Gyngell et al argue that no intrinsic differences exist between embryos derived from fertilisation and stem cell-derived embryo models (SCEMs) that would justify attributing a higher moral status to the former. Nienke de Graeff and Lien De Proost challenge this claim by emphasising the diversity of SCEMs and by broadening moral evaluation beyond direct moral status to include relational, symbolic and instrumental value. This response argues that their pluralistic framework does not, in fact, undermine moral equivalence in cases where SCEMs successfully instantiate embryo-like human developmental organisation. Once the distinction between properties that ground moral status and considerations that merely shape social or regulatory responses is made explicit, no principled basis remains for differential moral standing. Variation among SCEMs defeats equivalence only where embryo-like organisation is absent; where it is present, moral parity follows. Likewise, relational and instrumental values may justify different governance strategies, but they cannot ground differences in moral worth without collapsing into policy convenience. Rejecting binary thinking does not require denying equivalence where morally relevant features coincide. Either SCEMs fail to model embryos, in which case equivalence never arises, or they succeed and must be treated as morally equivalent in respect of status. What cannot be coherently sustained is embryo-likeness without moral parity.
Gyngell等人认为，受精胚胎和干细胞衍生胚胎模型（SCEMs）之间不存在内在差异，因此前者的道德地位更高。Nienke de Graeff和Lien de Proost通过强调SCEMs的多样性和将道德评价从直接的道德地位扩展到包括关系、象征和工具价值来挑战这一说法。这一回应认为，事实上，在胚胎干细胞成功实例化胚胎样人类发育组织的情况下，它们的多元框架并不会破坏道德上的平等。一旦明确区分了作为道德地位基础的属性和仅仅塑造社会或监管反应的考虑因素，那么区分道德地位就没有原则基础了。只有在胚胎样组织缺失的情况下，干细胞之间的差异才会破坏等效性；只要有平等，道德平等就会随之而来。同样，关系价值和工具价值可以证明不同的治理策略是合理的，但它们不能在不崩溃为政策便利的情况下，为道德价值的差异奠定基础。拒绝二元思维并不需要否认道德相关特征重合的等价性。胚胎干细胞要么无法模拟胚胎，在这种情况下，对等永远不会出现；要么它们成功了，必须在道德上被视为地位平等。没有道德平等的胚胎相似性是无法连贯地维持下去的。
{"title":"Moral equivalence and the grounds of moral status in stem cell-derived embryo models: a response to de Graeff and De Proost.","authors":"Johnny Sakr","doi":"10.1136/jme-2026-111712","DOIUrl":"https://doi.org/10.1136/jme-2026-111712","url":null,"abstract":"<p><p>Gyngell <i>et al</i> argue that no intrinsic differences exist between embryos derived from fertilisation and stem cell-derived embryo models (SCEMs) that would justify attributing a higher moral status to the former. Nienke de Graeff and Lien De Proost challenge this claim by emphasising the diversity of SCEMs and by broadening moral evaluation beyond direct moral status to include relational, symbolic and instrumental value. This response argues that their pluralistic framework does not, in fact, undermine moral equivalence in cases where SCEMs successfully instantiate embryo-like human developmental organisation. Once the distinction between properties that ground moral status and considerations that merely shape social or regulatory responses is made explicit, no principled basis remains for differential moral standing. Variation among SCEMs defeats equivalence only where embryo-like organisation is absent; where it is present, moral parity follows. Likewise, relational and instrumental values may justify different governance strategies, but they cannot ground differences in moral worth without collapsing into policy convenience. Rejecting binary thinking does not require denying equivalence where morally relevant features coincide. Either SCEMs fail to model embryos, in which case equivalence never arises, or they succeed and must be treated as morally equivalent in respect of status. What cannot be coherently sustained is embryo-likeness without moral parity.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Voluntariness or validity? A reply to Smith and Mackie.","authors":"Diego S Silva, Kari Pahlman","doi":"10.1136/jme-2025-111504","DOIUrl":"https://doi.org/10.1136/jme-2025-111504","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Philip Reed has offered several interesting objections to my recent JME paper, 'Expressivist concerns for assisted dying on request.' In this brief reply, I address those objections.
