Neuroethics studies the ethical, social, and legal issues raised by actual or expected advances in neuroscience. The relevant fields in neuroscience include, but are not limited to, neuroimaging, cognitive neuroscience, neuropsychopharmacology, neurogenetics, and neuropsychiatry. For many, neuroethics is best understood as a subcategory of bioethics, and although not all agree, for the purposes of the present collection of articles, this definition is assumed. Although bioethics as a field of study started in the early 1970s as a normative enterprise, mainly practiced by philosophers and theologians, it has since become truly inter- and multidisciplinary, comprising also law, sociology, psychology, gender studies, disability studies, anthropology, history, and many other approaches. What we particularly wanted to do in this issue, however, was to find the most pertinent questions of neuroethics from the viewpoint of philosophy, and the call for papers was drafted accordingly.

The old saying that “you only have one chance to make a first impression” is one that applies to submitting papers to a journal. We have seen so many papers flounder on this first step that we want to share our list of dos and don'ts.

To quote Yogi Berra, writing this editorial is a “déja vu all over again” experience for us. It entails not only collaborating once more as coauthors but also reiterating some of the criticisms and concerns that have figured prominently in virtually all our previous publications about bioethics—most recently in our book Observing Bioethics.

The Cambridge Consortium for Bioethics Education took place at the Cambridge University Press offices in New York this April. Hosted and sponsored by the Press, with cosponsors, CQ and the Program in Medicine & Human Values at California Pacific Medical Center in San Francisco, the Consortium brought together representative leaders in bioethics to discuss some of the unsolved issues in the field: goals, curriculum, methods, and assessment. For three days participants shared their own programs, research, and current projects as well as ideas on where bioethics education needs to go in the future. Beginning with this special section, and in CQ’s Bioethics Education section in subsequent volumes, we will be bringing you what is happening as bioethicists everywhere take a more focused approach to the field.

The ethical tension in childhood vaccination policies is often framed as one of balancing the value of choice with the duty to protect. Because infectious diseases spread from person to person, unvaccinated children are usually described as putting others around them at risk, violating a perceived right to be protected from harm. Editors of Lancet Infectious Diseases recently argued against mandatory vaccination, reminding us that the resort to mandatory vaccination as a means of achieving high vaccination rates is still very much a topic of Western vaccine debates. The nation of Japan offers an interesting case study in childhood vaccination policy, as it has an entirely voluntary (opt-in) system that achieves high vaccination rates. In this paper, we offer an overview of Japanese childhood vaccine policy, suggest some ways to contextualize and understand how a voluntary system achieves high vaccination rates, and speculate on what the future of Japanese vaccination policymaking and government–public relations may hold.

It is said there are only two things in life that are certain: death and taxes … maybe only taxes.

Neuroethics addresses moral, legal, and social questions created or highlighted by theoretical and practical developments in neuroscience. Practices in need of scrutiny currently include at least brain imaging with new techniques, chemical attempts to shift exceptional brain function toward normality, chemical attempts to enhance ordinary brain function beyond normality, and brain manipulation by other methods.

Biomedical ethics is an essential part of the medical curriculum because it is thought to enrich moral reflection and conduce to ethical decisionmaking and ethical behavior. In recent years, however, the received idea that competency in moral reasoning leads to moral responsibility “in the field” has been the subject of sustained attention. Today, moral education and development research widely recognize moral reasoning as being but one among at least four distinguishable dimensions of psychological moral functioning alongside moral motivation, moral character, and moral sensitivity. In a reflection of this framework, medical educators and curriculum planners repeatedly advance the idea that educators should be concerned with supporting empathy, and this, very often, as a means of improving on and broadening medical ethics education’s traditional focus on moral reasoning.

Various authors have argued that progress in the neurocognitive and neuropsychiatric sciences might threaten the commonsense understanding of how the mind generates behavior, and, as a consequence, it might also threaten the commonsense ways of attributing moral responsibility, if not the very notion of moral responsibility. In the case of actions that result in undesirable outcomes (e.g., someone being harmed), the commonsense conception—which is reflected in sophisticated ways in the legal conception—tells us that there are circumstances in which the agent is entirely and fully responsible for the bad outcome (and deserves to be punished accordingly) and circumstances in which the agent is not at all responsible for the bad outcome (and thereby the agent does not deserve to be punished).

