Tomasz Żuradzki

Debates over distributive justice often agree that the worse-off deserve priority, yet disagree about when and on what basis someone counts as worse-off. Two dimensions structure these disagreements: the temporal unit (lifetime vs. time-slice assessment) and the currency (welfare, resources, capabilities, or other goods). This article develops a form of time-slice prioritarianism—future-oriented chance prioritarianism—which identifies the worse-off as those with the lowest near-term survival prospects. On this view, survival chances, rather than welfare or life-years, function as the distributive currency to which diminishing marginal weight applies. After situating the view within the landscape of lifetime and time-slice prioritarianisms, I analyze a stylized vaccine-allocation case to show how weighting survival prospects can diverge from utilitarian or standard welfarist prioritarian recommendations, and how the verdict flips when we switch the reference class (whole cohort vs. infected subpopulation). I then address two conceptual challenges: (i) clarifying the factors relevant for assigning normative weight to risk concentration, when it conflicts with aggregate outcomes; and (ii) diagnosing the partition-sensitivity of who counts as worse-off and its interaction with interpretations of probability.

We respond to Gillon’s critique of our data-driven analysis of the history of Journal of Medical Ethics (JME), in which we used a topic model to trace intellectual trends in the journal’s first 50 years. Gillon, drawing on his personal memories as JME’s second (and longest serving) editor, challenges several of our findings, particularly those concerning the prominence and classification of topics such as Ethics education. In this reply, we clarify misunderstandings that led to part of his criticisms of our method. At the same time, we also briefly discuss some nuances of topic modelling, in particular, its reliance on simplified representations of text, sensitivity to modeling choices and topic interpretations. Rather than viewing computational models and editorial memory as competing sources of insight, we propose that they are complementary: each illuminates different dimensions of the journal’s evolution. Gillon’s engagement with our work ultimately highlights the importance of methodological transparency and the value of combining digital humanities tools with lived experience in the historiography of academic disciplines.

This special issue of Diametros critically examines the evolving relationship between bioethics and political philosophy, focusing on the limitations of autonomy-centric and neutrality-based liberalism in addressing contemporary bioethical challenges. Through four contributions, by Greg Bognar, Søren Holm, Jurga Jonutytė, and Thaddeus Metz, the issue explores the normative tensions surrounding genetic enhancement, the exclusionary use of public reason in bioethics, the ontological dimensions of identity under institutional humiliation, and the moral justification of healthcare allocation. Drawing on real-world examples such as vaccine hesitancy, conscientious objection in healthcare, disability activism, and treatment prioritization, the authors argue for a rethinking of liberal frameworks in light of biopolitical complexity.

In this paper, we discuss the processes of racialisation on the example of biomedical research. We argue that applying the concept of racialisation in biomedical research can be much more precise, informative and suitable than currently used categories, such as race and ethnicity. For this purpose, we construct a model of the different processes affecting and co-shaping the racialisation of an individual, and consider these in relation to biomedical research, particularly to studies on hypertension. We finish with a discussion on the potential application of our proposition to institutional guidelines on the use of racial categories in biomedical research.

The analysis of citation flow from a collection of scholarly articles might provide valuable insights into their thematic focus and the genealogy of their main concepts. In this study, we employ a topic model to delineate a subcorpus of 1,360 papers representative of bioethical discussions on enhancing human life. We subsequently conduct an analysis of almost 11,000 references cited in that subcorpus to examine quantitatively, from a bird’s-eye view, the degree of openness of this part of scholarship to the specialized knowledge produced in biosciences. Although almost half of the analyzed references point to journals classified as Natural Science and Engineering (NSE), we do not find strong evidence of the intellectual influence of recent discoveries in biosciences on discussions on human enhancement. We conclude that a large part of the discourse surrounding human enhancement is inflected with “science-fictional habits of mind.” Our findings point to the need for a more science-informed approach in discussions on enhancing human life.

