The Nuffield Council on Bioethics (NCOB) is delighted to pick up the mantel of the Ethics briefings. For readers less familiar with the NCOB’s work, we are a leading independent policy and research centre, and the foremost bioethics body in the UK. We identify, analyse and advise on ethical issues in biomedicine and health so that decisions in these areas benefit people and society.1 Established in 1991, the NCOB has tackled a wide range of bioethics and medical ethics issues over (...) its thirty-two years, including issues relating to the beginning and end of life, health and society, data and technology, and research ethics. Early reports in the 1990s included, for example, ‘Genetics screening: the ethical issues’ and ‘Animal-to-human transplants: the ethics of Xenotransplantation’. More recent projects include setting out an ethical framework in the report ‘The future of ageing: ethical considerations for research and innovation’2 and a current joint project with the Ada Lovelace Institute3 considering the potential ethical implications of the convergence of AI and genomics technologies.4 In recent years, NCOB has increasingly focused on horizon scanning. What current and future national and international developments are likely to raise ethical issues in the short, medium and long-term? Insights for 2023 will soon be available at www.nuffieldbioethics.org/what-we-do/horizon-scanning, with new developments likely to be included alongside ongoing areas of medical and scientific research that we are tracking progress in, for example, in vitro derived gametes, surrogacy, biosafety and novel neurotechnologies. Disagreements between parents and healthcare teams about …. (shrink)

Several European countries have recently started taking steps to protect access to abortion. France is one of these, with a bill having made its way through the legislature to enshrine the ‘liberté garantie’ (‘guaranteed freedom’) to an abortion in its constitution. It is the first country in the world to explicitly include abortion access in its constitution. Although abortion was decriminalised in France in 1975, proponents of the bill stated that they were motivated by protecting freedom for future generations (rather (...) than any perceived current threats)—the French minister for justice described this as characteristic of constitutional lawmaking.1 Enshrining such a freedom within the constitution was not without opposition. Although the bill passed through the Assemblée in January 2024 with 99 votes in favour and 13 against,2 it followed 8 hours of debate in which a number of issues were discussed. The Sénat (the upper house of Parliament) was initially thought to be more likely to oppose the bill. The bill was carried through the Sénat, however, with its Law Commission indicating prior to debate that it would not oppose making abortion a constitutional freedom, despite ‘some reservations’ about the text of the bill.3 Some of the issues raised in the Assemblée related to the language used, with some parliamentarians preferring to constitutionalise the ‘droit’ (right) to abortion; in line with language used in previous debates on the subject, rather than the term ‘liberté’ that was settled on.4 Other concerns were raised about the appropriateness of ‘preventative constitutionalisation’,5 the potential impact on a clinician’s ability to exercise conscientious objection6 and fears of creating an imbalance more generally between women’s …. (shrink)

The infected blood inquiry, chaired by Sir Brian Langstaff, has now concluded.1 It is the largest public inquiry ever carried out in the UK, investigating what has been described as the ‘worst treatment disaster in the history of the NHS’.1 2 It was established to examine the circumstances in which more than 30 000 people in the UK were infected with HIV and hepatitis C after being given contaminated blood and blood products during the 1970s and 1980s, which had been (...) imported to meet the demand for a new blood-clotting treatment known as ‘factor VIII’. This treatment was created by pooling the plasma from thousands of donors, increasing the risk of infection. The risk was further heightened by the inclusion of donor plasma from the USA, where people with a high risk of infection, including prisoners, were paid to provide blood, whereas the UK system has always relied on altruistic donation.3 The inquiry gathered extensive evidence and was informed by the involvement of over 2000 infected individuals. It considered questions of informed consent, openness and transparency, including disclosure of risks. In his report, Sir Langstaff concluded that the scandal "could largely, though not entirely, have been avoided" and resulted from "systemic, collective and individual failures to deal ethically, appropriately and quickly, with the risk of infections being transmitted in blood, with the infections when the risk materialised and with the consequences for thousands of families". He highlighted six themes arising from the inquiry. (shrink)

The upper time limit on growing embryos in culture for research could be revised, following a new recommendation by the Human Fertilisation and Embryology Authority (HFEA), the regulator of embryo research and fertility treatments in the UK. The recommendation was agreed at a meeting of the HFEA Authority, as part of wider discussions about modernising fertility law in the UK.1 Under the Human Fertilisation and Embryology Act 1990 (as amended), embryos which have been donated or created for research may be (...) grown in culture for up to 14 days or until the appearance of the primitive streak (whichever occurs sooner).2 This rule is widely replicated in other jurisdictions which permit the use of embryos in research.3 When this rule was adopted nearly 35 years ago, there was no prospect of sustaining embryos in vitro for more than a few days, and until recently, it has not posed a significant barrier to research.4 However, pressure to review the limit has grown following the publication of two studies in 2016 which demonstrated the technical feasibility of growing embryos to and potentially beyond the 14-day-limit.5 6 Proponents of changing the limit point to possible benefits of allowing …. (shrink)

Following the well-publicised case of Dr Sarah Benn, the former General Practioner (GP) who was suspended from the UK medical register earlier this year for breaching injunctions in order to peacefully protest climate change,1 uncertainty and wider discourse has persisted about the extent to which doctors can be involved in protests without risking regulatory action. In response to this uncertainty, in July the General Medical Council (GMC) published an explanation of how it manages concerns about doctors’ actions as part of (...) protests and activism. It includes the statement that they are bound by law to refer any conviction resulting in a custodial sentence directly to a Medical Practioners Tribunal Service (MPTS) hearing.2 They also state that the nature of the protest does not impact their consideration of whether there was a serious breach of professional standards or a risk to public protection.2 The move to clarify the GMC’s position has been cautiously welcomed by the UK Health Alliance on Climate Change but with criticisms that important questions remain unanswered, such as the GMC’s rationale for determining that public confidence in doctors is harmed by convictions arising from environmental activism.3 Interest in this issue shows little sign of fading, as regulatory action continues to be taken against climate activist doctors. Dr Diana Warner, a retired GP, was suspended from the medical register in August following a series of convictions for …. (shrink)