Cover
Title Page
Preface
About the Companion Website
Part I: Setting the Scene
1. 1 Science and Society
  1. 1.1 What’s It All About?
  2. 1.2 What Is Science?
  3. 1.3 Modern Science
  4. 1.4 Science, Ethics and Values
  5. 1.5 Attitudes to Science
  6. Key References and Suggestions for Further Reading
2. 2 Ethics and Bioethics
  1. 2.1 Ethics and Morals
  2. 2.2 The Development of Ethics
  3. 2.3 Making Ethical Decisions
  4. 2.4 Medical Ethics
  5. 2.5 The Growth of Bioethics
  6. Key References and Suggestions for Further Reading
Part II: Biomedical Science and Medical Technology
1. 3 Life before Birth I: The New Reproductive Technologies
  1. 3.1 Introduction
  2. 3.2 Gametes Outside the Body
  3. 3.3 Techniques of Artificial Reproductive Medicine
  4. 3.4 Embryo Testing
  5. 3.5 Mitochondrial Donation
  6. 3.6 Embryo Research
  7. 3.7 Rights of the Unborn Child
  8. 3.8 Men and Women: Do We Need Both?
  9. Key References and Suggestions for Further Reading
2. 4 Life before Birth II: Embryos, Foetuses and Associated Issues
  1. 4.1 Introduction
  2. 4.2 The Early Human Embryo
  3. 4.3 Embryo Research
  4. 4.4 Screening and Diagnosis
  5. 4.5 Reproductive Rights
  6. 4.6 Abortion: Maternal–Foetal Conflict
  7. 4.7 Surrogacy
  8. 4.8 Artificial Wombs
  9. Key References and Suggestions for Further Reading
3. 5 Cloning and Stem Cells
  1. 5.1 Introduction
  2. 5.2 Frogs and Sheep
  3. 5.3 Genes and Clones
  4. 5.4 It’s Not Natural: It Should Be Banned!
  5. 5.5 The Ethics of Human Cloning: An Overview
  6. 5.6 Reproductive Cloning of Non‐human Mammals
  7. 5.7 Unlocking the Genetic Potential of Stem Cells
  8. 5.8 Concluding Remarks
  9. Key References and Suggestions for Further Reading
4. 6 Human Genes and Genomes
  1. 6.1 Some History
  2. 6.2 Molecular Genetics and the Human Genome Project
  3. 6.3 Some Thoughts on Eugenics
  4. 6.4 Use of Human Genetic Information
  5. 6.5 Genetic Modification of Humans: Fact or Fiction?
  6. 6.6 A Gene for This and a Gene for That
  7. Key References and Suggestions for Further Reading
5. 7 Transhumanism
  1. 7.1 Introduction
  2. 7.2 From Wooden Legs to Would‐Be Cyborgs
  3. 7.3 Mind and Matter
  4. 7.4 Stronger, Fitter, Faster, Cleverer: Biological Aspects of Transhumanism
  5. 7.5 Military Applications
  6. Key References and Suggestions for Further Reading
6. 8 Decisions at the End of Life: When May I Die and When Am I Dead¹?
  1. 8.1 Introduction: Four Important Examples to Inform Our Thinking
  2. 8.2 How Did We Get Here?
  3. 8.3 What Is Euthanasia?
  4. 8.4 Case for Assisted Dying
  5. 8.5 The Arguments against Assisted Dying
  6. 8.6 The Debate Continues: Will the Law Ever Be Changed?
  7. 8.7 When Should Medical Treatment Be Withheld or Withdrawn?
  8. 8.8 Concluding Remarks
  9. Key References and Suggestions for Further Reading
Part III: Biotechnology
1. 9 Genetic Modification and Synthetic Biology
  1. 9.1 Introduction
  2. 9.2 Ethical Aspects of Genetic Modification
  3. 9.3 Pharmaceuticals
  4. 9.4 Genetic Modification of Animals
  5. 9.5 Research Uses of Genetic Modification
  6. 9.6 Gene and Genome Editing
  7. 9.7 Synthetic Biology
  8. Key References and Suggestions for Further Reading
2. 10 Genetic Modification of Plants
  1. 10.1 Introduction and Definitions
  2. 10.2 Back to the Beginning
  3. 10.3 Basic Methodology
  4. 10.4 The Debate
  5. 10.5 GM Crops: Is a Different Approach Possible?
  6. 10.6 Closing Comments: Consumer Choice
  7. Key References and Suggestions for Further Reading
3. 11 Genes: Some Wider Issues
  1. 11.1 Introduction
  2. 11.2 Crop GM Technology, World Trade and Global Justice
  3. 11.3 Gene Patenting
  4. 11.4 Genetic Piracy
  5. 11.5 DNA Fingerprinting and DNA Databases
  6. 11.6 Concluding Remarks
  7. Key References and Suggestions for Further Reading
4. 12 Biofuels and Bioenergy: Environmental and Ethical Aspects
  1. 12.1 Introduction
  2. 12.2 Biofuels: A Brief Survey
  3. 12.3 Biofuels: Ethical Issues
  4. 12.4 Concluding Comment
  5. Key References and Suggestions for Further Reading
Part IV: Humans and the Biosphere
1. 13 Humans and Non‐human Animals
  1. 13.1 Introduction
  2. 13.2 Humankind’s Place in the Animal Kingdom
  3. 13.3 Human Use of Animals: An Overview
  4. 13.4 Vivisection and the Use of Animals in Research
  5. 13.5 The Ethics of Animal Research
  6. 13.6 Animals in Sport, Companionship, Leisure and Fashion
  7. 13.7 Working Animals
  8. 13.8 Animals for Food
  9. 13.9 Concluding Comments
  10. Key References and Suggestions for Further Reading
2. 14 The Environmental Crisis: Not Just about Climate
  1. 14.1 Introduction
  2. 14.2 Environmental Damage: It’s a Fivefold Problem
  3. 14.3 Climate Change
  4. 14.4 Valuing the Environment
  5. Key References and Suggestions for Further Reading
3. 15 Planet and Population
  1. 15.1 Introduction: The Anthropocene
  2. 15.2 How Many?
  3. 15.3 How Many Can We Feed?
  4. 15.4 How Many Is Too Many?
  5. 15.5 Water
  6. 15.6 Concluding Comments
  7. Key References and Suggestions for Further Reading
Index
End User License Agreement

