On April 16, 2007, Cho Seung-Hui used two semiautomatic handguns to kill 32 persons and then himself at Virginia Tech University in the largest campus shooting in U.S. history. Mr. Cho purchased his handguns from a pawnshop and a gun store in Virginia, where under state law a background check was conducted to determine whether he had any disqualifying criminal or mental health history. The paperwork for the background check was completed at the gun store, and the check itself was conducted through an “instant” system facilitated by a toll-free telephone number. The entire transaction took approximately 20 minutes. At no point was Mr. Cho asked why he wished to purchase the guns. And although he had been deemed a potential danger to himself by a state magistrate in 2005 – which should have disqualified his purchase of a gun under federal law – this information never reached those conducting the background check.

DNA evidence has rapidly become a significant and routine feature of modern criminal prosecutions. The first introduction of DNA evidence in a U.S. Court occurred in 1987. By 1994, 42 percent of local prosecutors reported that they had used DNA evidence in a felony case at least once. By 2001 that number had increased to 68 percent. Moreover, from a technical point of view, the potential benefits of DNA testing are substantial. Early hurdles to admissibility during trial have been overcome by the adoption of rigorous standards for DNA analysis. Rapid development of identification technology, fueled in significant part by the Human Genome Project, and the resultant development and expansion of national forensic DNA databases, has increased the potential of DNA to play a major role in crime solving. Indeed, over three million offender profiles, collected by state and federal authorities, now reside in the National DNA Index System (NDIS). This number is likely to increase as more states and the federal government are expanding compelled DNA collections to individuals arrested for certain crimes.

Bioethics, once a four-letter word in the private sector, is now an integral part of the decisionmaking process of biotechnology and pharmaceutical companies. And bioethicists, once confined to the classroom and limited to abstract, philosophical discussions about what is right and wrong in medicine and medical research, now play an important role in the practical implementation of ethical boundaries. Bioethicists increasingly are hired by biomedical companies as consultants to highlight and help resolve complex ethical issues that arise in the companies’ normal business practices. Whether motivated by profit, reputation, or a genuine desire to act morally, these companies are willing to pay bioethicists substantial consultation fees for their “expert” opinions. This fairly recent phenomenon has caused some to be concerned about the potential for bioethicists to encounter conflicts of interests. Specifically, many critics of this new relationship between bioethicists and the private sector “are concerned about the appropriateness of ethicists who should have broader interests, such as concerns about social justice, serving clients whose primary interest is profit-maximizing.”

It is axiomatic that the first responsibility of researchers, whether they are working in the developed or the developing world, is to (strive to) do no harm to those who participate in their studies or trials. However, on neither side of the Atlantic is there any such settled view with regard to the responsibility of researchers to attend to the ancillary-care needs of their participants – that is, a responsibility to advise or assist participants who have medical condition X in circumstances where the research concerns medical condition Y, and the research did not contribute to the presence of condition X in participants, nor did the having of condition X contribute to the research. Consider, for example, the following hypothetical posed by Leah Belsky and Henry Richardson:

When making decisions for adults lacking decision-making capacity and having no discernable preferences, widespread support exists for using the Best Interests Standard. For example, the President's Council on Bioethics supports this view in its publication, Taking Care: Ethical Caregiving in Our Aging Society. The President's Council maintains that decision-makers should seek the best available care for incapacitated adults, yet clarifies the best care does not always extend biological life for the longest time and advocates careful attention to comfort care and pain control. Their recommendations for making medical decisions for incapacitated adults match guidelines by American Academy of Pediatrics (AAP) committees and by the U.K’.s Nuffield Council on Bioethics report for making medical decisions for children and infants.

For reasons of consistency, fairness, and compassion, this guidance should be applied to all people lacking decision-making capacity. Uniform guidelines, however, would be incompatible with a policy for infants based on the Child Abuse Prevention and Treatment Act (CAPTA) amendments, widely known as the “Baby Doe” Rules.

Physicians have long served as expert witnesses in litigation, and their medical knowledge can contribute to the appropriate resolution of a case. However, ethical issues may arise when physicians appear on behalf of the tobacco industry. Two ways that doctors participate in lawsuits are through depositions (statements given under oath before trial to attorneys, who often use them to prepare the case or develop a strategy) and by testifying in court during trial. The Tobacco Deposition and Trial Testimony Archive (DATTA) is an electronic database of depositions, trial testimony, opening and closing statements, and other material from tobacco lawsuits collected by the Center for Tobacco Use Prevention and Research. At the time the research for this article was conducted, the database included depositions and trial testimony of expert witnesses from 232 smoking and health cases.

The desire to have healthy and happy children is the most basic parental instinct. A parent's moral obligation to care for the child extends before the moment of birth back to the point of conception. In classical Jewish tradition, the Talmud itself offers pregnant women advice on how to improve the well-being of their offspring, such as eating parsley in order to have handsome children, drinking wine in order to bear healthy children, or eating coriander to have especially plump children. We stand on the cusp of a new era today because an explosion of genetic knowledge in recent years has provided us the ability to pursue certain health and wellness advantages even before pregnancy has begun. Technology called preimplantation genetic diagnosis (PGD) allows parents to screen the DNA of embryos fertilized in vitro and to implant only those embryos that match the parents' desired genetic makeup. This may include selecting only embryos guaranteed not to have a particular genetic disease, only embryos of one particular gender, or eventually even only embryos with a predisposition for certain traits such as height, eye color, or enhanced memory.

Slippery slope arguments appear regularly whenever morally contested social change is proposed. Such arguments assume that all or some consequences which could possibly flow from permitting a particular practice are morally unacceptable.

Thus the legalization of abortion in limited circumstances is asserted to lead down the slippery slope towards abortion on demand and even infanticide; and the legalization of assisted suicide to lead inexorably to the acceptance of voluntary euthanasia and subsequently to the sanctioning of the practice of nonvoluntary euthanasia – even involuntary euthanasia of “undesirable” individuals.

In a little noted passage in A Theory of Justice, John Rawls argued that genetic intervention in the traits of offspring may be morally required as a matter of distributive justice. Given that the “greater natural assets” of each “enables him to pursue a preferred plan of life[,]” Rawls wrote, the parties to the original position “want to insure for their descendents the best genetic endowment.…Thus over time a society is to take steps at least to preserve the general level of natural abilities and to prevent the diffusion of serious defects.…The pursuit of reasonable policies in this regard is something that earlier generations owe to later ones.” (Emphasis added.) Whether biological enhancement actually is a moral obligation we owe to future generations is a question that I have taken up elsewhere, but which lies beyond my scope here. If we agree with Rawls that some measure of safe and effective genetic intervention may be required as a matter of justice, it stands to ask how the distribution of genetic goods – that is, the hereditary basis of human traits – should be carried out.