There is nothing so foolish that some philosopher has not said it, and there is nothing so evil that some bioethicist has not proposed it. Indeed, the entire purpose of the new discipline of bioethics often seems to be the finding of bad reasons for worse conclusions. Bioethicists are ever on the lookout for new categories of human beings to kill or to allow to be killed.

The most famous bioethicists live and advance their careers by using the logic of the arms race or that of the transgressive artist. The painter who incorporates elephant dung into his pictures of religious subjects soon finds that there are painters who use nothing but excrement as a medium, and he is therefore obliged to scour his imagination for ever more obscene methods and subjects if he wishes to remain a member of the avant-garde. In a world of soundbites, moreover, there is no point in being only moderately offensive; there must be no holds barred if that notoriety which is indistinguishable from success in our world of shallow sensation is to be achieved. A bioethicist is unlikely, therefore, to reach the top of the greasy academic pole by suggesting that the Hippocratic injunction “First do no harm” is the beginning of wisdom for doctors. If he wants to get on, he must be prepared to decimate a countryside, at least in theory.

There is little doubt, of course, that the accelerating Prometheanism of modern medicine has generated ethical dilemmas