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Alex K, Winkler EC. Comparative ethical evaluation of epigenome editing and genome editing in medicine: first steps and future directions. JOURNAL OF MEDICAL ETHICS 2024; 50:398-406. [PMID: 37527926 PMCID: PMC11137457 DOI: 10.1136/jme-2022-108888] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 07/17/2023] [Indexed: 08/03/2023]
Abstract
Targeted modifications of the human epigenome, epigenome editing (EE), are around the corner. For EE, techniques similar to genome editing (GE) techniques are used. While in GE the genetic information is changed by directly modifying DNA, intervening in the epigenome requires modifying the configuration of DNA, for example, how it is folded. This does not come with alterations in the base sequence ('genetic code'). To date, there is almost no ethical debate about EE, whereas the discussions about GE are voluminous. Our article introduces EE into bioethics by translating knowledge from science to ethics and by comparing the risks of EE with those of GE. We, first (I), make the case that a broader ethical debate on EE is due, provide scientific background on EE, compile potential use-cases and recap previous debates. We then (II) compare EE and GE and suggest that the severity of risks of novel gene technologies depends on three factors: (i) the choice of an ex vivo versus an in vivo editing approach, (ii) the time of intervention and intervention windows and (iii) the targeted diseases. Moreover, we show why germline EE is not effective and reject the position of strong epigenetic determinism. We conclude that EE is not always ethically preferable to GE in terms of risks, and end with suggestions for next steps in the current ethical debate on EE by briefly introducing ethical challenges of new areas of preventive applications of EE (III).
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Affiliation(s)
- Karla Alex
- Section Translational Medical Ethics, Department of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg University Hospital, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Eva C Winkler
- Section Translational Medical Ethics, Department of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg University Hospital, Medical Faculty, Heidelberg University, Heidelberg, Germany
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2
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Hofmann B. Bioethics: No Method-No Discipline? Camb Q Healthc Ethics 2024:1-10. [PMID: 38515428 DOI: 10.1017/s0963180124000136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
This article raises the question of whether bioethics qualifies as a discipline. According to a standard definition of discipline as "a field of study following specific and well-established methodological rules" bioethics is not a specific discipline as there are no explicit "well-established methodological rules." The article investigates whether the methodological rules can be implicit, and whether bioethics can follow specific methodological rules within subdisciplines or for specific tasks. As this does not appear to be the case, the article examines whether bioethics' adherence to specific quality criteria (instead of methodological rules) or pursuing of a common goal can make it qualify as a discipline. Unfortunately, the result is negative. Then, the article scrutinizes whether referring to bioethics institutions and professional qualifications can ascertain bioethics as a discipline. However, this makes the definition of bioethics circular. The article ends by admitting that bioethics can qualify as a discipline according to broader definitions of discipline, for example, as an "area of knowledge, research and education." However, this would reduce bioethics' potential for demarcation and identity-building. Thus, to consolidate the discipline of bioethics and increase its impact, we should explicate and elaborate on its methodology.
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Affiliation(s)
- Bjørn Hofmann
- Centre of Medical Ethics, University of Oslo, Oslo, Norway
- Institute for the Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
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3
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Johnson T, Romanis EC. The relationship between speculation and translation in Bioethics: methods and methodologies. Monash Bioeth Rev 2023; 41:1-19. [PMID: 37770722 PMCID: PMC10754718 DOI: 10.1007/s40592-023-00181-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 09/30/2023]
Abstract
There are increasing pressures for bioethics to emphasise 'translation'. Against this backdrop, we defend 'speculative bioethics'. We explore speculation as an important tool and line of bioethical inquiry. Further, we examine the relationship between speculation and translational bioethics and posit that speculation can support translational work. First, speculative research might be conducted as ethical analysis of contemporary issues through a new lens, in which case it supports translational work. Second, speculation might be a first step prior to translational work on a topic. Finally, speculative bioethics might constitute different content altogether, without translational objectives. For each conception of speculative bioethics, important methodological aspects determine whether it constitutes good bioethics research. We conclude that whether speculative bioethics is compatible with translational bioethics-and to what extent-depends on whether it is being employed as tool or content. Applying standards of impact uniformly across bioethics may inappropriately limit speculative bioethics.
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Affiliation(s)
- Tess Johnson
- Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Elizabeth Chloe Romanis
- Centre for Ethics and Law in the Life Sciences, Durham Law School, University of Durham, Durham, UK.
- Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics at Harvard Law School, and Edmond and Lily Safra Center for Ethics, Harvard University, Cambridge, MA, USA.
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Schneider M, Vayena E, Blasimme A. Digital bioethics: introducing new methods for the study of bioethical issues. JOURNAL OF MEDICAL ETHICS 2023; 49:783-790. [PMID: 34509981 PMCID: PMC10646908 DOI: 10.1136/medethics-2021-107387] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 08/18/2021] [Indexed: 06/13/2023]
Abstract
The online space has become a digital public square, where individuals interact and share ideas on the most trivial to the most serious of matters, including discussions of controversial ethical issues in science, technology and medicine. In the last decade, new disciplines like computational social science and social data science have created methods to collect and analyse such data that have considerably expanded the scope of social science research. Empirical bioethics can benefit from the integration of such digital methods to investigate novel digital phenomena and trace how bioethical issues take shape online.Here, using concrete examples, we demonstrate how novel methods based on digital approaches in the social sciences can be used effectively in the domain of bioethics. We show that a digital turn in bioethics research aligns with the established aims of empirical bioethics, integrating with normative analysis and expanding the scope of the discipline, thus offering ways to reinforce the capacity of bioethics to tackle the increasing complexity of present-day ethical issues in science and technology. We propose to call this domain of research in bioethics digital bioethics.
