A pro-life view can be called harm-theoretic if it claims abortion is impermissible because of the harm caused to the fetus. These positions are important in the abortion discussion because they allow pro-lifers to argue abortion is impermissible without claiming the fetus is a moral person. A major problem with harm-theoretic abortion views is that they fall victim to the contraception reductio. The contraception reductio was originally posed towards the Future like Ours argument for the impermissibility of abortion, but I show it is a problem for harm-theoretic positions in general. I argue that the currently proposed solutions aimed at solving the contraception reductio are unsatisfactory because they commit you to unnecessary controversial metaphysical positions, such as animalism and denying mereological universalism. Then, I give a new solution to the contraception reductio that avoids those metaphysical commitments. The main conclusion is that harm-theoretic views can avoid the contraception reductio by accepting a biological account of the harm of death.

Smajdor and Rasanen (2024) argue that pregnant women are routinely denied appropriate treatment because pregnancy is seen as normal, and so they are denied 'patient status'. They claim that formally classifying pregnancy as a disease may lead to better treatment for pregnant women. In this response, we argue that pathologising pregnancy and classifying all pregnant women as 'diseased patients' won't reconfigure care in ways that benefit all women. Rather, it will likely only embolden the view that clinicians are entitled to exercise jurisdiction over pregnant women and beget the increased use of medical intervention where it is not necessarily needed.

The recent legal dispute about medical treatment for a 19-year-old patient, Sudiksha Thirumalesh, (known initially by the Court of Protection as 'ST') in A NHS Trust versus ST & Ors (2023) raised several challenging ethical issues. While Sudiksha's case bears similarities to other high-profile cases in England and Wales, there are key differences. Crucially, Sudiksha herself was part of the disagreement. She was alert, communicative and sought to advocate for herself. Furthermore, this case was framed in the courts as pivoting not on considerations of best interests but on a determination of decisional capacity. Sudiksha was deemed to lack capacity because she did not believe her doctors' view of her prognosis.While the legal questions in the case were central to a recent Court of Appeal decision (which overturned the original finding), in this commentary, we focus on the ethical questions therein. We start by describing Sudiksha's court case and the initial judgment. We then offer an ethical analysis of the relationship between false beliefs, values and the 'capacity' to make decisions, arguing for a need for particular care when judging patients to lack capacity based purely on 'false and fixed beliefs'. After briefly noting the legal basis for the appeal finding, we offer ethical implications for future cases. Although it appears that Sudiksha had decision-making capacity, this did not settle the ethical question of whether health professionals were obliged to continue treatment that they believed to have no prospect of success.

In this paper, we discuss the ethical concerns that may arise from the synthesis of human DNA. To date, only small stretches of DNA have been constructed, but the prospect of generating human genomes is becoming feasible. At the same time, the significance of genes for identity, health and reproduction is coming under increased scrutiny. We examine the implications of DNA synthesis and its impact on debates over the relationship with our DNA and the ownership of our genes, its potential to disrupt common understandings of reproduction and privacy, and the way in which synthetic DNA challenges traditional associations between genes and identity. We explore the degree to which synthetic DNA may further undermine overgeneticised accounts of identity, health, reproduction, parenthood and privacy that are prevalent in the public domain and in some areas of policy-making. While avoiding making normative claims of our own, we conclude that there is a need for reflection on the ethical implications of these developing technologies before they are on us.

How important is it, morally speaking, that banning the sale of organs removes the best option available to would-be organ sellers? According to a widespread argument called the best option argument, this is very important. In a recent article I criticised such reasoning, drawing on considerations of distributive justice. Luke Semrau has argued that I have misunderstood the best option argument. In this article, I respond to Semrau's criticism and elaborate on my original argument.

An AI-based 'patient preference predictor' (PPP) is a proposed method for guiding healthcare decisions for patients who lack decision-making capacity. The proposal is to use correlations between sociodemographic data and known healthcare preferences to construct a model that predicts the unknown preferences of a particular patient. In this paper, I highlight a distinction that has been largely overlooked so far in debates about the PPP-that between algorithmic prediction and decision-making-and argue that much of the recent philosophical disagreement stems from this oversight. I show how three prominent objections to the PPP only challenge its use as the sole determinant of a choice, and actually support its use as a source of evidence about patient preferences to inform human decision-making. The upshot is that we should adopt the evidential conception of the PPP and shift our evaluation of this technology towards the ethics of algorithmic prediction, rather than decision-making.

