Francesca Minerva

This chapter examines the ethical implications of cryopreservation. Cryopreservation is usually performed soon after the heart has stopped beating, and after the individual has been pronounced legally dead. A few hundred people in the world had been “cryopreserved” — that is, fully immerged in liquid nitrogen at -196 C — in the hope that science will eventually discover a therapy for the disease that has killed them, and that future technology will succeed in bringing them back to life. Understandably, the root of many objections to cryonics seem to be its perceived weirdness. Another major objection to cryonics is that it is a waste of money, or a scam, i.e. a way to make money by promising dying people something that cannot possibly be achieved. The chapter then considers the concepts of human mortality and immortality.

This paper explores the ethical implications of emerging weight‐loss medications such as Semaglutide (Ozempic) and Tirzepatide (Mounjaro), analysing their therapeutic applications for obesity and potential use as enhancement drugs. These medications promise significant benefits, including improved individual health outcomes, reduced healthcare costs and, potentially, reduced environmental harms. However, their widespread adoption raises various concerns, such as unknown long‐term side effects, the exacerbation of weight‐based discrimination, and the reinforcement of socioeconomic disparities. The paper argues that, with robust regulatory frameworks in place, the potential benefits of these medications are likely to outweigh the risks. Nonetheless, ongoing monitoring of their effect on individuals and society at large remains essential.

In recent years, bioethical discourse around the topic of ‘genetic enhancement’ has become increasingly politicized. We fear there is too much focus on the semantic question of whether we should call particular practices and emerging bio-technologies such as CRISPR ‘eugenics’, rather than the more important question of how we should view them from the perspective of ethics and policy. Here, we address the question of whether ‘eugenics’ can be defended and how proponents and critics of enhancement should engage with each other.

The book provides an argument against a right to conscientious objection by healthcare professionals. In increasingly multicultural societies inspired by pluralism, and given the range of controversial medical procedures that are or will be legal in many countries, claims about healthcare professionals' right to abide by their own moral or religious views in the exercise of their profession become more frequent. This book explains why arguments for pluralism, tolerance, and diversity that support a right to freedom of conscience in society at large do not support the same right within the healthcare profession, or indeed any profession governed by internal norms of professionalism that someone freely decides to enter.

We argue that, in certain circumstances, doctors might beprofessionallyjustified to provide abortions even in those jurisdictions where abortion is illegal. That it is at least professionally permissible does not mean that they have an all-things-considered ethical justification or obligation to provide illegal abortions or that professional obligations or professional permissibility trump legal obligations. It rather means that professional organisations should respect and indeed protect doctors’ positive claims of conscience to provide abortions if they plausibly track what is in the best medical interests of their patients. It is the responsibility of state authorities to enforce the law, but it is the responsibility of professional organisations to uphold the highest standards of medical ethics, even when they conflict with the law. Whatever the legal sanctions in place, healthcare professionals should not be sanctioned by the professional bodies for providing abortions according to professional standards, even if illegally. Indeed, professional organisation should lobby to offer protection to such professionals. Our arguments have practical implications for what healthcare professionals and healthcare professional organisations may or should do in those jurisdictions that legally prohibit abortion, such as some US States after the reversal ofRoe v Wade.

Although the COVID-19 pandemic is a serious public health and economic emergency, and although effective vaccines are the best weapon we have against it, there are groups and individuals who oppose certain kinds of vaccines because of personal moral or religious reasons. The most widely discussed case has been that of certain religious groups that oppose research on COVID-19 vaccines that use cell lines linked to abortions and that object to receiving those vaccine because of their moral opposition to abortion. However, moral opposition to COVID-19 vaccine research can be based on other considerations, both secular and religious. We argue that religious or personal moral objections to vaccine research are unethical and irresponsible, and in an important sense often irrational. They are unethical because of the risk of causing serious harm to other people for no valid reason; irresponsible because they run counter to individual and collective responsibilities to contribute to important public health goals; and in the case of certain kinds of religious opposition, they might be irrational because they are internally inconsistent. All in all, our argument translates into the rather uncontroversial claim that we should prioritize people’s lives over religious freedom in vaccine research and vaccination roll out.