List of Illustrations

Chapter 01
1. Figure 1.1 The Ancient Greek Antikythera Mechanism (150 BC), a simple analogue computer.
Chapter 03
1. Figure 3.1 Methods for mitochondrial donation. (a) Pronuclear transfer. (b) Transfer of maternal spindle.
Chapter 04
1. Figure 4.1 (a) Photographs of the early developmental stages of the human embryo. The zygote is the one‐cell embryo formed by fertilisation. The two pro‐nuclei, one from the egg and one from the sperm, are clearly visible. After merger of the pro‐nuclei (syngamy), cell divisions occur; the embryo then becomes compacted (morula stage); in the final stage before implantation, it has hollowed out to form the blastocyst. Key: D1, D2, etc. indicate days of development. (b) Diagram of human development from fertilisation to implantation.
Chapter 05
1. Figure 5.1 Micrograph of a human blastocyst. The embryo now consists of an inner mass of cells (ICM) that will, if the embryo implants, become the embryo proper and an outer layer of cells, the trophectoderm (TE), from which the placenta will be derived if a pregnancy is established (see Chapters 3 and 4). Stem cell cultures may be established from the inner cell mass.
Chapter 06
1. Figure 6.1 Changes in the cost of sequencing an individual human genome. The dramatic fall from 2007 onwards coincides with the increasing use of second‐generation sequencing methods and departs significantly from predictions made by application of Moore’s law.
Chapter 07
1. Figure 7.1 Neil Harbisson who classifies himself as a cyborg. Photograph reproduced by kind permission of Lars Norgaard. See also www.cyborgarts.com/neil‐harbisson
Chapter 09
1. Figure 9.1 Diagram of the basic mechanisms involved in gene editing by the Crispr‐CAS9 system. The diagram, which is reproduced by kind permission of Discovery Zone (www.discovery‐zone.com), emphasises its possible use in correcting genetic defects in humans. However, as mentioned in the text, the technique has a much wider range of possible applications.
2. Figure 9.2 Artemisinin.
Chapter 10
1. Figure 10.1 Diagram of the tumour‐inducing (Ti) plasmid of Agrobacterium tumefaciens. Note that for the sake of clarity, the various important sequences of the plasmid are not drawn to scale with each other. We thank Richard Tennant, University of Exeter, for drawing this diagram. The earliest successful plant GM experiments were carried out with this vector and many of the more modern vectors employ the key features of this gene transfer system. When Agrobacterium tumefaciens infects a plant host, a copy of the T‐region of the plasmid, the T‐DNA, is transferred to the host cells. Proteins encoded by the Virulence (vir) genes mediate this process. Inside the host cell’s nucleus, the T‐DNA is integrated into the host’s DNA by plant enzymes. The 24‐base‐pair left and right border sequences are essential for the process. In a natural infection, the host cells are transformed to a tumorous phenotype under the action of enzymes encoded by the auxin and cytokinin genes, causing formation of a ‘crown gall’. The cells of the gall synthesise amino acid derivatives called opines using enzymes encoded in the opine region of the T‐DNA. Enzymes that mediate opine catabolism are encoded by genes on the Ti plasmid, thus enabling the bacterium to use these compounds as sources of carbon and nitrogen. In forming a useful vector from the Ti plasmid, the first stage is to remove the genes that cause the tumorous phenotype and replace them with the genes that it is wished to transfer to the plant. In some early applications, the opine genes were left in as markers but other marker systems were quickly developed.
Chapter 12
1. Figure 12.1 Aerial photo of the lands taken by Addax Bioenergy for its sugar‐cane plantation in Sierra Leone.
Chapter 13
1. Figure 13.1 Experimental procedures on animals in the United Kingdom, 1960–2003.
2. Figure 13.2 English bulldog.
Chapter 14
1. Figure 14.1 The wrecked power station at Chernobyl.

