The scope of noninvasive prenatal testing (NIPT) could expand in the future to include detailed analysis of the fetal genome. This will allow for the testing for virtually any trait with a genetic contribution, including “non-medical” traits. Here we discuss the potential use of NIPT for these traits. We outline a scenario which highlights possible inconsistencies with ethical decision-making. We then discuss the case against permitting these uses. The objections include practical problems; increasing inequities; increasing the burden of choice; negative (...) impacts on the child, family, and society; and issues with implementation. We then outline the case for permitting the use of NIPT for these traits. These include arguments for reproductive liberty and autonomy; questioning the labeling of traits as “non-medical”; and the principle of procreative beneficence. This summary of the case for and against can serve as a basis for the development of a consistent and coherent ethical framework. (shrink)

Assisted reproductive technologies have greatly increased our control over reproductive choices, leading some bioethicists to argue that we face unprecedented moral obligations towards progeny. Several models attempting to balance the principle of procreative autonomy with these obligations have been proposed. The least demanding is the minimal threshold model (MTM), according to which every reproductive choice is permissible, except creating children whose lives will not be worth living. Hence, as long as the future child is likely to have a life worth (...) living, prospective parents may be allowed to use preimplantation genetic diagnosis (PGD) to select embryos with genetic diseases or disabilities. Assuming a consequentialist person‐affecting view of morality, this paper investigates whether the MTM is an appropriate tool to guide procreative decisions given the continuous development of reproductive genetic technologies. In particular, I consider germline genome editing (GGE) and I argue that its application in human reproduction, unlike PGD, should be conceived as person‐affecting towards future progeny. I claim that even if we assume the plausibility of the MTM within PGD, we are committed to accepting that a greater moral obligation towards progeny should guide procreative decisions if GGE were available. In this case, the MTM should no longer be considered an appropriate instrument to guide procreative choices. Finally, I investigate when we face this greater moral obligation, concluding that it applies only when prospective parents have already engaged in the in vitro fertilization process. (shrink)

Ethical debates around genetic enhancement tend to include an argument that the technology will eventually be fairly accessible once available. That we can fairly distribute genetic enhancement has become a moral defence of genetic enhancement. Two distribution solutions are argued for, the first being equal distribution. Equality of access is generally believed to be the fairest and most just method of distribution. Second, equitable distribution: providing genetic enhancements to reduce social inequalities. In this paper, I make two claims. I first (...) argue that the very assumption that genetic enhancements can be distributed fairly is problematic when considering our understanding of gene–environment interactions, for example, epigenetics. I then argue that arguments that genetic enhancements are permissible because the intended benefits can be distributed fairly as intended are misinformed. My first claim rests on the assertion that genetic enhancements do not enhance traits in a vacuum; genes are dependent on conducive environments for expression. If society cannot guarantee fair environments, then any benefit conferred from being genetically enhanced will be undermined. Thus, any argument that the distribution of genetic enhancements will be fair and that the technology is therefore morally permissible, is mistaken. (shrink)

The evaluation of whether an animal has a life worth living (LWL) has been suggested as a useful concept for farm animal policymaking. But there are a number of different ways in which the concept could be applied. This paper attempts to identify and evaluate candidate ethical principles based on the concept. It suggests that an appropriate principle by which to apply the concept is one that (1) is framed in terms of preventing an animal having a life worth avoiding (...) (LWA), rather than ensuring they have LWL, (2) is based on a prospective, rather than retrospective, concept of a life’s worth, and (3) relates to both the perpetuation and creation of an animal at all times during its life. The paper concludes by endorsing an overarching principle that no animal should be unreasonably caused to be, or allowed to remain, in a position of having a prospective LWA. (shrink)

The view that it is better for life to be created free of disability is pervasive in both common sense and philosophy. We cast doubt on this view by focusing on an influential line of thinking that manifests it. That thinking begins with a widely-discussed principle, Procreative Beneficence, and draws conclusions about parental choice and disability. After reconstructing two versions of this argument, we critique the first by exploring the relationship between different understandings of well-being and disability, and the second (...) by more briefly focusing on the idea of a significant reason. By placing these results against the broader historical and ongoing contexts in which the lives of those with disabilities have been deemed of inferior quality, we conclude with a call for greater humility about disability and well-being in thought and practice. (shrink)

