When I was invited some months ago by Tomi Kushner to contribute my memories on how some of us early birds came into bioethics, I hesitated. At the end of 2013 I published a memoir of my life in bioethics over nearly 50 years: In Search of the Good: A Life in Bioethics (MIT Press). I felt I had said all I wanted to say in that book about my life and couldn’t imagine doing it again, even in a short article. I was terminally bored with the topic—me.

The idea—the possibility—of reading the mind, from the outside or indeed even from the inside, has exercised humanity from the earliest times. If we could read other minds both prospectively, to discern intentions and plans, and retrospectively, to discover what had been “on” those minds when various events had occurred, the implications for morality and for law and social policy would be immense. Recent advances in neuroscience have offered some, probably remote, prospects of improved access to the mind, but a different branch of technology seems to offer the most promising and the most daunting prospect for both mind reading and mind misreading. You can’t have the possibility of the one without the possibility of the other. This article tells some of this story.

In 1966, Henry K. Beecher published an article entitled “Ethics and Clinical Research” in the New England Journal of Medicine, which cited examples of ethically problematic human research. His influential paper drew attention to common moral problems such as inadequate attention to informed consent, risks, and efforts to provide ethical justification. Beecher’s paper provoked significant advancements in human research policies and practices. In this paper, we use an approach modeled after Beecher’s 1966 paper to show that moral problems with animal research are similar to the problems Beecher described for human research. We describe cases that illustrate ethical deficiencies in the conduct of animal research, including inattention to the issue of consent or assent, incomplete surveys of the harms caused by specific protocols, inequitable burdens on research subjects in the absence of benefits to them, and insufficient efforts to provide ethical justification. We provide a set of recommendations to begin to address these deficits.

Two court cases that involve selling prescription data for pharmaceutical marketing affect biomedical informatics, patient and clinician privacy, and regulation. Sorrell v. IMS Health Inc. et al. in the United States and R v. Department of Health, Ex Parte Source Informatics Ltd. in the United Kingdom concern privacy and health data protection, data de-identification and reidentification, drug detailing (marketing), commercial benefit from the required disclosure of personal information, clinician privacy and the duty of confidentiality, beneficial and unsavory uses of health data, regulating health technologies, and considering data as speech. Individuals should, at the very least, be aware of how data about them are collected and used. Taking account of how those data are used is needed so societal norms and law evolve ethically as new technologies affect health data privacy and protection.

Many critics of bioenhancement go to considerable lengths to establish the existence of reasons against pursuing bioenhancements but do little to establish the absence of reasons in favor. This suggests that they accept what Allen Buchanan has called the conclusive reasons view (CRV). According to this view, our reasons against bioenhancement are obviously decisive, so there is no need to balance them against countervailing reasons. Buchanan criticizes the CRV by showing that the reasons most commonly adduced against bioenhancement are not decisive, or, at least, not obviously so.

In this article, I suggest that both Buchanan and the authors to whom he is responding underestimate the strength of the case for the CRV. There are, I argue, harm-based reasons against bioenhancement that provide stronger support to the CRV than the reasons that have most often been adduced by critics of enhancement. However, I then argue that even these harm-based reasons are not obviously decisive. Thus, I ultimately agree with Buchanan about the falsity of the CRV, though I disagree with him about the reasons for its falsity.

This article provides an overview of approaches to bioethics—practical and theoretical, philosophical and nonphilosophical. It is argued that those who yearn for pragmatism and real-life relevance would do well to concentrate on politics, legislation, social policy, and lobbying. Those, on the other hand, who seek knowledge about our moral thought might be interested in philosophical bioethics—in the explication of concepts, arguments, views, and normative statements.

The suggestion that deliberative democratic approaches would suit the management of bioethical policymaking in democratic pluralistic societies has triggered what has been called the “deliberative turn” in health policy and bioethics. Most of the empirical work in this area has focused on the allocation of healthcare resources and priority setting at the local or national level. The variety of the more or less articulated theoretical efforts behind such initiatives is remarkable and has been accompanied, to date, by an overall lack of method specificity. We propose a set of methodological requirements for online deliberative procedures for bioethics. We provide a theoretical motivation for these requirements. In particular, we discuss and adapt an “epistocratic” proposal and argue that, regardless of its merits as a general political theory, a more refined version of its normative claims can generate a useful framework for the design of bioethical forums that combine maximal inclusiveness with informed and reasonable deliberation.

This article challenges recent calls for moral bioenhancement—the use of biomedical means, including pharmacological and genetic methods, to increase the moral value of our actions or characters. It responds to those who take a practical interest in moral bioenhancement. I argue that moral bioenhancement is unlikely to be a good response to the extinction threats of climate change and weapons of mass destruction. Rather than alleviating those problems, it is likely to aggravate them. We should expect biomedical means to generate piecemeal enhancements of human morality. These predictably strengthen some contributors to moral judgment while leaving others comparatively unaffected. This unbalanced enhancement differs from the manner of improvement that typically results from sustained reflection. It is likely to make its subjects worse rather than better at moral reasoning.

This article argues that practicality is currently overemphasized in philosophical contributions to bioethics. The inclinations to aim at relevance, to ground normativity on common morality, and to involve many academic disciplines in ethical discussions is understandable, but they are all poorly founded. When answers to difficult questions are already known at the outset, these endeavors can help decisionmakers in gaining the acceptance of the general public. Wider theoretical analyses, in which philosophers could excel, however, tend to be lost in these practical enterprises.

Nonhuman animal (“animal”) experimentation is typically defended by arguments that it is reliable, that animals provide sufficiently good models of human biology and diseases to yield relevant information, and that, consequently, its use provides major human health benefits. I demonstrate that a growing body of scientific literature critically assessing the validity of animal experimentation generally (and animal modeling specifically) raises important concerns about its reliability and predictive value for human outcomes and for understanding human physiology. The unreliability of animal experimentation across a wide range of areas undermines scientific arguments in favor of the practice. Additionally, I show how animal experimentation often significantly harms humans through misleading safety studies, potential abandonment of effective therapeutics, and direction of resources away from more effective testing methods. The resulting evidence suggests that the collective harms and costs to humans from animal experimentation outweigh potential benefits and that resources would be better invested in developing human-based testing methods.