Bioethicists are Unethical: Suffering, Wasted Lives, & Deaths in the Name of "Ethics"
Most modern bioethicists are a scourge on humanity... slowing progress and increasing total suffering.
Today’s dominant bioethics/safetyism is itself unethical because, by systemically blocking informed adults from opting into higher‑risk human experimentation (including enhancement), it predictably produces far more death and disability than it prevents.
I’ll put the load‑bearing facts up front, quantify the harm from delay (with math), show the track record of rapid experimentation (e.g., Operation Warp Speed and human challenge trials), and then lay out a concrete, tightly‑designed “opt‑in” framework that could flip the sign on net human suffering.
I.) The empirical baseline: suffering today is not abstract—it’s measured and enormous
MENTAL DISORDERS AND LOW BACK PAIN ARE A SMALL SUBSET OF THE ENTIRE SWATH OF MEDICAL CONDITIONS THAT CAUSE SUFFERING AND POOR QUALITY OF LIFE.
Mental disorders alone accounted for ~155 million DALYs (disability‑adjusted life years) in 2021—that’s 155 million healthy years lost per year, worldwide. DALY is a hard unit: 1 DALY = one full year of healthy life lost. (PMC)
Low back pain is the top cause of years lived with disability, responsible for ~15.9 million DALYs annually. Headache disorders (mostly migraine) cause ~46.6 million YLDs. Osteoarthritis adds tens of millions more YLDs. These are not terminal, but they destroy quality of life at planetary scale. (Frontiers)
Suicide: in the U.S., ~49,000 deaths in 2023 (near the historic peak); globally ~700,000 annually. The Global Burden of Disease estimates millions of years of life lost to suicide each year. Many who die are not “terminally ill”; they’re people with chronic, refractory conditions and no credible hope of improvement under the status quo. (CDC)
Translation: Conservatism in human experimentation doesn’t preserve utopia; it preserves this. HUNDREDS OF MILLIONS of life‑years lost every single year to conditions we could attack more aggressively.
II.) What delay really costs (math, not vibes)
Let’s quantify the minimum annual harm of being “extra careful.”
Take four gigantic, mostly nonterminal burdens: mental disorders (155.4M DALYs), low back pain (15.9M), migraine (46.6M YLDs), osteoarthritis (~21.3M YLDs).
Suppose a portfolio of credible, logically‑grounded interventions (gene therapies, neuromodulation, biological upgrades, device/drug combinations) would, once deployed and iterated, reduce each category’s burden by a tiny 1% (that’s deliberately modest).
Mental disorders: 1% × 155.4M = 1.554M DALYs/year averted.
Low back pain: 1% × 15.9M = 0.159M DALYs/year averted.
Migraine: 1% × 46.6M = 0.466M YLDs/year averted.
Osteoarthritis: 1% × 21.3M ≈ 0.213M YLDs/year averted.
Total at only 1% improvement = ~2.39 million healthy life‑years averted per year.
Now add the absolutely standard reality that today’s pipeline takes 7–10 years from first‑in‑human to approval; even with expedited programs, median combined development + review still runs ~7.0–8.3 years.
Every extra year we wait to move from “sound in theory” to “in human bodies at scale” burns those life‑years. (PMC)
One year of delay at 1% effect ≈ 2.39 million DALYs.
3 years of delay ≈ ~7.2 million DALYs.
What is that in dollars (to make policymakers move)? The U.S. cost‑effectiveness norm prices a healthy life‑year at $100k–$150k per QALY.
Multiply:
Per year of delay: 2.39M × $100k–$150k = $239–$358.5 billion destroyed.
Three years: $717–$1,075 billion destroyed.
These are minimal; 1% is laughably conservative, and I’ve ignored huge categories (dementias, COPD, autoimmune disease, etc.).
The point: procedural caution easily costs society a trillion‑dollar order of magnitude within a typical development window. (ICER)
We can also look at hard outcomes from accelerated pathways: FDA’s Accelerated Approval program, despite all its flaws, is estimated to have already yielded ~263,000 life‑years gained through 2022 (oncology alone).
