This collection of articles celebrates the 40^th anniversary of John Harris’ book The Value of Life: An Introduction to Medical Ethics (TVoL, 1985)Footnote ¹ and pays homage to John himself. It brings together international scholars whose academic journeys have been influenced by John’s work and by John personally. Some of the authors were drawn to the field after being introduced to John’s writings and all of us have been inspired by his work at one point or another during our careers. We have also been fortunate to work with John as colleagues, co-authors, research partners, and many starting out as his students. John’s work invites you to engage in the arguments he presents. You might not agree with everything he says – and all of us have challenged him on occasions – but you cannot but appreciate his conviction and the irresistible style of delivery.

The opening article, David Lawrence’s “Bioethics transformed: 40 years of The Value of Life” reminds us of the landscape of bioethics at the time TVoL was written. It proceeds to provide us with a comprehensive overview of bioethics through the decades. The article shows us how certain key elements of TVoL are still as relevant as they were 40 years ago, while in other aspects, bioethics has moved beyond the individual clinical ethics that formed the core of TVoL. The vast developments in the field of biotechnologies, the widening circle of those we see as worthy of moral concern, and bioethics itself having become entangled with public policy, laws and regulations are all matters that have required us to expand the scope of bioethical enquiry from the original ideas of TVoL.

John Coggon and Søren Holm’s articles dive deep into specific aspects of TVoL.

In “Making sense of John Harris and ‘The Value of Life’: an enigma, wrapped in mysterious contradictions, inside an absence of theoretical commitments?” John Coggon gives us a thorough analysis of the style of argumentation used in TvoL and in John’s other writings, while concentrating on the question of political authority. In TvoL the political obligations explicated are presented as morally required, but there is not enough, Coggon shows us, said about a moral theory to create a solid foundation for the named political obligations. This omission, he argues, presents some problems for John’s key credo, respect for persons.

Søren Holm’s paper “The contested value of life” centers on assessing the value of life. When, for instance, resource allocation decisions are made, a third-person perspective is used to assess whose life is worth saving. A similar third-person perspective is predominant when we, say, are trying to determine whether someone’s life is good or has been lived well. One of the key features of TVoL is the idea that assessing one’s value of life should be done from the first-person perspective. What is important is how valuable my life is to me. Given that John has also used third-person assessment, Holm’s contribution sets to study whether John’s work could bridge the gap between third-person and first-person assessments in bioethics.

The theme of assessing the value of someone’s life continues in Rebecca Bennett’s article “Why we must change the bioethical terminology around so-called ‘lives not worth living’, and ‘worthwhile’ and ‘unworthwhile lives’”. With John Harris’ work as a starting point, she analyses the terminology of ‘lives not worth living’, ‘worthwhile lives’, and ‘unworthwhile lives’ frequently used in bioethical discussions on resource allocation, and regarding decisions at the beginning and at the end of life. Bennett shows how while these terms have been helpful, they can also conceal eugenic tendencies. While concealed eugenic tendencies are always a problem, it is especially when it comes to reproductive decisions that they might go unnoticed. To overcome this issue, Bennett suggests that we should use the terms ‘intrinsically valuable’ and ‘intrinsically harmful’ instead.

The articles by Lucy Frith, and Elisa Calleja-Sordo and Maria de Jesús Medina-Arellano concentrate specifically on reproductive matters.

John Harris has always held reproductive autonomy in high regard and has advocated the need for strong arguments to put any limitations on it. In her “The value of life and reproductive autonomy” Lucy Frith takes this as her starting point and studies to what extent reproductive autonomy should be extended to medical professionals involved in reproductive medicine. She uses the United Kingdom as an example, but, for the main part, her arguments apply equally to other jurisdictions.

The second contribution in the reproduction part of this collection takes us to Mexico. In their contribution, “Uterus transplant: Bioethical and biolegal issues from Mexico” Elisa Calleja-Sordo and Maria de Jesús Medina-Arellano look at the practice of, and research into, uterus transplants as a means of helping certain infertile women. They start with John Harris’ idea that there is a moral duty to engage in research practices that will alleviate future suffering and proceed to assess whether uterus transplants would indeed fit the criteria. While they recognize the potential benefits of uterus transplants, they remain cognizant of the challenges they present, especially in the context of countries such as Mexico where women remain a vulnerable group.

Julian Savulescu’s paper, “Collective reflective equilibrium, algorithmic bioethics and complex ethics” directs our attention to research allocation. John Harris has made two seminal contributions to this discussion, the ‘fair innings argument’ and egalitarian replies to such utilitarian approaches as maximizing ‘quality adjusted life years’. Savulescu compares these sufficientarian and egalitarian approaches with utilitarian and contractual alternatives and provides a methodology to decide among them. As an example, he then applies this to the allocation of ventilators in the pandemic and creates an ethical algorithm for their deployment.

In “Bioethics and the value of human life” Matti Häyry studies the different approaches to ‘value of life’ found within the discipline. Bioethicists vary vastly in the kinds of life they value and in what kinds of value and why they assign to it. Some emphasize the indisputable value of all human life at all stages of development, while others stress the importance of personhood. There are schools of thought for whom being human is irrelevant and they see the value either through sentience or simply in life itself. For others, the value of life is defined through the quality of life. All of these approaches lead to significantly different practical conclusions. At the polar ends we will find views according to which more life is always better and those who believe that no life should be the ultimate goal.

The collection closes with “Intellectual lightening: A tribute to John Harris” compiled by Inez de Beaufort (with contributions from Rebecca Bennett, John Coggon, Daniela Cutas, Katrien Devolder, Maria de Jesús Medina Arellano, Raanan Gillon, Simona Giordano, Jonathan Glover, Matti Häyry, Søren Holm, Tomi Kushner, David Lawrence, Ruth Macklin, Maurizio Mori, Muireann Quigley, Bonnie Steinbock, and Tuija Takala). For her article, de Beaufort contacted people who have worked closely with John and asked them to write a paragraph or two on a book they have always wanted to write with John or a book they would have always wanted John to write. As it turns out, few followed the instructions and de Beaufort’s piece includes when-I-met-John-stories, old disagreements, imaginary book and manuscript reviews, and fictional communications. However, it turned out to be a fitting end to this collection. The article portrays a man who has been highly influential in many people’s lives. People who have not always agreed with him but have always respected and liked him for his intellect, wit, humor, and kindness.

John, it is always a pleasure having you around. Thank you!