Julian Koplin

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.

Genomic research can reveal ‘unsolicited’ or ‘incidental’ findings that are of potential health or reproductive significance to participants. It is widely thought that researchers have a moral obligation, grounded in the duty of easy rescue, to return certain kinds of unsolicited findings to research participants. It is less widely thought that researchers have a moral obligation to actively look for health-related findings. This paper examines whether there is a moral obligation, grounded in the duty of easy rescue, to actively hunt for genomic secondary findings. We begin by showing how the duty to disclose individual research findings can be grounded in the duty of easy rescue. Next, we describe a parallel moral duty, also grounded in the duty of easy rescue, to actively hunt for such information. We then consider six possible objections to our argument, each of which we find unsuccessful. Some of these objections provide reason to limit the scope of the duty to look for secondary findings, but none provide reason to reject this duty outright. We argue that under a certain range of circumstances, researchers are morally required to hunt for these kinds of secondary findings. Although these circumstances may not currently obtain, genomic researchers will likely acquire an obligation to hunt for secondary findings as the field of genomics continues to evolve.

The precautionary principle aims to influence decision‐making in contexts where some activity poses uncertain but potentially grave threats. This perfectly describes the controversy surrounding germline gene editing. This article considers whether the precautionary principle should influence how we weigh the risks and benefits of human germline interventions, focusing especially on the possible threats to the health of future generations. We distinguish between several existing forms of the precautionary principle, assess their plausibility and consider their implications for the ethics of germline modification. We also offer a novel form of the precautionary principle: the sufficientarian precautionary principle. Some plausible versions of the precautionary principle recommend placing somewhat greater weight on avoiding threats to future generations than on achieving short‐term benefits. However, no plausible versions of the precautionary principle entail that we should outright reject the use germline gene editing in human reproduction and some, such as the sufficientarian version, might endorse its use.

Human‐animal chimeras—creatures composed of a mix of animal and human cells—have come to play an important role in biomedical research, and they raise ethical questions. This article focuses on one particularly difficult set of questions—those related to the moral status of human‐animal chimeras with brains that are partly or wholly composed of human cells. Given the uncertain effects of human‐animal chimera research on chimeric animals’ cognition, it would be prudent to ensure we do not overlook or underestimate their moral status. However, to assess moral status, we first need to determine what kinds of capacities are morally relevant. The standard view holds that it matters, morally, if chimeric animals develop uniquely human cognitive capacities. I argue that this view is mistaken, highlighting three problems with it: that we can think of examples of uniquely human cognitive capacities that are not morally significant, that we can think of examples of morally significant cognitive capacities that are not uniquely human, and that evidence that some cognitive capacity is shared with nonhuman animals does not undermine claims that this capacity is morally significant. We need a better framework for thinking about the moral status of part‐human beings.

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.

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. 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 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 in the context of meat production than human–animal chimera research. We do not think the social consensus in favour …

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.

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.

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.