A large tranche of contemporary bioethical inquiry is self-consciously focused on purpose and methodology. Bioethics is a field of disparate disciplines, and it is not always clear what role the philosopher plays in the wider scheme. Even when philosophical reflections can, in principle, find application in the real world (and often, in bioethics, there is too heady a degree of abstraction for this), there can be difficulty in finding sound resolution between the competing perspectives. Where fundamentals differ, we face apparent deadlock, with theorists seemingly able only to talk across each other. Perspectives on this vary. For example, some will argue that the philosopher’s role is purely reflective and need have no practical resonance whatsoever. Others may say that philosophers are not equipped to engage with empirical questions or, when they do, they do so on flawed understandings of “the real world”; bad science or science fiction replaces brute fact and emotional, social, and empirical reality. Some may seek to strike a balance by trying to engage the questions within a political framing, allowing both for normative and real-world concerns.

In an earlier CQ editorial (Vol. 19, No. 1, January 2010,) we offered some suggested “Do’s and Don’ts” for authors submitting papers to bioethics journals and we invited readers’ comments, including their own experiences. Responses from readers were prompt, numerous, and sometimes battle scarred. They fell into two categories: (1) advice intended for fellow authors and (2) comments directed at editors regarding the review process. Examples of suggestions for fellow authors included: “When you send a paper to a journal, already have your cover letter prepared for your next choice so if a rejection comes your disappointment won’t feel like such a setback.” and “Before submitting a paper, always have it critiqued by colleagues you trust to tell you the truth not just what you want to hear—and more than one if possible.” and “Carefully check your submission correspondence. I once sent a paper to a journal erroneously addressed to a rival publication in the cover letter—I never heard anything back.”

Philosopher Mary Midgely’s observation that it is helpful to think of the world as “a huge aquarium” has application to bioethics today. She says, “We cannot see it as a whole from above so we peer at it through a number of small windows, . . . but if we insist that our own window is the only one worth looking through, we should not get very far.”

A decade has passed since the mapping of the human genome—an event that paved the way for many new developments in biomedicine and related fields. In ethics, this milestone was accompanied by calls for changes in ruling ethical frameworks.

Bioethics is, as is moral philosophy in general, a field spanning a range of different philosophical approaches, normative standpoints, methods and styles of analysis, metaphysics, and ontologies. In discussing bioethics, it is often seen as useful to introduce some kind of order on the field by categorizing individual philosophers or specific arguments into a relatively small number of categories. Such categorization or classification has several functions. It may help to show the relationship between basic assumptions and specific arguments or it may be used argumentatively by arguing not against a single philosopher or her arguments but against the category to which she or they belong or are claimed to belong. In this way, whole lines of argument can be disposed of in one fell swoop and whole groups of philosophers dismissed by showing that they belong to some category that can, in some way, be discounted because it is fallacious. Or, conversely, lines of arguments and groups of philosophers can be celebrated and appropriated as support for yet new arguments.

At the end of a paper on international research ethics published in the July-August 2010 issue of the Hastings Center Report, London and Zollman argue the need for grounding our duties in international medical and health-related research within a broader normative framework of social, distributive, and rectificatory justice. The same goes for Thomas Pogge, who, in a whole range of publications during the past years, has argued for a human-rights-based approach to international research. In a thought-provoking paper in the June 2010 issue of the American Journal of Bioethics, Angela J. Ballantyne argues that “the global bioethics priority” in medical and health-related research ethics today is how to do research fairly in an unjust world.

Human rights are universally acknowledged to be important, although they are, of course, by no means universally respected. This universality has helped to combat racism and sexism and other arbitrary and vicious forms of discrimination. Unfortunately, as we shall see, the universality of human rights is both too universal and not universal enough. It is time to take the “human” out of human rights. Indeed, it is very probable that in the future there will be no more humans as we know them now, because the further evolution of our species, either Darwinian or more likely determined by human choices, will, we must hope, result in the emergence of new sorts of beings better able to cope with the intellectual and physical challenges of the future. One example of the ways in which this is already happening is the sorts of cognitive enhancement that are already coming on stream. Another is signaled by stem cell research and the birth of regenerative medicine.

The practice of obtaining informed consent has its history in, and gains its meaning from, medicine and biomedical research. Discussions of disclosure and justified nondisclosure have played a significant role throughout the history of medical ethics, but the term “informed consent” emerged only in the 1950s. Serious discussion of the meaning and ethics of informed consent began in medicine, research, law, and philosophy only around 1972.