That is what faster‑than‑usual looks like even under today’s rules; now imagine letting competent adults opt into even faster data generation. (PubMed)
III.) “Safety first” often means more death: what speed buys in the real world
Operation Warp Speed (OWS) compressed vaccine timelines by many months. Modeling shows ~20 million global deaths averted in the first year of COVID vaccination; in the U.S. alone, ~3.2 million deaths and $1.15 trillion in medical costs were averted by Dec 2020–Nov 2022. Even a 90‑day slower rollout during the Jan 2021 surge (≈3,000 U.S. COVID deaths per day) would have cost hundreds of thousands of extra lives. Speed matters. (The Lancet)
Human challenge trials (HCTs) — the archetype of “ethically spicy” research— have an extraordinary safety record under modern protocols: across 308 studies covering 15,046 participants, 0.2% experienced a challenge‑related serious adverse event and no deaths were reported in the systematic review. That’s a safety profile at least comparable to many approved interventions—and far safer than the background risk that excessive delay imposes. (PubMed)
Bottom line: Real‑world acceleration saves lives on a mass scale; real‑world “wait for more certainty” kills through inaction.
IV.) How the “ethics consensus” gained a veto (and why it defaults to “no”)
Hospitals traditionally leaned on formal ethics mechanisms. For years, The Joint Commission’s standards cemented “ethics committee” processes in hospital workflows (two core ethics standards were only retired in 2023—the habits remain). Administrators still route the novel or risky through “bioethics.” (NEJM)
IRBs (ethics committees for research). Historically, every site re‑reviewed the same protocol—producing inconsistent rulings and long start‑up delays. The problem is so well‑documented it has a name: the “paradox of multiple IRB review.” U.S. policy now requires a single IRB for most cooperative research, precisely to fix this.
Journals (ICMJE) won’t even consider publication without documented ethics approval and trial registration. That gives IRBs/ethics advisers a practical veto. (Hastings Center)
Why it skews conservative: Visible trial harms create headlines and inquiries; the invisible harms of delay (millions of lost healthy years) draw no attention. So committees optimize to avoid Type‑I errors (“we approved something that hurt a volunteer”) while discounting Type‑II errors (“we blocked or slow‑walked something that would have helped”). That bias has been recognized for years; the Common Rule’s single‑IRB move and the UK’s Proportionate Review track are explicit attempts to rebalance.
V.) Why the “egalitarian/blank‑slate” veto is a non sequitur
Biology is not a blank canvas; improvement and enhancement are coherent goals—and refusing them in the name of a fiction is not ethical. (Gwern)
The world is unequal by nature and history. Across 17,804 measured human traits, average heritability is ~49%—people start different and want different things. Free adults should be allowed to reduce their own suffering or seek upgrades, period. Meanwhile, acceleration tends to reduce inequality over time because scale slashes cost:
Experience curves (“Wright’s law”). As cumulative production doubles, unit costs drop in many technologies. Biomedical platforms are no exception—see genome sequencing’s crash from ~$100M to hundreds of dollars per genome. Early adopters pay more; mass adoption pushes price down for everyone. (PLOS)
iPhone‑style diffusion logic. We got cheap smartphones because someone bought pricey ones first; then manufacturing, logistics, and supply chains learned and scaled. It’s the same with any repeatable platform (mRNA, AAV, gene editing, neuromodulation): the more we do, the cheaper and better it gets. (ScienceDirect)
So fixating on first‑round “equality” by blocking upgrades or experimental care locks in today’s inequality. Letting consenting adults move first drives cost curves down and expands access faster. (DON’T BE A WOKE MORON.)
Upgraded humans help everyone including you and I.
VI.) “This would never be allowed today”… yet it built modern biomedicine
We don’t have to glorify past ethics to recognize a fact: purposeful human risk‑taking unlocked transformative gains.
Smallpox vaccination began with Jenner’s 1796 experiment (cowpox inoculation then smallpox exposure); earlier, variolation (an intentional infection with ~1–2% mortality versus ~20–45% for natural smallpox) was a calculated risk that saved innumerable lives. (WHO)
Yellow fever transmission was proven via voluntary infection experiments in 1900–01, pioneering formal consent and safely showing mosquito transmission—paving the way for control of a mass‑killer. (Journal of Ethics)
Modern challenge trials for cholera and malaria repeatedly de‑risked and accelerated vaccines and countermeasures—again, with careful consent and net societal benefit. (PMC)
No one is arguing for coercion or things like Tuskegee/Willowbrook.
The point is narrower: informed adults taking known, bounded risks for potential outsized personal and societal benefit is how progress actually happens—and modern data show it can be done safely.
