










































  ARESTY  RUTGERS UNDERGRADUATE RESEARCH JOURNAL, VOLUME I, ISSUE III 
 
 
 

 
 

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ETHICAL IMPLICATIONS 
OF BIOHACKING AS  

ACTIVISM:  

DEMOCRATIZED  
HEALTH CARE, DANGER, 

OR WHAT? 

JULIA ZHENG 
 

 

✵ ABSTRACT 
Biohacking refers to optimizing one’s body 

through modifying biology. In the 20th century, do-it-
yourself (DIY) biology emerged as a type of biohack-
ing involving biotechnology. Current high-
healthcare costs promote DIY biology insulin and 
EpiPens as ways to challenge norms in healthcare, 
thus serving as forms of activism. Biohacked insulin 
is part of the #WEARENOTWAITING movement to sup-
port improved treatment of Type 1 diabetes, where-
as biohacked EpiPens allow people to make lifesav-
ing autoinjectors at low costs. Social media acts as a 
catalyst and aids in the spread of insulin and EpiPen 
biohacking as activism. In 1979, Principles of Bio-
medical Ethics by Beauchamp and Childress pro-
posed four principles that continue to guide deci-
sion-making in clinical medicine: beneficence, non-
maleficence, autonomy, and justice. This paper ap-
plies these principles to explore whether the bene-
fits of performing DIY biology outweigh the potential 
health risks. Examining biohacking with a biomedical 
ethics frame, as outlined by Beauchamp and Chil-
dress, reveals that biohacking acts as a response to 
current issues but cannot serve as a solution in its 
current form. However, biohacking can grant pa-
tients more power in their relationship with the 
healthcare system, therefore lessening the domi- 
nance of formal institutions. Out of the four princi-  

ples, autonomy applies most differently when re-
garding biohacking than traditional medicine. Ac-
cordingly, a model of ethics for biohacking, such as 
of Beauchamp and Childress’ with the autonomy al-
tered to acknowledge the additional implications of 
biohacking, should be developed in the future. 

 

1 INTRODUCTION 
Recent rising healthcare costs and lack of in-

surance have jeopardized access to health care for 
many Americans. This problem has sparked a move-
ment towards open-source medicine, leading to in-
creased interest in biohacking.[5] Biohacking is a 
broad term that refers to modifying one’s biology in 
an informal setting. Examples of biohacking range 
from dieting to implanting computer chips in one’s 
body. Specifically, do-it-yourself (DIY) biology is a 
type of biohacking that expands access to individu-
als, communities, and small organizations studying 
biology with the same biotechnology as formal re-
search institutions. Biohacking has made biotechnol-
ogy financially and intellectually accessible to those 
without proper training, who often work out of make-
shift labs in their garages or kitchens. Pharmaceutical 
companies and the lucrative nature of the healthcare 
system have driven many Americans to take the issue 
into their own hands, forcing people to use DIY biol-
ogy to synthesize their medicines or conduct genetic 
testing. Biohacking serves as an act of activism 
(which can be defined as campaigning to bring 
about change) against rising healthcare costs, 
providing otherwise powerless individuals a voice 
against the unfair practices of the healthcare system. 
Biohacking responds to high healthcare costs, but its 
viability from the perspective of biomedical ethics 
must be analyzed when determining if it can be a 
real solution to current issues. 

Applying a biomedical ethics framework, 
like Beauchamp and Childress’ prominent Principles 
of Biomedical Ethics, serves as a valuable context to 
explore the ethical implications of biohacking activ-
ism. The authors indicate four principles of biomed-
ical ethics: beneficence, nonmaleficence, autonomy, 
and justice. These principles were first proposed in 
1979 and are currently used widely by medical pro- 



  ARESTY  RUTGERS UNDERGRADUATE RESEARCH JOURNAL, VOLUME I, ISSUE III 
 
 
 

fessionals and ethical review boards when making 
healthcare decisions. Beneficence refers to health 
care providers preventing harm and working to ben-
efit the patient. Nonmaleficence holds healthcare 
professionals to a “standard of due care…taking suf-
ficient and appropriate care to avoid causing harm, 
as the circumstances demand of a reasonable and 
prudent person,” in which “reasonable” refers to one 
who approaches a situation with caution and sensi-
bly takes action[1]. Nonmaleficence requires medical 
professionals to prevent harming patients purpose-
fully or negligently. Autonomy allows patients the 
ability to make informed, voluntary decisions without 
controlling influences. Justice in healthcare refers to 
the equal treatment of patients, regardless of 
money, age, or race.  Regarding biohacking, how-
ever, one must note that the biohacker is the patient 
and the medical professional, further complicating 
this issue.  

