It was only a matter of time before the portmanteau term “genethics” would be coined and a whole field within bioethics delineated. The term can be dated back at least to 1984 and the work of James Nagle, who claims credit for inventing the word, which he takes “to incorporate the various ethical implications and dilemmas generated by genetic engineering with the technologies and applications that directly or indirectly affect the human species.” In Nagle’s phrase, “Genethic issues are instances where medical genetics and biotechnology generate ethical problems that warrant societal deliberation.” The great promises and terrific threats of developments in scientific understanding of genetics, and the power to enhance, modify, or profit from the knowledge science breeds, naturally offer a huge range of issues to vex moral philosophers and social theorists. Issues as diverse as embryo selection and the quest for immortality continue to tax analysts, who offer reasons as varied as the matters that might be dubbed “genethical” for or against the morality of things that are actually possible, logically possible, and even just tenuously probable science fiction.

This quotation from the London Review of Books is an example of a turn—a different way of looking at things that involves a redefinition of the kind of thing higher education is and how it should be provided. It is a turn away from a public good perspective—the opposite, it might be said, of the kind of turn addressed in this article.

The Universal Declaration on Bioethics and Human Rights adopted by UNESCO in 2005 advocates for the establishment of independent, multidisciplinary, and pluralist ethics committees at national, regional, local, or institutional levels. The purpose of these committees is (a) to evaluate the relevant ethical, legal, scientific, and social issues related to research involving human beings; (b) to provide advice on ethical problems in clinical settings; (c) to assess scientific and technological development, formulate recommendations, and contribute to the preparation of guidelines; and (d) to foster debate, education, and public awareness of and engagement in bioethics (Article 19). Already in the very first draft of the Declaration the need to promote and establish national bioethics committees was mentioned. Although the text was gradually elaborated, the same basic idea has been preserved throughout the process of drafting, negotiating, and adopting the text.

Dashiell Hammett’s reaction was “sharp and angry, snarling” when he read, at her request, a work in progress by his friend and lover, Lillian Hellman. “He spoke as if I had betrayed him.” His judgment was absolute and his advice unsparing: “Tear this up and throw it away. It’s worse than bad—it’s half good.” That is exactly what I thought of Matti Häyry’s Rationality and the Genetic Challenge as, for the third time in the evening, I penned a note in its margins and sent it sailing across the room in disgust. Cambridge University Press knows its book binding, however, and the spine of the text was undamaged.

Matti Häyry’s new book is deliberately challenging; it tells six contemporary bioethicists, and all who share their methodologies or even their general approach, that they have got it badly wrong. From the striking photograph of Häyry himself on the front cover to the very last line, the genetic challenge is issued and elaborated. Häyry has divided his protagonists into three pairs, of which I find myself a member, and this makes responding a duty as well as a pleasure. Although I cannot speak for my partner in crime, Jonathan Glover, I am at least in the very best of all possible company.

The first clinical ethics committees (CEC) in Norway were established in 1996. This started as an initiative from hospital clinicians, the Norwegian Medical Association, and health authorities and politicians. Norwegian hospitals are, by and large, publicly funded through taxation, and all inpatient treatment is free of charge. Today, all the 23 hospital trusts (providing specialized and hospital-based healthcare services to the Norwegian population of 4.9 million people) have established at least one committee. Center for Medical Ethics (SME), University of Oslo, receives an annual amount of US$335,000 from the Ministry of Health and Care Services to coordinate the committees and to facilitate competency building for committee members.

The expression “common good” usually conjures up benevolent associations: it is something to be desired, a worthy goal, and it would be a brave person who declared he or she was against the common good. Yet modern times have taught us to be critical and even suspicious of such grand rhetoric, leading us to query what lies behind this ambitious notion, who formulates what it stands for, and how such formulations have been reached.

The “doctrine of double effect” has a pleasing ring to it. It is regarded by some as the cornerstone of any sound approach to end-of-life issues and by others as religious mumbo jumbo. Discussions about “the doctrine” often generate more heat than light. They are often conducted at cross-purposes and laced with footnotes from Leviticus.

From the first initiatives in preimplantation genetic diagnosis (PGD) and gene therapy through the advent of stem cell research to the development of mammalian cloning, the past two decades have witnessed remarkable advances in “reprogenetic” medicine: the union of assisted reproductive technologies (ARTs) with genetic control. This period has also been marked by intense debates within the bioethical literature and in national policy forums about the appropriate uses of these emerging human capabilities. We can now, in a limited way, select for genetic traits, and the power to modify the genome or introduce new gene sequences is not far off. How should these new powers be used?

One of the most significant developments in the area of reproductive health in Ireland is the Roche v. Roche [2009] case. The case concerned a woman who wished to implant cryopreserved embryos made with a former partner, against the partner’s wishes. Of particular interest are questions about the status of the embryo: in Ireland the life of “the unborn” is constitutionally protected. Therefore the courts in Roche had to decide whether embryos were “unborn” within the meaning of the Irish Constitution.