Imagine a world where everyone is healthy, intelligent, long living and happy. Intuitively this seems wonderful albeit unrealistic. However, recent scienti c breakthroughs in genetic engineering, namely CRISPR/Cas bring the question into public discourse, how the genetic enhancement of humans should be evaluated morally. In 2001, when preimplantation genetic diagnosis (PGD) and in vitro fertilisation (IVF), enabled parents to select between multiple embryos, Julian Savulescu introduced the principle of procreative bene cence (PPB), stating that parents have the obligations to choose (...) the child that is expected to have the best life. In this paper I argue that accepting the PPB and the consequentialist principle (CP) that two acts with the same consequences are morally on par, commits one to accepting the parental obligation of genetically enhancing one's children. (shrink)

In ‘in vitro eugenics’ (IVE), I outlined a theoretical use of a technology of artificial gametogenesis, wherein repeated iterations of the derivation of gametes from embryonic stem cells, followed by the fusion of gametes to create new embryos, from which new stem cells could be derived, would allow researchers to create multiple generations of human embryos in the laboratory and also to produce ‘enhanced’ human beings with desired traits. As a number of commentators observed, my purpose in publishing this paper (...) was to provoke ethical discussion of a largely unremarked upon technological possibility and surrounding issues. Even if this was, as Murphy observes archly, to aim ‘low’, discussion of IVE is valuable for three reasons. First, it may render us better prepared should IVE become practical. I noted of my original discussion that it was speculative and several of the respondents suggest that IVE is even less likely to come about than I allowed there. Nevertheless, second, discussion of IVE is valuable for what it reveals about the ethics of new reproductive technologies (NRTs) more generally and, third, about the ethics of genetic human enhancement in particular. The responses to my paper demonstrate this nicely by (a) illustrating the selective way in which arguments about risk are mobilised in debates about NRTs and (b) highlighting the tension between any obligation of ‘procreative beneficence’ and a concern for genetic relatedness. Even if IVE should never be pursued, then, discussion of this possibility may help us better understand the ethics of other NRTs and means of genetic human enhancement. (shrink)

According to the Principle of Procreative Beneficence, reproducers should choose the child, of those available to them, expected to have the best life. Savulescu argues reproducers are therefore morally obligated to select for nondisease traits, such as intelligence. Carter and Gordon recently challenged this implication, arguing that Savulescu fails to establish that intelligence promotes well-being. This paper develops two responses. First, I argue that higher intelligence is likely to contribute to well-being on most plausible accounts. Second, I argue that, even (...) if it does not, one can only resist the conclusion that reproducers should select on the basis of intelligence if its expected net effect is neutral. If intelligence reduces expected well-being, then reproducers should select offspring of low intelligence. More likely, the effect of increased intelligence on expected well-being varies at different levels, which makes identifying an optimum for well-being more complex than hitherto appreciated. (shrink)

Advances in reproductive technology have already revolutionized our culture in various ways, and future potential developments, particularly in genetics, promise more of the same. The practice of surrogacy threatens to upend the way we understand the family. Germline engineering of human embryos could, among other things, lead to the treatment of genetic diseases hitherto incurable; but the widespread use of such engineering could have broader ramifications for our culture, for better and for worse. Parents may eventually be able to select (...) for desirable traits in their offspring, whether by genetic modification at conception or by choosing to implant one of several genetically profiled embryos. Authors in this issue of The Journal of Medicine and Philosophy address some of the ethical implications of these technological and cultural changes. (shrink)

Theoretical ethics includes both metaethics (the meaning of moral terms) and normative ethics (ethical theories and principles). Practical ethics involves making decisions about every day real ethical problems, like decisions about euthanasia, what we should eat, climate change, treatment of animals, and how we should live. It utilizes ethical theories, like utilitarianism and Kantianism, and principles, but more broadly a process of reflective equilibrium and consistency to decide how to act and be.

