When Jonathan Swift published “A Modest Proposal for Preventing the Children of Poor People of Being a Burden on their Country or Parents, and for Making Them Beneficial to the Publick” in 1729, many early readers were shocked and repulsed. Yet if a similar proposal were published today in a reputable academic journal, we could not be sure of its satirical character: it might well be entirely sincere. In late February this year, the Journal of Medical Ethics prepublished online a paper that can be seen as a modernized bioethical version of Swift's “Modest Proposal.” All the authors had done is present a “well reasoned argument based on widely accepted premises” that allowed them to “proceed logically” from those premises to the conclusions.