Recent and forthcoming publications
If you want the full or final text of a paper which is not downloadable from this page, email me. In most cases, if a paper is not available on this page (because of publishers’ restrictions), I can email a copy on request.
How useful is the concept of the ‘harm threshold’ in reproductive ethics and law? Theoretical Medicine and Bioethics. 2014;1-16
It is commonly assumed that the use of reproductive technologies should be limited by considerations of harm to the resulting offspring. Derek Parfit has argued that where a child could not exist without a particular genetic condition, we cannot say it has been harmed unless its suffering passes a certain threshold. In this paper, I consider how this threshold might be set, and what role it should play in law. I demonstrate that the concept of such a threshold is flawed, and that it is not possible to show that a child has been harmed by the means of its conception.
Artificial gametes and the ethics of unwitting parenthood (with Daniela Cutas). Journal of Medical Ethics. 2014. doi:10.1136/medethics-2013-101824
In this paper, we explore the ethical and legal implications of collecting discarded skin cells, using them to develop sperm or eggs that would be genetically those of the unwitting donor, and then producing offspring, who would likewise be the genetic children of ‘parents’ who might never have been aware that their cells were being used in this way.
Perimortem gamete retrieval: should we worry about consent? Journal of Medical Ethics. doi:10.1136/medethics-2013-101727
Perimortem sperm retrieval involves the surgical extraction of sperm from a dying man. This can then be frozen and stored for future use. Usually, the request for this intervention comes from a spouse or partner after the man in question has lost capacity to consent. But is it acceptable to perform this kind of procedure on a dying patient?
Will artificial gametes end infertility? With Daniela Cutas. Healthcare Analysis. 2013:1-14
The ability to create sperm and eggs from other body cells may make it easier for people to reproduce despite their biological limitations, but it will also call into question the ways in which we define infertility.
Reification and compassion in medicine: a tale of two systems. Clinical Ethics. 2013;8(4):85-92
First published on September 18, 2013 as doi:10.1177/1477750913502620.
If doctors and nurses were more compassionate, would this help to avoid problems in the health service? In this paper, I argue that the answer is not necessarily ‘yes’, and that a scientistic healthcare system will always struggle to accommodate incommensurable virtues such as compassion.
In defense of ectogenesis. Cambridge Quarterly of Healthcare Ethics. 2012;21(1):90-103.
Ectogenesis (the gestation of foetuses outside the womb) may be a necessary development if we are to address the inherent inequalities of natural reproduction. In this paper I discuss the merits of ectogenesis, and rebut some of the criticisms brought against it.
Ethical challenges in foetal surgery. Journal of Medical Ethics. 2011;37:88-91.
Foetal surgery involves the partial removal of a foetus while it is still connected to the placenta; following treatment it is returned to the womb. Healing in utero can be scar-free, but the risks of surgery are imposed on both mother and foetus, making it an ethically-complex issue.
The limits of empathy: problems in medical education and practice. With A Stöckl and C Salter. Journal of Medical Ethics. 2011;37:380-383.
It is often assumed that empathy is a necessarily attribute for a good doctor. Here, we query that assumption and suggest that the concept of empathy and its role in medicine require further analysis.
The ethics of IVF over 40. Maturitas. 2011;69:37–40.
IVF can be less effective in older women. Its provision in a publicly funded healthcare system is therefore open to question. But are there additional ethical reasons to withhold IVF from women over 40?
Applying for ethical approval for research in the United Kingdom. With MR Sydes, L Gelling and M Wilkinson. British Medical Journal. 2009;339:b4013.
In this paper, we explain the process of getting ethical approval and describe some of the pitfalls to be avoided.
Should IVF guidelines be relaxed in the UK?. Expert Review of Obstetrics & Gynecology. 2009;4(5):501-508.
I argue that rationing IVF on the basis of socio-ethical judgements is commonplace in the UK, but is contrary to the principles on which the NHS is founded.