The aim of this paper is to criticise the well-discussed Principle of Procreative Beneficence (PB) lately refined by Julian Savulescu and Guy Kahane. First, it is argued that advocates of PB leave us with an implausible justification for the moral partiality towards the child (or children) reproducers decide to bring into existence as compared with all other individuals. This is implausible because the reasons given in favour of the partiality of PB, which are based on practical reason and common-sense morality, (...) can just as well be used to guide reproducers to make choices that do not support partiality towards one’s possible children. This seems to be true as least in some situations. Secondly, it is argued that Jakob Elster’s recent critique of PB is problematic, and specifically that a counterexample designed by Elster to criticise PB because of its partiality towards one’s own children misses the target. Finally, a genuine counterexample to PB is developed in order to show that the partiality of PB means it gives the wrong answer in a specific case. (shrink)

Rethinking Reprogenetics by Immaculada de Melo-Martin has at its heart a desire to spark discussion about the foundations of our right to reproduce. While many of the arguments are familiar in feminist ethics, de Melo-Martin's text is a useful addition in that she is focusing on the development and application of genetic technology toward reproductive ends, including the ends of transhumanism. Particularly, de Melo-Martin is skeptical about claims that genetic reproduction is a need or right deserving of social resources. This (...) is particularly an issue when genetic reproduction requires public resources to do it or as a consequence of it. She raises questions about whether the desire to have genetically related... (shrink)

The argument of Julian Savulescu’s 2001 paper, “Procreative Beneficence: Why We Should Select the Best Children” is flawed in a number of respects. Savulescu confuses reasons with obligations and equivocates between the claim that parents have some reason to want the best for their children and the more radical claim that they are morally obligated to attempt to produce the best child possible. Savulescu offers a prima facie implausible account of parental obligation, as even the best parents typically fail to (...) do everything they think would be best for their children let alone everything that is in fact best for their children. The profound philosophical difficulties which beset the attempt to formulate a plausible account of the best human life constitute a further independent reason to resile from Savulescu’s conclusion. Savulescu’s argument also requires parents to become complicit with racist and homophobic oppression, which is yet another reason to reject it. Removing the equivocation from Savulescu’s argument allows us to see that the assertion of an obligation to choose the “best child” has much more in common with the “old” eugenics than Savulescu acknowledges. (shrink)

This article analyzes the main reasons offered by the literature in relation to the question of whether pre-implantation genetic diagnosis and selection should be allowed in the context of assisted reproduction techniques to avoid the birth of children with disabilities. The bioethical literature faces a challenge from the disability discourse. When the oppressive social dimension of disability is taken into account, it results in a series of questions that could challenge the most settled conclusions of the bioethical debate. However, the (...) social model has not been without criticism and one of them, the underestimation of the importance of biological traits origin against a disability of social origin, resonates particularly in the debate on preimplantation genetic selection. (shrink)

It is often argued that it does not matter morally whether biomedical interventions treat or prevent diseases or enhance nondisease traits; what matters is whether and how much they promote well-being. Therapy and enhancement both promote well-being, the argument goes, so they are not morally distinct but instead continuous. I provide three reasons why this argument should be rejected when it is applied to choices concerning the genetic makeup of future people. First, it rests on too simple a conception of (...) the badness of disease. Second, it wrongly assumes that disease avoidance and enhancement can proceed with similar accuracy. Third, it overlooks that disease avoidance tends to be more urgent than enhancement from the point of view of distributive justice. Although none of these reasons establishes a firm therapy-enhancement distinction, they show that a continuum model is not an attractive alternative. (shrink)