VII.) Where the “ethicists” go wrong (mechanics of harm)
Asymmetric visibility. A single adverse event in a trial is front‑page news; the millions of invisible life‑years lost to delay are not. Regulators and IRBs are thus structurally rewarded for saying “no,” even when “no” is deadlier. Median development + review still eats most of a decade; each month of delay during high‑burden conditions burns huge DALYs (see §II). (PMC)
False equivalence. They weigh short‑term trial risk against a hypothetical long‑term benefit, when in fact we can price the expected benefit (VOI—Value of Information). If the expected information from a faster human study enables even tiny improvements across massive disease pools, the expected value dominates the small, bounded risk to consenting participants. (PMC)
Chokepoints masquerading as protection. The U.S. already allows Expanded Access and approves >99% of single‑patient requests; most denials come from manufacturers, not FDA. “Right‑to‑Try” added a parallel path, but use has been limited and poorly integrated. We are choosing not to scale access and data capture. (U.S. FDA)
VIII.) Not just the terminally ill: the suffering majority needs an opt‑in path
Saying “only the terminally ill can volunteer” erases the reality that chronic conditions account for the bulk of human suffering (see DALYs above).
People with refractory depression, cluster headache, CRPS, advanced osteoarthritis, ME/CFS, severe tinnitus, intractable neuropathic pain — and older adults with limited healthy years left — should be allowed to trade low‑probability, high‑impact experimental benefit for risk.
Toy calculation (conservative):
Pick just refractory migraine and low back pain. Combined burden ≈ 62.5M YLDs.
Suppose early opt‑in trials and rapid iteration yield a 2% durable reduction. That’s 1.25M healthy life‑years per year.
Valued at $100k–$150k/QALY, that’s $125–$187.5B/year. A 3‑year acceleration: $375–$562.5B in value and 3.75M YLDs not suffered. (And this ignores mental disorders, osteoarthritis, neuropathic pain, etc.) (BioMed Central)
Additionally we shouldn’t even care if people want bioenhancements (distinct from treating disease). Why? Bioenhancements trickle down and diffuse through the population… rising tide lifts all boats (just like free market capitalism); the feedback loops just work.
IX.) A concrete blueprint: National Opt‑In Human Experimentation & Enhancement (NOH2E)
Principle: Competent adults (and appropriate older/near‑end‑of‑life cohorts) may opt in to higher‑risk experimental therapies or enhancements when (a) preclinical and mechanistic logic is strong; (b) the participant’s counterfactual quality of life is poor or deteriorating; (c) risk‑mitigation and monitoring are maximal; and (d) data yield is high.
Key components (tight, testable, and hard‑nosed):
Eligibility based on Suffering Index: Use standardized instruments (e.g., PROMIS, WHODAS), disease‑specific scales, and DALY/YLD mapping to define “severe refractory”—not just “terminal.” A numeric threshold qualifies you. (Think of this as the ethically relevant mirror of palliative exceptions.)
Bounded‑risk tiers
Tier A (challenge‑like): risks comparable to established HCT safety (see above: ~0.2% SAE, no deaths in modern datasets). Use for pathogen/immune challenges, neuromodulation, device/gene “dose‑finding.” (PubMed)
Tier B (gene/cell/device with plausible single‑organ risk): e.g., AAV gene therapy where vector biodistribution is understood; prior in vivo efficacy logic is strong; long‑term monitoring in place.
Tier C (systemic/high‑uncertainty): permitted for older volunteers or those with severe, refractory disability; requires higher indemnification and in‑hospital administration.
Radically simplified consent + dynamic re‑consent: One clear, short, quant‑heavy consent (absolute risk, expected value, tail risks). Dynamic re‑consent for protocol changes via secure app; allow instant withdrawal (with sunk‑data retention for safety).
Independent participant advocate + real‑time DSMB: Each volunteer gets a fiduciary advocate (not employed by sponsor). Data Safety Monitoring Board sees streaming lab/AE data with pre‑registered stopping rules.
Open‑science by default: All protocols and results into a public registry in near‑real time (including adverse events). This massively increases the expected Value of Information (VOI) and prevents knowledge hoarding. (PMC)
Challenge‑trial track (for infectious disease and immunology): Expand controlled human infection models (CHIM/HCT) under modern safeguards—because they have excellent safety records and generate outsized information per participant. (PubMed)
Expanded‑access that actually expands: Default manufacturer participation with safe‑harbor liability protection if the protocol is followed; FDA already approves >99% of single‑patient INDs—scale this and mandate minimal telemetry so every case feeds the dataset.
Funding & incentives: Prize payments and milestone bonds tied to DALYs averted at interim looks; payer pre‑commitments (outcomes‑based) once minimal signals appear. (This rewards speed and truthfulness.)
Proportionate review by design: Copy the UK HRA’s Proportionate Review Service for low‑intrusion studies and encode time‑boxed review for higher‑risk tiers (e.g., 21 days to yes/no). No endless limbo. (Health Research Authority)
Ethical guardrails without paternalism: No coercion, no deception, no withholding of standard care. But no veto from third parties on competent adult choices once thresholds are met.
