From erewhon to alphaGo: For the sake of human dignity, should we destroy the machines?

This paper asks whether, for the sake of human dignity, regulators should adopt a precautionary approach to the development of smart machines. Having identified a set of essential (or commons’) conditions for the existence of human social agents, including respect for human dignity in both foundational and non-foundational senses, consideration is given to human reliance on personal digital assistants, to the development of autonomous vehicles and lethal autonomous weapons systems, and to the use of smart machines in the criminal justice system. The paper concludes that, while smart machines should not be destroyed, a degree of precaution for the sake of human dignity is warranted. In particular, it is recommended that international agencies should monitor the impact of smart machines on the commons’ conditions; and that national commissions should facilitate the articulation of the local social licence for the development and application of such machines

New genetic tests, new research findings: Do patients and participants have a right to know – and do they have a right not to know?

In the context of the systematic genotyping of UK Biobank’s participants and the piloting of non-invasive pre-natal testing within the screening pathway for Down syndrome, this paper considers the plausibility, basis, scope, and weight of the claim that participants and patients have a right to know as well as a right not to know the results of the genetic analysis undertaken. It also considers the possible relevance to these issues of the landmark decision of the UK Supreme Court in Montgomery v Lanarkshire Health Board

Regulating in the Global Village: The Case of Non-Invasive Pre-Natal Tests

In the context of the global village, this paper focuses on the development of Non-Invasive Prenatal Testing (NIPT)—a test that provides clinicians and prospective parents with an easy, early and safe opportunity to obtain potentially reliable genetic and health information about the future child. In the first part of the article, we identify various concerns relating to NIPT, now released into an environment that is remarkably difficult to regulate. For example, we question whether the online information about NIPT upon which women might rely will be reliable and up-to-date, whether women might use Internet suppliers to work round local legal restrictions, and whether the stored test results might impact on future children. In the second part of the article, whilst recognising the limited opportunities for making effective regulatory interventions in the global village, we suggest some possible responses to the particular concerns about NIPT identified in the paper

Emerging Technologies, Extreme Uncertainty, and the Principle of Rational Precautionary Reasoning

This paper argues that, in a context of 'extreme uncertainty' (where it is believed that it is possible that an emerging technology might cause harm to humans, damage to the environment, or some form of moral violation; but where the likelihood of such harm can be expressed only as lying in the range >0<1), regulators should be guided by a 'Principle of Rational Precautionary Reason' (the PRPR). The PRPR, which is to be distinguished from the precautionary principle, is presented as a rational response to cases of extreme uncertainty that regulators might encounter in both their prudential and moral calculations. For illustrative purposes, the application of the PRPR is tested in relation to the Large Hadron Collider, nanotechnologies and food, and the application of neuroscience and neurotechnologies in the criminal justice system

In ordinary times, in extraordinary times: Consent, newborn screening, genetics and pandemics

Against the backdrop of newborn genetic screening and pandemics, this article examines disputes between parents, acting as proxies for their children, and healthcare professionals. While some will support parents, others will push-back against proxy consent and the right to veto actions that are proposed by the professionals. Whereas in ordinary times, such a push-back might seek to displace or downgrade parental rights (e.g. by appealing to professional duty or the optimisation of health) or to de-centre or dilute consent, in extraordinary times, rights and consent are superseded by appeals to responsibility, solidarity, and even “states of exception”

Good governance and the development of an ethical framework for the UK National Screening Committee

Following COVID-19, good governance of public health is self-evidently a priority. Those who have governance responsibilities should act with integrity, and public health interventions should be both effective and ethically sound. In this context, this article focuses on the work recently undertaken by the UK National Screening Committee (NSC) in reviewing how it engages with and resolves the ethical questions raised by health screening. The article sketches the context for this review and the challenges faced; it describes the review process and the principal review outputs (including the ethical framework); and it reflects on a number of issues that are provoked by the ethical framework. Given the post-pandemic re-organisation of public health, the importance of embedding ethics in screening practice is underlined. If the United Kingdom is to be a standard-bearer for world-leading screening, it is essential that the NSC sustains its commitment to the ideals of good governance