Recent breakthroughs in stem cell differentiation and reprogramming suggest that functional human gametes could soon be created in vitro. While the ethical debate on the uses of in vitro generated gametes (IVG) was originally constrained by the fact that they could be derived only from embryonic stem cell lines, the advent of somatic cell reprogramming, with the possibility to easily derive human induced pluripotent stem cells from any individual, affords now a major leap in the feasibility of IVG derivation and (...) in the scope of their potential applications. In this paper we develop an ethical framework, rooted in recent scientific evidence, to support a robust experimental pipeline that could enable the first-in-human use of IVG. We then apply this framework to the following objectives: (1) a clarification of the genetic parenting options afforded by IVG, along with their ethical underpinnings; (2) a defence of the use of IVG to remedy infertility, broadening their scope to same-sex couples; (3) an assessment of the most far-reaching implications of IVG for multiplex parenting. These include, first, the liberation of parenting roles from the constraints of biological generations in vivo, allowing multiple individuals to engage in genetic parenting together, thus blurring the distinction between biological and social generations. Second, we discuss the conflation of IVG with sequencing technology and its implications for the possibility that prospective parents may choose among a hitherto unprecedented number of potential children. In view of these perspectives, we argue that, contrary to the exhausted paradigm according to which society lags behind science, IVG may represent instead a salient and most visible instance where biotechnological ingenuity could be used in pursuit of social experimentation. (shrink)

We argue in this essay that (1) the embryo is an irredeemably ambiguous entity and its ambiguity casts serious doubt on the arguments claiming its full protection or, at least, its protection against its use as a means fo research, (2) those who claim the embryo should be protected as "one of us" are committed to a position even they do not uphold in their practices, (3) views that defend the protection of the embryo in virtue of its potentiality to (...) become a person fail, and (4) the embryo does not have any rights or interests to be protected. Given that many are willing to treat the embryo as a means in other practices, and that human embryonic stem cell (hESC) research holds the potential to benefit many people, one cannot but conclude that hESC research is permissible and, because of its immense promise for alleviating human even obligatory. (shrink)

In this issue of CQ we introduce a new feature, in which noted bioethicists are invited to reflect on vital current issues. Our first invitee, John Harris, will subsequently assume editorship of this section.

Has the time come to put to bed the concept of a harm threshold when discussing the ethics of reproductive decision making and the legal limits that should be placed upon it? In this commentary, we defend the claim that there exist good moral reasons, despite the conclusions of the non-identity problem, based on the interests of those we might create, to refrain from bringing to birth individuals whose lives are often described in the philosophical literature as ‘less than worth (...) living’. (shrink)

Matti Häyry’s new book is deliberately challenging; it tells six contemporary bioethicists, and all who share their methodologies or even their general approach, that they have got it badly wrong. From the striking photograph of Häyry himself on the front cover to the very last line, the genetic challenge is issued and elaborated. Häyry has divided his protagonists into three pairs, of which I find myself a member, and this makes responding a duty as well as a pleasure. Although I (...) cannot speak for my partner in crime, Jonathan Glover, I am at least in the very best of all possible company. (shrink)

El artículo ofrece una interpretación de la controversial y aparentemente inaceptable caracterización de la poesía desarrollada por Platón en la República. Los objetivos principales de la discusión son: aclarar las motivaciones de dicha caracterización, desentrañar los múltiples y discontinuos argumentos que la componen, y evaluar críticamente sus aciertos y sus límites. Se concluye que no todas las posturas que adopta Platón frente a la poesía son insostenibles, y que cuando sí lo son las razones para ello resultan particularmente esclarecedoras. The (...) article offers an interpretation of the controversial and apparently unacceptable characterization of poetry developed in Plato's Republic. The main objectives of the discussion are: to clarify the motivations for such characterization, to disentangle the various and discontinuous arguments that compose it, and to critically evaluate its limitations and the extent of its defensibility. It is concluded that not all the positions adopted by Plato with respect to poetry are unsustainable, and that when they are, this is due to reasons which result particularly revealing. (shrink)

In his ‘Moral Enhancement, Freedom, and What We Value in Moral Behaviour’,1 David DeGrazia sets out to defend moral bioenhancement from a number of critics, me prominently among them. Here he sets out his stall: "Many scholars doubt what I assert: that there is nothing inherently wrong with MB. Some doubt this on the basis of a conviction that there is something inherently wrong with biomedical enhancement technologies in general. Chief among their objections are the charges that biomedical enhancement is (...) unnatural, use of biomedical enhancements evinces an insufficient appreciation for human “giftedness”, and biomedical enhancements pose a threat to personal identity. Elsewhere I have attempted to neutralize these objections. Here I will address a set of concerns that are directed at MB in particular and appeal to the nature and value of human freedom."Let me make clear at once that I do not believe there is anything inherently wrong with MB. I have been an advocate for human enhancement for over 30 years writing four books defending such enhancements.2–⇓4 The most recent of these published in 2007 covers much the same ground as Allen Buchanan's 2011 book cited by DeGrazia,5 but, unlike Buchanan, I do not define enhancements in terms of the intention or the motivation of those who produce them but rather in terms of their effect. I must also make clear that, like DeGrazia, I have also, for a very long time, attempted to neutralise objections 1–3 listed in the above passage.2–⇓4DeGrazia introduces his critique of my approach like this: "I will construe Harris’ argument and similar arguments as directed entirely at motivation-based MB—though I will hereafter omit the qualifier, “motivation-based.” (Certainly, these arguments do not apply to embryo selection, which … ". (shrink)

