•  262
    Kidney Sales and the Burden of Proof
    Journal of Practical Ethics 7 (3): 32-53. 2019.
    Janet Radcliffe Richards’ The Ethics of Transplants outlines a novel framework for moral inquiry in practical contexts and applies it to the topic of paid living kidney donation. In doing so, Radcliffe Richards makes two key claims: that opponents of organ markets bear the burden of proof, and that this burden has not yet been satisfied. This paper raises four related objections to Radcliffe Richards’ methodological framework, focusing largely on how Radcliffe Richards uses this framework in her…Read more
  •  193
    Generative AI entails a credit–blame asymmetry
    with Sebastian Porsdam Mann, Brian D. Earp, Sven Nyholm, John Danaher, Nikolaj Møller, Hilary Bowman-Smart, Joshua Hatherley, Monika Plozza, Daniel Rodger, Peter V. Treit, Gregory Renard, John McMillan, and Julian Savulescu
    Nature Machine Intelligence 5 (5): 472-475. 2023.
    Generative AI programs can produce high-quality written and visual content that may be used for good or ill. We argue that a credit–blame asymmetry arises for assigning responsibility for these outputs and discuss urgent ethical and policy implications focused on large-scale language models.
  •  132
    Germline gene editing and the precautionary principle
    with Christopher Gyngell and Julian Savulescu
    Bioethics 34 (1): 49-59. 2019.
    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 prec…Read more
  •  95
    Assessing the Likely Harms to Kidney Vendors in Regulated Organ Markets
    American Journal of Bioethics 14 (10): 7-18. 2014.
    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…Read more
  •  47
    An innovative program recently initiated at the University of California, Los Angeles Medical Center allows people to donate a kidney in exchange for a voucher that a loved one can redeem for a kidney if and when needed. As a relatively new practice, the ethical implications of advanced kidney donation have not yet been widely discussed. This paper reflects on some of the bioethical issues at stake in this new donation program, as well as some broader philosophical issues related to the meaning …Read more
  •  40
    Commodification and Human Interests
    Journal of Bioethical Inquiry 15 (3): 429-440. 2018.
    In Markets Without Limits and a series of related papers, Jason Brennan and Peter Jaworski argue that it is morally permissible to buy and sell anything that it is morally permissible to possess and exchange outside of the market. Accordingly, we should open markets in “contested commodities” including blood, gametes, surrogacy services, and transplantable organs. This paper clarifies some important aspects of the case for market boundaries and in so doing shows why there are in fact moral limit…Read more
  •  39
    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 …Read more
  •  34
    Moral Limits of Brain Organoid Research
    with Julian Savulescu
    Journal of Law, Medicine and Ethics 47 (4): 760-767. 2019.
    Brain organoid research raises ethical challenges not seen in other forms of stem cell research. Given that brain organoids partially recapitulate the development of the human brain, it is plausible that brain organoids could one day attain consciousness and perhaps even higher cognitive abilities. Brain organoid research therefore raises difficult questions about these organoids' moral status – questions that currently fall outside the scope of existing regulations and guidelines. This paper sh…Read more
  •  34
    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 overloo…Read more
  •  30
    Moral uncertainty and the farming of human-pig chimeras
    Journal of Medical Ethics 45 (7): 440-446. 2019.
    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 uniqu…Read more
  •  28
    Emerging moral status issues (review)
    with Christopher Gyngell
    Monash Bioethics Review 38 (2): 95-104. 2020.
    Many controversies in bioethics turn on questions of moral status. Some moral status issues have received extensive bioethical attention, including those raised by abortion, embryo experimentation, and animal research. Beyond these established debates lie a less familiar set of moral status issues, many of which are tied to recent scientific breakthroughs. This review article surveys some key developments that raise moral status issues, including the development of in vitro brains, part-human an…Read more
  •  27
    Burden of Proof in Bioethics
    Bioethics 29 (9): 597-603. 2015.
    A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight general problems with this style of arg…Read more
  •  25
    Kidney Sales and Market Regulation: A Reply to Semrau
    Journal of Medicine and Philosophy 42 (6): 653-669. 2017.
    Luke Semrau argues that the documented harms of existing organ markets do not undermine the case for establishing regulated systems of paid kidney donation. He offers two arguments in support of this conclusion. First, Semrau argues that the harms of kidney selling are straightforwardly amenable to regulatory solution. Second, Semrau argues that even in existing black markets, sellers would likely have experienced greater harm if the option of selling a kidney were not available. This commentary…Read more
  •  23
    Consent-GPT: is it ethical to delegate procedural consent to conversational AI?
    with Jemima Winifred Allen, Brian D. Earp, and Dominic Wilkinson
    Journal of Medical Ethics 50 (2): 77-83. 2024.
    Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to members of the clinical team not performing the procedure (eg, junior doctors). However, it is common for consent-taking delegates to lack sufficient time and clinical knowledge to adequately promote patient autonomy and informed decision-making. Such problems might …Read more
  •  22
    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 w…Read more
  •  22
    Dual-use implications of AI text generation
    Ethics and Information Technology 25 (2): 1-11. 2023.
    AI researchers have developed sophisticated language models capable of generating paragraphs of 'synthetic text' on topics specified by the user. While AI text generation has legitimate benefits, it could also be misused, potentially to grave effect. For example, AI text generators could be used to automate the production of convincing fake news, or to inundate social media platforms with machine-generated disinformation. This paper argues that AI text generators should be conceptualised as a du…Read more
  •  21
    Lessons from Frankenstein 200 years on: brain organoids, chimaeras and other ‘monsters’
    with John Massie
    Journal of Medical Ethics 47 (8): 567-571. 2021.