Advances in reproductive genetic engineering have the potential to transform human lives. Not only do they promise to allow us to select children free of diseases, they can also enable us to select children with desirable traits. In this paper, I consider two clusters of arguments for the moral permissibility of reproductive genetic engineering, what I call the Perfectionist View and the Libertarian View; and two clusters of arguments against reproductive genetic engineering, what I call the Human Nature View and (...) the Motivation View. I argue that an adequate theory of the ethics of reproductive genetic engineering should take into account insights gained from these views. (shrink)

The use of Intelligent Assistive Technology in dementia care opens the prospects of reducing the global burden of dementia and enabling novel opportunities to improve the lives of dementia patients. However, with current adoption rates being reportedly low, the potential of IATs might remain under-expressed as long as the reasons for suboptimal adoption remain unaddressed. Among these, ethical and social considerations are critical. This article reviews the spectrum of IATs for dementia and investigates the prevalence of ethical considerations in the (...) design of current IATs. Our screening shows that a significant portion of current IATs is designed in the absence of explicit ethical considerations. These results suggest that the lack of ethical consideration might be a codeterminant of current structural limitations in the translation of IATs from designing labs to bedside. Based on these data, we call for a coordinated effort to proactively incorporate ethical considerations early in the design and development of new products. (shrink)

The screening of in vitro embryos resulting from in vitro fertilization treatment for chromosomal abnormalities has as a primary aim to help patients achieve a successful pregnancy. Most IVF centers will not transfer aneuploid embryos, as they have an enhanced risk of leading to implantation failure and miscarriage. However, some aneuploidies, such as trisomy-21, can lead to viable pregnancies and to children with a variable health prognosis, and some prospective parents may request transfer of such embryos. I present two cases (...) where the testing for and detection of trisomy-21 can lead to conflicts between IVF professionals and patients and argue that in most such cases respect for choices of patients should prevail. (shrink)

Reliance on intuitive and emotive responses is widespread across many areas of bioethics, and the current debate on biotechnological human enhancement is particularly interesting in this respect. A strand of “bioconservatives” that has explicitly drawn connections to the modern conservative tradition, dating back to Edmund Burke, appeals explicitly to the alleged wisdom of our intuitions and emotions to ground opposition to some biotechnologies or their uses. So-called bioliberals, those who in principle do not oppose human bioenhancement, tend to rely on (...) rational arguments and to see intuitions and emotions mostly as sources of biases. This approach often translates into shifting the burden of proof onto bioconservatives and challenging them to provide arguments against the proposed enhancement to back what bioliberals perceive as merely intuitive, emotive, and irrational reactions. -/- In this article, I am going to show that the methodological divide between bioliberals and bioconservatives is less significant than at first glance it appears to be and less significant than it is often taken to be. I will do so by defending two theses. The first is that reliance on intuitions and emotions is not a prerogative of bioconservatives: bioliberals have their typical intuitions and emotive responses and are for this reason exposed to potential biases in the same way as bioconservatives are. The second thesis is that reliance on intuitions and emotions is not necessarily antithetic to reason and rationality. This latter thesis has been philosophically defended with particular reference to the debate on biotechnologies, while the former is perhaps more controversial and more difficult to accept—at least for bioliberals. In both cases, I will support the claims by drawing on resources from the field of moral psychology and the sciences of the mind and, particularly, by applying to some positions in the enhancement debate recent findings about the role of intuitions and emotions in human moral assessment. This new empirically informed perspective holds promises for solving the methodological controversy between bioconservatives and bioliberals, thus enabling proper dialogue and debate between the two sides. (shrink)

The neural basis of human memory is incredibly complex. We argue that the diversity of neural systems underlying various forms of memory suggests that any discussion of enhancing ‘memory’ per se is too broad, thus obfuscating the biopolitical debate about human enhancement. Memory can be differentiated into at least four major systems with largely dissociable neural substrates. We outline each system, and discuss both the practical and the ethical implications of these diverse neural substrates. In practice, distinct neural bases imply (...) the possibility, and likely the necessity, of specific approaches for the safe and effective enhancement of various memory systems. In the debate over the ethical and social implications of enhancement technologies, this fine-grained perspective clarifies—and may partially mitigate—certain common concerns in enhancement debates, including issues related to safety, fairness, coercion, and authenticity. While many researchers certainly appreciate the neurobiological complexity of memory, the political debate tends to revolve around a monolithic one-size-fits-all conception. The overall project—exploring how human enhancement technologies affect society – stands to benefit from a deeper appreciation of memory’s neurobiological diversity. (shrink)

