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Mandatory vaccination, including for COVID-19, can be ethically justified if the threat to public health is grave, the confidence in safety and effectiveness is high, the expected utility of mandatory vaccination is greater than the alternatives, and the penalties or costs for non-compliance are proportionate. I describe an algorithm for justified mandatory vaccination. Penalties or costs could include withholding of benefits, imposition of fines, provision of community service or loss of freedoms. I argue that under conditions of risk or perceived risk of a novel vaccination, a system of payment for risk in vaccination may be superior. I defend a payment model against various objections, including that it constitutes coercion and undermines solidarity. I argue that payment can be in cash or in kind, and opportunity for altruistic vaccinations can be preserved by offering people who have been vaccinated the opportunity to donate any cash payment back to the health service.

Semaglutide, sold under the brand names of Ozempic, Rybelsus and Wegovy, is one of the most popular drugs on the market. Manufactured by Novo Nordisk, semaglutide is the newest in a family of glucagon-like peptide-1 receptor agonists used most commonly to treat type II diabetes. To date, the results of semaglutide for the treatment of type II diabetes have been overwhelmingly positive. It is for the drug’s effects on appetite suppression and weight loss, however, that have led its surge in popularity, with many hailing semaglutide as the new ‘miracle drug for weight loss’. Despite its popularity, both the governmental and popular reception to the drug has largely been mixed. In this paper, we address a range of ethical concerns and argue that while many are legitimate, they do not provide conclusive reason not to prescribe semaglutide for weight loss.

Mandates and incentives are being considered to increase uptake of vaccines against COVID-19, but payment for vaccination may be the fairest approach.

On 24 June 2025, the Australian Productivity Commission (PC) released an interim report evaluating the National Mental Health and Suicide Prevention Agreement. While the PC’s recommendations are certainly important components of a robust national strategy for mental health and suicide prevention, they remain incomplete. A more fundamental question is when suicide is even a public health issue. We need to identify what is bad about suicide and articulate why and when it should be prevented. In this article, we will consider three possible approaches to suicide prevention: (1) suicide prevention as the prevention of death, (2) suicide prevention as the prevention of wrongful death and (3) suicide prevention as the prevention of bad death. We will ultimately demonstrate that only the third approach is adequately equipped to achieve what should ostensibly be the goals of a national suicide prevention scheme.

Brain organoid research raises ethical challenges not seen in other forms of stem cell research. Given that brain organoids partially recapitulate the development of the human brain, it is plausible that brain organoids could one day attain consciousness and perhaps even higher cognitive abilities. Brain organoid research therefore raises difficult questions about these organoids' moral status – questions that currently fall outside the scope of existing regulations and guidelines. This paper shows how these gaps can be addressed. We outline a moral framework for brain organoid research that can address the relevant ethical concerns without unduly impeding this important area of research.

Although it is reasonable and valuable to seek explanations for decisions made by artificial intelligence (AI), it is simply not possible with black-box AI algorithms. However, these algorithms can produce highly beneficial and efficient outputs that could be extremely useful to patients, treating teams, hospitals, and funding bodies. This poses a dilemma: is black-box AI justifiable to use in healthcare? This article analyses the normative reasons that can defend and justify the use of black-box AI in healthcare; this analysis includes, but does not give lexical priority to, explainability. This is pertinent given the current prohibitions of black-box AI in healthcare, such as in Australia. This article defines justifiability as decisions based on robust reasons and thus identifies reasons that can justify the use of black-box AI in healthcare. These include the algorithms’ explainability and accuracy, the seriousness of the decision's consequences, any relevant bias, the context of the decision, and the level of human intervention. We argue that whilst each of these separate considerations is important, only accuracy and reliability are necessary, and to be sufficient, it is likely that some further reasons arising from the nature and context of the decision will be required.

