respect for autonomy is a central moral principle in bioethics. The concept of autonomy can be construed in various ways. Under the non-ideal conceptualization proposed by Beauchamp and Childress, everyday choices of generally competent persons are autonomous to the extent that they are intentional and are made with understanding and without controlling influences. It is sometimes suggested that authenticity is important to personal autonomy, so that inauthenticity prevents otherwise autonomous persons from making autonomous decisions. Building from Beauchamp and Childress’s theory, (...)
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  32. How Payment For Research Participation Can Be Coercive.Joseph Millum & Michael Garnett - 2019 - American Journal of Bioethics 19 (9):21-31.
    The idea that payment for research participation can be coercive appears widespread among research ethics committee members, researchers, and regulatory bodies. Yet analysis of the concept of coercion by philosophers and bioethicists has mostly concluded that payment does not coerce, because coercion necessarily involves threats, not offers. In this article we aim to resolve this disagreement by distinguishing between two distinct but overlapping concepts of coercion. Consent-undermining coercion marks out certain actions as impermissible and certain agreements as unenforceable. By contrast, (...)
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  33. Three Things Digital Ethics Can Learn From Medical Ethics.Carissa Véliz - 2019 - Nature Electronics 2:316-318.
    Ethical codes, ethics committees, and respect for autonomy have been key to the development of medical ethics —elements that digital ethics would do well to emulate.
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  34. No One Who Loves Anyone.Alison Reiheld - 2019 - Journal of Medical Humanities 40 (3):451-453.
    In this bioethical poem, the narrator reflects on the experience of their father's degenerative illness, and decisions that must be made about whether to continue life support technologies such as ventilation and nutrition/hydration. What is it that is owed to family and patient at the end of life? What must no one who loves anyone ever do to the one they love?
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  35. Scientific Practice and the Moral Task of Neurophilosophy.Christian Carrozzo - 2019 - American Journal of Bioethics Neuroscience 10 (3):115-117.
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  36. Enhancement Technologies and Inequality.Walter Veit - 2018 - Proceedings of the IX Conference of the Spanish Society of Logic, Methodology and Philosophy of Science.
    Recognizing the variety of dystopian science-fiction novels and movies, from Brave New World to Gattaca and more recently Star Trek, on the future of humanity in which eugenic policies are implemented, genetic engineering has been getting a bad reputation for valid but arguably, mostly historical reasons. In this paper, I critically examine the claim from Mehlman & Botkin (1998: ch. 6) that human enhancement will inevitably accentuate existing inequality in a free market and analyze whether prohibition is the optimal public (...)
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  37. Schrödinger’s Fetus.Joona Räsänen - 2020 - Medicine, Health Care and Philosophy 23 (1):125-130.
    This paper defends and develops Elizabeth Harman’s Actual Future Principle with a concept called Schrödinger’s Fetus. I argue that all early fetuses are Schrödinger’s Fetuses: those early fetuses that survive and become conscious beings have full moral status already as early fetuses, but those fetuses that die as early fetuses lack moral status. With Schrödinger’s Fetus, it becomes possible to accept two widely held but contradictory intuitions to be true, and to avoid certain reductiones ad absurdum that pro-life and pro-choice (...)
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  38. The Case Against Forced Methadone Detox in the US Prisons.Daniel D’Hotman, Jonathan Pugh & Thomas Douglas - 2019 - Public Health Ethics 12 (1):89-93.
    Methadone maintenance therapy is a cost-effective, evidence-based treatment for heroin dependence. In the USA, a majority of heroin-dependent offenders are forced to detox from methadone when incarcerated. Recent research published in The Lancet has demonstrated the negative health and economic outcomes associated with such policies. Methadone Continuation Versus Forced Withdrawal on Incarceration in a Combined US Prison and Jail: A Randomised, Open Label Trial. The Lancet, 386, 350–359). This novel evidence raises questions as to the justification for current policies of (...)
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  39. From X-Phi to Bioxphi: Lessons in Conceptual Analysis 2.0.Jonathan Lewis - 2020 - Ajob Empirical Bioethics 11 (1):34-36.
    Recent developments in experimental philosophy (‘x-phi’) suggest that there is a new way in which the empirical and normative dimensions of bioethics can be brought into successful dialogue with one another. It revolves around conceptual analysis – though not the kind of conceptual analysis one might perform in an armchair. Following Édouard Machery, this is Conceptual Analysis Rebooted. In short, morally-pertinent medical concepts like ‘treatment’, ‘euthanasia’ and ‘sanctity of life’ can each have several meanings that underwrite inferences with different moral (...)
