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.

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.

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.

This article deals with the question as to what makes bioethics a critical discipline. It considers different senses of criticism and evaluates their strengths and weaknesses. A primary method in bioethics as a philosophical discipline is critical thinking, which implies critical evaluation of concepts, positions, and arguments. It is argued that the type of analytical criticism that restricts its critical role to critical thinking of this type often suffers from other intellectual flaws. Three examples are taken to demonstrate this: premature criticism, uncritical self-understanding of theoretical assumptions, and narrow framing of bioethical issues. Such flaws can lead both to unfair treatment of authors and to uncritical discussion of topics. In this context, the article makes use of Häyry’s analysis of different rationalities in bioethical approaches and argues for the need to recognize the importance of communicative rationality for critical bioethics. A radically different critical approach in bioethics, rooted in social theory, focuses on analyses of power relations neglected in mainstream critical thinking. It is argued that, although this kind of criticism provides an important alternative in bioethics, it suffers from other shortcomings that are rooted in a lack of normative dimensions. In order to complement these approaches and counter their shortcomings, there is a need for a bioethics enlightened by critical hermeneutics. Such hermeneutic bioethics is aware of its own assumptions, places the issues in a wide context, and reflects critically on the power relations that stand in the way of understanding them. Moreover, such an approach is dialogical, which provides both a critical exercise of speech and a normative dimension implied in the free exchange of reasons and arguments. This discussion is framed by Hedgecoe’s argument that critical bioethics needs four elements: to be empirically rooted, theory challenging, reflexive, and politely skeptical.

The end of the last century was a particularly vibrant period for feminist bioethics. Almost two decades on, we reflect on the legacy of the feminist critique of bioethics and investigate the extent to which it has been successful and what requires more attention yet. We do this by examining the past, present, and future: we draw out three feminist concerns that emerged in this period—abstraction, individualism, and power—and consider three feminist responses—relationality, particularity, and justice—and we finish with some thoughts about the future.

In this article, postmodernism is presented as posing a challenge to the role of philosophy within bioethics. It is argued that any attempt to develop a postmodern bioethics must respond to arguments concerning power, relational responsibility, and violence. Contemporary work on the topic of relational autonomy and naturalized bioethics is interpreted as engaging with the postmodern challenge. This article proposes that the role of philosophy in bioethics should be not to provide moral guidance but rather to adopt a critical approach to the possible consequences of privileging any position or understanding over others.

This article examines the relationship between philosophy and culture in global bioethics. First, it studies what is meant by the term “global” in global bioethics. Second, the author introduces four different types, or recognizable trends, in philosophical inquiry in bioethics today. The main argument is that, in order to make better sense of the complexity of the ethical questions and challenges we face today across the globe, we need to embrace the universal nature of self-critical and analytical philosophical analysis and argumentation, rather than using seemingly philosophical approaches to give unjustified normative emphasis on different cultural approaches to bioethics.

This article analyzes a neat conjuring trick employed in bioethics, that is, the immediate conversion of a philosophical conclusion into a policy prescription, and compares it to the “grand leap of the whale up the Niagara Falls” mentioned by Benjamin Franklin. It is shown that there is no simple and easy way to achieve the conversion, by considering arguments falling under four headings: (1) reasonable disagreement about values and theories, (2) general jurisprudential arguments, (3) the differences between policymaking and philosophy, and (4) the messy world of implementation. The particular issue used to illustrate the difficulties in moving from philosophical conclusion to policy description is infanticide of healthy infants, but the analysis is general, and the conclusion that the immediate move to policy is illegitimate is quite general.

This article discusses the notion of social responsibility for personal health and well-being in bioethics. Although social responsibility is an intrinsic aspect of bioethics, and its role is increasingly recognized in certain areas, it can still be claimed that bioethics in general is committed to an individualistic theoretical framework that disregards the social context in which decisions, health, and well-being are situated. The philosophical premises of this framework regard individuals as rational decisionmakers who can be held accountable for their health conditions and who should be the primary objects of intervention in attempts to reduce lifestyle-associated chronic diseases. There are, however, social determinants of health that challenge this conclusion. Because their impact can be controlled, to a certain extent, by social and public policy decisions, their existence shows the inadequacy of the purely individualistic approach. I suggest, accordingly, that bioethics would benefit, both academically and societally, from a more social perspective. Bioethical studies that acknowledge, from the start, the social determinants of health would be more amenable to constructive multi- and interdisciplinarity, and a more balanced account of responsibility would further the contribution of sound bioethical work to sensible public policies.

Recently the scope of protections afforded those healthcare professionals and institutions that refuse to provide certain interventions on the grounds of conscience have expanded, in some instances insulating providers (institutional and individual) from any liability or sanction for harms that patients experience as a result. With the exponential increase in the penetration of Catholic-affiliated healthcare across the country, physicians and nurses who are not practicing Catholics are nevertheless required to execute documents pledging to conform their patient care to the Ethical and Religious Directives for Health Care Services as a condition of employment or medical staff privileges. In some instances, doing so may result in patient morbidity or mortality or violate professional standards for respecting advance directives or surrogate decisionmaking. This article challenges the ethical propriety of such institutional mandates and argues that legal protections for conscientious refusal must provide redress for patients who are harmed by care that falls below the prevailing clinical standards.

Therapeutic misconception (TM)—when clinical research participants fail to adequately grasp the difference between participating in a clinical trial and receiving ordinary clinical care—has long been recognized as a significant problem in consent to clinical trials. We suggest that TM does not primarily reflect inadequate disclosure or participants’ incompetence. Instead, TM arises from divergent primary cognitive frames. The researchers’ frame places the clinical trial in the context of scientific designs for assessing intervention efficacy. In contrast, most participants have a cognitive frame that is personal and focused primarily on their medical problems. To illustrate this, we draw on interview material from both clinical researchers and participants in clinical trials. We suggest that reducing TM requires encouraging subjects to adjust their frame, not just add information to their existing frame. What is necessary is a scientific reframing of participation in a clinical trial.