Between fecklessness and selfishness: is there a biologically optimal time for motherhood? A reply to Daniel Callahan. In Simonstein F (ed.) Reprogen-ethics and the future of gender. Springer. 2009. 105-117.
This chapter explores arguments commonly brought against the trend towards delaying motherhood. I suggest that on closer analysis many of these arguments are unfounded or based on over-simplified assumptions.
The ethics of egg donation in the over 50s. Menopause International. 2008;14(4):173–177.
An overview of the ethical concerns raised by postmenopausal motherhood
The changing face of IVF regulation. Expert review of obstetrics & Gynecology. 2008;3(4):433-436.
An analysis of the regulatory environment since the birth of the first IVF baby in 1978.
From IVF to immortality: controversy in the era of reproductive technology. With Ruth Deech. Oxford University Press. 2007.
This book, co-authored with the former chair of the Human Fertilisation and Embryology Authority, explores some of the most contentious issues related to reproductive technology and embryo research.
Getting from the empirical to the ethical and back again. With Emma Baldock, Adele Langlois and Jon Ives. Health Care Analysis. 2008;16(1).
This editorial explores the meaning of ’empirical bioethics’ and reviews five papers that engage diverse empirical approaches to ethical questions.
Deciding the fate of disputed embryos: ethical issues in the case of Natallie Evans. Journal of Experimental & Clinical Assisted Reproduction. 2007;4:2.
A critical analysis of some of the arguments against allowing a woman to use embryos created with the sperm of her former partner.
Harm, law and reproductive cloning. In Arguments and Analysis in Bioethics. Hayri M, Takala T. (eds). Rodopi Values in Bioethics Series. Amsterdam/New York, NY, 2010.
An evaluation of the claim that reproductive cloning should be banned on the grounds of harm to the clone.
The moral imperative for ectogenesis. Cambridge Quarterly of Healthcare Ethics. 2007;16(3):336-345.
Using an argument based on Ronald Dworkin’s conception of equality and justice, I argue that women’s reproductive role is inherently unjust and that we should focus resources on finding alternatives.
State-funded IVF will make us rich …or will it? Journal of Medical Ethics. 2007;33:468-469.
It has been argued that state-funded IVF would be profitable since the amount that the average citizen contributes in tax exceeds the money which would be spent on fertility treatment. I argue that this view is misguided and simplistic.
Artificial gametes: new paths to parenthood?. With Ainsley Newson. Journal of Medical Ethics. 2005;31(3):184-186.
Research on murine embryonic stem cells has revealed that in certain conditions they can differentiate into gametes. In this paper we explore the ethical implications if this development is achieved with human cells.
Newspaper and other articles
Whose sperm is it anyway? BioNews, 1st October 2012
The IVF Lottery BioNews, 8th August 2011
Should we harvest eggs from a comatose woman? BioNews, 22nd August 2010
Consent for embryo creation and storage: time for a change in the law? BioNews, 17th May 2010
Time to put a stop to postmenopausal mothers? BioNews, 1st February 2010
Genetic testing of children prior to adoption BioNews, 24th August 2009
Incarceration and infertility: do prisoners have the right to access IVF? BioNews, 19th January 2009
Posthumous retrieval of gametes: a case of deja vu? BioNews, 1st December, 2008
Artificial gametes: the end of infertility? BioNews, 26th February, 2008
The review of the HFE Act: ethical expertise or moral cowardice? BioNews, 6th November, 2007
There’s no such thing as a free egg BioNews, 13th August, 2007
Is there a right not to be a parent? BioNews, 30th April, 2007
The egg and sperm race BioNews, 7th November, 2006
The Irwin video: would you watch it? BBC News Online, 8th September, 2006
How will artificial sperm success affect further research? BioNews, 17th July, 2006
A moral choice best left to the individual. The Times, July 13th, 2006
Your genes, but are they your children? The Times, July 11th, 2006
Going up in smoke The Imperial Ethics Newsletter, Spring 2005