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The Winners Are . . .

We are pleased to announce and congratulate the winners of the Bioethics Forum Reply All contest. Wit, creativity, and social commentary have received their due recognition.

We also want to share some fascinating insights and themes that emerged in the nearly 500 other responses that we received. Reading them was like dipping a cup into a stream and sampling its contents – in this case, what people who practice and study bioethics think about some of the major issues. How might transhumanism transform us? What is particularly unethical about health care and health policy today? What surprises might assisted human reproduction have in store?

First, the winners.

1. Transhumanists believe that science and technology will free us from the limits of our bodies. We will be smarter and healthier, and we will live forever. But we’ve been wondering: will “transhumans” have better sex or no sex at all?

“During the evolutionary period of transhumanists, when their bodies will consist of only a cerebral cortex and an index finger, one can only assume that sex (like everything else) will be digital.” – Vince Cornellier

2. Just as the practice of lying to patients about their diagnosis seems patently wrong today, what medical practice or health policy is going to look blatantly unethical 50 years from now?

“The U.S. not having a universal healthcare system will look unethical in 50 years. People will say, ‘Even people working two full-time jobs and taking care of a family might not have access to healthcare? How could enabling insurance companies’ profitability take priority over giving the population basic healthcare?’” – Brandon Hamm

3. The cartoon by Eric Juengst:



“I wish the media would stop calling her the ‘first uterus baby’ . . .” – Kate Heffernan

The transhumanism question elicited two basic categories of response: yes (they will have better sex – “transcendent,” some said) and no (they will not or they will have no sex at all). Those who answered yes gave a variety of reasons, including “technological enhancements and endless stamina” and a hedge against the “boredom of immortality.” Curiously, conflicting emotional factors were identified as being condusive to better sex in the transhuman world: some respondents said sex would be “without emotional attachments” (a good thing to them, apparently) while others thought that emotional bonds would be stronger and relationships deeper.

The “no” respondents had other things in mind. One person wrote, “There are some things that just can’t be improved.” But others thought that to highly evolved transhumans, sex would cease to be important (“’sex’ as we know it would be moot.”)

Like the winning reply to the question about what medical practice or health policy would look unethical in 50 years, more than a dozen responses cited the lack of universal health care in the U.S. A few took that idea a step further and said that it would be seen as unethical not to consider health care a basic human right.

Other major themes that emerged in the responses to that question were financial conflicts of interest in medicine and medical education, problems with the organ transplantation process (lack of organs as well as questions about the definition of death), and futile care of dying patients (“They will say, ‘They used to routinely offer people who are in the final state of a disease CPR? What WERE they thinking?’”). Some cited as unethical the lack of advance care planning and not allowing people to choose how they die.

What else will be considered unethical in half a century? Conducting clinical trials on vulnerable populations (especially in developing countries), sex and gender bias in health care (“I suspect denying sexually active gay men the chance to give blood will be regarded as a sign of our ignorance.”), vaccination, vaccination refusal, circumcision, and chemotherapy (“blasting away at healthy cells,” especially without testing tumor sensitivity to the drug). One respondent, assuming that designer babies would be the norm in 50 years, said that declining to have one would be unethical: “Not enhancing your unborn baby while in the womb will be looked down on.”

Perhaps this respondent was also thinking about the cartoon. Unsurprisingly, it inspired the most humorous responses. Folks who stopped by our booth at ASBH last week laughed out load when they saw the cartoon and read the three finalist captions.

Among the hundred-plus other captions, puns ran rampant (“Sure is healthy, but still a little testy!” and “Honestly, it was a tubal pregnancy” and “Are the ‘terrible tubes’ really as bad as they say?”). There were inevitable comparisons between human assisted reproduction and the traditional method. (“Well, Roger insisted on doing it the ‘old fashioned way’ . . .” and “Throwback”) A few alluded to the test tubes’ resemblance to condoms (“The test tube broke.”). There were also more serious commentaries on the hazard of parental overinvestment in their child’s future: “Yes, I know there is no resemblance – we did spend a lot of money, energy and time getting him.”

The contest was great fun and gave us many laughs, but we also took away a message. The replies provided a snapshot of the bioethics issues that are front and center, at least for those who participated. To say that the replies suggest which issues deserve priority or are most important is an overstatement, but they do point to the scope and challenge of the work to be done in bioethics. Congratulations to the winners. Thanks those all who replied and voted. And special thanks to Eric Juengst.

Susan Gilbert is the editor of Bioethics Forum.

Published on: October 18, 2011
Published in: Hastings Bioethics Forum

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