X.) Anticipating the best objections (and why they don’t hold)
Do people stop driving cars because there are some accidents? Should you avoid going outside because you might be exposed to some rare bacteria that kills you?
Life always has some element of risk. Even not taking risks carries risk; inaction is still an action.
“We’ll hurt people.”: Yes, some participants will be harmed. But expected harm across informed volunteers is bounded and small relative to the expected benefit (see the DALY math). Moreover, modern high‑risk research (e.g., HCTs) shows extremely low SAE rates and no deaths in large reviews. The counterfactual is guaranteed harm at global scale from delay. (PubMed)
“This worsens inequality.”: Refusing enhancement or high‑risk treatment to all in the name of formal equality locks in existing inequality of health. Targeting NOH2E eligibility by suffering and refractoriness is substantive egalitarianism: prioritize those in the worst states first.
“Fast tracks already exist.”: They don’t go far enough: median development + review still ~7–8.3 years; the review is faster (6–10 months) but clinical development remains slow, and real‑world access even slower. We need a parallel lane for consenting adults that collapses timelines. (PMC)
XI.) Historical proof that speed wins—and safely
Even if human trials aren’t as safe as what we’ve historically observed, it doesn’t really matter. Most end up far safer than people think.
Nobody wants to design trails that inflict pain/suffering and/or death on someone. Most scientists are trying to cure conditions as safely as possible.
And you’d have an objective AI system think through the logic and generate the risk/benefit of participating in a trial (accounting for one’s present condition).
COVID vaccines: First U.S. EUA Dec 11, 2020; vaccination prevented ~3.2 million U.S. deaths and $1.15T medical costs in 24 months. That’s the payoff to compressing time. (FDA)
Challenge trials: Across decades, 0.2% challenge‑related SAEs, no deaths in the largest review. That safety record compares favorably with routine, approved procedures. (PubMed)
Gene therapy: For SMA type 1, onasemnogene abeparvovec converts an almost uniformly fatal infant disease into survival with milestone gains and durable benefit over 5–7.5 years of follow‑up. The signal was visible early; the main ethical failure would have been slowing it. (PMC)
XII.) If we don’t change: the arithmetic of status‑quo harm
Recall: At just 1% improvement across a few nonterminal but massive burdens, each year of delay costs ≈ 2.39 million healthy life‑years and $239–$358.5B in welfare value.
Over typical 3‑year bureaucratic frictions, that’s ~7.2 million healthy years and $0.7–1.1 trillion wasted—and that’s a floor.
Scale up to a realistic portfolio (depression, osteoarthritis, neuropathic pain, tinnitus, ME/CFS, Parkinson’s, etc.) and the foregone benefit dwarfs the worst plausible short‑term harms from more aggressive human experimentation. (ICER)
XIII.) Concrete near‑term moves (no hand‑waving)
Legalize and fund U.S. HCT centers of excellence (malaria, influenza, RSV, C. difficile, etc.) with standing protocols and pre‑screened volunteer panels. (We know they’re safe; we know they’re fast.) (PubMed)
Mandate telemetry for Expanded Access/Right‑to‑Try: every use uploads core outcomes to a national registry within 72 hours; manufacturers get liability safe‑harbor for participation. FDA already green‑lights >99% of single‑patient INDs—turn that trickle into a data firehose. (FDA)
Create a “Suffering‑Qualified” volunteer class: standardized thresholds unlock Tier B/C trials for severe, refractory nonterminal conditions.
Time‑boxed IRB with proportionate review (UK‑style) for lower‑risk protocols; statutory deadlines for decisions on higher‑risk tiers.
Pay for information: NIH/Barriers grants convert to bounty payments per DALY averted at interim analyses. That aligns incentives to move fast where signal exists—and to stop fast where it doesn’t.
The ethical crux
The ethicist’s typical posture is: “Harm from action (a trial death) is morally weightier than harm from inaction (millions of unseen life‑years lost), therefore slow down.”
That collapses under arithmetic.
Informed adults can rationally choose higher personal risk when the expected value—to themselves and to others like them—is high.
The data show that speed under guardrails (HCTs, accelerated approvals, OWS‑style parallelization) saves staggering numbers of lives and healthy years, while modern consent + monitoring keep participant risk very low and bounded.
If ethics is about minimizing suffering and maximizing flourishing, then systematically blocking informed, high‑suffering people from volunteering for well‑designed, high‑yield human experimentation is—on the numbers—unethical.