Julian Koplin

One common objection to establishing regulated live donor organ markets is that such markets would be exploitative. Perhaps surprisingly, exploitation arguments against organ markets have been widely rejected in the philosophical literature on the subject. It is often argued that concerns about exploitation should be addressed by increasing the price paid to organ sellers, not by banning the trade outright. I argue that this analysis rests on a particular conception of exploitation, and outline two additional ways that the charge of exploitation can be understood. I argue that while increasing payments to organ sellers may mitigate or eliminate fair benefits exploitation, such measures will not necessarily address fair process exploitation or complicity in injustice. I further argue that each of these three forms of wrongdoing is relevant to the ethics of paid living organ donation, as well as the design of public policy more generally.

A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight general problems with this style of argument, and particular problems with its use in specific cases. We conclude that the burden ultimately falls on decision-makers to choose the policy supported by the best reasons

This paper argues that uterine transplants are a potentially dangerous distraction from the development of alternative methods of providing reproductive options for women with absolute uterine factor infertility. We consider two alternatives in particular: the bioengineering of wombs using stem cells and ectogenesis. Whether biologically or mechanically engineered, these womb replacements could provide a way for women to have children, including genetically related offspring for those who would value this possibility. Most importantly, this alternative would avoid the challenge of sourcing wombs for transplant, a practice that we argue would likely be exploitative and unethical. Continued research into bioengineering and ectogenesis will therefore remain morally important despite the recent development of uterine transplantation, even if the procedure reaches routine clinical application.

Elizabeth Chloe Romanis argues that surrogacy, uterine transplantation (UTx) and ectogestation belong to a genus of ‘assisted gestative technologies” (“AGTs”).1 These technologies are conceptually distinct from assisted reproductive technologies (ARTs) in that they support gestation rather than conception. Romanis argues that they also raise some overlapping ethical and policy issues that are best appreciated by ‘considering these technologies together’, thus placing the issues that AGT’s share at the forefront of ethical analysis. The neologism ‘AGTs’ picks out a distinctive and important category of technologies, and there is value in considering the ethical parallels between various AGT’s. However, the category of AGTs should provide neither the only nor the main level of ethical analysis. Surrogacy, UTx and ectogestation share important parallels not only with each other but also with other practices; indeed, some of these parallels are stronger than those AGT’s share with each other. Consider ectogestation. One striking implication of ‘artificial placentas’ is that they may make it possible to terminate a pregnancy without causing the death of the fetus. This is noteworthy in part because it threatens to disrupt one influential defence of abortion rights: that they are protected by something like a moral right to bodily integrity. Once fetuses can be transferred to artificial wombs, bodily integrity would no longer support a …

Advocates of paid living kidney donation frequently argue that kidney sellers would benefit from paid donation under a properly regulated kidney market. The poor outcomes experienced by participants in existing markets are often entirely attributed to harmful black-market practices. This article reviews the medical and anthropological literature on the physical, psychological, social, and financial harms experienced by vendors under Iran's regulated system of donor compensation and black markets throughout the world and argues that this body of research not only documents significant harms to vendors, but also provides reasons to believe that such harms would persist under a regulated system. This does not settle the question of whether or not a regulated market should be introduced, but it does strengthen the case against markets in kidneys while suggesting that those advocating such a system cannot appeal to the purported benefits to vendors to support their case.

Our recent article begins by describing a new technique for creating human–animal chimeras. This technique—known as interspecies blastocyst complementation—may enable us to generate human organs inside of human–pig chimeras (and/or other kinds of chimeric animals). One central concern about farming human–pig chimeras for their organs is that their moral status would be uncertain and potentially significant. Our article is partly, but not only, about such concerns. At the heart of our paper are two broader questions. First, how should we treat beings of uncertain moral status? And second, do our reasons for thinking that human–pig chimeras have uncertain moral status also provide reason to think regular, non-chimeric pigs have uncertain moral status? We thank Mike King, Christian Munthe, David Resnik, Per Sandin and Rob Streiffer for their commentaries on our paper, each of which serves to clarify the ethical issues at play. In this response, we want to respond to one criticism, acknowledge the force of several others, and point towards some philosophical work that remains to be done. First, the criticism. Resnik questions the parallel we draw between human–pig chimeras and regular pigs. In the case of regular pigs, there is currently a social consensus (or near consensus) that it is morally acceptable to farm pigs for food. For Resnik, this consensus imposes a special burden on those who wish to argue against it; ‘one needs substantial evidence that the majority view is wrong’.1 Since an equivalent consensus does not exist in relation to human–pig chimeras, one might think that moral uncertainty concerns have less force (or require greater support) in the context of meat production than human–animal chimera research. We do not think the social consensus in favour …

