Christopher A. Bobier

Introduction Brain-computer interface technology offers potential for non-therapeutic military applications, including enhanced decision-making and human–machine teaming. While ethical implications are frequently debated, empirical research regarding the viewpoints of servicemembers—the end-users facing unique operational risks—is largely missing. This scoping review aims to map the current state of the literature on empirically gathered viewpoints of military personnel toward non-therapeutic BCIs. Methods Three databases (EMBASE, PubMed, and SCOPUS) were searched for articles published in English through October 2025. Supplemental strategies included backward citation tracking and targeted grey literature searches. Eligibility criteria required empirical studies (qualitative, quantitative, or mixed methods) evaluating military servicemember attitudes toward brain-computer interfaces. Two investigators independently performed screening. Results Only two relevant sources were identified, highlighting a significant data gap. One survey study of 332 international officers found consensus on the need for pre-surgical transparency regarding post-service implant retention. A qualitative study of 13 special forces operators emphasized concerns regarding command pressure, data security, and the absolute necessity of guaranteed long-term, post-service maintenance. Conclusion There is a near-total absence of empirical data on servicemember perspectives toward military BCIs. The limited evidence reveals foundational concerns regarding trust, accountability, and post-service care. Neglecting end-user viewpoints risks creating ethically misaligned systems. We provide several recommendations for next steps.

By introducing proprietary, patent-protected, genetically engineered porcine organs into an organ transplant system, kidney xenotransplantation has the potential to alter many aspects of the system. While it is too soon to know for sure what the impact will be, we are cautious: patent-protected kidneys, like patent-protected pharmaceuticals, may be prohibitively expensive; some patients may not want to receive a pig organ; barriers to equitable access and distribution will remain; potential living donors may be discouraged if xenogeneic options are available; and the concept of ‘demand’ may change as the supply increases. Emilien Seizilles de Mazancourt believes that our arguments are unconvincing and that we should all be more optimistic. In this response, we defend our concern that implementing clinical xenotransplantation may not be the panacea it is hoped for.

Beyond legal requirement, why should physicians obtain parental permission to treat a pediatric patient? Children are not the property of their parents, physicians have the relevant medical expertise, and a physician’s primary responsibility is to the child, not the parents. In response, scholars have provided several instrumental reasons grounded in the parent–child relationship beyond legal obligation (e.g., parents know their child best; parents can resist substandard care; doing so fosters parental buy-in). While I agree with these reasons, they are not enough to support parental permission in every case in which it should be obtained. Accordingly, I defend a further reason: physicians should obtain parental permission as part of their role responsibility in the physician-parent relationship. I delineate this largely neglected but morally significant relationship and explain why it helps account for physician responsibilities toward parents in pediatric care.

In response to the 2022 Russian invasion of Ukraine, some scholars have advocated for pharmaceutical companies to voluntarily cease all operations and sales in Russia, including essential medicines. This proposal has been criticized on ethical and practical grounds. This study aims to understand the perspectives of global pharmaceutical companies regarding the provision of medicines following the Russian invasion of Ukraine. We analyzed press releases and similar statements from the public websites of 19 global pharmaceutical companies following Russia’s invasion of Ukraine. Companies were selected based on third-party reports of top 20 global pharmaceutical companies by revenue. Data were analyzed using conventional content analysis. Two researchers with ethics expertise independently identified key concepts, assessed ethical justifications (consequentialist, deontological, or values-based), and categorized findings. Analysis of the press releases revealed two major themes: “scale-back” of non-essential operations in Russia (58% of companies) and a commitment to continuing to sell “essential products or medicines” (79% of companies). Companies scaling back operations often hinted at ethical justifications, including consequentialist, deontological, and values-based reasoning. The commitment to essential medicines was justified using consequentialist, deontological, and values-based reasoning, although values-based reasons were most common. Global pharmaceutical companies have responded to the Russian invasion of Ukraine with a nuanced approach, characterized by scaling back non-essential operations while maintaining the supply of essential medicines. This approach reflects a complex interplay of ethical, practical, and geopolitical considerations. The findings highlight a shared understanding of the humanitarian imperative to ensure access to life-saving treatments, but they also raise questions about the variable articulation of ethical justifications and the potential influence of economic factors.