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Affiliation(s)
- Manuel Schneider
- Health Ethics and Policy Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Effy Vayena
- Health Ethics and Policy Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Alessandro Blasimme
- Health Ethics and Policy Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
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Bystranowski P, Dranseika V, Żuradzki T. The Disconnection That Wasn't: Philosophy in Modern Bioethics from a Quantitative Perspective. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:36-40. [PMID: 36416428 DOI: 10.1080/15265161.2022.2134490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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6
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Rhodes R, Ostertag G. Bioethics is Philosophy. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:22-25. [PMID: 36416435 DOI: 10.1080/15265161.2022.2134499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Rosamond Rhodes
- Icahn School of Medicine at Mount Sinai
- CUNY The Graduate Center
| | - Gary Ostertag
- Icahn School of Medicine at Mount Sinai
- CUNY The Graduate Center
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Dalrymple-Fraser C. Bioethics, Philosophy, and Philosophy of Disability. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:64-66. [PMID: 36416426 DOI: 10.1080/15265161.2022.2134496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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8
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Shelton W, Kim DT, Randall P. The Place of Bioethics in Philosophy: Toward a Mutually Constructive Integration. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:54-56. [PMID: 36416429 DOI: 10.1080/15265161.2022.2134491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Wayne Shelton
- Alden March Bioethics Institute, Albany Medical College
| | - Daniel T Kim
- Alden March Bioethics Institute, Albany Medical College
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Battin MP. The Place of Philosophy in Bioethics Today? Ancestry Counts. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:25-27. [PMID: 36416431 DOI: 10.1080/15265161.2022.2134501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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10
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Crisp R. A Future for Bioethics? THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:56-58. [PMID: 36416421 DOI: 10.1080/15265161.2022.2134502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Metselaar S, Widdershoven G. The Role of Philosophy After the Empirical Turn in Bioethics. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:49-51. [PMID: 36416422 DOI: 10.1080/15265161.2022.2134493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Felder RM, Magnus D. A Rejection of "Applied Ethics": Philosophy's Real Contributions to Bioethics Found Elsewhere. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:1-2. [PMID: 36416420 DOI: 10.1080/15265161.2022.2140539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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13
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Schmitz D, Duewell M. Ethics Consultation-A Blind Spot of Philosophy in Bioethics? THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:47-48. [PMID: 36416432 DOI: 10.1080/15265161.2022.2134486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Fedyk M. How Philosophy of Science Can Unlock New Methods in Bioethics. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:51-53. [PMID: 36416430 DOI: 10.1080/15265161.2022.2134492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Alvarez A. Exploring the "Other" Role of Philosophy in Bioethics: The Case of Addressing Moral Distress and Rediscovering Meaning and Purpose. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:67-69. [PMID: 36416424 DOI: 10.1080/15265161.2022.2134495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Räsänen J, Häyry M. The Role of Philosophers in Bioethics. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:58-60. [PMID: 36416427 DOI: 10.1080/15265161.2022.2134485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Langlois D, Butler J. Bioethics Consultation and First-Order Moral Reasoning: Leaving Philosophy at the Hospital Doors. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:41-43. [PMID: 36416434 DOI: 10.1080/15265161.2022.2134487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Dave Langlois
- Centre for Clinical Ethics
- University of Toronto Dalla Lana School of Public Health
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Díaz-Cobacho G, Hannikainen IR. Rethinking the Role of Experimental Philosophy in Bioethics. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:69-72. [PMID: 36416423 DOI: 10.1080/15265161.2022.2134494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Banja J. Bioethicist Position Available: Philosophers Need Not Apply. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:30-33. [PMID: 36416425 DOI: 10.1080/15265161.2022.2134484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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DeGrazia D. Some Reflections on the Importance of Philosophy to Bioethics. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:27-29. [PMID: 36416433 DOI: 10.1080/15265161.2022.2134498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Koch T. The practitioner as endangered citizen: a genealogy. Monash Bioeth Rev 2021; 39:157-168. [PMID: 34913156 PMCID: PMC8674021 DOI: 10.1007/s40592-021-00143-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 11/29/2022]
Abstract
Medical practice has always involved at least three roles, three complimentary identities. Practitioners have been at once clinicians dedicated to a patient's care, members of a professional organization promoting medicine, and informed citizens engaged in public debates on health issues. Beginning in the 1970s, a series of social and technological changes affected, and in many cases restricted, the practitioner's ability to function equally in these three identities. While others have discussed the changing realities of medical practice in recent decades, none have commented on their effect on their effect on rights of practitioners as citizens. Here several cases begin an analysis of the manner in which those changes have limited the physician's right to act conscientiously and speak publicly in the face of organizational agendas and political priorities.
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Affiliation(s)
- Tom Koch
- Department Geography (Medical), University of British Columbia, Vancouver, BC, Canada.
- Ethics, Gerontology, Chronic Care, Alton Medical Centre, Toronto, ON, Canada.
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