New Horizons for The New Bioethics

As we approach the end of 2018, this issue of the journal introduces a new Essay section which will allow authors the opportunity to explore an issue in greater depth than in a usual length paper. We are delighted that Dr Peter De Pergola, Assistant Professor of Medicine at the University of Massachusetts Medical School has contributed our inaugural essay on neuroethics. In a wide-ranging exploration of the ongoing debate about the relationship between neuroscientific advances, free will and moral responsibility, he outlines what is known currently about the neurobiological basis of moral reasoning, surveys advances in cognition and memory modification in neuropharmacology (particularly with beta-adrenergic receptor blockers), deep brain stimulation, electroconvulsive therapy and the creation of false memories. He concludes that ‘memory manipulation, which promises to take away that which is bad in human experience, also removes that which enables human beings to be good’.

He doesn’t however consider brain transplants which is the subject of the intriguing paper by Downey in which she assesses the continuing efforts of Sergio Canavero to undertake a surgical head transplant, in the light of current concerns regarding the role of non-neurological bodily systems, especially the immune system, in establishing personal identity. If Downey is correct, our immunity and our identity are linked far more closely than was previously thought, thus making a successful brain transplant even less likely than even the more commonly raised potential obstacles would allow.

Even when treatments become widely accepted, ethical concerns may still continue to be raised. As one of the book reviews in the issue reminds us, the birth of Louise Brown in 1978 means this year is the 40^th anniversary of Steptoe and Edwards’ ground breaking success in their pioneering work in IVF. Despite its rapid uptake leading to it becoming almost a default treatment for fertility problems, it still has its critics. Sutton in her paper drawing on the work of Radcliffe-Richards and Sandel, argues that egg donation, though not coercive is never-the-less intrinsically exploitative.

Ethical issues at the beginning of life don’t end of course with conception and Silberberg et al in a paper from Argentina, argue that in spite of complications such as premature birth, neonatal death and uterine damage, the improved prognosis for intra-uterine surgery for myelomeningocele means that such interventions are still positive but require careful evaluation in each case to minimize the risks.

In the final paper of this issue, Westin revisits the familiar territory of Beauchamp and Childress’ four principles but with a novel slant, ‘looking at the role of a hopeful hermeneutic in understanding and applying the principles through a particular lens, without, as Macklin warns, reducing moral decision-making to “a virtuous motive that results in a bad outcome”’. This Westin claims will use the principles in order to guide the patient-practitioner in a more helpful way than some other approaches.

In addition to the book review already referred to which appraises an ethnographic study from the Netherlands celebrating 40 years of IVF, this issue is completed by two additional reviews on books concerning the philosophical influences on the ethics of Peter Singer and on the arguments for and against abortion rights.

The New Bioethics celebrates its 25th anniversary next year and to mark the occasion the journal is to be published quarterly in 2019 and thereafter. Do write to me if you have an idea for an essay feature and of course we will be able to publish articles in an even more timely fashion with the increased capacity that will result from the change.

We also intend to increase the number of themed issues which have proved especially popular over the past few years when we have commissioned them. The personalized medicine issue last year had a particularly high online readership and continues to do so. For the coming year, we have themed issues planned on organ trafficking and on conscientious objection in healthcare. We would be very keen to have readers' suggestions for future topics and indeed expressions of interest from potential guest editors.

ORCID

Trevor Stammers http://orcid.org/0000-0002-4454-2501