Dual-use research of concern (DURC) is research that can benefit humanity but poses substantial potential risk as well. There is scholarly agreement that each stakeholder has ethical responsibilities vis-à-vis DURC, from researchers to the broader international community, and that ethical DURC requires each stakeholder fulfill their ethical responsibilities. In this paper, we argue that few if any stakeholders are presently fulfilling their ethical responsibilities; therefore, present-day DURC may be unethical. This conclusion does not rest on the assumption that any particular stakeholder is acting with malicious intent. Rather, we contend that the unprecedented pace of scientific and technological advancement has significantly outstripped the development of corresponding ethical oversight mechanisms, regulatory frameworks, and systems of public accountability. As a result, the institutional and normative infrastructure required to ensure that DURC is conducted in a responsible and ethically defensible manner has failed to keep pace.

Alexandre Erler’s commentary challenges our argument against creating human ‘bodyoids’. While he considers our concerns speculative, we briefly defend speculative bioethics as vital for anticipating ethical risks before technologies emerge. We maintain that historical practices such as organ procurement and embryo experimentation illustrate how instrumental uses of human bodies can erode moral boundaries. Erler’s confidence in safeguards like the dead donor rule is, we suggest, misplaced. Ethical reflection at this formative stage is essential to prevent the normalization of technologies that risk profound dehumanization.

Alexandre Erler’s commentary challenges our argument against creating human ‘bodyoids’. While he considers our concerns speculative, we briefly defend speculative bioethics as vital for anticipating ethical risks before technologies emerge. We maintain that historical practices such as organ procurement and embryo experimentation illustrate how instrumental uses of human bodies can erode moral boundaries. Erler’s confidence in safeguards like the dead donor rule is, we suggest, misplaced. Ethical reflection at this formative stage is essential to prevent the normalization of technologies that risk profound dehumanization.

In this paper, we examine an apparent tension between the following three claims: (1) there is an afterlife, for example, in Heaven or Hell, and individuals experience perfect happiness in the former, (2) deceased embryonic children go to Heaven, and (3) that abortion is morally wrong because it harms the fetus. We consider whether abortion harms a fetus given (1) and (2). Our paper assesses this claim—that abortion harms the embryonic child aborted—by applying the most prominent accounts of harm on offer in the literature while presupposing (1) and (2). Our goal is to determine which accounts of harm avoid or fall prey to the apparent tension involved in maintaining (1) and (3).

According to a standard view, therapeutic misconception is a problem for informed consent and thereby respect for participant autonomy. This view is plausible given that therapeutic misconception refers to the mistaken beliefs of research participants regarding the nature and purpose of and their role in research. I do not disagree that therapeutic misconception can be a problem for informed consent and respect for autonomy; I disagree that it is only a problem for informed consent and respect for autonomy. The aim of this paper is to show that therapeutic misconception also harms participants, and as such, it is a matter of non-maleficence. I do this by showing that therapeutic misconception (often) fosters and sustains false hope, and since false hope harms people, therapeutic misconception is also a concern of non-maleficence.

Although much has been written about how generative artificial intelligence (GenAI) may affect bioethics, there is limited research on its use in bioethics scholarship. The objectives of our study are (i) to assess the extent to which GenAI is being used in the production of bioethics scholarship and (ii) to analyze how such utilization is described when disclosed. 20 bioethics journals were selected based on Google Scholar’s 2024 H5-index rankings. All publications from these journals’ 2024 volumes were reviewed for disclosure of GenAI use. In parallel, we examined each journal’s and publisher’s stated policies regarding GenAI-generated content, classifying them as permissive or prohibitive. The frequency and contextual framing of GenAI-utilization acknowledgements were analyzed. Of 1,808 publications, only 12 articles across five journals included a reference to GenAI use or non-use. Among the 12 mentions, nine disclosed GenAI utilization, while three stated non-utilization. The nine utilization acknowledgments appeared in different sections of the papers, with ChatGPT being the most frequently cited GenAI model and “tool” the most commonly used descriptor. Drawing on wider research trends, a disclosure rate of at least 10% was expected; however, the observed rate was under 1% and may reflect limited uptake, underreporting, or both. This finding raises important questions about transparency, methodological reporting standards, and the evolving norms of scholarly practice within the field of bioethics. We recommend clearer standards for when, how, and where GenAI use should be disclosed.

