Like many people, Peter Singer was the first bioethicist to occupy any space in my consciousness. He first got my attention with his concern for animal welfare and calls for vegetarianism. I suppose he is best known for saying we should not eat animals but that it is sometimes acceptable to kill our babies, which many people find upside down, especially if they haven’t actually read all his arguments, and few of his critics seem to have read his arguments.

But Singer has also spent a great deal of effort offering suggestions on relieving the problems of globalization, wealth inequality, and further destruction of the planet. One can offer reasoned objections to his suggestions, of course, but his choice of topics and concerns helped define what bioethics was for me.

Singer’s concerns fit nicely with the term “bioethics” as originally conceived by Van Rensselaer Potter in 1970. Potter said bioethics should be “a new discipline that combines biological knowledge of human value systems.” Potter saw bioethics as a systematic attempt to ensure the survival of the planet and all the people on it. One of Potter’s goals was to eliminate “needless suffering among humankind as a whole.”

Unfortunately, by the middle of the 1970s, the term “bioethics” had already been co-opted by the medical establishment and applied primarily to medical ethics. Concerns for ensuring the well-being of humankind were replaced by concerns for patients and doctors, with a strong emphasis on patient autonomy. Today’s bioethicists tend to ignore problems that have nothing to do with healthcare or medical research, but millions of people in the world have no access to healthcare and so escape any attention from bioethicists at all, which is itself an injustice.

To be sure, bioethicists are still in the world working for justice and, in some notable cases, the survival of the planet, but those working on themes outside of healthcare or medical research are outsiders at best. (For a couple of examples, see Martha Nussbaum and Thomas Pogge.)

I will continue to argue that this is the wrong approach to bioethics. Potter’s and Singer’s concern for promoting the health of the earth and all its inhabitants is the only reasonable way to think of bioethics, and those who disagree are the ones who should defend their positions.

What are some of the issues we need to address? Just to get us started, we can look at environmental justice, war, climate change, worker’s rights, wealth inequality, access to water, human rights abuses, women’s equality, and children’s welfare. Too broad? The problems that threaten life and health are vast. Medical practice requires an enormous cadre of professional ethicists to develop policy and practice guidelines, of course, but bioethicists following the vision of Potter should be welcome at the table as well.