Anna Smajdor

In this paper, I argue for an expansion of moral concern in bioethics beyond sentience-based and status-based frameworks. Drawing on Lukács' and Honneth's work on reification, I show that even where the sentience, species membership, or moral status of an entity is unknown, there are compelling ethical reasons to be concerned about the creation, manipulation, and use of such entities. I reconceive reification not just as a social pathology but as a moral vice: a disordered, objectifying mode of perception. Understood in this way, reification provides a flexible normative framework that applies across a wide range of entities, including humans, non-human animals, plants, ecosystems, and even inanimate objects. This vice-based approach helps explain why certain modes of interaction are ethically flawed regardless of the moral status of the entity in question. This facilitates a more inclusive ethical sensibility suited to emerging biotechnologies and the ecological challenges that pose an increasingly complex challenge for bioethics.

Rapid advances in AI for medical applications are accompanied by an increasing demand for vast datasets. Privacy constraints – legal restrictions such as GDPR, as well as more general ethical concerns – pose significant barriers to the acquisition and use of data. Synthetic medical data (SMD) is AI-generated data that mimics real patient information. SMD is being promoted as an ethical solution that preserves privacy while enabling scalable model training. However, as we will show, the use of SMD raises its own set of issues. SMD’s emphasis on privacy and scalability subtly embeds ethical and epistemic trade-offs that undermine the principles commonly regarded as being paramount in medical ethics. These trade-offs lack the kind of ethical justification one would expect in decisions that disrupt commonly accepted values and priorities, such as those captured by Beauchamp and Childress’ four principles. In the discourse on the ethical advantages of SMD, privacy tends to be treated as a value in its own right. We show that this is a problematic assumption. Transparency, privacy, scalability, and fidelity are all linked in complex ways with the principles of medical ethics. We map these relationships and show that when privacy is privileged over other values, it conflicts with autonomy and beneficence. Our aim here is not to establish that this privileging is wrong per se, but to show that it needs careful analysis before we can accept the idea that SMD is indeed ethically advantageous.

This open access book explores the interplay between individual and collective procreative interests against the background of cutting-edge developments in reproductive science. Reproductive technologies have made possible a range of novel practices that challenge some of our most fundamental assumptions about parenthood and the family. Gametes have been collected from dying or deceased individuals to enable their spouses or parents to create children. Children have undergone invasive fertility preservation interventions at their parents' request. Mothers have donated their wombs to their daughters. Meanwhile, new scientific discoveries in epigenetics and microbiomics are reshaping our understanding of biological connections. The Ethics of Human Reproduction and the Family brings together philosophers and social scientists to examine these challenges. Contributors explore, among others, the ethics of posthumous reproduction, uterus transplantation, intrafamilial adoption, conflicts between women's interests and state policies, and the implications of postgenomic science for genetic and social kinship.

In this paper, we discuss the ethical concerns that may arise from the synthesis of human DNA. To date, only small stretches of DNA have been constructed, but the prospect of generating human genomes is becoming feasible. At the same time, the significance of genes for identity, health and reproduction is coming under increased scrutiny. We examine the implications of DNA synthesis and its impact on debates over the relationship with our DNA and the ownership of our genes, its potential to disrupt common understandings of reproduction and privacy, and the way in which synthetic DNA challenges traditional associations between genes and identity. We explore the degree to which synthetic DNA may further undermine overgeneticised accounts of identity, health, reproduction, parenthood and privacy that are prevalent in the public domain and in some areas of policy-making. While avoiding making normative claims of our own, we conclude that there is a need for reflection on the ethical implications of these developing technologies before they are on us.

We recently suggested that there are both pragmatic and normative reasons to classify pregnancy as a disease. Several scholars argued against our claims. In this response, we defend the disease view of pregnancy against their criticism. We claim that the dysfunctional account of disease that some of our critics rely on has some counterintuitive results. Furthermore, we claim that our critics assume what needs to be argued that the primary function of our sexual organs is to reproduce. Since only a small percentage of sexual intercourse leads to pregnancy, it is far from obvious that reproduction is the primary biological function of our sexual organs. We also claim that while taking pregnancy itself as a reference class could avoid the conclusion that pregnancy is a disease, the strategy is problematic since it renders the Boorsean approach to disease and health circular and effectively deprives it of any utility in determining whether a particular phenomenon is a disease or not.