In this paper, we take a data-driven approach to analyse intellectual trends over the first five decades of the Journal of Medical Ethics (JME). Our data set, comprising all texts published in the JME since 1975, reveals not only the most distinctive topics of the JME in comparison to other key journals with similar profiles but also diachronic fluctuations in the prominence of certain topics. Overall, the distribution of topics shifted gradually, with each editorial period at the JME showing continuity with its immediate predecessor. However, a significant drift in topic distribution is evident over the 50 years, with some editorial periods being more ‘disruptive’ than others. These disruptions were influenced by external events (eg, Public health emergencies), broader trends in bioethics (eg, the recent growth of topics such as Race, Privacy and Vaccination) or editors’ preferences (eg, Ethics education). Additionally, our data provides insights into editorials where editors outlined their visions for the journal or reflected retrospectively on their past editorship.

We argue that there are neither scientific nor social reasons to require gathering ethno-racial data, as defined in the US legal regulations if researchers have no prior hypotheses as to how to connect this type of categorisation of human participants of clinical trials with any mechanisms that could explain alleged interracial health differences and guide treatment choice. Although we agree with the normative perspective embedded in the calls for the fair selection of participants for biomedical research, we demonstrate that current attempts to provide and elucidate the criteria for the fair selection of participants, in particular, taking into account ethno-racial categories, overlook important epistemic and normative challenges to implement the results of such race-sorting requirements. We discuss existing arguments for and against gathering ethno-racial statistics for biomedical research and present a new one that refers to the assumption that prediction is epistemically superior to accommodation. We also underline the importance of closer interaction between research ethics and the methodology of biomedicine in the case of population stratifications for medical research, which requires weighing non-epistemic values with methodological constraints.

According to what McMahan and Savulescu (2024) call the “popular position”, embryo selection is less ethically problematic than gene editing (other things being equal). The Two-Tier View, defended by McMahan and Savulescu, implies that the popular position is mistaken. The authors treat gene editing of embryos similarly to standard cases of medical treatments that promise expected benefits for the (subsequent) person even though gene editing also may create risks of harmful side effects for her. McMahan and Savulescu assume that if gene editing is (successfully) done, it is better for the person who developed from the beneficently edited embryo. And, if the editing had not been done, although it was possible, that would have been worse for the same person in question. Thus, the comparator must always be a possible, even if unlikely, world in which she would have existed. That is why gene editing, in their view, resembles medical treatments. Therefore, assuming that standard medical treatments are not more ethically problematic than embryo selection, they conclude that (in general) gene editing should also be treated as not more problematic than embryo selection. In this paper, I am taking one step further than McMahan and Savulescu in questioning the central assumptions in the bioethical debates about new reproductive technologies. In the previous work, we argued that the very distinction between person-affecting and identity-affecting interventions is based on a questionable form of material-origin essentialism (Żuradzki and Dranseika 2022). Here, I argue that the bipartite distinction between person-affecting and impersonal reasons, as used by McMahan and Savulescu, insufficiently represents different possible counterfactual comparisons between real and merely possible outcomes. In particular, I argue that the evaluation of gene editing requires counterfactual comparisons to situations in which the benefited person might or might not exist. Such evaluation requires an additional class of reasons, let me call them “semi-person-affecting,” that cannot be reduced to either person-affecting or impersonal ones. This aspect of gene editing makes it dissimilar to standard cases of medical treatments.

A cross-cultural survey experiment revealed a dominant tendency to rely on a rule’s letter over its spirit when deciding which behaviors violate the rule. This tendency varied markedly across (k = 15) countries, owing to variation in the impact of moral appraisals on judgments of rule violation. Compared with laypeople, legal experts were more inclined to disregard their moral evaluations of the acts altogether and consequently exhibited stronger textualist tendencies. Finally, we evaluated a plausible mechanism for the emergence of textualism: in a two-player coordination game, incentives to coordinate in the absence of communication reinforced participants’ adherence to rules’ literal meaning. Together, these studies (total n = 5,794) help clarify the origins and allure of textualism, especially in the law. Within heterogeneous communities in which members diverge in their moral appraisals involving a rule’s purpose, the rule’s literal meaning provides a clear focal point—an identifiable point of agreement enabling coordinated interpretation among citizens, lawmakers, and judges.

