The American journal of bioethics : AJOB最新文献

{"title":"Evaluating the Lives of Others.","authors":"Rosemarie Garland-Thomson","doi":"10.1080/15265161.2022.2105607","DOIUrl":"https://doi.org/10.1080/15265161.2022.2105607","url":null,"abstract":"the need for treatment, they choose the risk of having to treat an affected fetus over the risk of having to reject an affected embryo. I regard this as the morally better choice (Wasserman and Asch 2006); it manifests a preference for qualified acceptance over categorical rejection. But, to end on a concurring note, even this limited virtue cannot be found in the choice made by prospective parents who employ gene-editing for enhancement. In seeking a “better” child than mere selection could yield, they display a reluctance to parent an unenhanced child. With Sparrow, I think their decision would manifest a morally unattractive perfectionism.","PeriodicalId":145777,"journal":{"name":"The American journal of bioethics : AJOB","volume":" ","pages":"30-33"},"PeriodicalIF":13.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personhood, Welfare, and Enhancement.","authors":"Hugh Desmond","doi":"10.1080/15265161.2022.2105428","DOIUrl":"https://doi.org/10.1080/15265161.2022.2105428","url":null,"abstract":"The debate on enhancement ethics cannot escape some of the deeper questions troubling the concept of personhood. That is, in a sentence, my reading of Robert Sparrow’s target article (Sparrow 2022). This development is significant for enhancement ethics, because personhood has assumed the grounding role once played by human nature. Thinking in terms of effects on persons (instead of on human nature) fits in with liberal approaches to enhancement, where enhancements are either like life choices to be regulated along libertarian principles, or like goods such as education to be regulated along principles of fairness. Genetic enhancement in particular can be subsumed under parental autonomy: parents choosing the best for their child. However, insofar the liberal approach rests on the metaphysical fulcrum of personhood, problems with the latter reverberate throughout enhancement ethics. In this commentary I will add two problems to those already identified by Sparrow: one regarding person-affecting enhancement, and the other regarding identity-affecting enhancement.","PeriodicalId":145777,"journal":{"name":"The American journal of bioethics : AJOB","volume":" ","pages":"37-39"},"PeriodicalIF":13.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetics, Harm, and Identity.","authors":"Joona Räsänen, Anna Smajdor","doi":"10.1080/15265161.2022.2105424","DOIUrl":"https://doi.org/10.1080/15265161.2022.2105424","url":null,"abstract":"Robert Sparrow (2022) argues that genome editing is unlikely to be person-affecting for the foreseeable future and, as a result, will neither benefit nor harm edited individuals. We regard Sparrow’s claim as being plausible—up to a certain point. However, Sparrow overlooks the role of epigenetics when it comes to determining our identity. Gene editing, as Sparrow suggests, would likely involve complex intervention, either at the gamete stage, or at the blastocyst stage. Since gene editing may result in “mosaicism,” where the amended genes are only active in a subset of the embryo’s cells, anything that focuses on one individual embryo would be fraught with uncertainty. It is currently very difficult if not impossible to control and predict the degree to which the change will permeate the organism. Also, in practice, in order to check the accuracy of the editing, genome editing will involve creation of, and selection from amongst, multiple embryos. These are some of the reasons Sparrow suggests genome editing is unlikely to be person-affecting. In all these regards, we suggest that his argument is compelling. Nevertheless, in his treatment of identity and the way it relates to questions about gene editing, the picture is considerably more complex than even Sparrow recognizes. Environmental factors, including our own behavior, and the behavior of our parents, can cause changes that affect the way our genes work (Hens 2017). If genes are an important aspect of our identity, epigenetic changes, as they are called, are also important; perhaps even more so, since they determine which of our genes are actually expressed. Therefore, epigenetics must also be taken into account when considering whether certain medical interventions harm or benefit specific individuals. Since Parfit (1984) wrote about the nonidentity problem, it has been widely accepted by many bioethicists that the essence of identity lies in the genes of the resulting offspring. It is this that makes it true that when Jane chooses to postpone having her child until she is cured of syphilis, she does not benefit that child, but gives birth to a different child. The egg and sperm that create the offspring are different in each case, therefore the child is genetically distinct from whatever child Jane might have had if she hadn’t waited. If identity is, as is commonly held, essentially connected with genes, then any intervention that alters genes raises the question of identity. Sparrow claims that bioethicists have assumed that genetic intervention would be person-affecting (rather than identity changing). Yet it seems strange that this should be the case. After all, if our focus is on genes, it would seem to follow that altering those genes does in fact change the identity of the organism. Thus, there can be no therapeutic genetic intervention, whether one is an adult, child, embryo or gamete. However, perhaps it is a question of degree: altering a few base pairs might not be identity chan","PeriodicalId":145777,"journal":{"name":"The American journal of bioethics : AJOB","volume":" ","pages":"40-42"},"PeriodicalIF":13.