Following the invasion of Ukraine by Russia in February 2022, the international community responded in a number of ways. Individual companies acted by ending certain business relations in Russia. Certain countries enacted sanctions against Russia and specific Russian nationals. Exempt from these sanctions has been pharmaceutical products, which have continued to be imported into Russia. Long-standing convention is that medical and pharmaceutical products are exempted from government sanctions due to their humanitarian nature and the harm that such bans would likely effect upon civilian populations. However, it has recently been argued that pharmaceutical products should not be exempt from sanctions and should rather be used as a means of political pressure to cause a state to alter its behavior. We question this proposal based upon the principle of discrimination, as well as practical considerations.

The persistent shortage of organs, cadavers, and research participants in medicine has prompted proposals such as human 'bodyoids'—engineered human bodies lacking neural components necessary for consciousness and pain. Here, we critically assess the feasibility and ethics of creating bodyoids, highlighting significant technological challenges that render their development highly speculative and economically impractical. We further argue that even if feasible, engineering bodies devoid of consciousness raises profound ethical issues, including moral ambiguity, potential dehumanization, and legal concerns akin to those surrounding patients with severe brain injuries. Our analysis suggests that pursuing bodyoids raises concerns about respect for human life and dignity. We conclude that resources should instead focus on more viable and ethically sound alternatives to address urgent clinical needs in transplantation and research.

Dual use research of concern (DURC) refers to research conducted for legitimate scientific purposes that could also be misused to pose a significant threat to public health and safety, agricultural crops and other plants, animals, the environment, or national security. Scant discussion of bioethics in relation to DURC has taken place, with even less attention to DURC within a global bioethics framework. Herein, we demonstrate the connections of global bioethics—due to globalization, solidarity and cooperation, the precautionary principle, and collective consent—to DURC and present a number of questions that the field can help clarify.

Since the beginning of the Israel–Hamas war in 2023, the healthcare infrastructure within Gaza has been dismantled. While international humanitarian law mandates distinction between lawful targets (combatants and military objectives) and non‐lawful targets (civilians and civilian objects), and acknowledging the inherent complexities of applying this principle in conflicts involving non‐state actors like Hamas operating within civilian areas, numerous reports indicate that Israel's actions have resulted in significant and foreseeable consequences for the Gazan civilian population. Due to these substantial and foreseeable harms, which have led to a long‐term humanitarian crisis, we argue that the Israeli government bears a moral responsibility to help mitigate the long‐term humanitarian crisis, which, at a minimum, requires helping to rebuild the healthcare infrastructure to its status quo ante bellum.

Introduction The 2022 Russian invasion of Ukraine prompted diverse responses from global corporations. This study investigates the perspectives and actions of leading pharmaceutical companies amidst this geopolitical crisis, focusing on their public response to Russia’s invasion.Methods Three rankings were used to identify top global pharmaceutical companies by revenue in 2022. Public statements, collected from public-facing company websites and archival websites, were analyzed via thematic content analysis to understand the responses of individual companies.Results Five key themes emerged: (1) Solidarity: expressions of support for Ukraine and condemnation of Russia; (2) Scaling-back: suspension of non-essential operations, including new clinical trials and investments; (3) Essential Medicines: commitment to maintaining the supply of life-saving medications; (4) Sanction Compliance: adherence to international sanctions; and (5) Donations: increased humanitarian aid. A majority of companies affirmed a commitment to the continued sales of essential medicines while simultaneously scaling back non-essential activities in the Russian market. Less than half of companies explicitly condemned Russia. Humanitarian donations were frequently mentioned.Conclusion Pharmaceutical companies adopted a nuanced approach, balancing ethical obligations to provide essential medicines with responses to the conflict. The findings highlight the complex decision-making processes faced by multinational corporations during international conflicts, revealing a strategic response that prioritizes humanitarian needs and regulatory compliance alongside business continuity.

