Summary
Bioethicists influence practices and policies in medicine, science, and public health. However, little is known about bioethicists' views in aggregate. We recently surveyed 824 U.S bioethicists on a wide range of ethical issues, including several issues of interest to the EA community (e.g., compensating organ donors, priority setting, paternalistic regulations, and trade-offs between human and animal welfare, among others). We aimed to contact everyone who presented at the American Society for Bioethics and Humanities Annual Conference in 2021 or 2022 and/or is affiliated with a US bioethics training program. Of the 1,713 people contacted, 824 (48%) completed the survey.
Why should EAs care?
- As Devin Kalish puts it in this nice post: "Bioethics is the field of ethics that focuses on issues like pandemics, human enhancement, AI, global health, animal rights, and environmental ethics. Bioethicists, in short, have basically the same exact interests as us."
- Many EAs don't hold the bioethics community in high regard. Much of this animus seems to stem from EAs' perception that bioethicists have bad takes. (See Devin's post for more on this.) Our survey casts light on bioethicists' views; people can update their opinions accordingly.
What did we find?
Chris Said of Apollo Surveys[1] separately analyzed our data and wrote a blog post summarizing our results:
Primary results
- A large majority (87%) of bioethicists believed that abortion was ethically permissible.
- 82% thought it was permissible to select embryos based on somewhat painful medical conditions, whereas only 22% thought it was permissible to select on non-medical traits like eye color or height.
- 59% thought it was ethically permissible for clinicians to assist patients in ending their own lives.
- 15% of bioethicists thought it was ethically permissible to offer payment in exchange for organs (e.g. kidneys).
Question 1
- Please provide your opinion on whether the following actions are ethically permissible.
- Is abortion ethically permissible?
- Is it ethically permissible to select some embryos over others for gestation on the basis of somewhat painful medical conditions?
- Is it ethically permissible to make trade-offs between human welfare and non-human animal welfare?
- Is it ethically permissible for a clinician to treat a 14-year-old for opioid use disorder without their parents’ knowledge or consent?
- Is it ethically permissible to offer payment in exchange for blood products?
- Is it ethically permissible to subject people to regulation they disagree with, solely for the sake of their own good?
- Is it ethically permissible for clinicians to assist patients in ending their own lives if they request this?
- Is it ethically permissible for a government to allow an individual to access treatments that have not been approved by regulatory agencies, but only risk harming that individual and not others?
- Is it ethically permissible to consider an individual’s past decisions when determining their access to medical resources?
- Is it ethically permissible to select some embryos over others for gestation on the basis of non-medical traits (e.g., eye color, height)?
- Is it ethically permissible to offer payment in exchange for organs (e.g., kidneys)?
- Is it ethically permissible for decisional surrogates to make a medical decision that they believe is in a patient's best interest, even when that decision goes against the patient’s previously stated preferences?
- Is it ethically permissible for a clinician to provide life-saving care to an adult patient who has refused that care and has decision-making capacity?
Results
Question 2
In general, should policymakers consider non-health benefits and harms (like whether expanding access to a service will reduce beneficiaries’ financial risk) when allocating medical resources?
Results
Question 3
A being becomes a person at...
Results
Question 4
Does the fact that a person's life is expected to be worth living once we bring them into existence give us a moral reason to bring them into existence?
Results
Question 5
If there are not enough lifesaving resources for everyone at risk of death, we should:
Results
Question 6
Is being unable to see disadvantaging?
Results
Question 7
It is most important to prevent someone from dying at which of the following ages:
Results
Some concluding thoughts
- There are more analyses/data in the paper (e.g., comparisons of bioethicists' views to those of the US public; data on bioethicists' backgrounds; analyses of the relationship between bioethicists' normative commitments and their views on specific issues). You can access the paper here. Feel free to reach out if you have trouble accessing it.
- We also surveyed bioethicists about issues related to research ethics (e.g., challenge trials; information hazards). These results will be published separately.
- If you're interested in administering this survey to EAs, please reach out.
- The American Journal of Bioethics will solicit peer commentaries on this paper in the near future. Please consider writing a commentary if you have thoughts. Edit: the link to do so can be accessed here.
- Sophie Gibert (the second author) and I have a podcast, Bio(un)ethical, where we often discuss issues at the intersection of bioethics and EA. If these issues are of interest to you, consider checking it out.
- ^
Apollo Surveys and EA Funds supported this work.
I don't think the distinction you are making works, because then the decision to not abort for non-medical reasons would be impermissible, since it affects the full life of a moral patient. Yet I highly doubt that bio-ethicists believe that, while you are allowed to abort a child for ~ any reason, you are not allowed to choose to not abort them.
Perhaps I have done a poor job of getting across my objection here, so here is a short dialog to demonstrate what I see as the absurdity:
Bioethicist lab tech: Good news! We managed to fertilize six healthy embryos for you. I have their genetic results right here.
Jane: Awesome! Does it say if they have blue or brown eyes?
Bioethicist lab tech: Sure does; one has blue eyes, five have brown eyes.
Jane: Great, lets go with the blue eyed one.
Bioethicist lab tech: Sorry, I can't let you do that. It's immoral. Bioethicists say so.
Jane: Why?
Bioethicist lab tech: Because choosing would affect the blue eyed child.
Jane: It seems like they would probably be happy with the outcome since it would mean they get to live a happy life... please can you make an exception?
Bioethicist lab tech: I can't do that... but, psst - there is a loophole. After you get an embryo implanted, you can get another genetic test done, and then abort them if they're the wrong eye colour.
Jane: Urgh, that sounds gruesome!
Bioethicist lab tech: Don't be so dramatic. Once they're inside you, it's just birth control.
Jane: Wait, you said choosing an embryo in vitro would be bad because it would affect the child... surely aborting them would also affect them?
Bioethicist lab tech: That's a misconception common among those who haven't studied bioethics. Actually, once they're dead, they can't be affected, simple as.
Jane: I'm not sure I follow but lets keep going. Then you'd implant the blue eyed one next?
Bioethicist lab tech: Nahh, you might have to do this several times.
Jane: What? I might have to have five abortions according to this absurd scheme? Doesn't this seem like unnecessary medical procedures with the potential for side effects?
Bioethicist lab tech: Potentially. Also, you'll have to wait till you get the genetic testing each time to see the eye colour, because I can't officially tell you which one I chose - that would be too close to embryo selection, regulations don't allow it.
Jane: That's crazy! Surely the later in pregnancy, the worse abortion is for the baby?
Bioethicist lab tech: Oh no, it's permissible at any point. Even if the fetus can feel pain it's not a person, doesn't matter one bit, no need for anesthesia. You can get rid of them at any point from week zero to week 40
Jane: Can I get rid of it before week zero?
Bioethicist lab tech: No, are you some kind of monster? That would affect the future person. You have to wait till they're implanted. Then they're no longer a future person, just an inconvenience.