Jack Harris

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

On both sides of the debate on the use of embryos in stem cell research, and in reproductive technologies more generally, rhetoric and symbolic images have been evoked to influence public opinion. Human embryos themselves are described as either “very small human beings” or “small clusters of cells.” The intentions behind the use of these phrases are clear. One description suggests that embryos are already members of our community and share with us a right to life or at least respectful treatment, whereas the other focuses on the differences between embryos and adult human beings with normal capacities, that is, their lack of sentience and of personal identity. The research on stem cells has been nicknamed “Frankenstein science” or presented as “research that could stop Parkinson disease.” Again, one description reminds us of scary science-fiction scenarios where the scientist is guilty of “playing God,” whereas the other description highlights the worth and potential benefits of the research outcomes

Editor-in-Chief John Harris discusses the four events that remind us of the concerns about what happens before birth and after death.Four recent events have reminded us that many people are concerned about what happens before birth and after death, even if what happens before birth happens to those who will never be born and even if the near death happenings occur after death and to those who cannot care about them. The recent events involve a decision of the European Court of Human Rights, a decision of the UK Human Fertilization and Embryology Authority , a proposal before the UK Parliament and a book by the most famous living German philosopher.On 8th July 2004 The European Court of Human Rights in Vo v France1 confirmed the view that the scope of legal principles protecting human individuals does not normally extend to the unborn and that in the words of the court “the unborn child is not regarded as a “person” …

This paper continues the debate between myself and Peter Singer et al started in the Journal of Medical Ethics volume 21, no 3 about the ethical respectability of the use of QALYs in health care allocation. It discusses the question of what, in the way of health care provision, would be chosen by rational egoists behind a Rawlsian "veil of ignorance", and takes forward the vexed question of what is to count as "doing good" and hence as "doing the most good" in health care. Most importantly, this paper argues that it would be unfair to discriminate against people because they have been disadvantaged by their genetic condition. It notes that McKie et al in their reply to my first contribution to this debate continue to fail to distinguish between chance and probability and it is argued that this failure causes them to miss the whole point of the argument

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 … "

In a number of papers, including the one published in this journal, Robert Sparrow has mounted attacks on consequentialism using principally what he takes to be an important fact, which he believes constitutes a reductio ad absurdum of consequentialism in its many forms and of this author's approach to enhancement and disability in particular (see page 276). This fact is the current longer life expectancy of women when compared with men. Here the author argues that Sparrow's arguments and entire approach utterly fail. In doing so the author hopes to shed further light on the role of normalcy, normal species functioning and species-typical functioning in debates about enhancement and disability

The principle that each individual is entitled to an equal opportunity to benefit from any public health care system, and that this entitlement is proportionate neither to the size of their chance of benefitting, nor to the quality of the benefit, nor to the length of lifetime remaining in which that benefit may be enjoyed, runs counter to most current thinking about the allocation of resources for health care. It is my contention that any system of prioritisation of the resources available for healthcare or of rationing such resources must be governed by this principle. This can have apparently paradoxical conclusions in that it can seem wasteful to give someone with a very slim chance of a lifesaving treatment the same priority as someone with a much better chance. In an important and thoughtful recent paper, Julian Savulescu has concentrated on this apparent weakness and has argued for a particular conception of the good or benefit to be achieved by a healthcare system which purports to demonstrate the inadequacies of an equal opportunities approach to prioritisation and to replace it with an altogether better account. This paper will show that a rational ‘reasons based consequentialism’ is more in line with the equal opportunities approach, which I defended some time ago in these pages, than with that of Savulescu. I shall then examine more closely the conception of equal opportunities in health care and show that if we give weight to an individual's reasons, and what is expected to be good for them, we will opt for exactly the equality based account of distributive justice that I have recommended.