Is it ethically defensible to remove xenotransplant recipients’ right to withdraw from long term biosurveillance on grounds of theoretically possible but potentially excessive third-party risk? Some think so arguing that to protect public health from potential infectious diseases originating in the xenograft, xenotransplant recipients should not be allowed to withdraw from long term biosurveillance. We present a dilemma for this view: if xenotransplant research poses such significant risk to public health as to warrant the requirement that xenotransplant recipients voluntarily waive their right to withdraw, then the research warrants long term quarantine. If the risk is not so great as to require long term quarantine, however, then individuals should not have to forfeit this right in order to participate in xenotransplant research. Either way, xenotransplant recipients should not be required to waive their right to withdraw from long term biosurveillance.

This article introduces and analyzes a hitherto overlooked phenomenon, that of false fear in medicine. Closely aligned to cases of false hope, false fear is characterized by belief, aversion, and fixation components. Because false fear involves a fixation on an unlikely aversive outcome, it often causes harm to the person and others, and this makes intentionally causing false fear prima facie wrong. The author discusses some of false fear's sources in medicine and explains how physicians and other health-care practitioners may be blameworthy for not addressing false fear.

Brain-computer interface research is an interdisciplinary field aiming to establish direct communication between the brain and external devices and holds great promise for assistive technology and healthcare. Ethical issues have been covered for years alongside BCI research, yet novel ethical issues are forthcoming. This paper critically examines a recent proposal advocating for the use of Ulysses contracts within BCI research, drawing parallels with its proposed application in xenotransplantation. While Ulysses contracts in psychiatry serve as advance directives, being enacted when a patient loses decision-making capacity, their proposed application in BCI research—specifically concerning the explantation of devices—fundamentally misconstrues their purpose. We argue that the telos of genuine Ulysses contracts is incongruent with their proposed reappropriation in the BCI context. Furthermore, enforcing such contracts on individuals with retained decision-making capacity is ethically problematic and legally untested, representing a violation of bodily autonomy. Unlike the public health rationale sometimes invoked in xenotransplantation, no comparable justification exists for BCIs. Ultimately, the issues surrounding device explantation in BCI research are rooted in property and contract law, not in the management of diminished autonomy that Ulysses contracts are designed to address.

According to many scholars, kidney xenotransplantation promises to mitigate the organ supply shortage. This claim has a certain obviousness to it: by flooding the market with a new source of kidneys, xenotransplantation promises to be a panacea. Our goal is to challenge this claim. We argue that xenotransplantation may increase rather than decrease demand for kidneys, may reduce kidney allotransplants, and may be inaccessible or otherwise unused. By offering the challenge, we hope to show deeper reflection is needed on how xenotransplantation will affect the dearth of available organs.

Aim To examine the challenges and opportunities presented by generative artificial intelligence in healthcare education and explore how it can be used ethically to enhance rather than compromise future healthcare workforce competence. Background Generative artificial intelligence is fundamentally changing healthcare education, yet many universities and healthcare educators have failed to keep pace with its rapid development. Design A discussion paper. Methods Discussion and analysis of the challenges and opportunities presented by students' increasing use of generative artificial intelligence in healthcare education, with particular focus on assessment approaches, critical thinking development and artificial intelligence literacy. Results Students' widespread use of generative artificial intelligence threatens assessment integrity and may inhibit critical thinking, problem-solving skills and knowledge acquisition. Without adequate artificial intelligence literacy there is a risk of eroding future healthcare workforce competence and compromising patient safety and professional integrity. Conclusion While generative artificial intelligence presents significant challenges to healthcare education, it offers great promise if used carefully with awareness of its limitations. The development of artificial intelligence literacy is crucial for maintaining professional standards and ensuring patient safety and mitigating its potentially negative impact on the formation of critical thinking skills.