When parents face the distressing news during pregnancy that their baby is affected by a serious medical condition that will likely lead to the baby's death before or soon after birth, they experience a range of complex emotions. Perhaps paradoxically, one common response is that of hope. Navigating such hope in antenatal interactions with parents can be difficult for healthcare professionals. That can stem from a desire to accurately communicate prognostic information and a fear of conveying 'false hope' to families. In this paper, we examine the role that hope plays when parents and healthcare professionals are grappling with a confirmed antenatal diagnosis of a life-limiting condition. We assess what it means to hope in this context and consider the different types of hopes held by both parents and healthcare professionals as well as why hopeful thinking might be helpful and not harmful. We propose 'hope pluralism' as a concept that might allow healthcare professionals to accommodate a multitude of parental and professional hopes, even where these conflict. Finally, we offer some practical suggestions for how professionals should evaluate and respond to hope in situations that might (from the outside) appear hopeless.

The idea of a 'tobacco-free generation' promises to make smoking a thing of the past by making cigarettes unavailable to birth cohorts in the future. If implemented, such a generational ban would lead to a society in which some individuals are allowed the freedom to smoke while others are not. This paper examines the ethical significance of this fact through the lens of 'relational egalitarianism', an approach to social justice that emphasises equal and respectful social relationships. It explores various dimensions in which a society can fail to live up to the idea of equal status, such as the denial of moral agency, discrimination, stigmatisation, the unequal recognition of interests and violations of political equality. While acknowledging the complexity of practical and ethical challenges, the paper maintains that the generational ban need not violate egalitarian commitments.

Hamas militants have raped and mutilated the bodies of dozens of men and women in Israel during their attack and captivity in Gaza. The exact extent of these atrocities, however, is unknown. For reasons of this sort and others, prosecuting sexual abusers during armed conflicts is notoriously difficult. In an attempt to make a legal case against Hamas militants, the Israeli authorities have recently ordered civilian hospitals to breach medical confidentiality and report unidentified data of patients who have suffered bodily mutilation and sexual abuse during the Hamas attack or during captivity in Gaza. Patients were not informed about this policy. This article first establishes a case for why medical confidentiality is such an important existential and normative value. In this light, it then argues that the Israeli policy is morally unjustified.

We recently suggested that there are both pragmatic and normative reasons to classify pregnancy as a disease. Several scholars argued against our claims. In this response, we defend the disease view of pregnancy against their criticism. We claim that the dysfunctional account of disease that some of our critics rely on has some counterintuitive results. Furthermore, we claim that our critics assume what needs to be argued that the primary function of our sexual organs is to reproduce. Since only a small percentage of sexual intercourse leads to pregnancy, it is far from obvious that reproduction is the primary biological function of our sexual organs. We also claim that while taking pregnancy itself as a reference class could avoid the conclusion that pregnancy is a disease, the strategy is problematic since it renders the Boorsean approach to disease and health circular and effectively deprives it of any utility in determining whether a particular phenomenon is a disease or not.

Arguments for mandatory or compulsory vaccination must justify the coercive infringement of bodily integrity via the injection of chemicals that permanently affect a body's inner constitution. Four arguments are considered. The allegedly libertarian argument declares unvaccinated persons a threat; accordingly, vaccination could take the form of justifiable defence of self and others. This argument conflates material and statistical threats. The harsh coercive measures permissible in defence against the former are not permissible in prevention of the latter. The argument from tax evasion claims that people can be permissibly coerced into bearing their fair financial burdens of community life and likens this to sharing burdens in the face of a viral threat. The argument fails to demonstrate that vaccination would be fair, permissible in spite of potential lethal side-effects, and sufficiently similar to taxation despite the categorical difference between temporary deprivation of money and permanent deprivation of one's original inner bodily constitution. The argument from 'social liberty' claims that the loss of freedom due to mandatory vaccination is only apparent, namely outweighed by corresponding gains in freedom. This argument conflates freedom as the absence of coercion with freedom as the presence of options for action. It fails to give the former its due weight and to demonstrate that persons may be coerced into increasing the options of others. The argument from the priority of life elevates the protection of life to an absolute value. This is unwarranted and leads to counterintuitive implications. Without better arguments, mandatory vaccination must be rejected.