It may soon be possible to generate human organs inside of human-pig chimeras via a process called interspecies blastocyst complementation. This paper discusses what arguably the central ethical concern is raised by this potential source of transplantable organs: that farming human-pig chimeras for their organs risks perpetrating a serious moral wrong because the moral status of human-pig chimeras is uncertain, and potentially significant. Those who raise this concern usually take it to be unique to the creation of chimeric animals with ‘humanised’ brains. In this paper, we show how that the same style of argument can be used to critique current uses of non-chimeric pigs in agriculture. This reveals an important tension between two common moral views: that farming human-pig chimeras for their organs is ethically concerning, and that farming non-chimeric pigs for food or research is ethically benign. At least one of these views stands in need of revision.

Mary Shelley’s Frankenstein has captured the public imagination ever since it was first published over 200 years ago. While the narrative reflected 19th-century anxieties about the emerging scientific revolution, it also suggested some clear moral lessons that remain relevant today. In a sense, Frankenstein was a work of bioethics written a century and a half before the discipline came to exist. This paper revisits the lessons of Frankenstein regarding the creation and manipulation of life in the light of recent developments in stem cell and neurobiological research. It argues that these lessons are becoming more relevant than ever.

In their recent paper in this journal, Zümrüt Alpinar-Şencan and colleagues review existing dignity-based objections to organ markets and outline a new form of dignity-based objection they believe has more merit: one grounded in a social account of dignity. This commentary clarifies some aspects of the social account of dignity and then shows how this revised account can be applied to other perennial issues in bioethics, including the ethics of human embryo research and the ethics of creating part-human chimeras.

We do not always benefit from the expansion of our choice sets. This is because some options change the context in which we must make decisions in ways that render us worse off than we would have been otherwise. One promising argument against paid living kidney donation holds that having the option of selling a ‘spare’ kidney would impact people facing financial pressures in precisely this way. I defend this argument from two related criticisms: first, that having the option to sell one’s kidney would only be harmful if one is pressured or coerced to take this specific course of action; and second, that such forms of pressure are unlikely to feature in a legal market.

This chapter considers the prospect of generating human organs within chimeric animals comprised of a mix of human and animal cells. Although seemingly farfetched – the term ‘chimera’ even means, in some modern usage, a “mere wild fancy” or “unfounded conception” (Oxford English Dictionary (n.d.) ‘chimera | chimaera, n.’, OED Online. Oxford University Press. Available at: https://www.oed.com/view/Entry/31708) – recent research into interspecies blastocyst complementation is paving the way toward growing human organs inside of human-animal chimeras, potentially within the not-too-distant future Zheng et al. (Development 148(12), 2021). These human-animal chimeras promise important advances within regenerative medicine and medical research. They also raise some profound bioethical issues, which we survey below.

In the wake of ChatGPT’s release, academics and journal editors have begun making important decisions about whether and how to integrate generative artificial intelligence (AI) into academic publishing. Some argue that AI outputs in scholarly works constitute plagiarism, and so should be disallowed by academic journals. Others suggest that it is acceptable to integrate AI output into academic papers, provided that its contributions are transparently disclosed. By drawing on Taylor’s work on academic norms, this paper argues against both views. Unlike “traditional” forms of plagiarism, use of generative AI can be consistent with the norms that should underlie academic research. In these cases, its use should neither be prohibited nor required to be disclosed. However, some careless uses of generative AI do threaten to undermine the quality of academic research by mischaracterizing existing literature. This, not “AI plagiarism,” is the real concern raised by ChatGPT and related technologies.