By using preimplantation haplotype diagnosis, prospective parents are able to select embryos to implant through in vitro fertilization. If we knew that the naturally-occurring (but theoretical) MoralKinder (MK+) haplotype would predispose individuals to a higher level of morality than average, is it permissible or obligatory to select for the MK+ haplotype? I.e., is it moral to select for morality? This paper explores the various potential issues that could arise from genetic moral enhancement.

The authors analyse a new paradigmatic approach to the enhancement of human beings proposed in transhumanist visions. Transhumanist authors promote the biochemical enhancement of healthy people via the concepts of bio-happiness and bio-love. The paper is based on an assessment of the value attributed to the lives of disabled people vis-à-vis those of healthy people. The value imbalance in the transhumanist conception is criticized on the grounds that it is an incorrect response to the posthuman urge to redefine human beings. (...) The authors’ final standpoint is that the value of human beings should be derived primarily from our naturalness and that artificiality should be subordinate to this. (shrink)

Existing debate on procreative selection focuses on the well-being of the future child. However, selection decisions can also have significant effects on the well-being of others. Moreover, these effects may run in opposing directions; some traits conducive to the well-being of the selected child may be harmful to others, whereas other traits that limit the child’s well-being may preserve or increase that of others. Prominent selection principles defended to date instruct parents to select a child, of the possible children they (...) could have, likely to have a good (or nonbad) life, but they do not instruct parents to independently take the well-being of others into account. We refer to these principles as individualistic selection principles. We propose a new selection principle—Procreative Altruism—according to which parents have significant moral reason to select a child whose existence can be expected to contribute more to (or detract less from) the well-being of others than any alternative child they could have. We present the case for adopting Procreative Altruism alongside any of the major individualistic selection principles proposed to date and defend this two-principle model against a range of objections. (shrink)

This article brings together two debates in bioethics more substantively than has been the case until now. One is the methodological debate over "principlism," i.e., the theoretical framework for analyzing and solving ethical problems proposed by Beauchamp and Childress in Principles of Biomedical Ethics. The other is the normative debate about reproductive ethics, i.e., procreative rights and obligations in a time of pervasive opportunities for making detailed choices about the properties and capacities of future people. The obvious point of bringing (...) the debates together is to show how they can illuminate each other in fruitful ways consistent with the method of reflective equilibrium endorsed in PBE. Furthermore, discussions of reproductive ethics is almost absent in PBE, making it an interesting "test case" on how principlist theory can have an impact on and be affected by confrontations with new practices and considerations in biomedicine. Reproductive ethics is especially interesting due to the so-called non-identity considerations, which pose a challenge to common morality views on harm to and respect for persons. My focus is mainly on some methodological points about the import of concrete normative discussions for formulating basic normative principles. However, I unfold a number of substantial points in order to demonstrate this. It is my impression that most writers on principlism underestimate the effect of engaging with concrete problems. Specifically, I conclude that reflecting on procreative obligations provides strong reasons for specifying the basic principles in ways that uncover new dimensions of them and not just new applications. _Key words: _principlism, reproductive ethics, non-identity problem, nonmaleficence, respect for persons. (shrink)