A woman who finds herself pregnant against her plans (e.g. because contraceptives have failed) has only two available options: continuing or terminating the pregnancy. Continuing the pregnancy may not be an option due to lack of economic resources, possible birth defects, or other life plans; yet terminating the pregnancy may be considered immoral by the woman, the society in which she lives, or both, and the decision may thus be a source of great distress. This chapter suggests that a hypothetical future technology aimed at extracting and cryopreserving foetuses could provide unwillingly pregnant women with an alternative to the dilemma of either continuing or terminating the pregnancy. Cryopreserved foetuses could be reimplanted at a later time, when circumstances are more favourable to continuing a pregnancy and raising a child.

Cryonics is considered a key step towards indefinite life extension. But are there good reasons to extend the human lifespan beyond its current limit? One possible reason is that death is bad, and since death is bad, we should avoid dying by staying alive indefinitely. In this chapter, possible explanations for why death might be bad are examined. In particular, two accounts of the badness of death are considered in detail: death as deprivation of a future life and death as frustration of desires and preferences. These two accounts of the badness of death provide good reasons for considering death bad under certain circumstances (although not under all circumstances, such as when a life entails unbearable pain), yet leave open the question of whether immortality might be an even worse alternative.

Cryonics is the act of preserving legally dead individuals at ultra-low temperatures, in the hope that they can someday be revived using future technology. Although still in its infancy, the potential success of cryonics carries many crucial implications for human society, and discussing these ahead of time may help us avoid unwelcome developments and unnecessary conflicts. However, the discussion around cryonics has not advanced significantly since its introduction over 50 years ago, and we must look to other advances in biotechnology for clues about how society should deal with cryonics. This chapter reviews the public response to in vitro fertilization (IVF) and embryo cryopreservation (EC), two closely related medical technologies that have been available to the public for over 30 years and that share many relevant aspects with cryonics. Objections to IVF and EC have tended to fall into five broad categories: unnaturalness, playing God, repugnancy, uncertainty, and social inequality.

Most objections to euthanasia are based on the moral principle that killing an innocent person is wrong. This principle also applies to cases wherein people ask (for help) to die in order to avoid unbearable, intractable, and incurable pain. It has been suggested that such patients could be offered an alternative in which they are cryosuspended immediately after their (legal) death has been medically induced. Such “cryothanasia” would allow them to be stored indefinitely with a non-negligible chance of being revived in a more medically advanced future. Since cryonics ultimately seeks to preserve and extend lifespan, these cryothanasia patients would, in effect, be choosing to die in order to (hopefully) live longer in the future. This chapter argues that classical objections to euthanasia, based on the principle that it is always morally wrong to kill an innocent person, cannot be used to oppose cryothanasia.

Most objections to cryonics deal with either the unlikelihood that cryonics will succeed in reviving people or the claim that the enterprise as a whole would be undesirable (whether due to high cost or some potential implications). This chapter starts with an analysis of arguments based on the wastefulness of cryonics, as compared with other costly enterprises, focusing on a comparison between cryonics and various investments that could extend the lifespan of a large number of people for many years. Other common objections to cryonics are based on the assumption that the future will not present socio-economic circumstances that would be favourable to the revival of cryosuspended individuals; hence cryonicists would never be revived by future people. Finally, different possible scenarios in which the cryonicist could be revived are considered, ending with a discussion about the possibility that life for a revived cryonicist would not be good enough to justify their investing in cryonics arrangements today.

Hypothetical future treatments aimed at “rejuvenating” the body, thereby keeping it young and healthy for an indefinite amount of time, could offer a form of biological immortality. This chapter explores whether such immortality would come with downsides that would eventually make it an immoral or an undesirable goal. In order to assess the desirability of an immortal life, a few key questions must be addressed: What would an immortal (or indefinitely long) life look like? What kinds of benefits and downsides would it provide? Some authors have suggested that an indefinitely long life would be unbearably boring, and thus undesirable. It has also been suggested that an individual living an immortal life would not be able to recognize it as belonging to them in particular, or even as a human life at all. This chapter addresses these and other questions about the nature and desirability of an indefinitely long life.