A dogma accepted in many ethical, religious, and legal frameworks is that the reasons behind conscientious objection (CO) in healthcare cannot be evaluated or judged by any institution because conscience is individual and autonomous. This paper shows that this background view is mistaken: the requirement to reveal and explain the reasons for conscientious objection in healthcare is ethically justified and legally desirable. Referring to real healthcare cases and legal regulations, this paper argues that these reasons should be evaluated either ex ante or ex post and defends novel conceptual claims that have not been analyzed in the debates on CO. First, a moral threshold requirement: CO is only justified if the reasons behind a refusal are of a moral nature and meet a certain threshold of moral importance. Second, this paper considers the rarely discussed conceptual similarities between CO in healthcare and the legal regulations concerning military refusals that place the burden of proof on conscientious objectors. This paper concludes that conscientious objection in healthcare can be accommodated only in some cases of destroying or killing human organisms.

With the limited initial availability of COVID-19 vaccines in the first months of 2021, decision-makers had to determine the order in which different groups were prioritized. Our aim was to find out what normative approaches to the allocation of scarce preventive resources were embedded in the national COVID-19 vaccination schedules. We systematically reviewed and compared prioritization regulations in 27 members of the European Union, the United Kingdom, and Israel. We differentiated between two types of priority categories: groups that have increased infection fatality rate (IFR) compared to the average for the general population and groups chosen because their members experience increased risk of being infected (ROI). Our findings show a clear trend: all researched schedules prioritized criteria referring to IFR (being over 65 years old and coexisting health conditions) over the ROI criteria (eg occupation and housing conditions). This is surprising since, in the context of treatment, it is common and justifiable to adopt different allocation principles (eg introducing a saving more life-year approach or prioritizing younger patients). We discuss how utilitarian, prioritarian, and egalitarian principles can be applied to interpret normative differences between the allocation of curative and preventive interventions.

A cross-cultural survey experiment revealed a widespread tendency to rely on a rule’s letter over its spirit when deciding which acts violate the rule. This tendency’s strength varied markedly across (k = 15) field sites, owing to cultural variation in the impact of moral appraisals on judgments of rule violation. Compared to laypeople, legal experts were more inclined to disregard their moral evaluations of the acts altogether, and consequently exhibited more pronounced textualist tendencies. Finally, we evaluated a plausible mechanism for the emergence of textualism: In a two-player coordination game, incentives to coordinate in the absence of communication reinforced participants’ adherence to rules’ literal meaning. Together, these studies (Ntotal = 5495) help clarify the origins and allure of textualism, especially in the law. Within heterogeneous communities in which members diverge in their moral appraisals involving a rule’s purpose, the rule’s literal meaning provides a clear focal point—an easily identifiable point of agreement enabling coordinated interpretation among citizens, lawmakers and judges.

In this article, we analyse how researchers use the categories of race and ethnicity with reference to genetics and genomics. We show that there is still considerable conceptual “messiness” (despite the wide-ranging and popular debate on the subject) when it comes to the use of ethnoracial categories in genetics and genomics that among other things makes it difficult to properly compare and interpret research using ethnoracial categories, as well as draw conclusions from them. Finally, we briefly reconstruct some of the biases of reductionism to which geneticists (as well as other researchers referring to genetic methods and explanations) are particularly exposed to, and we analyse the problem in the context of the biologization of ethnoracial categories. Our work constitutes a novel, in-depth contribution to the debate about reporting race and ethnicity in biomedical and health research. First, we reconstruct the theoretical background assumptions about racial ontology which researchers implicitly presume in their studies with the aid of a sample of recent papers published in medical journals about COVID-19. Secondly, we use the typology of the biases of reductionism to the problem of biologization of ethnoracial categories with reference to genetics and genomics.

