TY - JOUR T1 - The concise argument: consistency and moral uncertainty JF - Journal of Medical Ethics JO - J Med Ethics SP - 423 LP - 424 DO - 10.1136/medethics-2019-105645 VL - 45 IS - 7 AU - Kenneth Boyd Y1 - 2019/07/01 UR - http://jme.bmj.com/content/45/7/423.abstract N2 - Although in certain contexts judged to be over-rated,1 consistency is generally held to be a virtue in arguments about medical ethics. In everyday life, to be told that you are acting hypocritically, in a manner that is inconsistent with values you profess, is at least embarrassing, and depending on the circumstances can have more serious consequences, not least for politicians. How far complete consistency in thought and action is humanly possible or even desirable is a more doubtful however. In terms of inconsistency over time, certainly, the maxim ‘When the facts change, I change my mind’ can be a reasonable defence: but in order to avoid less defensible forms of inconsistency, changing your mind about one thing may require changing it about others also. To take seriously just such a possibility is the ethical challenge of this month’s feature article: ‘Moral Uncertainty and the Farming of Human-Pig Chimeras’ by Julian Koplin and Dominic Wilkinson (see page 440).2 In this case, the facts that have or could soon have changed surround the emerging possibility of generating, within human-pig chimeras, human organs for transplantation into patients who need them and (although as yet the theoretical possibility) of avoiding the need for immunosuppression by generating the organs using stem cells from the patients themselves. The potential benefits of this possible answer to the worldwide shortage of transplantable organs clearly are immense. But, Koplin and Wilkinson point out, there are also serious potential harms. If human-pig chimeras with ‘partly humanised brains’ were to ‘develop morally relevant cognitive capacities’, such as dawning self-awareness, their moral status would make farming and killing them ‘a serious moral wrong’. Yet having said that, the real difficulty is that we cannot be certain, philosophically, ‘precisely what capacities confer what … ER -