We describe a form of moral artificial intelligence that could be used to improve human moral decision-making. We call it the “artificial moral advisor” (AMA). The AMA would implement a quasi-relativistic version of the “ideal observer” famously described by Roderick Firth. We describe similarities and differences between the AMA and Firth’s ideal observer. Like Firth’s ideal observer, the AMA is disinterested, dispassionate, and consistent in its judgments. Unlike Firth’s observer, the AMA is non-absolutist, because it would take into account the human agent’s own principles and values. We argue that the AMA would respect and indeed enhance individuals’ moral autonomy, help individuals achieve wide and a narrow reflective equilibrium, make up for the limitations of human moral psychology in a way that takes conservatives’ objections to human bioenhancement seriously, and implement the positive functions of intuitions and emotions in human morality without their downsides, such as biases and prejudices.

There is much debate about the use of immunity passports in the response to the COVID-19 pandemic. Some have argued that immunity passports are unethical and impractical, pointing to uncertainties relating to COVID-19 immunity, issues with testing, perverse incentives, doubtful economic benefits, privacy concerns, and the risk of discriminatory effects. We first review the scientific feasibility of immunity passports. Considerable hurdles remain, but increasing understanding of the neutralising antibody response to COVID-19 might make identifying members of the community at low risk of contracting and transmitting COVID-19 possible. We respond to the ethical arguments against immunity passports and give the positive ethical arguments. First, a strong presumption should be in favour of preserving people's free movement if at all feasible. Second, failing to recognise the reduced infection threat immune individuals pose risks punishing people for low-risk behaviour. Finally, further individual and social benefits are likely to accrue from allowing people to engage in free movement. Challenges relating to the implementation of immunity passports ought to be met with targeted solutions so as to maximise their benefit.

The past few years have brought significant breakthroughs in understanding human genetics. This knowledge has been used to develop ‘polygenic scores’ (or ‘polygenic risk scores’) which provide probabilistic information about the development of polygenic conditions such as diabetes or schizophrenia. They are already being used in reproduction to select for embryos at lower risk of developing disease. Currently, the use of polygenic scores for embryo selection is subject to existing regulations concerning embryo testing and selection. Existing regulatory approaches include ‘disease-based' models which limit embryo selection to avoiding disease characteristics (employed in various formats in Australia, the UK, Italy, Switzerland and France, among others), and 'laissez-faire' or 'libertarian' models, under which embryo testing and selection remain unregulated (as in the USA). We introduce a novel 'Welfarist Model' which limits embryo selection according to the impact of the predicted trait on well-being. We compare the strengths and weaknesses of each model as a way of regulating polygenic scores. Polygenic scores create the potential for existing embryo selection technologies to be used to select for a wider range of predicted genetically influenced characteristics including continuous traits. Indeed, polygenic scores exist to predict future intelligence, and there have been suggestions that they will be used to make predictions within the normal range in the USA in embryo selection. We examine how these three models would apply to the prediction of non-disease traits such as intelligence. The genetics of intelligence remains controversial both scientifically and ethically. This paper does not attempt to resolve these issues. However, as with many biomedical advances, an effective regulatory regime must be in place as soon as the technology is available. If there is no regulation in place, then the market effectively decides ethical issues.

A virologist recently made headlines after successfully using an experimental form of oncolytic virotherapy to treat her own recurrent breast cancer. This case has come at a time when regulators are increasingly having to grapple with the proliferation of self-experimentation outside of accredited research institutions. There is, therefore, a pressing need to outline the key ethical dimensions of self-experimentation and to develop ethical guidance for journals that may be faced with decisions about whether to publish research involving self-experimentation. In this paper, we aim to provide such guidance. We argue that while self-experimentation is not always ethically problematic, neither is there an in-principle moral reason for exempting it from ethical evaluation. After summarising the details of the recent case report of self-experimentation and briefly placing it in historical context, we suggest that it is possible to navigate the ethical issues raised in cases of self-experimentation by returning to fundamental values in research ethics, focusing on the implications of self-experimentation for respect for autonomy, reasonable risk, and preventing harm to others. We apply these principles to the case report and explain why the publication of this report can be morally justified. We ultimately advocate for a case-by-case assessment of studies involving self-experimentation submitted for publication by ethical review boards and journal editors, and we propose a decision-making algorithm to help guide such decisions.