People have a powerful interest in geneticprivacy and its associated claim to ignorance,and some equally powerful desires to beshielded from disturbing information are oftenvoiced. We argue, however, that there is nosuch thing as a right to remain in ignorance,where a right is understood as an entitlementthat trumps competing claims. This doesnot of course mean that information must alwaysbe forced upon unwilling recipients, only thatthere is no prima facie entitlement to beprotected from true or honest information aboutoneself. Any claims to be shielded frominformation about the self must compete onequal terms with claims based in the rights andinterests of others. In balancing the weightand importance of rival considerations aboutgiving or withholding information, if rightsclaims have any place, rights are more likelyto be defensible on the side of honestcommunication of information rather than indefence of ignorance. The right to free speechand the right to decline to acceptresponsibility to take decisions for othersimposed by those others seem to us moreplausible candidates for fully fledged rightsin this field than any purported right toignorance. Finally, and most importantly, ifthe right to autonomy is invoked, a properunderstanding of the distinction between claimsto liberty and claims to autonomy show that theprinciple of autonomy, as it is understood incontemporary social ethics and English law,supports the giving rather than the withholdingof information in most circumstances

This article examines certain aspects of current English doctrine in the light of applied property theory. Two of the problems of home-sharing which the law must address are: When should a claim be sustainable against the party who has legal title? Should such claims be exigible against successors of the title-holder? When statue is silent, three doctrinal streams of case-law are invoked. They concern money-down resulting trust interests, proprietary estoppel claims, and common intention constructive trust interests. The 'just outcome' is prayed in aid, intermittently and interstitially, when the doctrinal solution is unclear or when doctrine itself is developed. This article reverses the usual approach. It asks what sound 'property-specific justice reasons' are relevant to the home-sharing problems. They are canvassed before an imaginary Justice Tribunal: (i) no going back on a gift; (ii) perfecting a contract; (iii) fruits of money; (iv) induced expectations; (v) labour desert; (vi) home need; (vii) windfall wealth. Current doctrine is assessed in their light

This article states that drugs could be used to produce, if not more intelligent individuals, at least individuals with better cognitive functioning. Cognitive functioning is something that we might strive to produce through education, including of course the more general health education of the community. Enhancements are good if and only if they make people better at doing some of the things they want to do including experiencing the world through all of the senses, assimilating and processing what is experienced, remembering and understanding things better, becoming more competent, and experiencing more. Beneficial neural changes have been reported for such familiar technologies as reading, education, physical exercise, and diet. Smart drugs create irresistible competitive pressures such that once they are used everyone is forced to follow in order to keep up, and this is coercive and corrosive.

This article looks at some of the chance discoveries and elegant ideas that were borne out through the availability of archived tissue samples. It then discusses some of the planned changes to the method and purpose of tissue storage and collection. The changes are in the form of new types of tissue bank, or biobank as they are conceived. These banks are part of a trend to move towards a preventative approach to public health rather than the current costly interventionist model. This approach is not without its problems and it is these that threaten the unfettered continuation of the tissue archive. The sophistication of new research tools can uncover information about individuals that may have a detrimental effect on their well-being in various ways. The article analyses these possibilities in the context of how health care might develop.

New UK consensus statement on core curriculum in medical ethics and lawThe most important paper in this month’s JME is not a standard paper but the new UK consensus statement on the core curriculum in medical ethics and law for medical students. The first consensus statement was published in the JME in 1998 and has been instrumental in ensuring the embedding of a common standard of teaching in these subjects across UK medical schools. 1 However, even the most hard core moral realist has to accept that, even if the fundamental principles of ethics do not change, the best way to teach it might evolve and the problems of most interest may change as the healthcare system changes. The core curriculum can therefore not be cast in stone and must be revised and updated from time to time. The current revision is the result of an extensive process involving reviews of the way …

Opponents of destructive embryo research, such as embryo rightists, as well as proponents accept that natural reproduction is permissible. There is an alternative to natural reproduction—to remain childless. John Harris began this series of articles by asking, what does a commitment to the permissibility of natural reproduction entail? Harris has argued that a commitment to the permissibility of natural reproduction entails a commitment to the permissibility of destructive embryo research. Julian Savulescu has denied this. However, there are significant areas in which our views have converged

I have argued that because human sexual reproduction inevitably involves the creation and destruction of embryos, it is a problematic activity for those who believe that the embryo is “one of us.” Or, if it is not a problematic activity, then neither is the creation and destruction of embryos for a purpose of comparable moral seriousness—the development of lifesaving therapy, for example. I assume that, whereas it is possible for the very first act of unprotected intercourse to result in a live human baby, and hence not in a given case cause any embryo loss, this is a rare event and that, statistically, for every live birth from three to five embryos must be created only to die. For dramatic effect, I assume that five is a reasonable figure, giving each embryo a 20% chance of survival; however, nothing in the argument depends on any specific figures being correct. a