Ripperdocs and game makers: Bioethics in the dystopian future of (post)cyberpunk fiction

The basic ethical principles that underlie biomedical and behavioral research involving human subjects - respect for persons, beneficence, and justice - face deterioration and decline in the future envisioned in cyberpunk and dystopian science fiction. In the near-future setting of the first-person role-playing game Cyberpunk 2077, well-being, longevity, and enhancements are the privileges of corporate elites. However, they can be partially afforded across social strata thanks to the grassroots and do-it-yourself "ripperdoc" clinics. Some people can live for as long as 150 years; most die young due to crime and extreme social disparities, but all have access to a range of life-enhancing treatments advocated and envisioned by transhumanist scholars. In recent novels that represent post-cyberpunk genres, such as Neal Stephenson's Fall; or, Dodge in Hell (2019), the distribution of advanced technologies such as personality constructs and mind uploads becomes problematic. The ripperdoc is replaced by an afterlife "game-maker", a maverick of world-building who sells virtual real estate to those who can afford their place in the expanding cloud of afterlife worlds. This article focuses on the evolution of the theme of affordability and access to biotechnology and how it becomes more nuanced and aligned with current discussions around resources, climate change, and social disparities in access to healthcare and technology.