    Mary Shelley’sFrankensteinhas captured the public imagination ever since it was first published over 200 years ago. While the narrative reflected 19th-century anxieties about the emerging scientific revolution, it also suggested some clear moral lessons that remain relevant today. In a sense,Frankensteinwas a work of bioethics written a century and a half before the discipline came to exist. This paper revisits the lessons ofFrankensteinregarding the creation and manipulation of life in the ligh…Read more
  •  21
    Choice, pressure and markets in kidneys
    Journal of Medical Ethics 44 (5): 310-313. 2018.
    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…Read more
  •  20
    Julian J. Koplin Replies
    Hastings Center Report 50 (1): 46-46. 2020.
  •  15
    ‘It’s not worse than eating them’: the limits of analogy in bioethics
    Monash Bioethics Review 38 (2): 129-145. 2020.
    Bioethicists often defend novel practices by drawing analogies with practices that we are already familiar with and currently tolerate. If some novel practice is less bad than some widely-accepted practice, then (it is argued) we cannot rightly reject it. Using the bioethics literature on xenotransplantation and interspecies blastocyst complementation as a case study, I show how this style of argument can go awry. The key problem is that our moral intuitions about familiar practices can be disto…Read more
  •  15
    In The Gift Relationship, Richard Titmuss argued that the practice of altruistic blood donation fosters social solidarity while markets in blood erode it. This paper considers the implications of this line of argument for the organ market debate. I defend Titmuss’ arguments against a number of criticisms and respond to claims that Titmuss’ work is not relevant to the context of live donor organ transplantation. I conclude that Titmuss’ arguments are more resilient than many advocates of organ ma…Read more
  •  15
    Why genomics researchers are sometimes morally required to hunt for secondary findings
    with Julian Savulescu and Danya F. Vears
    BMC Medical Ethics 21 (1): 1-11. 2020.
    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 th…Read more
  •  14
    Old Challenges or New Issues? Genetic Health Professionals’ Experiences Obtaining Informed Consent in Diagnostic Genomic Sequencing
    with Danya F. Vears, Pascal Borry, and Julian Savulescu
    AJOB Empirical Bioethics 12 (1): 12-23. 2021.
    Background While integrating genomic sequencing into clinical care carries clear medical benefits, it also raises difficult ethical questions. Compared to traditional sequencing technologies, genomic sequencing and analysis is more likely to identify unsolicited findings (UF) and variants that cannot be classified as benign or disease-causing (variants of uncertain significance; VUS). UF and VUS pose new challenges for genetic health professionals (GHPs) who are obtaining informed consent for ge…Read more
  •  14
    The Moral Relevance of Humanization
    American Journal of Bioethics 21 (1): 59-61. 2021.
    Greely’s target article outlines six categories of ethical issues associated with human brain surrogate research. Some of these issues are familiar from other research contexts; others, less...
  •  12
    Moving from ‘fully’ to ‘appropriately’ informed consent in genomics: The PROMICE framework
    with Christopher Gyngell, Julian Savulescu, and Danya F. Vears
    Bioethics 36 (6): 655-665. 2022.
    Genomic sequencing technologies (GS) pose novel challenges not seen in older genetic technologies, making traditional standards for fully informed consent difficult or impossible to meet. This is due to factors including the complexity of the test and the broad range of results it may identify. Meaningful informed consent is even more challenging to secure in contexts involving significant time constraints and emotional distress, such as when rapid genomic testing (RGS) is performed in neonatal …Read more
  •  11
    Ethics of Buying DNA
    with Jack Skeggs and Christopher Gyngell
    Journal of Bioethical Inquiry 19 (3): 395-406. 2022.
    DNA databases have significant commercial value. Direct-to-consumer genetic testing companies have built databanks using samples and information voluntarily provided by customers. As the price of genetic analysis falls, there is growing interest in building such databases by paying individuals for their DNA and personal data. This paper maps the ethical issues associated with private companies paying for DNA. We outline the benefits of building better genomic databases and describe possible conc…Read more
  •  11
    Consequences and Kidneys
    International Journal of Applied Philosophy 31 (2): 137-148. 2017.
    Kidney for Sale by Owner discusses a range of different arguments that can be offered in defence of live donor kidney markets. Although Cherry’s case for establishing such markets does not rest on consequentialist considerations, Cherry nonetheless suggests that allowing the sale of organs would have net positive consequences. He argues that both renal failure patients and people living in poverty could benefit from participating in the market, and further claims that a legal trade in organs wou…Read more
  •  11
    Old Challenges or New Issues? Genetic Health Professionals’ Experiences Obtaining Informed Consent in Diagnostic Genomic Sequencing
    with Danya F. Vears, Pascal Borry, Julian Savulescu, and Julian J. Koplin
    AJOB Empirical Bioethics 12 (1): 12-23. 2021.
    Background While integrating genomic sequencing into clinical care carries clear medical benefits, it also raises difficult ethical questions. Compared to traditional sequencing technologies, genomic sequencing and analysis is more likely to identify unsolicited findings (UF) and variants that cannot be classified as benign or disease-causing (variants of uncertain significance; VUS). UF and VUS pose new challenges for genetic health professionals (GHPs) who are obtaining informed consent for ge…Read more