This edition first published 2019
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Library of Congress Cataloging‐in‐Publication Data

Names: Bryant, J. A., author. | Baggott la Velle, Linda, author.
Title: Introduction to bioethics / by John A. Bryant and Linda la Velle.
Description: Second edition. | Hoboken, NJ : Wiley‐Blackwell, 2018. | “John Bryant, University of Exeter, Exeter, UK; Linda la Velle, University of Plymouth, Plymouth, UK.” | Includes bibliographical references and index. | Identifiers: LCCN 2017061639 (print) | LCCN 2018000727 (ebook) | ISBN 9781118719589 (pdf) | ISBN 9781119080152 (epub) | ISBN 9781118719619 (hardback) | ISBN 9781118719596 (paper)
Subjects: LCSH: Bioethics. | BISAC: SCIENCE / Life Sciences / General.
Classification: LCC QH332 (ebook) | LCC QH332 .B79 2018 (print) | DDC 174.2–dc23
LC record available at https://lccn.loc.gov/2017061639

Cover Design: Wiley
Cover Images: (Corn) © Candus Camera/Shutterstock; (intracytoplasmic sperm injection) Phanie / Alamy Stock Photo; (Sheep) © Binnerstam/Gettyimages; (DNA sequence) © Gio_tto/Gettyimages; (Tobacco cells) Courtesy of Dr Dennis Francis; (Mouse) © Bliznetsov/Gettyimages; (Sky) © spooh/Gettyimages; (Forest) © AustralianCamera/Shutterstock

Preface

Each new power won by man is a power over man as well. Each advance leaves him weaker as well as stronger. In every victory, besides being the general who triumphs, he is also the prisoner who follows the triumphal car.

These words, written in 1947 by the scholar of medieval English, CS Lewis, headed the Preface of the first edition of this book. The quotation, from the book The Abolition of Man, illustrates the ambiguity inherent in many scientific advances and technological inventions: they can be used for good or bad. It is probable that one of the issues that Lewis had in mind was nuclear fission but we can trace similar concerns down through the decades in other fields, including medicine, agriculture and biotechnology.

The idea is also expressed well by the historian Francis Fukuyama in his 2002 book, Our Posthuman Future:

Biotechnology presents us with a special moral dilemma, because any reservations we may have about progress need to be tempered with a recognition of its undisputed promise.

Thus, there has been a growing awareness of the need for informed discussion on the ethical issues arising in biological and biomedical sciences. This has led to bioethics courses being added to university degree programmes in life sciences, thus providing the impetus for our first edition, which was specifically written for students as well as for academics who were not yet engaged with bioethical issues. Feedback from members of our target audiences has been very positive and this has encouraged us to produce this second updated edition. Progress in many areas of biological and biomedical science has been spectacular in the 13 years since the first edition was published, providing huge opportunities for new developments in medicine, agriculture and biotechnology but also raising new ethical issues (or at the least, new ‘versions’ of old ethical issues). Further, this is set against a background of the expanding human population of our planet and of increasing concern about environmental issues, especially climate change.

All this has led us to an almost complete reworking of the book, although several useful case studies and examples from the first edition remain in this one. We have tried to be as up to date as is humanly possible but the speed of progress means that for some topics discussed here, further developments will have taken place in the few months between completion of the manuscript and publication. However, we will provide updates plus links to other relevant material on the book’s website www.wiley.com/go/Bryant/IntroductiontoBioethics2e, which will provide a very useful adjunct to the text.

It is a pleasure to express our thanks to the many people who have helped us in our thinking. First we must mention John Searle, our co‐author for the first edition but who, because of other commitments, has been unable to work with us on this edition. Nevertheless, he has always been willing to discuss bioethical issues, especially those arising at the end of life. We are very grateful for his support. We continue to be grateful to all those who helped us during our writing of the first edition. It has been a privilege for JB to work with Chris Willmott in our roles as bioethics advisors to the UK’s Higher Education Academy, during which we have enjoyed ongoing discussions of many bioethical issues. In relation to specific topics in this edition, we thank Alex Aylward and members of South West NHS Genomic Medicine Centre, Exeter (human genetics and genomics); Suzi Leather and Philippa Taylor (fertility issues and human embryology); Elaine Storkey (selective abortion); John Clifton‐Brown, John Love and David Stafford (biofuels); Margot Hodson, Martin Hodson, Rachel Oates and Chris Southgate (environmental issues); Steve Hughes (GM crops and biofuels); Hannah Farrimond (science/ethics); Tim Miller (for introducing us to ‘futurology’ literature); Mike Fowler (genetic piracy in relation to phytopharmacology).

We also thank our colleagues at Wiley‐Blackwell who have been very patient while waiting for us to finish this book. We thank them too for all the hard work that has gone into the production of the book.

Exeter and Plymouth, July 2017John A. Bryant
Linda la Velle

Introduction to Bioethics

Preface

About the Companion Website

Part I
Setting the Scene