In this paper, we discuss the processes of racialisation on the example of biomedical research. We argue that applying the concept of racialisation in biomedical research can be much more precise, informative and suitable than currently used categories, such as race and ethnicity. For this purpose, we construct a model of the different processes affecting and co-shaping the racialisation of an individual, and consider these in relation to biomedical research, particularly to studies on hypertension. We finish with a discussion on the potential application of our proposition to institutional guidelines on the use of racial categories in biomedical research.

Blumenthal-Barby and her colleagues (2022) situate their discussion of philosophy and bioethics in the context of (reportedly) widely held assumption that, when compared to the early days of bioethics, the role of philosophy is now diminished across the field – the assumption we call the Disconnection Thesis. This assumption can be summarized, to use the authors’ own words, by the phrase “philosophy’s glory days in bioethics are over“. While in no place of the article they explicitly endorse the Disconnection Thesis, at least some of the authors had previously endorsed it in print (Savulescu 2015). Such expressions of collective expert wisdom might be a valuable source of information on the discipline's history, but they should not be accepted uncritically. Given the explosion in the size and scope of bioethical research in recent decades, any scholar’s familiarity with the area is necessarily based on selective reading and might be biased. Hence, in this commentary, we examine what kind of more rigorous evidence could corroborate the Disconnection Thesis. In other words, if the role of philosophy in bioethics has been indeed diminishing, what kind of observable patterns should we expect to see? Drawing on our previous research (Bystranowski, Dranseika, Żuradzki 2022), here we focus on two useful perspectives: citation analysis and topic modeling. While the first approach allows us to indirectly measure the level of engagement of bioethicists with philosophical literature (by measuring the proportion of references from articles published in journals in bioethics that cite philosophy journals), the latter provides a window into the content and argumentative style of bioethical texts.

Topic modeling—a text‐mining technique often used to uncover thematic structures in large collections of texts—has been increasingly frequently used in the context of the analysis of scholarly output. In this study, we construct a corpus of 19,488 texts published since 1971 in seven leading journals in the field of bioethics and philosophy of medicine, and we use a machine learning algorithm to identify almost 100 topics representing distinct themes of interest in the field. On the basis of intertopic correlations, we group the content‐based topics into eight clusters, thus providing a novel, fine‐grained intellectual map of bioethics and philosophy of medicine. Moreover, we conduct a number of diachronic analyses, examining how the “prominence” of different topics has changed across time. In this way, we are able to observe the distinct patterns in which bioethics and philosophy of medicine have evolved and changed their focus over the past half a century.

In this commentary paper, we are taking one step further in questioning the central assumptions in the bioethical debates about reproductive technologies. We argue that the very distinction between “person affecting” and “identity affecting” interventions is based on a questionable form of material-origin essentialism. Questioning of this form of essentialist approach to human identity allows treating genome editing and genetic selection as more similar than they are taken to be in the standard approaches. It would also challenge the idea that normative reasons we have in these two types of cases markedly differ in strength.

My paper builds on the conceptual tools from three interrelated philosophical debates that—as I believe—may help structure important if chaotic discussions about surrogates for living human brains and resolve some practical issues related to regulatory matters. In particular, I refer to the discussions about the “moral precautionary principle” in research ethics (Koplin and Wilkinson 2019); about normative uncertainty in ethics (MacAskill, Bykvist, and Ord 2020), and about the inductive risk problem for animal welfare scientists (Birch 2018). I elucidate upon the possible meanings of the phrase “a too good human brain surrogate” used by Henry T. Greely (2021), and I demonstrate that the evaluation of the practical and regulatory implications of the “goodness” of such surrogates created for research purposes should be sensitive to the possible consequences of two types of errors: the under-attribution and over-attribution of moral status to such beings. Many authors writing about this topic (including Greely 2021, but see also, e.g., Koplin and Savulescu 2019) concentrate only on the first type of error, neglecting the negative consequences of the second type, i.e., over-attribution.

