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Euthanasia

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Euthanasia, defined as the intentional ending of a human life to relieve suffering, presents one of the most serious ethical challenges in modern medicine. The World Medical Association states that euthanasia occurs when “a physician deliberately administers a lethal substance or carries out an intervention to cause the patient’s death” and affirms that it is “unethical, even if carried out at the request of the patient” (World Medical Association, Declaration on Euthanasia). While medical science has made extraordinary advances in sustaining life and relieving pain, these same advances have intensified questions about whether the role of medicine is to end suffering by ending life, or to care for patients without intentionally causing death. 

A needle.

From a scientific and clinical standpoint, medicine is traditionally guided by the principles of beneficence and nonmaleficence, emphasizing healing and the avoidance of harm. Research in palliative medicine consistently shows that “most pain and distress in patients with life-limiting illness can be effectively relieved” through modern palliative and supportive care (World Health Organization, Palliative Care). Ethical scholars caution that when physicians participate in intentionally causing death, medicine risks a fundamental shift in purpose, as it moves from treating illness to determining when a life is no longer worth sustaining (Pellegrino, Journal of Medical Ethics).

Canada’s Medical Assistance in Dying (MAID) program highlights how scientific authority and ethical responsibility increasingly intersect. Originally limited to individuals whose death was reasonably foreseeable, eligibility has expanded to include certain non-terminal conditions marked by ongoing suffering. This expansion places clinicians in the role of assessing not only diagnosis and prognosis, but also subjective experiences such as suffering and perceived quality of life. As observed in the Canadian Medical Association Journal, MAID represents “an unprecedented transformation of medical practice by framing death itself as a clinical outcome” (Canadian Medical Association Journal). 

A doctor stands over a patient.

The euthanasia debate underscores a broader ethical challenge in science: technological capability often advances more rapidly than moral agreement. As medicine gains greater power over life and death, the responsibility to protect vulnerable populations becomes more urgent. Bioethicists warn that social factors such as disability, inadequate care, loneliness, or financial hardship may subtly influence end-of-life decisions, raising concerns about coercion and unequal vulnerability (Hastings Center Report). Ultimately, the ethical question facing modern science is not only what can be done, but what should be done, and how the intrinsic value of human life is safeguarded amid advancing medical power.

Prenatal Screening

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Advances in prenatal genetic screening have transformed how societies respond to disability, raising serious ethical questions about human value and the aims of medical science. Down syndrome, a genetic condition caused by an extra copy of chromosome 21, can now be detected during pregnancy with high accuracy through noninvasive prenatal testing. While such screening is often presented as a neutral tool for information, ethicists note that its routine use can strongly influence decision-making and shape societal attitudes toward which lives are considered acceptable.

A patient being briefed after her ultrasound.

Iceland is frequently cited in ethical discussions because of the outcomes associated with its prenatal screening practices. Reporting and medical ethics analyses indicate that the vast majority of pregnancies in which Down syndrome is diagnosed in Iceland end in abortion, resulting in the birth of very few children with the condition each year (CBS News 2017). An Icelandic physician involved in prenatal care acknowledged that “we end pregnancies where the fetus has Down syndrome” as a common outcome, despite the absence of any legal mandate (CBS News 2017). Scholars emphasize that the result is not a policy of prohibition, but a near-elimination driven by medical practice and social expectation.

 

From an ethical perspective, this raises concerns about the implicit messages conveyed by modern science. Bioethicists writing in the Journal of Medical Ethics warn that when a condition is routinely screened for and selectively aborted, it risks signaling that lives with disabilities are less valuable (Journal of Medical Ethics 2019). Disability advocates counter that Down syndrome is compatible with meaningful, fulfilling lives when individuals receive appropriate medical care, education, and community support. The Icelandic case highlights a broader ethical challenge: whether scientific progress is being used to support diverse human life, or to quietly narrow the range of lives deemed worthy of being born (Hastings Center Report 2017).

Population Control

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View of Mumbai skyline over slums in the Bandra suburb

View of Mumbai skyline over slums in the Bandra suburb

Efforts to regulate population growth have long intersected with scientific advancement, public policy, and ethical debate. Under the term “population control,” governments and institutions have employed strategies ranging from family planning incentives to coercive measures intended to limit births. While demographic research and reproductive technologies are often presented as neutral scientific tools, ethicists emphasize that their application reflects value judgments about which populations should grow, decline, or be restrained. As bioethicist Daniel Callahan observed, population policies raise “fundamental questions about the moral limits of social planning over human life” (Callahan, Ethics and Public Policy).

