One of the strongest objections to the development and use of substantially life-extending interventions is that they would exacerbate existing unjust disparities of healthy lifespans between rich and poor members of society. In both popular opinion and ethical theory, this consequence is sometimes thought to justify a ban on life-prolonging technologies. However, the practical and ethical drawbacks of banning receive little attention, and the viability of alternative policies is seldom considered. Moreover, where ethicists do propose alternatives, there is scant effort (...) to consider their merits in light of developing world priorities. In response to these shortcomings, I distinguish four policy options and, on the basis of a plausible intuition about fairness, evaluate their implications for a fair distribution of healthy lifespans. I claim that even in developing nations it would be fairest to favor policies that promote equal access to at least one promising category of substantially life-extending intervention: calorie restriction mimetics. (shrink)

Taking the critical turn is one of the main tools of the humanities and inculcates an intellectual discipline that prevents ossification of thinking about issues and of organizational policies in clinical ethics. The articles in this "Clinical Ethics" number of the Journal take the critical turn with respect to cherished ways of thinking in Western clinical ethics, life extension, the clinical determination of death, physicians' duty to treat even at personal risk, clinical ethics at the interface of research ethics, and (...) the pertinence of the Hippocratic Oath to clinical ethics. These articles challenge clinical ethicists to inculcate the intellectual discipline of the critical turn into everyday practice and continuous quality enhancement of clinical ethics. (shrink)

Transhumanism at once embodies our most modern thinking and our biggest longstanding problems. Transhumanism aims to enhance human core capacities: health-span, lifespan, and cognition. The thesis answers the following ethical challenges arising from transhumanist aims. First, whether transhumanism can be an ethical endeavour if it relies on authoritarian intervention by governments and governing bodies to change, generate and enforce behaviour, or to influence and enforce the uptake of medical procedures. Second, the thesis answers the challenge that it is unethical deliberately (...) to encourage the uptake of and pursuit of medical transhumanism given the extent of accessibility and distributive issues that remain unresolved in existing medicine. Finally, the thesis addresses a particular mental health crisis that is often predicted for transhuman beings, namely loss of meaning from loss of death and vulnerability, resulting in widespread loss of social cohesion. The thesis argues that the right solution to the first two problems is a libertarian paternalist approach, viz. nudging, and that this approach will also neutralise the risk of widespread and inevitable boredom or alienation that might otherwise result from the widespread introduction of human enhancement if people are nudged to engage more and more reflectively in their enhancement choices. Additionally, lifestyle issues like obesity, heart disease, cancers, and inaccessibility of vaccines and birth control pose unresolved problems for existing general medicine, killing millions every year worldwide. As a result, another serious challenge for enhancement medicine, which I propose would be addressed by the nudge approach, is to justify its place in the professional domain of medicine. (shrink)