Rapid advancements in artificial intelligence (AI) pose novel ethical and practical challenges for scholarly publishing. Although AI-related policies are emerging in many disciplines, little is known about the extent and clarity of AI guidance in bioethics and health humanities journals. A search of publicly available journal lists from the American Society for Bioethics and Humanities, Health Humanities Consortium, and Association for Medical Humanities was supplemented with Google Scholar’s top 20 bioethics journals ranked by h5-index. This yielded 54 unique journals, of which 50 remained after excluding those without a functional website or recent publications. AI policies were reviewed at the journal and publisher levels were assessed via website review, and editors were contacted for clarification when required. Data extraction was conducted by one author and independently verified by two additional researchers to ensure accuracy. Of the 50 journals analyzed, only 8 (16%) had a clear AI policy, while 27 (54%) were published by a publisher with an identifiable AI policy. Publisher AI policy statements were favorable to considering AI-assisted manuscripts. Five (10%) of the 8 journals with a clear AI policy explicitly prohibited AI-generated text in submissions. The remaining 15 (30%) journals did not have a publicly available AI policy. Ten of these 15 journals confirmed an absence of any formal AI policy, and seven indicated that discussion to develop guidelines was ongoing. The adoption of AI policies in bioethics and health humanities journals is currently inconsistent. Some journals explicitly ban AI-generated text, whereas others permit AI-assisted writing, with publisher policies being favorable to considering AI-assisted manuscripts. The lack of standardized AI guidelines underscores the need for further discussion to ensure the ethical and responsible integration of AI in academic publishing.

Scientists will soon be able to grow human-transplantable organs in pigs. This paper focuses on the question of whether it is morally permissible to eat genetically altered pigs after harvesting their organs. Despite a lack of scholarly discussion of this question, the impetus for it is straightforward. There is no reason to think that peoples’ taste for pig will subside when scientists reach the point of being able to growing mature human organs inside them. In this paper, I argue that there is a good reason why we should eat genetically altered pigs and currently no compelling reasons to the contrary.

Scholars have examined how hope can be a distinct moral virtue. Some consider it to be a moral virtue along Aristotelian lines, while others consider it to be a structural virtue. My goal in this paper is to examine hope's relationship to emotions and moral virtues. I highlight hope's relationship to emotions such as anger, fear, despair and love, and discuss how various moral virtues (and vices) promote, sustain or mitigate various hopes. This complicates the view that there is a singular moral virtue of hope. The upshot, I argue, is that the virtue-making features of hope are best captured by a combination of virtuous dispositions present in other virtues, and so, if hope is a single moral virtue, it is constituted by features of other virtues.

Fervent attention was paid to what is coined dual-use research (DUR), or research that can both benefit and harm humanity, and dual-use research of concern (DURC), a particular subset of DUR that is reasonably anticipated to be a safety and security concern if misapplied. The aim of this paper is not to reiterate the challenges of DURC governance but to look at a new turn in DURC, namely the challenges posed by the use of artificial intelligence (AI) in pharmaceutical development. This is important, as AI is increasingly being used for pharmaceutical development in the industry. There is growing recognition that AI is DURC, and there is a dearth of industry and governmental guidance.

Xenotransplantation has the potential to alter the U.S. transplant system in profound ways. However, this emerging “spare parts” solution spearheaded by biotechnology companies raises concerns about its impact on the organ shortage, healthcare systems, population health, and health inequalities. We contend that xenotransplantation may have limited benefits in improving health, could prove prohibitively expensive for many, and may divert resources away from proven public health measures. Additionally, it carries the risk of perpetuating stigma. Xenotransplantation may thereby exacerbate existing healthcare inequities across racial, ethnic, socio‐economic, and geographic lines. To mitigate these risks, we contend that public health expert input is integral for xenotransplant policy development and outreach and that this underscores the importance of federal government investment in transplant infrastructure.

Following on the heels of groundbreaking research in 2022, perhaps the most notable of which involved a genetically-altered pig heart being transplanted into a severely ill patient, a xenotransplant phase I clinical trial has been registered in the United States. While the hope is that xenotransplantation will save human lives, the research requires the genetic alteration and subsequent death of animals. In this paper, I respond to criticism of the ethical defensibility of xenotransplant research from within Catholic moral teaching. I present three necessary conditions set forth by Catholic moral teaching for ethical animal research and argue that xenotransplant research satisfies each condition. I respond to the concern that xenotransplant research is grounded in a non-theologically tenable paradigm and argue that it is ethically defensible.