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Enduring Allure of Person-Affecting Arguments for Reproductive Technologies.","authors":"I Glenn Cohen, Eli Y Adashi","doi":"10.1080/15265161.2022.2105425","DOIUrl":"https://doi.org/10.1080/15265161.2022.2105425","url":null,"abstract":"continuity of identity among possible persons. Law, Ethics and Philosophy 7:15–28. doi:10.31009/LEAP.2019.V7.02. Parfit, D. 1984. Reasons and Persons. New York: Oxford University Press. Priest, G. 1998. Fuzzy identity and local validity. The Monist 81 (2):331–42. Rulli, T. 2017. The mitochondrial replacement ‘therapy’ myth. Bioethics 31 (5):368–74. doi:10.1111/bioe.12332. Smith, N. J. J. 2008. Why sense cannot be made of vague identity. Nous 42 (1):1–16. doi:10.1111/j.1468-0068.2007.00671.x. Sparrow, R. 2022. Human germline genome editing: On the nature of our reasons to genome edit. The American Journal of Bioethics 22 (9):4–15. doi: 10.1080/15265161. 2021.1907480. Wrigley, A., S. Wilkinson, and J. B. Appleby. 2015. Mitochondrial replacement: Ethics and identity. Bioethics 29 (9):631–8. doi:10.1111/bioe.12187.","PeriodicalId":145777,"journal":{"name":"The American journal of bioethics : AJOB","volume":" ","pages":"44-46"},"PeriodicalIF":13.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procreative Beneficence and Genome Editing.","authors":"Robert Ranisch","doi":"10.1080/15265161.2022.2105435","DOIUrl":"https://doi.org/10.1080/15265161.2022.2105435","url":null,"abstract":"ments in favor of reproductive embryo editing. I think that Sparrow’s call to better understand how to conceptualize the effects of genome editing on identity is well taken. As he indicates, the challenges presented by genome-editing are already complex enough that we should be reluctant to muddle the debate any more than needed. That said, and without denying the significance of the nonidentity problem in reproductive ethics, we should also resist giving too much importance to the challenges presented by the nonidentity problem when assessing the ethical permissibility of developing and using reprogenetic technologies. Let’s not limit our argumentative options.","PeriodicalId":145777,"journal":{"name":"The American journal of bioethics : AJOB","volume":" ","pages":"20-22"},"PeriodicalIF":13.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconceptualizing Identity and Ethics in the Context of Conception.","authors":"Janet Malek","doi":"10.1080/15265161.2022.2105429","DOIUrl":"https://doi.org/10.1080/15265161.2022.2105429","url":null,"abstract":"Homosexuality as a consequence of epigenetically canalized sexual development. The Quarterly Review of Biology 87 (4):343–68. doi:10.1086/668167. Sparrow, R. 2022. Human germline genome editing: On the nature of our reasons to genome edit. The American Journal of Bioethics 22 (9):4–15. doi: 10.1080/15265161. 2021.1907480. Watts, T. M., L. Holmes, J. Raines, S. Orbell, and G. Rieger. 2018. Sexual arousal patterns of identical twins with discordant sexual orientations. Scientific Reports 8 (1):14970. doi:10.1038/s41598-018-33188-2.","PeriodicalId":145777,"journal":{"name":"The American journal of bioethics : AJOB","volume":" ","pages":"42-44"},"PeriodicalIF":13.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Gene Editing Harmless? Two Arguments for Gene Editing.","authors":"Julian Savulescu, Marcos Alonso","doi":"10.1080/15265161.2022.2105432","DOIUrl":"https://doi.org/10.1080/15265161.2022.2105432","url":null,"abstract":"… the decision to genome edit will almost certainly be identity affecting, as a couple (or individual) will usually make it before they have created any embryos and the process itself will, at the very least, alter the timing of conception. This is itself usually sufficient to bring it about that a different sperm fertilises the ovum, with the consequence that a different person is born (Parfit","PeriodicalId":145777,"journal":{"name":"The American journal of bioethics : AJOB","volume":" ","pages":"23-28"},"PeriodicalIF":13.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modality and Counterfactuals: Understanding the Role and Context of Metaphysical Underpinnings for Harm, Benefit and Identity Claims Arising from Genome Editing and Genetic Modification.","authors":"Anthony Wrigley","doi":"10.1080/15265161.2022.2105426","DOIUrl":"https://doi.org/10.1080/15265161.2022.2105426","url":null,"abstract":"Deriving ethical conclusions from arguments that rely heavily on metaphysical foundations, as Parfit (1984) does in generating his Nonidentity Problem, is an approach fraught with problems. Sparrow’s use of these Parfitian distinctions between “person-affecting” and “identity-affecting” interventions is just such a case in point. For, while Sparrow has very effectively highlighted some of the technical particulars of genome editing, he, like many other bioethicists, has fallen into a philosophical mire. This involves utilizing metaphysical assumptions as if they were a fixed, determinate matter in order to establish what they take to be an inescapable ethical conclusion about some new area of application. Parfit’s arguments have undoubtedly shaped attitudes in bioethics. Although Parfit’s own arguments were brilliant, original, and imaginative, they too suffer from this very problem—a failure to fully contextualize the metaphysical underpinnings—resulting in ethical conclusions of quite staggering proportions about the welfare of future generations presented as if they were inevitable and inescapable. If more bioethicists were to contextualize such theoretical underpinnings, we could avoid the constant catch-all justifications based on a re-application of them every time a new genetic or reproductive technology came around and shift to a more productive area of ethical debate about the welfare of future generations. QUESTIONABLE METAPHYSICS: THE ASSUMPTIONS UNDERPINNING PARFIT’S NONIDENTITY ARGUMENTS","PeriodicalId":145777,"journal":{"name":"The American journal of bioethics : AJOB","volume":" ","pages":"52-54"},"PeriodicalIF":13.