Policy analysis without ethical consideration is incomplete
Ethics has a PR issue. It can seem dull and, to some, even unnecessary: Why discuss ethics when we already have laws that tell us what to do? The most interesting part of ethics for many people is the thought experiments that have only tenuous ties to real-world issues.
It is worse for bioethics. Few people have a solid understanding of what it is, and when they find out—artificial intelligence! death penalty! psilocybin!—it seems exciting and interesting, but it is not a subject that they want to look at too closely. Bioethics is ethics, but applied to certain types of cases. It broadly addresses issues arising from advancements in medicine and technology, and those often-contentious issues often have political undertones.
What makes the issues contentious is that they are emotional, and that emotion stems from their actual effects on real people. Rather than resting comfortably in the realm of philosophical “armchair” ethics, where a conclusion to a question presented may never be reached, bioethical issues must have a conclusion that is applied as law/policy. Bioethics moves ethics from a theoretical space to a practical one.
Why is this relevant to think tanks?
Ethical considerations are a crucial part of any policy analysis. Many of the current, global headline-making policies are controversial social policies: abortion, surrogacy, transgender women’s rights, etc. More specifically, these are bioethical issues, and they must be addressed using logical reasoning and civil discourse, with consideration of the various principles of bioethics and their interactions.
Some think tanks avoid these topics because there is no consensus among their scholars about what the narrative should be, so there is no possibility of promoting “one voice.” Other think tanks avoid these topics because they are not comfortable approaching controversial bioethical issues in a charged political climate.
If think tank scholars analyse bioethical issues such as immigration, artificial intelligence, and medical aid-in-dying from a purely legal perspective, they might be perplexed as to why the general consensus is that “X is wrong but technically legal,” and confused about how to support an argument against the implementation of X given its legality.
While we do have some laws that guide bioethical analyses, we also need to question whether the law that is codified is what the law should be. Without this, the analysis is incomplete. Law and ethics don’t always perfectly overlap. There might only be a sliver of “legal” at the nexus of the two circles—and this is the important aspect for think tanks to examine. Looking for the illegality of X is the first step, but we must then also question whether just because something is “technically legal” means that it is morally right.
Examples of bioethical issues
Surrogacy, for example, is one bioethical issue that has cycled through the global news several times in recent years, and the laws regulating surrogacy are fractured.
In the United States, surrogacy laws are determined at the state level rather than at the federal level.
In France, while surrogacy is illegal, French citizens are permitted to travel abroad to engage in “procreative tourism,” and any child born via a foreign surrogate will be recognised as the child of the French parents.
The laws in Spain are similar to those in France to the extent that surrogacy is illegal, but Spanish citizens are permitted to travel internationally to use a surrogate. However, recent updates to Spanish policy mean that the Civil Registry will no longer directly register children born through surrogacy abroad, even if there is a foreign judicial decision, which makes it more impractical—but not impossible—for Spanish citizens to use a foreign surrogate.
Italy takes this one step further. In 2024, Italy passed a law that renders surrogacy a universal crime—Italian citizens are prohibited outright from engaging in procreative tourism, and violators of the law could face fines up to €1 million and two years in prison. Other universal crimes include genocide, torture, war crimes, and crimes against humanity. To use the same language for surrogacy can either appear extreme or underscore the depth of moral concern.
A legal analysis of surrogacy would primarily focus on constitutionality. A bioethical analysis would primarily focus on the morality, balancing an aversion to potential coercion and exploitation of the surrogate mother with her interest in autonomous and informed decision-making. If a surrogate is economically disadvantaged, is consent truly voluntary? And if we prohibit surrogacy to prevent exploitation, are we overriding a woman’s agency?
While moral considerations likely shape codified surrogacy laws, a bioethical analysis would provide a deeper understanding of the moral arguments embedded in the policy. A bioethicist would first determine which principles of bioethics control (there are different principles in the United States (heavily focused on autonomy) than, for example, Europe (heavily focused on dignity), though they have many commonalities), then parse how the principles interact in order to reach a practical conclusion.
For surrogacy, if the directive to “do no harm” controls, then the first task would be to define “harm.” Harm to whom? The surrogate, the child, or the parents? Depending on who is potentially harmed, could “harm” be considered the failure to act or to provide the service? Or would “harm” be the active step of withholding the use of a surrogate mother?
Only when a bioethical conclusion (or several conclusions that can be reconciled) is reached can the morality of the law or policy in place be evaluated to determine whether what the law is and what the law should be are aligned.
Bioethical issues are indeed uncomfortable. They can be difficult to analyse and even more difficult to live through while governments grapple with creating blanket policies. But avoiding them does not mean that the conversation won’t continue, and think tanks that avoid bioethics due to discomfort with discussing controversial topics will be left out of that discourse. They must not avoid engaging with bioethical issues if they want to have a persuasive voice that addresses the social policies that everyday people focus on. Ethics may not make headlines, but it shapes the policies that do.