Abortion is largely accepted even for reasons that do not have anything to do with the fetus' health. By showing that (1) both fetuses and newborns do not have the same moral status as actual persons, (2) the fact that both are potential persons is morally irrelevant and (3) adoption is not always in the best interest of actual people, the authors argue that what we call ‘after-birth abortion’ (killing a newborn) should be permissible in all the cases where abortion is, including cases where the newborn is not disabled

The treatment-enhancement distinction is often used to delineate acceptable and unacceptable medical interventions. It is likely that future assistive and augmenting technologies will also soon develop to a level that they might be considered to provide users, in particular those with disabilities, with abilities that go beyond natural human limits, and become in effect an enhancing technology. In this paper, we describe how this process might take place, and discuss the moral implications of such developments. We argue that such developments are morally acceptable and indeed desirable.

The range of opportunities people enjoy in life largely depends on social, biological, and genetic factors for which individuals are not responsible. Philosophical debates about equality of opportunities have focussed mainly on addressing social determinants of inequalities. However, the introduction of human bioenhancement should make us reconsider what our commitment to equality entails. We propose a way of improving morally relevant equality that is centred on what we consider a fair distribution of bioenhancements. In the first part, we identify three main positions in the debate on bioenhancement and equality, and we show how each of them fails to meet the demands of a serious commitment to equality. In the second part, we formulate a new proposal that we think better promotes equality of opportunities: people from disadvantaged socio-economic backgrounds should be given access to bioenhancements while people from privileged socio-economic background should be prohibited from using them. We argue that those who are concerned about the inequality implications of bioenhancement should embrace this solution, rather than reject bioenhancement.

A very high percentage of the world population doesn’t exercise enough and, as a consequence, is at high risk of developing serious health conditions. Physical inactivity paired with a poor diet is the second cause of death in high income countries. In this paper, I suggest that transcranial direct stimulation holds promise for “couch potatoes” because it could be used to make them more active, without causing any major side-effect. I also argue that other, less safe, tools could be used to achieve the goal of decreasing physical inactivity, insofar as they have overall fewer side-effects than physical inactivity.

Cryonics—also known as cryopreservation or cryosuspension—is the preservation of legally dead individuals at ultra-low temperatures. Those who undergo this procedure hope that future technology will not only succeed in reviving them, but also cure them of the condition that led to their demise. In this sense, some hope that cryopreservation will allow people to continue living indefinitely. This book discusses the moral concerns of cryonics, both as a medical procedure and as an intermediate step toward life extension. In particular, Minerva analyses the moral issues surrounding cryonics-related techniques by focusing on how they might impact the individuals who undergo cryosuspension, as well as society at large.

In his paper ‘The truth behind conscientious objection’ Nir Ben-Moshe develops a new approach aimed at justifying conscientious objection (CO) without relying on respect of moral integrity of the conscientious objector or tolerance towards her moral views.1 According to Ben-Moshe, the problem with justifications of CO based on moral integrity and tolerance is that ‘truth of conscience’s claims is irrelevant to their justification’. He argues, to the contrary, that whether the claims of the conscientious objector are true or false makes a difference in assessing whether their objection is justifiable or not. He goes on explaining that someone’s CO can be justified if it can be proved that ‘conscience can express true moral claims’. Ben-Moshe then proceeds to explain how one can determine true moral claims. He develops an account of conscience that is modelled on that of Adam Smith. In particular, he uses the idea of the ‘impartial spectator’ to show how a true claim of conscience can emerge after careful thinking from the point of view of an impartial perspective. So, if the healthcare practitioner wants to object to a certain medical procedure after considering the issue at hand from the moral standpoint of such impartial spectator, then her claims of conscience are true (or …