{"title":"A reply to Reed on my 'Expressivist concerns for assisted dying on request'.","authors":"Jonathon VandenHombergh","doi":"10.1136/jme-2025-111632","DOIUrl":"https://doi.org/10.1136/jme-2025-111632","url":null,"abstract":"<p><p>Philip Reed has offered several interesting objections to my recent <i>JME</i> paper, 'Expressivist concerns for assisted dying on request.' In this brief reply, I address those objections.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
On 16 April 2025, the Supreme Court of the UK ruled that when interpreting the UK's Equality Act (2010)-the Act of the UK Parliament that details protections against unlawful discrimination-the terms 'man', 'woman' and 'sex' pick out 'biological sex' (defined in the Court's ruling as 'the sex of a person at birth') and not also 'certificated sex' (defined in the Court's ruling as 'the sex attained by the acquisition of a Gender Recognition Certificate'). Some have argued that the Court's decision represents a significant setback for trans people, while others have welcomed the perceived clarity the decision has provided. The decision has had, and will continue to have, wide impact, such as on the lawful operation of single-sex spaces and services in the UK. Scrutiny of the Court's judgement is therefore warranted. The judgement was based on an interpretation of what Parliament intended in the Equality Act, but there are unresolved questions: (1) Is the Court's interpretation of what Parliament intended the terms 'man', 'woman' and 'sex' to refer to correct? (2) Was the Court's ruling made in a sufficiently just way? With these questions in mind, this article has two main aims. First, to summarise the Court's recent decision and its social impacts. Second, to stress the importance of procedural justice in evaluating this verdict. This article thereby presents a preliminary case for the adequate consultation of all relevant stakeholders in potentially contentious legal decisions-especially where significant practical consequences for different social groups are likely.
{"title":"Who is a man and who is a woman? Implications of the UK Supreme Court decision.","authors":"Shalom Chalson, Brian D Earp, Julian Savulescu","doi":"10.1136/jme-2025-111202","DOIUrl":"https://doi.org/10.1136/jme-2025-111202","url":null,"abstract":"<p><p>On 16 April 2025, the Supreme Court of the UK ruled that when interpreting the UK's Equality Act (2010)-the Act of the UK Parliament that details protections against unlawful discrimination-the terms 'man', 'woman' and 'sex' pick out 'biological sex' (defined in the Court's ruling as 'the sex of a person at birth') and not also 'certificated sex' (defined in the Court's ruling as 'the sex attained by the acquisition of a Gender Recognition Certificate'). Some have argued that the Court's decision represents a significant setback for trans people, while others have welcomed the perceived clarity the decision has provided. The decision has had, and will continue to have, wide impact, such as on the lawful operation of single-sex spaces and services in the UK. Scrutiny of the Court's judgement is therefore warranted. The judgement was based on an interpretation of what Parliament intended in the Equality Act, but there are unresolved questions: (1) Is the Court's interpretation of what Parliament intended the terms 'man', 'woman' and 'sex' to refer to correct? (2) Was the Court's ruling made in a sufficiently just way? With these questions in mind, this article has two main aims. First, to summarise the Court's recent decision and its social impacts. Second, to stress the importance of procedural justice in evaluating this verdict. This article thereby presents a preliminary case for the adequate consultation of all relevant stakeholders in potentially contentious legal decisions-especially where significant practical consequences for different social groups are likely.</p>","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ethics of third-party coercion in medicine: some differences between health care professionals and tattooists.","authors":"Søren Holm","doi":"10.1136/jme-2025-111483","DOIUrl":"https://doi.org/10.1136/jme-2025-111483","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"If consent under third-party coercion is voluntary, we should rethink informed consent.","authors":"Katie H C Wong","doi":"10.1136/jme-2025-111547","DOIUrl":"https://doi.org/10.1136/jme-2025-111547","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Double effect sedation: reply to commentaries.","authors":"Hitoshi Arima","doi":"10.1136/jme-2025-111647","DOIUrl":"https://doi.org/10.1136/jme-2025-111647","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unpacking the 'paradox' of disease prevention and environmentally sustainable healthcare: a response to Richie.","authors":"Anand Bhopal","doi":"10.1136/jme-2025-111594","DOIUrl":"https://doi.org/10.1136/jme-2025-111594","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vaccine mandates impair voluntariness, even if consent-receivers do not.","authors":"Ben Saunders","doi":"10.1136/jme-2025-111463","DOIUrl":"https://doi.org/10.1136/jme-2025-111463","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Informed consent under coercion: the limits of the interpersonal justification.","authors":"Andrea Lavazza","doi":"10.1136/jme-2025-111514","DOIUrl":"https://doi.org/10.1136/jme-2025-111514","url":null,"abstract":"","PeriodicalId":16317,"journal":{"name":"Journal of Medical Ethics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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