Bioethics as a distinctive field is undergoing a critical turn. It may be a quiet revolution, but a growing body of scholarship illustrates a perceived need for a rethink of the scope of the field and the approaches and priorities that have carried bioethicists through many heady years of success. Few areas of bioethical practice have been left unexamined, ranging from questions as to the sustainability of the discipline in its current form to the “expertise” of its practitioners; the legitimacy of bioethics in the realms of policymaking; its relationship to philosophy; the purchase of empirical and interdisciplinary method; the relationship of bioethics to the real world; bioethical understandings of the concept of “health” (and methods of attainment); its agenda, priorities, and inclusiveness right up to what might be the overarching question: “What is bioethics all about?” Unsurprisingly, these questions elicit varied responses. Scholars from various disciplines have critiqued fundamental tenets of the “ethics” business, albeit as claims of its “conservatism,” “corruption,” and its questionable “usefulness” suggest, not always with a charitable or constructive eye. But quite crucially and often overlooked, bioethics itself has not shied away from the question as to what bioethics is and what it should become; increasingly apparent is that this kind of self-conscious and reflexive theorizing is regarded as a key priority for taking contemporary ethics forward.

In biomedical ethics the principle of autonomy is closely connected with the moral and legal claim to informed consent. After World War II and the dramatic misuse of medicine in Nazi Germany, informed consent regulations were expected to help avoid similar misuse in the future, to help overcome the traditional medical paternalism, and to advance the liberty rights of patients and human subjects of research. With the rise of the new field of bioethics in the 1970s, the traditional beneficence-based model of medical ethics shifted in the direction of an individual autonomy model.

Cameroon is a Central African country lying at latitude 6°N and longitude 12°E. The country has a surface area of circa 475,442 square kilometers, and is bordered by several other African countries: Nigeria, Chad, the Central African Republic, the Republic of Congo, Equatorial Guinea, and Gabon. With a population of nearly 20 million inhabitants, Cameroon is a very diverse country, geographically, culturally, and linguistically.

Picture this. You are having your regular medical checkup, when, all of a sudden, the physician turns to you and says: “Oh, did I remember to mention that you can now live forever?” You look at the doctor enquiringly and she goes on: “Well, it’s not actual immortality, you know, but they’ve invented this treatment—I don’t have the full details—that stops aging, getting physically older. It might not be for everyone, but you seem to be a suitable candidate. You could still die of accidents and illness, of course, but they’ve calculated that with care and any luck you should live to be a thousand, as opposed to the hundred or so that you would now have. And in a millennium, techniques will advance further, so there could be more in store for you after that.”

New Zealand is a South Pacific nation with a history of British colonization since the 19th century. It has a population of over four million people and, like other indigenous societies such as in Australia and Canada, Māori are now a minority in their land, and their experience of colonization is that of being dominated by settlers to the detriment of their own systems of society.

From my flat on the eighth floor, I enjoy the panoramic view of the bay and beaches of Montevideo. Except for days of rain and stormy weather—which happen often in these months of winter—the beach is frequented by dogs and their masters and mistresses. I have a passion for dogs, and every morning and afternoon I take short breaks to watch from my window the playfulness of my four-feeted soulmates. They differ in race, color, and size, but from a bird’s-eye view, these differences are negligible, as are the differences in their behavior: they all stop to sniff and deposit their “biological fingerprints” at exactly the same places, they leap and jump around, they move back and forward in different directions, always close to water—a few of them even risk brief visits into the water—and always ahead of their guardians, though not too far away from them. Only occasionally do I observe barking confrontations. Often, however, I see them joined in ceremonial acts aimed at repeatedly outshining each other with regard to “depositional” pace and outreach.

The United States, along with other nations and international organizations, has developed an elaborate system of ethical norms and legal rules to govern biomedical research using human subjects. These policies govern research that might provide direct health benefits to participants and research in which there is no prospect for participant health benefits. There has been little discussion, however, about how well these rules would apply to research designed to improve participants’ capabilities or characteristics beyond the goal of good health. When mentioned at all in the literature, this so-called enhancement research, as opposed to research aimed at diagnosing, preventing, curing, or treating illnesses or medical conditions, is usually dismissed without explanation.

Whereas in the 1970s early bioethicists believed that bioethics is an arena for the application of philosophical theories of utilitarianism, deontology, and natural law thinking, contemporary policy-oriented bioethicists seem rather to be keen on framing ethical issues through political ideologies. Bioethicists today are often labeled “liberal” or “communitarian,” referring to their different understandings of the relationship between the individual and society. Liberal individualism, with its conceptual base of autonomy, dignity, and privacy, enjoyed a long period of dominance in bioethics, but it has increasingly come under attack from ideologies promoting a more salient role for concepts of solidarity, community, and public interest.