This special issue on controversial arguments in bioethics explores the role that philosophers can play in bioethics when they consider cases or examples or theses that venture beyond the margins of common moral acceptability. These arguments startle, and often provoke visceral negative reactions. Importantly, however, such arguments can contribute to ethics (and to bioethics in particular) either by fostering more rapid progress in the field or by stimulating defenders of the moral status quo to deepen the arguments that justify the commonly accepted positions that these arguments challenge. Examples of such controversial positions proposed in this issue include whole body gestational donation [1], state-sponsored sex doulas for disabled persons [2], and an argument that at least certain forms of vegetarianism entail a commitment to anti-natalism [3].

These are not mainstream positions. One can even call them outrageous. If these arguments are correct, then our set of collective moral commitments must adopt new standards and we will be forced, through a process of reflective equilibrium, to adjust other moral commitments as well. If these positions are morally wrong, then, in the process of showing why they are wrong, the justificatory structure of the moral status quo will be strengthened.

When done well and used wisely, such controversial arguments can help to expose previously unexamined premises, to force reflection on meta-ethical presuppositions, or at the least, to force reflection on views that are often unreflectively assumed to be true [4].

When done well, outrageous arguments can also be humorous, and humor can help us to deepen our understanding of the human condition. Satire, as Matti Häyry points out, is an ancient form of moral argument [5]. Some controversial arguments in bioethics, then, might best be advanced as satire. While satire can be an effective tool of ethical analysis, satire requires a social and intellectual climate in which people do not take themselves too seriously, but are serious about important ideas. The contemporary Western world, by contrast, is a world in which people seem to take themselves very seriously, but do not care much about ideas. Satire falls flat in such a context. “I’m offended” is now a common retort when an author attempts satire. The conversation then stops dead in its tracks. We may be living in a humorless society, incapable of appreciating either satire or irony. What role can controversial arguments play in such a world?

A series of vices also can tempt the philosopher who considers proposing and defending a seemingly outrageous position. Such arguments sometimes reflect a kind of smugness. One should be wary of philosophers whose true motive (whether conscious or not) is to demonstrate their intellectual superiority by showing how they can take outrageous ethical positions and argue credibly that they are morally correct. Similarly, philosophers might pose outrageous positions simply to shock and grab attention. Such motives spring from cynicism and nihilism. One can do ethics unethically. The posing of outrageous arguments never ought to spring from such motives.

Personally, I disagree with all of the controversial arguments made in this special issue, but we made an editorial decision not to challenge these positions in the process of review. That would have undermined the point by diluting and taming the outrageousness of the articles. I am certain that these articles will provoke strong reactions. The challenge for readers who disagree will be to respond with solid arguments explaining why the suggested practices ought not be permitted. That will require either exposing flaws in the reasoning of the authors or an examination and rejection of the underlying premises; whether or not these moral axioms have been forthrightly stated. The outrageous proposals made in this special issue may exemplify the brave new world that follows from the rigorous and logical application of morally correct premises to particular situations. Or, they might be the result of deficient reasoning from those morally correct premises. Or, they might represent a reductio ad absurdum refutation of those premises. We leave it to the readers of Theoretical Medicine and Bioethics to judge. We stand ready to serve as a forum for airing such discussion and debate.