Non è un caso che l’enhancement umano, cioè il potenziamento di capacità fisiche, cognitive ed emotive degli esseri umani con l’ausilio di tecnologie, sia diventato un tema centrale nei dibattiti etico-applicativi e nei tentativi contemporanei di arrivare a una comprensione più adeguata della natura umana. In esso si incontrano quesiti decisamente ricchi e complessi, sia dal punto di vista tecnoscientifico e medico sia da quello filosofico – e lo fanno in un modo che ci permette di vedere questi quesiti sotto (...) una nuova luce. Il numero raccoglie alcune voci italiane, tedesche, inglesi e statunitensi su diversi aspetti della problematica dell’enhancement umano. Tra le tematiche discusse troviamo il potenziamento genetico, le dimensioni etiche dell’enhancement, la relazione uomo-tecnologia, il cosiddetto enhancement morale, la relazione tra enhancement ed eugenetica, la distinzione tra potenziamento e terapia e la rilevanza delle neuroscienze per lo sviluppo futuro delle bio-tecnologie, della medicina e dell’etica. (shrink)

Some parents have taken steps to ensure that they have deaf children, a choice that contrasts with the interest that other parents have in enhancing the traits of their children. Julian Savulescu has argued that, morally speaking, parents have a duty to use assisted reproductive technologies to give their children the best opportunity of the best life. This view extends beyond that which is actually required of parents, which is only that they give children reasonable opportunities to form and act (...) on a conception of a life that is good for them. Does the selection of deaf children violate that responsibility? Morally speaking, parents should refrain from using assisted reproductive treatments or prenatal interventions in order to have a child with a disability. Deafness and other disabilities represent intrinsic disadvantages that cannot be offset by other advantages that families and society can offer to people. By the same token, neither should parents seek enhancements of intelligence or physical traits that would undercut intrinsic goods of human life in similar ways. These moral arguments do not, however, sustain the judgment that the law should necessarily interfere with parents' decisions in these matters, even if those choices are morally unwise. (shrink)

What role should sentient animals play in the current debate on enhancement? The question covers several different philosophical fronts that demand urgent global ethical analysis. This touches issues that go from prohibition, permissivity or obligation that should characterize the new biotechnologies oriented to the enhancement of individuals, to the debate surrounding the moral rights of animals. Furthermore, the difficulty arises not only from the controversial moral categories involved, but also from the very extent of the objective proposed. However, this also (...) gives rise to the pertinence of the above-mentioned question posed at the outset: on the one hand, the need for consistency in an eminently biased debate, and on the other the need to justify the proposal in which all sentient individuals are legitimate protagonists without this necessarily leading to implausible scenarios. (shrink)

This paper argues against Julian Savulescu's principle of procreative beneficence. It maintains that prospective parents have no obligation at all to choose the child, out of a range of possible children, who is likely to lead the best life. This is because a standpoint that the author labels "the internal perspective" is a perfectly appropriate one for parents to adopt when thinking about their own future children. It is only policy makers who are obliged to take up an opposing standpoint--"the (...) external perspective"--and to be motivated by the sorts of "better for" judgements that that perspective delivers. (shrink)

As scientific progress approaches the point where significant human enhancements could become reality, debates arise whether such technologies should be made available. This paper evaluates the widespread concern that human enhancements will inevitably accentuate existing inequality and analyzes whether prohibition is the optimal public policy to avoid this outcome. Beyond these empirical questions, this paper considers whether the inequality objection is a sound argument against the set of enhancements most threatening to equality, i.e., cognitive enhancements. In doing so, I shall (...) argue that cognitive enhancements can be embraced wholeheartedly, for three separate reasons. However, though the inequality objection does not sufficiently support the conclusion that cognitive enhancements should be prohibited, it raises several concerns for optimal policy design that shall be addressed here. (shrink)

Probablemente la mayor responsabilidad actual de la ética aplicada es hacerse cargo de las grandes dificultades teórico-prácticas generadas con el incipiente desarrollo de las nuevas tecnologías de biomejora. Dificultades más allá de las preferencias individuales, viéndose involucradas cuestiones en torno a nuestra comprensión de la justicia distributiva. La identificación de dos hechos importantes nos da la clave para orientar el debate. Por un lado, las situaciones de partida tan arbitrarias que proporciona la lotería natual con relación a las oportunidades de (...) bienestar individual. Por otro, la posibilidad de realizar una mejora cognitiva, de aquellos más desafortunados en su configuración genética, que incidirá en la amplificación de tales oportunidades. (shrink)