If bioethical questions cannot be resolved in a widely acceptable manner by rational argument, and if they can be regulated only on the basis of political decision-making, then bioethics belongs to the political sphere. The particular kind of politics practiced in any given society matters greatly: it will determine the kind of bioethical regulation, legislation, and public policy generated there. I propose approaching bioethical questions politically in terms of decisions that cannot be “correct” but that can be “procedurally legitimate.” Two (...) procedures in particular can deliver legitimate bioethical decisions, once combined: expert bioethics committees and deliberative democracy. Bioethics so understood can exceed bioethics as a moral project or as a set of administrative principles to regulate medical practice; it can now aspire to a democratic project that involves ordinary citizens as far as reasonably possible. I advance this argument in four steps: (1) using the example of human germline gene editing, (2) I propose a general understanding of proceduralism, and (3) then combine two types and (4) conclude with a defense of majoritarian proceduralism. I develop this argument in terms of one example: germline gene editing. (shrink)

Given some of the various possible impacts of clinical germline editing, we can expect robust disagreement about how best to regulate it. One can point to examples of the promise of editing: “rough...

Vitoria’s 1537 lecture On the American Indians asserts moral equality and fundamental rights for all humans but is contradicted by the significant inequalities between Spanish conquistadores and indigenous peoples of Mexico and Peru. Despite recognizing these rights, Vitoria’s vision supports an unequal Euro-American relationship regarding territorial sovereignty, self-defense, self-determination, and religious freedom. His insights have implications for contemporary international law concerning indigenous rights. However, his theological framework limits this potential. To better address indigenous issues today, I advocate reframing Vitoria’s perspective (...) by replacing his natural law-based human-rights essentialism with a naturalistic approach that views human rights as social constructs. This shift can help develop international law to prevent violent interactions and promote equality between indigenous and non-indigenous peoples, reducing reliance on nation states to safeguard indigenous rights. Received: 03 August 2023 Accepted: 18 April 2024. (shrink)

Bioethicists’ views diverge public opinion on various ethical issues, particularly in healthcare. For instance, bioethicists generally oppose payment for organs and advocate for preventing death at any age, whereas the public is more supportive of organ payment and prioritizing younger patients. I offer four arguments on how best to view this divergence. (a) Bioethicists’ specialized training, objectivity, and reliance on research often lead to views that differ from those of the public, which may be less informed and more influenced by (...) biases. (b) Further, divergence between expert and public opinion is a normal and sometimes necessary aspect of bioethics. Divergence can lead to more informed and progressive ethical practices. (c) While public input is valuable, achieving meaningful engagement is difficult due to varying values, risk perceptions, and socioeconomic circumstances. Effective bioethics would balance expert knowledge with public input, aiming for policies that are both scientifically sound and democratically legitimate. (d) Maintaining public trust in bioethics does not require full alignment with public opinion. Instead, bioethicists should focus on educating the public and incorporating informed public perspectives into their analysis and recommendations. (shrink)

Mildred Cho and Nicole Martinez-Martin (2023) distinguish between two of the ways in which humans can be represented in medical contexts. One is technical: a digital model of aspects of a person’s...

Elizabeth Hildt’s (2023) notion of human-like artificial consciousness (AC) is vulnerable to several objections. First, she ties it to traits such as subjectivity and to capacities for rationality,...

Would direct genetic modification of human embryos affect the welfare of future persons? Sparrow’s approach to answering this question fails a core goal of bioethics: to generate perspectives capab...