Introduction

Philosophy and bioethics journals occasionally publish controversial contributions. Sometimes these contributions address real-life issues, and sometimes not – or at least not directly. An early example of the latter is “Survival Lottery” by John Harris [1]; a paradigmatic consequentialist account that appears to justify killing one innocent person to save the lives of many innocent persons.

Another variety are papers that allegedly target a failure in current regulation and go on to suggest a solution that has little or no chance of being accepted. A relatively recent example is “After birth abortion: Why should the baby live?” in which Alberto Giubilini and Francesca Minerva argue that women should be allowed to kill (by proxy) their babies if they do not want to keep them or give them up for adoption [2].

Yet another variation of the theme are discussions designed to address an emerging problem, but a problem that is not universally recognized and therefore not, in the opinion of the majority, in need of a solution to begin with. Joona Räsänen has participated in one such discussion with his “Moral case for legal age change” [3]. There is a moral case to be made for people facing ageism to be allowed to hide or change their chronological age, but opposition is strong.

A new journal, the Journal of Controversial Ideas (edited by Jeff McMahan, Francesca Minerva, and Peter Singer) dedicates itself to “widely controversial” issues. In their view, for ideas to be widely controversial, “certain views about them might be regarded by many people as morally, socially, or ideologically objectionable or offensive” [4]. The journal allows authors to use pseudonyms to protect them from personal attacks and to, presumably, encourage publication from people who might otherwise be scared to publish their views. Their underlying rationale seems to be that opening a new channel for controversial contributions is “a means of getting closer to the truth, advancing science, and reforming social and cultural paradigms”. Not everyone, however, is happy with academic authors hiding behind aliases [5]. In this collection, Matti Häyry offers humor as an alternative route to avoid being prosecuted for distributing controversial views [6].

Generally, in the special issue at hand, we decidedly left out debates over abortion, euthanasia, and other perennial matters on which people disagree and which appear in popular political debates. They too are controversial, but they would not, we felt, reveal anything new or particularly interesting about “controversial arguments” in bioethics. Rather, we aimed to address those kinds of arguments that, when presented in bioethics conferences, not only raise opposition from those who disagree with the premises, but also stir unease even within those who, in general terms, agree with them. The three first contributions are examples of such arguments, while the last three study the nature and role of controversial arguments in bioethics more generally.

The special issue opens with Anna Smajdor’s paper exploring the ethics of whole-body gestational donation as an option for people signing up to the organ donor register. With such a practice in place, embryos created by prospective parents could be transferred to brain dead donors who had signed up for it and, who then, would remain on ventilators while the pregnancy was underway. Following the delivery of the baby, the donor’s organs could be donated in the usual way and according to the donor’s wishes. Smajdor considers several objections and counterarguments, but, in the end, deems them all unsuccessful. If she is right, it seems that if the public is receptive to organ donation in general, it should be accepting of whole-body gestational donation too [7].

While Smajdor’s paper suggests a partial and potential solution to the shortage of surrogates and to the problems related to surrogacy arrangements, Steven J. Firth and Ivars Neiders’ contribution seeks to find a way for disabled persons to be included in sexual citizenship. They start by explicating the basic premises that sexuality is essential to the human condition and that disabled people often find themselves deprived of ways of experiencing their sexuality. Firth and Neiders’ answer is a state sponsored Sex Doula program that could meet the various and often complicated sexual needs of disabled people. In the paper, they show that such a program could be justified in at least two different moral frameworks–utilitarianism and the capabilities approach. They further go on to consider and repudiate arguments against state sponsored Sex Doulas [8].

In his paper, Joona Räsänen studies the normative premises of veganism and antinatalism, and the arguments used to defend the views. The key assumption in most readings of both ideologies is that causing unnecessary suffering is wrong. If this is the case, it seems that vegans, and probably most vegetarians too, should embrace antinatalism and refrain from having children. [9]

Räsänen’s paper is in some senses more controversial than the two previous ones as all the premises he puts forward are, arguably, minority views. Most people are not vegans, vegetarians, and even fewer are antinatalists. Räsänen suggests an answer to a question very few people see as worth asking. This is different from Smajdor’s paper–most people accept organ donations—and from Firth and Neiders’ contribution–most people would agree that sexuality is essential to the human condition. The first two articles are examples of philosophical contributions that point to problems in current regulations.

The fourth contribution takes the discussion to a meta-level. What is the reason behind the prevalence of unrealistic scenarios and controversial views in bioethics literature? According to Ole Martin Moen, the main reason is that philosophical bioethics needs to make sure to get the basics right. Without testing our arguments and intuitions to their limits, we cannot be sure that this is the case. A more pragmatic reason for the multitude of controversial views in bioethics publications is that papers and books with mundane themes simply are not that interesting. However, we should be glad that that is, and has been, the case as it is the controversial papers that have the potential to move one's thinking forward. Using unrealistic scenarios and controversial arguments is not without problems. Moen helps to spot some of the pitfalls and considers strategies to overcome them [10].

Henrik Rydenfelt’s paper looks at bioethics as a discursive practice and adds to the collection a meta-ethical viewpoint. Rydenfelt maintains that the very existence of controversies in bioethics proves that most bioethicists are committed to moral realism. Drawing from pragmatism, he shows how the controversies serve various epistemic purposes within the discursive practice of bioethics. They help us identify the problems that need to be solved and point towards the arguments that need to be presented [11].

This collection closes with Matti Häyry’s analysis of five well-known controversial views put forward in philosophical bioethics from eating babies to creating the best possible children. He analyzes and compares the views in terms of the seriousness of objections they raise, the type of proposals they make, and the justifications they use. In addition, he considers the different ideological motives of the authors and the types of criticism their suggestions have encountered. Häyry’s contribution offers an insight into the logic of controversial views and goes further to propose a practical suggestion. According to Häyry, bioethicists with controversial views would probably fare better if they added humor and modesty to their proposals. Infuriating and enraging those with opposing views is not fertile ground for reasoned discussion. However, there is at least some evidence that using satire opens a door for a more fruitful dialogue [6].

We hope that this collection helps those interested in bioethics understand the logic, role, and importance of controversial views. We also hope it illuminates the value in furthering one’s understanding of contested matters. In most cases, controversial views are not presented for shock value, but as an honest attempt to make an ethical point. Putting forward controversial views is, however, difficult and can easily turn out to be counterproductive. To further discussion, it needs to be done with care. Hopefully, this collection can also provide some initial guidance as to how to accomplish that.