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trojan Horses, Clinical Utility, and Parfitian Puzzles.","authors":"Bryan Cwik","doi":"10.1080/15265161.2022.2105434","DOIUrl":"https://doi.org/10.1080/15265161.2022.2105434","url":null,"abstract":"There is a burgeoning corner of the philosophical literature on germline gene editing (GGE) about whether GGE is “person-affecting” or “identify-affecting.” The distinction between actions that affect the welfare of future persons, and those that determine which future persons exist at all, is due to Derek Parfit, and is the source of a major puzzle widely discussed in the practical and applied ethics literature on several issues (Boonin 2014). The major aim of Robert Sparrow’s (2022) “Would Genome Editing Harm or Benefit the Person Born as a Result?” is to argue that GGE would not be person-affecting; this is because, according to Sparrow, GGE would still involve selection of which embryos to transfer to initiate a pregnancy. According to a widespread assumed premise in this debate, selection of embryos is equivalent to a choice of which person, out of a set of possible persons, eventually comes to exist, and as such, it is identity-affecting. Sparrow sets his argument within the giant debate about potential use of GGE as a tool for enhancement. He justifies this briefly toward the beginning of the paper. My concern here is with one of Sparrow’s reasons for focusing on enhancement. Sparrow rejects the potential for GGE to be used as a therapeutic intervention; since “... the therapeutic case for germline genome editing is weak,” he assumes that GGE will “primarily be used for... enhancement.” This seems to back up a sentiment about GGE that is in the air— namely, that any talk about its use for therapeutic purposes is really a kind of normative Trojan Horse, to speed the acceptance of GGE for enhancement (and, indeed, Sparrow seems to endorse this idea, when he says therapeutic use of GGE “...undoubtedly has utility for garnering public support for genome editing”). Sparrow’s reasoning in favor of this rejection is— apologies for the blunt statement, but sometimes bluntness is called for—flat out wrong. I’m not going to argue here that Sparrow is wrong because GGE really does have therapeutic value; rather, I think it’s an open question, as of now, whether it could, and there is a significant philosophical problem about whether GGE has any therapeutic utility. To be fair, Sparrow does not give a fully developed argument that there is a “weak” case for therapeutic use of GGE; his brief statement in support of this assumption repeats three widespread claims in the literature on GGE. The first is that GGE offers no clinical benefit over and above existing assisted reproductive technologies (ARTs) for dealing with heritable genetic disorders; preimplantation genetic diagnosis (PGD) is an already available means to accomplish the same goal (of having a disease-free child). Second, in cases where PGD won’t work, gamete donation is also available. The third reason Sparrow offers needs to be cited au naturel:","PeriodicalId":145777,"journal":{"name":"The American journal of bioethics : AJOB","volume":" ","pages":"16-18"},"PeriodicalIF":13.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Germline Genome Editing: On the Nature of Our Reasons to Genome Edit.","authors":"Robert Sparrow","doi":"10.1080/15265161.2021.1907480","DOIUrl":"https://doi.org/10.1080/15265161.2021.1907480","url":null,"abstract":"<p><p>Ever since the publication of Derek Parfit's <i>Reasons and Persons,</i> bioethicists have tended to distinguish between two different ways in which reproductive technologies may have implications for the welfare of future persons. Some interventions harm or benefit particular individuals: they are \"person affecting.\" Other interventions determine which individual, of a number of possible individuals, comes into existence: they are \"identity affecting\" and raise the famous \"non-identity problem.\" For the past several decades, bioethical debate has, for the most part, proceeded on the assumption that direct genetic modification of human embryos would be person affecting. In this paper, I argue that that genome editing is highly unlikely to be person affecting for the foreseeable future and, as a result, will neither benefit nor harm edited individuals.</p>","PeriodicalId":145777,"journal":{"name":"The American journal of bioethics : AJOB","volume":" ","pages":"4-15"},"PeriodicalIF":13.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/15265161.2021.1907480","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38892815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}