The importance of humanities in the medical curriculum is increasingly recognized. For example, in the United Kingdom, The General Medical Council (GMC), which is an independent body established under the Medical Act 1858 and responsible, among other things, for fostering good medical practice and promoting high standards of medical education, in its publication Tomorrow’s Doctors, encouraged inclusion of humanities in the medical curriculum. Literature, arts, poetry, and philosophy are thought to foster the doctors’ ability to “communicate with patients, to penetrate more deeply into the patient’s wider narrative, and to seek more diverse ways of promoting well being and reducing the impact of illness or disability.”

There are 12 different Mental Health Acts (MHAs) in Canada, all of which provide for the involuntary confinement of the mentally disordered to protect both them from themselves and others from them. The Acts differ in many ways, but three issues stand out above all: (1) involuntary admission criteria, (2) the right to refuse treatment, and (3) who has the authority to authorize treatment. I first describe how the MHAs differ on these issues. I then take up the methodological question of how to select or construct a MHA from the many, all of which have something to be said for them. Finally, I apply this test to the three main issues in dispute and identify which solutions would be in an ideal MHA. My aim in this last is not to settle the issues but to engage with them and so deepen our understanding of what is at stake.

The emergence of controlled, Maastricht Category III, non-heart-beating organ donation (NHBD) programs has the potential to greatly increase the supply of donor solid organs by increasing the number of potential donors. Category III donation involves unconscious and dying intensive care patients whose organs become available for transplant after life-sustaining treatments are withdrawn, usually on grounds of futility. The shortfall in organs from heart-beating organ donation (HBD) following brain death has prompted a surge of interest in NHBD. In a recent editorial, the British Medical Journal described NHBD as representing “a challenge which the medical profession has to take up.”

The debate around age-based healthcare rationing was precipitated by two books in the late 1980s, one by Daniel Callahan and the other by Norman Daniels. These books ignited a firestorm of criticism, best captured in the claim that any form of age-based healthcare rationing was fundamentally ageist, discriminatory in a morally objectionable sense. That is, the elderly had equal moral worth and an equal right to life as the nonelderly. If an elderly and nonelderly person each had essentially the same medical problem requiring the same medical treatment, then they had an equal right to receive that treatment no matter what the cost of that treatment. Alternatively, if cost was an issue because the benefits of the treatment were too marginal, then both the elderly and nonelderly patients requiring that treatment ought to be denied it. If there were something absolutely scarce about the treatment, then some fair process would have to be used to make an allocation decision (and that fair process could not use some age cutoff among the allocation criteria).

Brain research in neuroscience and related fields is changing our understanding of the brain and its relation to the mind and to human behavior, giving a new impetus to the problem of free will and moral responsibility. The reactions have covered the entire range, from claims to the effect that neuroscientific research is showing that our folk–psychological understanding of conscious free will and moral responsibility is deeply mistaken to claims to the effect that neuroscientific research is irrelevant to moral issues of free will and responsibility. In any case, neuroscience is posing some serious challenges to our conceptions of free will and moral responsibility.

Military medical ethics is garnering growing attention today among medical personal in the American and other armies. Short courses or workshops in “battlefield ethics” for military physicians, nurses, medics, social workers, and psychologists address the nature of patient rights in the military, care for detainees, enemy soldiers and local civilians, problems posed by limited resources, ethical questions arising in humanitarian missions, as well as end-of-life issues, ethics consultations, care for veterans, advance directives, and assisted suicide. Although many of these issues are the core subjects of any bioethics curriculum, military medical ethics presents unique challenges to bioethics educators.

Recent bioethics discussion and research in Iceland has been greatly affected by the fact that one of the world’s largest genetics research companies is based there and has been in the forefront of creating a population database resource for its research projects. Consequently, a large part of this article is centered around the bioethical discussion engendered by these projects, but other recent bioethical developments related to issues at the beginning and the end of life will also be discussed.