A mother and daughter traversing the slums of South-East Asia. 

A mother and daughter traversing the slums of South-East Asia. 

Historically, population control programs have frequently targeted vulnerable groups. In the twentieth century, policies justified by demographic science and economic modeling led to forced sterilizations, discriminatory family-size limits, and pressure-based reproductive interventions. The U.S. Supreme Court’s decision in Buck v. Bell notoriously endorsed compulsory sterilization, with Justice Oliver Wendell Holmes declaring, “Three generations of imbeciles are enough,” a statement now widely condemned as a grave ethical failure rooted in pseudoscientific eugenics (Buck v. Bell 1927). Scholars writing in the American Journal of Public Health note that such programs were often framed as scientifically necessary, yet resulted in profound violations of human rights.

 

Modern discussions of population control continue to raise ethical concerns as advances in contraception, data analytics, and reproductive medicine increase the ability to influence reproductive behavior at scale. Bioethicists warn that when scientific expertise is used to justify limiting births for economic, environmental, or social goals, the line between public health and coercion can become dangerously blurred (Hastings Center Report). The ethical challenge for modern science is to ensure that demographic knowledge serves human dignity rather than undermines it, respecting reproductive freedom while rejecting any use of science to rank, restrict, or devalue human lives.

Stem Cell Research

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Embryonic stem cell research raises enduring ethical concerns because it requires the destruction of human embryos—organisms that are already undergoing organized, self-directed development as distinct members of the human species. Embryos used for research are typically obtained either from induced abortions or from in-vitro fertilization (IVF) procedures in which so-called “excess” embryos are created and later discarded. The National Academies of Sciences acknowledge that deriving embryonic stem cells “necessarily involves the destruction of the embryo,” placing this field at the center of debates about whether early human life may be treated as research material rather than as a developing human being with inherent moral worth (National Academies of Sciences 2002).

 

Scientifically, embryonic stem cells are valued for their pluripotency, meaning they can differentiate into nearly any cell type in the body. However, obtaining these cells requires disaggregating the embryo at the blastocyst stage, an act that ends its life. As developmental biologists have long recognized, from fertilization onward the embryo is “a new, genetically distinct human organism” directing its own growth (Moore and Persaud, The Developing Human). This creates a direct ethical conflict: potential medical gains are pursued through the intentional destruction of early human life.

In response, many bioethicists and scientists point to ethically sound alternatives that do not require harming embryos. Adult stem cells and umbilical cord blood stem cells have been used for decades in the treatment of blood disorders, immune diseases, and cancers. More recently, induced pluripotent stem cells (iPSCs), first described by Shinya Yamanaka, allow adult cells to be reprogrammed to a pluripotent state, offering “embryonic-like” versatility without embryo destruction (Yamanaka 2006). Pro-life bioethicists argue that these advances demonstrate a central ethical principle: scientific progress need not come at the cost of nascent human life.

 

The ethical challenge posed by stem cell research reflects a broader question facing modern science—whether technological capability defines moral permission. As alternative methods continue to expand, the debate increasingly turns on whether destroying human embryos is a necessary path to healing, or a line that science ought not cross. How societies answer this question will shape not only biomedical research, but also how human life is valued at its earliest and most vulnerable stage.

Mature cartilage cells produced from iPSCs, demonstrating their ability to form all three germ layers.
Mature goblet cells produced from iPSCs, demonstrating their ability to form all three germ layers.
Mature neuron cells produced from iPSCs, demonstrating their ability to form all three germ layers.

These images show mature cells—not stem cells—produced from iPSCs, demonstrating their ability to form all three germ layers.

Honda, Arata, et al., CC BY 4.0 <https://creativecommons.org/licenses/by/4.0>, via Wikimedia Commons

Genetic Manipulation

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Gene-editing technologies such as CRISPR-Cas9 have given scientists unprecedented ability to alter DNA, offering potential treatments for genetic disease while raising profound ethical concerns. When applied to the human germline—embryos, eggs, or sperm—these edits become permanent and heritable, affecting future generations. Scientific reviews warn that germline editing carries serious risks, including off-target mutations, mosaicism, and unpredictable long-term health effects that cannot be fully assessed before birth (National Academies of Sciences, Engineering, and Medicine, Human Genome Editing: Science, Ethics, and Governance (Washington, DC: National Academies Press, 2017)).