Recently, concern has been raised regarding the politicization of public bioethics. Party politics has increasingly influenced public debate on ethical issues like stem cell research, human cloning, and end-of-life care. These debates have put bioethics “smack in the middle” of the culture wars. These recent events confirm Daniel Callahan’s prescient claim made in 1996 that “bioethical debates are beginning to reflect those culture wars … the larger moral struggles of our society.”

It is often argued that a major tension in bioethics is between protecting the private interests of individuals on one hand and contributing to the common good on the other. In this article I ask how fitting this description is as regards the interest at stake in relation to the issue of consent to participation in population data collections. I raise some doubts about what I take to be two common positions regarding public and private interests in this context. The first is that restricted individual consent protects private interests at the cost of public interest.

Informed consent is central to modern research ethics. Informed consent procedures have mainly been justified in terms of respect for autonomy, the core idea being that it should be every competent individual’s right to decide for herself whether or not to participate in scientific studies. A number of conditions are normally raised with regard to morally valid informed consent. These include that potential research subjects get adequate information, understand those aspects that are relevant to them, and, based on that information, make a voluntary decision whether or not to participate. These conditions are meant to guarantee that participation is genuinely the individual’s own choice and is coherent with his or her authentic interests.

The ongoing legal and bioethics debates on consent requirements for collecting, storing, and utilizing human biological material for purposes of basic and applied research—that is, genomic research biobanking—have already managed to pass through three ostensibly dissimilar stages

Rationality and the Genetic Challenge by Matti Häyry is a well-written and thoughtful book about important issues in the contemporary ethical discussion of genetics. The book is well structured around seven practical themes that the author takes to exemplify “the genetic challenge.” He also refers to them as “seven ways of making people better,” which the subtitle of the book already puts into question form: Making People Better? In the first chapter of the book, Häyry introduces these seven themes and he discusses each of them in Chapters 3–9. In the remaining two chapters, 2 and 10, he describes the main normative positions analyzed in the book and clarifies his own methodology and position. He chooses six authors, or three pairs of authors, whom he takes to “represent the three normative doctrines of Western Moral philosophy” (p. 27) in order to demonstrate six “divergent rationalities” or “methods of genethics.” In this way, Häyry both summarizes the main prescriptive positions in contemporary bioethical debate and contrasts them with his own “nonconfrontational notion of rationality,” which aims to show that there is a variety of divergent, not mutually exclusive normative views, the justification of which “depends ultimately on the choice of worldviews, attitudes, and ideas about the foundation of moral worth” (p. 47).

A wide variety of bioethical themes have recently been debated and researched in Sweden, including genetic screening, HPV vaccination strategies, end-of-life care, injustices and priority setting in healthcare, dual-use research, and the never-ending story of scientific fraud. Also, there are some new events related to Swedish biobanking that might be of general interest. Here we will concentrate on four themes: end-of-life care, dual-use research, scientific fraud, and biobanking.

We have arrived at a situation in which policymakers and ethicists are considering abandoning informed consent in the governance of certain new technologies, many of which are related to large-scale information systems. A paradigm case is the problem with using individuals’ informed consent to regulate biobanks. As sometimes suggested, there is a need for “new ethical frameworks.”

In a footnote to the first edition of Political Liberalism, John Rawls introduced an example of how public reason could deal with controversial issues. He intended this example to show that his system of political liberalism could deal with such problems by considering only political values, without the introduction of comprehensive moral doctrines. Unfortunately, Rawls chose “the troubled question of abortion” as the issue that would illustrate this. In the case of abortion, Rawls argued, “the equality of women as equal citizens” overrides both “the ordered reproduction of political society over time” and also “the due respect for human life.” It seems fair to say that this was not the best choice of example and also that Rawls did not argue for his example particularly well: a whole subset of the Rawlsian literature concerns this question alone.

NHS Blood and Transplant (NHSBT) is responsible for the procurement and allocation of human organs in the United Kingdom. Its main role is to “ensure that organs donated for transplant are matched and allocated to patients in a fair and unbiased way.” NHSBT’s liver allocation policies are underpinned by the National Liver Transplant Standards, a document published by the Department of Health in 2005 to oversee patient care, patient assessment, liver allocation and transplantation, education and training, and research and development. NHSBT has developed its own liver allocation protocols under the powers assigned to it by the Department of Health, which include a “super-urgent” liver allocation policy, a Liver Allocation Sequence, and pediatric candidate liver allocation protocols.

Matti Häyry’s new book Rationality and the Genetic Challenge discusses the ethics of human genetic modification and the bioethical rationalities that inform the different ethical conclusions authors have advanced. It is aimed at correcting the belief that “only one rationality exists or one morality exists; that those that disagree [with them] are unreasonable or evil.” Häyry argues that there are multiple rationalities, and that even though ethical issues may have solutions within individual rationalities, disagreements that have their root in separate rational approaches cannot be universally solved by intellectual arguments. In debates about the ethics of using new biotechnologies to genetically modify human beings, the normal state is one of fundamental disagreement over almost all of the anticipated uses to which the technology could be put. Häyry’s point is that such a state of affairs is not necessarily due to a lack of reason because there are many, equally valid, ways of being reasonable.