The goals and tasks of neuroethics formulated by Farahany and Ramos (2020) link epistemological and methodological issues with ethical and social values. The authors refer simultaneously to the social significance and scientific reliability of the BRAIN Initiative. They openly argue that neuroethics should not only examine neuroscientific research in terms of “a rigorous, reproducible, and representative neuroscience research process” as well as “explore the unique nature of the study of the human brain through accurate and representative models of its function and dysfunction”, but also its responsibilities or social consequences. In our commentary, we would like to concentrate on problem selection, which is shortly noticed by Farahany and Ramos, and by BRAIN Initiative’s Neuroethics Report itself. The document raises an important issue related to problem selection, which is strengthening or perpetuating existing prejudices and biases by choosing a research subject: “scientists are prompted to consider how the questions they choose to study in the laboratory might amplify existing biases.” This leads to several further problems: what constitutes bias?; how biases may be embedded in the selection of research programs?; is it possible to conduct completely unbiased research?; who should be a gatekeeper in the case of research that may amplify biases? We try to notice possible answers to these questions in the context of the research on differences (e.g., cognitive, medical, behavioral) between human populations.

Many psychologists have tried to reveal the formation and processing of moral judgments by using a variety of empirical methods: behavioral data, tests of statistical significance, and brain imaging. Meanwhile, some scholars maintain that the new empirical findings of the ways we make moral judgments question the trustworthiness and authority of many intuitive ethical responses. The aim of this special issue is to encourage scholars to rethink how, if at all, it is possible to draw any normative conclusions by discovering the psychological processes underlying moral judgments.

Until very recently, normative theorizing in ethics was frequently conducted without even mentioning uncertainty. Just a few years ago, Sven Ove Hansson described this state of affairs with the slogan: “Ethics still lives in a Newtonian world.” In the new Oxford Handbook of Philosophy and Probability, David McCarthy writes that “mainstream moral philosophy has not been much concerned with probability,” understanding probability as “the best-known tool for thinking about uncertainty.” This special predilection for certainty in ethics was surprising since most decisions or evaluations are made both by individuals and policy-makers through the fog of a widely understood uncertainty that includes risk, ignorance, indeterminacy. Therefore, the main task of this special issue is to encourage philosophers to rethink the standard paradigm in ethics by redirecting discussions about ethical questions to problems involving different kinds of uncertainty when an individual or a policy maker does not have access to or knowledge about.

Etycy nie poświęcali dotąd wiele uwagi niepewności, koncentrując się często na skrajnie wyidealizowanych hipotetycznych sytuacjach, w których zarówno kwestie empiryczne (np. stan świata, spektrum możliwych decyzji oraz ich konsekwencje, związki przyczynowe między zdarzeniami), jak i normatywne (np. treść norm, skale wartości) były jasno określone i znane podmiotowi. W poniższym artykule – który jest rezultatem projektu dotyczącego różnych typów decyzji w sytuacjach niepewności związanej z postępem w naukach i technologiach biomedycznych – przedstawię analizę sytuacji niepewności normatywnej, czyli takich, w których podmiot musi podjąć decyzję, nie mając pewności co do tego, jaka norma postępowania jest właściwa, np. dlatego, że ma sprzeczne intuicje normatywne na temat dopuszczalności danej decyzji. Stanowisko, które określa się niekiedy mianem komparatywizmu, głosi, że w tego typu sytuacjach należy uwzględniać nie tylko stopnie przekonań podmiotu w kwestii różnych norm, ale także to, na ile możliwe decyzje warte są podjęcia wedle tych norm. Przedstawię tu analizę kilku przypadków niepewności normatywnej, a także charakterystyczny argument przeciwko dotychczasowym wersjom komparatywizmu, wskazujący, że nie uwzględniają one różnych nastawień do ryzyka w sytuacjach niepewności normatywnej, choć dopuszczają jednocześnie różne nastawienia do ryzyka w sytuacjach niepewności empirycznej. Pokażę też, że zasada ostrożności dotycząca statusu moralnego w upraszczający sposób przedstawia sytuacje niepewności normatywnej.