In this article I rebut conservative objections to five phases of embryonic stem cell research. I argue that researchers using existing embryonic stem cell lines are not complicit in the past destruction of embryos because beneficiaries of immoral acts are not necessary morally tainted. Second, such researchers do not encourage the destruction of additional embryos because fertility clinics presently destroy more spare embryos than researchers need. Third, actually harvesting stem cells from slated-to-be-discarded embryos is not wrong. The embryos are not (...) sacrificed for the good of others because they would have been destroyed anyway. Fourth, harvesting stem cells from embryos that are not doomed is morally acceptable, because preserving frozen embryos is futile therapy. Finally, creating embryos solely for the sake of harvesting stem cells from them is morally acceptable because the assumption that embryos have the right to life has very counterintuitive implications. (shrink)

It seems uncontroversial to state that meeting the vital medical needs of the vulnerable is agoal of great moral importance. Those in need of an organ transplant are among the mostvulnerable and yet society has to a large extent failed them. Many would-be organ recipientshave to wait for long periods of time before they get the organ that they need and some haveto wait until it is too late. Something has to change. One of the most widely discussedsolutions is to (...) create a regulated market in organs. The financial incentives are believed toencourage more people to give someone else their organs, thus significantly increasingsupply. Regardless of the potential effectiveness of such a solution, there are many who takea principled stand against organ markets. These objections generally stem from a concern forthe insidious potential for coercion and the hazard of exploitation. I will argue that thearguments against organ markets fail due to the flawed conceptualization of coercion, fairnessand the expressive meaning of markets that these arguments are premised on. Furthermore,even though there is some truth to the exploitation objection, it does not have sufficient moralrelevance to justify a prohibition on a regulated market in organs. (shrink)

Asperger syndrome (AS) is an autistic spectrum condition that shares the range of social impairments associated with classic autism widely regarded as disabling, while also often giving rise to high levels of ability in areas such as maths, science, engineering and music. The nature of this striking duality of disability and ability is examined, along with its implications for our thinking about disability and the relevance of levels and kinds of disability to reproductive choices. In particular, it may be seen (...) as posing a challenge to John Harris's influential position in reproductive ethics relating to disability. The paper argues that if, as Harris maintains, there is a quite general moral obligation to avoid bringing disabled lives into the world regardless of the level of disability, then AS must be seen as having a strong claim to be exempt from such an obligation. However, a broader critique of Harris's position leads to the conclusion that, in fact, this putative obligation does not exist. (shrink)

During the last congress of the International Association of Bioethics in Beijing, there was a special session on human enhancement. John Harris, pioneer in the discussions on the ethics of enhancement,1 summarised this session, describing the focus of different panelists.2 This session included: Biopsychological enhancements The possibility of regulating emotions through pharmacological means Biases that may affect our judgments against human enhancement Health care inequalities that will follow from the adoption of genetic technology Social impact and costs of adopting the (...) new technology A discussion on women enhancing their physical strength as men through genetic modification .The Beijing panel did not address women’s involvement in the enhancement scenario. Of course, not every aspect of a topic can be covered in one session of a congress and some aspects may remain unaddressed; mainly, because these sessions draw from the research interests of the presenters. However, neither John Harris nor Julian Savulescu has yet addressed women’s crucial involvement in the enhancement scenario. It is the aim of this paper to draw attention to the invisibility of the ‘vessel’ in these discussions. Enhancement may be justified; but clearly, it will also affect women. In this scenario, will women be worse off?LATE ONSET DISEASES AND ENHANCEMENTFirstly, I would like to point out that I believe that enhancement may be a necessary step in the future of human evolution. As I have explained elsewhere,3 health care systems in the developed world are near to collapse under the pressure of late onset chronic diseases. Largely successful in preventing early deaths in the last century, health care systems have prompted a new plague, recognised lately by the World Health Organization as a new pandemic …. (shrink)

That we are morally responsible for what we do willingly and knowingly is a commonplace. That our moral responsibility extends as far as to cover at least the intended consequences of our voluntary actions and perhaps also the ones we did not intend, but could or did foresee, is equally beyond dispute. But what about omissions? Are we, or can we be, (equally) morally responsible for the harm that has occured because we did not prevent it, even though we could (...) have done so? Say, for all the enormous suffering, caused daily by famine, deprivation and curable diseases in the Third World countries? Moral intuitions and practices that one could consult in this matter seem to leave us in the dark. We regularly ascribe responsibility to people for harms resulting from their negligence or failure to fulfill professional duties. On the other hand, we tend to think that unless there is some evidence of the causal contribution that agents made to a harmful event and/or state, it is not really fair to blame it on them. And finally, to complicate things even more, most of us deny that omissions could effect anything (any change) in the world and consequently regard them as causally impotent (as well as possibly harmless). (shrink)

Vaccines, when available, will prove to be crucial in the fight against Covid-19. All societies will face acute dilemmas in allocating scarce lifesaving resources in the form of vaccines for Covid-19. The author proposes The Value of Lives Principle as a just and workable plan for equitable and efficient access. After describing what the principle entails, the author contrasts the advantage of this approach with other current proposals such as the Fair Priority Model.

Alexander Zambrano sets out to refute an argument that I have made on a number of occasions over many years since 1992, which he calls “Harris’s Greater Need Argument” (2002).