The Ethics of Animal Research and Uncertainty in Human Head Transplantation.

Whether or not experimental treatments and surgeries are morally permissible has been a hot topic in bioethics in recent years, especially with the advent of social media campaigns to facilitate compassionate use requests. Head transplant cases present one of the most controversial instances of this issue, pushing us to the very limit of medical ethics. Research in the subject also seems to be somewhat suspect: can we know enough information about a potential human head transplant surgery based on results gleaned through animal testing? Are the procedures done during the animal testing itself morally permissible? On the individual level, is a surgeon who performs a head transplant procedure in breach of the Hippocratic Oath given the current and projected state of our knowledge of the nature and consequences of the surgery? I discuss several crucial topics in this paper. I first address some of the arguments in favor of the technique and some of the medical and social benefits it might create. However, given several other considerations, I do not believe we have enough scientific knowledge to morally justify the human trial. To show this, I will offer several arguments. The first addresses the specific case of the first patient the technique will be tested on, Mr. Sprinidov, and his condition, Werdnig-Hoffmann disease. Although I am not a doctor, I do not believe there is a sufficient, good faith medical basis for believing a head transplant procedure would help him. Second, I analyze the animal testing procedures and results that have gone into researching head transplantation so far. I do not believe the testing itself passes ethical guidelines. Third, I argue that researchers have not gained sufficient information from the limited and flawed animal testing completed thus far, making an actual human head transplant procedure an irrational and unethical risk. Before concluding, I consider a possible contradiction: some clinicians might think physician-assisted suicide is permissible, but not head transplantation. I explore whether or not this presents a contradiction, and ultimately conclude that head transplantation cases are fundamentally different than physician-assisted suicide cases. Although a patient might be within his or her rights to ask a clinician to perform a head transplant operation, it is ethically impermissible for any clinician to actually perform the procedure.

Presented at the Long Island Philosophical Society Spring Conference on April 1st, 2017, and the 12th Annual Graduate Philosophy Conference at West Chester University,  on April 22nd 2017. PDF.

Three-Parent Babies and Social Welfare

Mitochondrial Replacement Techniques (MRTs) are genetic editing procedures that have undergone intense public scrutiny since their legalization in England in 2015. The techniques replace defective maternal mitochondria with healthy mitochondria to prevent several potentially life-threatening disorders. Dr. John Zhang, a physician who has used the technique before, has stated that “[saving] lives is the ethical thing to do.” However, it is not immediately clear that a life has been saved if the technique involves genetic modification of gametes or zygotes: if genetic material is modified during the early stages of development, has a different person been created? If so, has anybody actually been helped? Is it morally permissible to alter personal identity using genetic modification techniques? I argue that replacing the mitochondria leaves personal identity untouched because the genetic codes that determine personal identity reside in the nucleus. I will also argue that traditional objections to genetic modification (i.e. the fear of designer babies, that a technique is “unnatural,” etc.) are not persuasive in this case. However, I also suggest that while the techniques themselves may not be intrinsically wrong, spending resources on creating babies using these techniques might be morally wrong. I suggest that if we have a moral responsibility to help people who already exist that lack the objects of basic human rights, it is morally wrong to spend excessive amounts on creating additional people.

Presented at Albany Medical College, April 7th, 2017.

Facts as Determinants of Morality: How Human Action, Reason, Cognition, and Social Activity Determine What We Ought To Do

It is a central axiom of moral philosophy that “ought implies can.” We think that if someone can’t do something, they ought not to be held morally responsible if they don’t do it, and if someone can do something, they’ve done something morally wrong if they have not. Studies in neuroscience and social dynamics have shown and suggested that human beings do not always have the degree of control we think we do. We may not have free will or make moral judgments as we have traditionally believed.  The results of these studies and experiments suggest that we may not always be in control and that we may not always be rational, but that we can control and account for our biases and emotions with training and careful deliberation. I argue that studying philosophy, religion, literature, and the other humanities can enable us to make better decisions in the face of what recent developments in science have taught us.

Presented at  the International Conference on Morality, Moral Philosophy and the Humanities in the Age of Neuroscience, November 2016. PDF.

Principlism: Arguing the Inclusion of Dignity and Vulnerability in Clinical Ethics Consultation

Clinicial Ethics consultation has largely been dominated by principlism, the theory that conflicts in medical ethics can be resolved by balancing four ethical principles: beneficence, non-maleficence, justice, and autonomy. Autumn Fiester has criticized this model, claiming that, when put into practice, principlism becomes a mere check-list that often overlooks many issues and obligations clinicians have toward patients. Dr. Renee McLeod-Sordjan, Dr. Lauren Sparber and I proposed The Expanded Principles Model in a presentation at the American Society for Bioethics and the Humanities National Meeting in Washington, DC. The model includes dignity and vulnerability as distinct principles in order to provide clinicians with a more effective heuristic for discerning ethical issues and obligations.

Presented for the Philosophy of Medicine Affinity Group at the American Society for Bioethics and the Humanities National Meeting in Washington, DC, October 2016. Article forthcoming.

Do Professional Codes Give Us An Obligation To Enhance Ourselves?

We think it is wrong for athletes to take performance enhancing drugs to boost their athletic abilities because it violates the principles of sport. If it’s true that a profession can limit what we can use, can it also be true that a professional code can permit or even require us to take certain enhancements? Biomedical enhancement has been a topic of both popular and academic discussion for decades, with the possibility of dramatic enhancements growing ever closer as our scientific knowledge develops. In some cases, cognitive and physical enhancements already exist, and it is important to settle how we ought to best make use of them, as well as when they should be restricted. I argue that the principles manifested in professional codes (the Hippocratic Oath, Sir Robert Peel’s Principles of Policing, etc.) would permit professionals to take cognitive or physical enhancements as they become available. In some cases, taking enhancements might even be required.

Presented at Fordham University, March 2016, and The Long Island Philosophical Society’s Spring 2016 Conference, April 2016.

The Ethics of Mitochondrial Replacement Techniques: Three-Parent Babies and the Non-Identity Problem

In 2015, Britain legalized Mitochondrial Replacement Technique, a genetic IVF procedure that replaces defective maternal mitochondria with healthy donor mitochondria. The procedure ensures that the subsequent child will not develop with a mitochondrial disorder that could lead to epilepsy or other problems that lead to an early death. However, there are several eugenic concerns about the technology, as well as the worry that we create new persons by editing oocytes. The paper examines these worries and concludes that, based on a genetic account of biological and personal identity, Mitochondrial Replacement Technique, as it currently stands, does not raise eugenic concerns and does not fall subject to the Non-Identity Problem.

Presented at the Bowling Green State University Conference on the Ethics of Emerging Technologies, November 2016. PDF.