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  40. Meeting the Epicurean Challenge: A Reply to ’Abortion and Deprivation'.Nick Colgrove - 2019 - Journal of Medical Ethics 45 (6):380-383.
    Anna Christensen argues that it is implausible to claim that abortion and murder are morally impermissible given that they deprive individuals of a future like ours. In this essay, I provide two responses to Christensen’s argument. First, I show that the premises upon which Christensen’s argument relies have implausible implications. Second, I provide a direct response to Christensen’s challenge, showing that abortion and murder are morally impermissible given that they do deprive individuals of an FLO. Doing so involves drawing a (...)
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  41. Review of Margrit Shildrick, Leaky Bodies and Boundaries: Feminism, Post-Modernism and (Bio)Ethicsd. [REVIEW]Donna Dickenson - 1998 - Journal of Medical Ethics 24 (3):212-213.
    Review of Margrit Shildrick, Leaky Bodies and Boundaries.
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  42. Might There Be a Medical Conscience?Nir Ben-Moshe - 2019 - Bioethics 33 (7):835-841.
    I defend the feasibility of a medical conscience in the following sense: a medical professional can object to the prevailing medical norms because they are incorrect as medical norms. In other words, I provide an account of conscientious objection that makes use of the idea that the conscience can issue true normative claims, but the claims in question are claims about medical norms rather than about general moral norms. I further argue that in order for this line of reasoning to (...)
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  43. Coercive Offers Without Coercion as Subjection.William R. Smith & Benjamin Rossi - 2019 - American Journal of Bioethics 19 (9):64-66.
    Volume 19, Issue 9, September 2019, Page 64-66.
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  44. New Lamps for Old?Trevor Stammers - 2019 - The New Bioethics 25 (2):101-102.
    Volume 25, Issue 2, June 2019, Page 101-102.
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  45. Further Defence of Legal Age Change: A Reply to the Critics.Joona Räsänen - 2019 - Journal of Medical Ethics 45 (7):471-472.
    In ‘Moral case for legal age change’, I argue that sometimes people should be allowed to change their age. I refute six immediate objections against the view that age change is permissible. I argue that the objections cannot show that legal age change should always be prohibited. In this paper, I consider some further objections against legal age change raised by Iain Brassington, Toni Saad and William Simkulet. I argue that the objections fail to show that age change should never (...)
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  46. Can Conscientious Objection Lead to Eugenic Practices Against LGBT Individuals?Toni C. Saad & Daniel Rodger - 2019 - Bioethics 33 (4):524-528.
    In a recent article in this journal, Abram Brummett argues that new and future assisted reproductive technologies will provide challenging ethical questions relating to lesbian, gay, bisexual and transgender (LGBT) persons. Brummett notes that it is likely that some clinicians may wish to conscientiously object to offering assisted reproductive technologies to LGBT couples on moral or religious grounds, and argues that such appeals to conscience should be constrained. We argue that Brummett's case is unsuccessful because he: does not adequately interact (...)
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  47. Toward Realism About Genetic Enhancement.G. Owen Schaefer - 2019 - American Journal of Bioethics 19 (7):28-30.
    Volume 19, Issue 7, July 2019, Page 28-30.
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  48. Embracing Human Obsolescence: Implications for the Enhancement Project.John Danaher - 2019 - American Journal of Bioethics 19 (7):16-18.
    Volume 19, Issue 7, July 2019, Page 16-18.
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  49. When the Milk of Human Kindness Becomes a Luxury Good.Inmaculada de Melo-Martin - 2017 - Cambridge Quarterly of Healthcare Ethics 26 (1):159-165.
    A new reprogenetic technology, mitochondrial replacement, is making its appearance and, unsurprisingly given its promise to wash off our earthly stains --or at least the scourges of sexual reproduction--, John Harris finds only reasons to celebrate this new scientific feat.1 In fact, he finds mitochondrial replacement techniques (MRTs) so “unreservedly welcome” that he believes those who reject them suffer from “a large degree of desperation and not a little callousness.”2 Believing myself to be neither desperate nor callous, but finding myself (...)
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  50. The Promise and Perils of Biotech in Personalised Healthcare. Can New Regulatory Pathways Protect the Vulnerable?Giovanni De Grandis - 2018 - Risk 32 (Winter 2008):20-23.
    The paper discusses some of the implications of regulatory innovation in the area of advanced biological therapies and personalised medicine. Benefits, risks and trade-offs are highlighted.
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