The European Embryonic Stem-Cell Debate and the Difficulties of Embryological Kantianism

As elsewhere, the ethical debate on embryonic stem cell research in Central Europe, especially Germany and Switzerland, involves controversy over the status of the human embryo. There is a distinctive Kantian flavor to the standard arguments however, and we show how they often embody a set of misunderstandings and argumentative shortcuts we term "embryological Kantianism." We also undertake a broader analysis of three arguments typically presented in this debate, especially in official position papers, namely the identity, continuity, and potentiality arguments. It turns out that these arguments do not support the strong, quasi-personal status accorded to the embryos in these official opinion

Actions et omissions, effets voulus et effets latéraux : le conséquentialisme contre la morale intuitive

Intuitivement, nous jugeons que notre responsabilité concerne davantage ce que nous faisons que ce que nous omettons de faire, et qu’elle s’étend plus aux effets voulus qu’aux effets simplement prévus de nos actes. Ces intuitions ont été thématisées dans notre tradition par deux principes, celui de la distinction de l’action et de l’omission (PDAO) et celui des actions à double effet (PADE). Jonathan Glover reconnaît l’importance de ces principes, mais considère que, en définitive, il n’est pas judicieux de les conserver et qu’il vaut mieux s’en tenir à la doctrine conséquentialiste que notre responsabilité s’étend également à toutes les conséquences de nos actes et de nos omissions. Après avoir examiné les objections de Glover contre ces deux principes, je présente les recherches de Joshua Greene sur la neuropsychologie du jugement moral. Elles s’appuient sur nos réactions à certains dilemmes moraux, particulièrement à celui du wagon fou (trolley problem) et recourent à l’imagerie cérébrale. Ses conclusions vont dans le même sens que les arguments plus conceptuels de Glover. Toutefois, ces deux auteurs partagent une conception philosophique commune, le conséquentialisme. C’est pourquoi j’examine dans une dernière partie certaines objections que rencontre cette conception morale, ce qui m’amène, avec l’aide d’autres études de neuropsychologie, à conclure qu’il est peu judicieux de mettre de côté les intentions de l’agent

Neuromodulation in the Service of Moral Enhancement

Human enhancement is a much debated topic in the bioethical literature. Human beings have long tried to improve their capacities and their performances through training and with the aid of tools; but more recently new means have come to the fore, such as drugs and biotechnological devices, especially in the domain of bodily strength and cognitive powers. Moral enhancement has been more seldom discussed. However, this question has recently been hotly debated between two philosophers, Thomas Douglas and John Harris. Douglas claims that modulating certain ugly emotions directly would consist in moral progress—directly, that is, without using cognitive means like persuasion or deliberation. Harris makes three objections against this thesis: such a direct neuromodulation would be inefficacious, would put our liberty in jeopardy and would lead to a moral decline. In this paper, I examine the third argument: with direct modulation, we risk intervening too much or too little, inducing an inappropriate emotion or an inappropriate level of an otherwise appropriate emotion—two upshots that will put morality in jeopardy. I conclude that the validity of this objection depends on several meta-ethical positions: if you are a rationalist or think that intentionality and consciousness are at the core of morality, you will agree with Harris, but if you are a sentimentalist or someone for whom results count, you will disagree. Here as elsewhere, ethical questions cannot be divorced from meta-ethical ones

Changing the Brain, Changing the Society: Clinical and Ethical Implications of Neuromodulation Techniques in Neurology and Psychiatry

New neurotechnologies for modulating brain functions are becoming increasingly powerful and applicable to diverse diseases, but raise new questions for clinicians, ethicists, policy makers, and laymen. This issue of Brain Topography gathers several papers exploring the clinical and ethical implications of several invasive and noninvasive neuromodulation approaches. The opportunities and challenges associated with the emergence of neuro-engineering solutions to brain research and brain repair require a close dialogue between multiple disciplines, as well as open discussion with the general public

Fostering responsible research with genome editing technologies : a European perspective

In this consensus paper resulting from a meeting that involved representatives from more than 20 European partners, we recommend the foundation of an expert group (European Steering Committee) to assess the potential benefits and draw-backs of genome editing (off-targets, mosaicisms, etc.), and to design risk matrices and scenarios for a responsible use of this promising technology. In addition, this European steering committee will contribute in promoting an open debate on societal aspects prior to a translation into national and international legislation.peer-reviewe

Clinical practice guidelines for BRCA1 and BRCA2 genetic testing

BRCA1 and BRCA2 gene pathogenic variants account for most hereditary breast cancer and are increasingly used to determine eligibility for PARP inhibitor (PARPi) therapy of BRCA-related cancer. Because issues of BRCA testing in clinical practice now overlap with both preventive and therapeutic management, updated and comprehensive practice guidelines for BRCA genotyping are needed. The integrative recommendations for BRCA testing presented here aim to (1) identify individuals who may benefit from genetic counselling and risk-reducing strategies; (2) update germline and tumour-testing indications for PARPi-approved therapies; (3) provide testing recommendations for personalised management of early and metastatic breast cancer; and (4) address the issues of rapid process and tumour analysis. An international group of experts, including geneticists, medical and surgical oncologists, pathologists, ethicists and patient representatives, was commissioned by the French Society of Predictive and Personalised Medicine (SFMPP). The group followed a methodology based on specific formal guidelines development, including (1) evaluating the likelihood of BRCAm from a combined systematic review of the literature, risk assessment models and expert quotations, and (2) therapeutic values of BRCAm status for PARPi therapy in BRCA-related cancer and for management of early and advanced breast cancer. These international guidelines may help clinicians comprehensively update and standardise BRCA testing practices

The Argument of Ethical Naturalism

Ethical naturalism, the theory claiming that natural facts and especially facts concerning human nature play a justificatory role in ethics, is not very popular amongst moral philosophers. Especially in countries where Kant's influence is large, the charge of naturalistic fallacy is often made against it. The aim of this paper is to show that this charge misses the point: every ethical theory is at a certain level based on pure facts, natural or not, and natural facts concerning human nature are particularly suited for this role. The arguments in favour of ethical naturalism rely on a concept of human nature that includes basic desires related to ends we ought to pursue, as Aristotle and the Scholastics already saw long ago

Le diagnostic préimplantatoire (DPI) à l’ère de la médecine prédictive

Le séquençage à haut débit est en train de révolutionner les différents diagnostics génétiques et notamment le diagnostic préimplantatoire (DPI), ouvrant les portes à une médecine prédictive de plus en plus performante. Le DPI n’est pas lui-même nouveau, et les différentes législations s’en sont saisies depuis une vingtaine d’années ; les comités nationaux d’éthique ont de leur côté largement débattu des tests anténataux dans le cadre de l’assistance médicale à la procréation. Cet article examine les travaux de ces comités concernant le DPI dans trois États, la France, la Belgique et la Suisse, afin de mettre en lumière leurs similitudes et leurs différences. Le sujet a par ailleurs été soulevé et discuté dans le cadre des États généraux de la bioéthique qui se sont déroulés cette année en France et, vu les progrès diagnostiques réalisés depuis peu, ils se sont fait l’écho de certaines demandes de la société civile. Toutefois, en France, c’est la prudence qui continue de dominer