These dangers became evident in 2018 when Chinese scientist He Jiankui announced the birth of genetically edited twins. His experiment bypassed ethical safeguards and regulatory oversight and was widely condemned by the international scientific community as irresponsible and unsafe. A commentary in Nature emphasized that the work exposed children to “unknown and potentially serious lifelong risks,” underscoring how rapidly powerful technologies can be misused when ethical limits are ignored (Cyranoski, “What CRISPR-baby Prison Sentences Mean for Research,” Nature 577 (2020)).

 

Beyond safety, germline genetic manipulation raises deeper concerns about human dignity and the risk of modern eugenics. Bioethicists caution that moving from therapy to trait selection could transform children from individuals to engineered outcomes, shifting genetics from healing to design (Journal of Medical Ethics). The ethical challenge facing modern science is not simply what can be done, but what should be done, and whether permanent alterations to human life respect the inherent value of every person.

Artificial Wombs

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Artificial womb technology, often referred to as ectogenesis, seeks to support the development of extremely premature infants outside the human body by replicating aspects of the uterine environment. Researchers have demonstrated experimental systems that allow premature animal fetuses —primarily lambs and piglets— to continue development using fluid-filled chambers and external oxygenation (Partridge et al. 2017). While the FDA is currently reviewing the technology for human clinical trials, there have been no documented human cases to date. Proponents argue that such technology could improve survival rates for extremely preterm infants and reduce pregnancy-related risks. Yet these advances also raise complex ethical questions about how science defines pregnancy, birth, and the responsibilities owed to developing human life.

 

From a scientific standpoint, artificial wombs blur traditional boundaries between fetal and neonatal care. As developmental biology and neonatal medicine converge, ethicists caution that removing gestation from the human body may fundamentally alter how society understands parental responsibility, maternal–child relationships, and medical decision-making. Scholars writing in the Journal of Medical Ethics note that ectogenesis could shift the perception of unborn children from patients within a mother to independent subjects of technological management, introducing new moral and legal uncertainties (Romanis 2018).

 

Artificial wombs also present ethical concerns related to misuse and unintended consequences. Bioethicists warn that the technology could be employed not only to save vulnerable infants, but also to bypass pregnancy entirely, commodify reproduction, or facilitate experimentation on developing humans. As one analysis in the Hastings Center Report observes, ectogenesis risks transforming human development into “a process increasingly governed by technological control rather than relational care” (Cavaliere 2018). The ethical challenge facing modern science is to ensure that innovations designed to preserve life do not inadvertently reduce human beings to objects of manufacture or undermine the inherent dignity of early human life.

In Vitro Fertilization (IVF)

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In vitro fertilization (IVF) is widely used to address infertility, yet it raises serious ethical concerns regarding the treatment of human life at its earliest stage. IVF typically involves creating multiple embryos outside the body, only a fraction of whom are implanted. Medical and ethical literature acknowledges that many embryos created through IVF are frozen indefinitely, discarded, or used for research, resulting in the loss or instrumentalization of developing human life (American Society for Reproductive Medicine Ethics Committee 2018; Journal of Medical Ethics).

A syringe injecting a sperm cell into an ovum cell during an IVF. DrKontogianniIVF, CC0, via Wikimedia Commons

A syringe injecting a sperm cell into an ovum cell during an IVF. DrKontogianniIVF, CC0, via Wikimedia Commons

IVF also introduces ethical challenges through embryo selection and genetic screening. Embryos are often graded or tested for chromosomal or genetic conditions before implantation, a practice that bioethicists warn can promote a utilitarian view of human worth based on health or perceived desirability. Scholars note that such selection risks reinforcing discriminatory attitudes toward disability and echoes modern forms of eugenic thinking (Journal of Medical Ethics).

Finally, IVF raises broader moral questions about the commercialization of reproduction. By relocating conception to the laboratory, human life becomes subject to efficiency metrics, contracts, storage decisions, and disposal policies. As observed in bioethics scholarship, treating embryos as property rather than persons challenges the principle of inherent human dignity (Hastings Center Report). The ethical question facing modern science is whether the pursuit of parenthood can proceed without compromising respect for the lives created in the process.

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