This paper will apply the bioethical frame-
work of Beauchamp and Childress to biohacked in-
sulin and EpiPens to weigh the benefits and risks of 
biohacking as a potential solution to high costs im-
posed by pharmaceutical companies. First, it will dis-
cuss the ethical implications of biohacking activism 
concerning insulin for type 1 diabetes. Next, it will 
examine the DIY EpiPen as a form of biohacking ac-
tivism for those with allergies. Then, it will compare 
autonomy in its traditional sense with autonomy in 
biomedical ethics. Continuing the discussion of au-
tonomy, it will further explore its applications and nu-
ances regarding parents and children before con-
cluding with a proposed plan to promote future eth-
ical activity. 

 

2 INSULIN ACTIVISM  

 For patients with type 1 diabetes and those 
with type 2 diabetes who do not produce enough 
insulin, insulin therapy is necessary to keep blood 
sugar within a target range, prevent hypoglycemia 
and ketoacidosis, as well as ultimately sustain and 
enhance life. However, continuously rising insulin 
costs have presented a barrier to patients with dia-
betes from receiving this medication. In the past 
twenty years, the price of insulin has increased from 
$21 per vial to $332 per vial in 2019, a more than 

1000% increase. Dr. S. Vincent Rajkumar of the Mayo 
Clinic comments on this issue: “There is limited inno-
vation when it comes to insulin; the more pressing 
need is affordability.”[12] Gallegos agrees with Rajku-
mar that these high costs present a concern and un-
derscores instances of people “rationing treatments, 
using expired products, fasting, and even intention-
ally inducing diabetic ketoacidosis in order to obtain 
insulin from hospital emergency rooms.”[5] These ex-
amples show that current healthcare conditions par-
adoxically push people to harm themselves in order 
to save their own lives. Beauchamp and Childress 
would view the issue presented by Rajkumar and 
Gallegos as a violation of the principle of justice, par-
ticularly distributive justice.[1] Rajkumar agrees, stat-
ing that “Insulin pricing in the United States is the 
consequence of the exact opposite of a free market: 
extended monopoly on a lifesaving product in which 
prices can be increased at will…”[12] All four of these 
authors would argue that pharmaceutical compa-
nies behave unethically regarding the distribution of 
insulin, creating an environment that pushes people 
to engage in biohacking as activism.  
         Although insulin is not currently successfully 
synthesized using DIY biology, multiple organiza-
tions conduct experiments to move towards this 
goal. For instance, The Open Insulin Project is a col-
laboration of community biolabs worldwide that is 
currently attempting to produce insulin more 
cheaply than pharmaceutical companies. Once 
widespread, biohacked insulin could act as a life-sav-
ing alternative for patients who cannot afford tradi-
tional insulin. One main difference between formally 
produced and biohacked insulin is the rigorous test-
ing a new drug must undergo in the United States, 
which “cost[s] between $30 and $250 million.” Thus, 
regulatory costs create a major barrier to entry for 
potential biosimilar producers and necessitate high 
drug prices to recoup investments spent on clinical 
trials”.[5] Biohacked insulin can avoid extensive test-
ing, but this lack of assurance results in risks of unin-
tentional poisoning for consumers. The lack of re-
quired training for people to perform DIY biology 
also presents a risk. For instance, a biohacker work-
ing for the Open Insulin Project was described as 
“frequently check[ing] the instructions on his 



  ARESTY  RUTGERS UNDERGRADUATE RESEARCH JOURNAL, VOLUME I, ISSUE III 
 
 
 

smartphone, because he is not too familiar with this 
kind of work yet…[he] has a major in business eco-
nomics.”[10] This behavior implies an unfamiliarity 
with the science, further highlighting the dangers of 
being unvetted and underprepared. Gallegos and 
Osterath demonstrate the trade-off between safety 
and financial accessibility that biohackers must con-
sider. The problematic situation that people with di-
abetes find themselves in jeopardizes their ability to 
obtain a life-sustaining medication, resulting in des-
peration and fear of death that enables immense 
psychological discomfort. This situation prevents bi-
ohackers from acting as “reasonable” people and 
thus fully demonstrating nonmaleficence. Further-
more, trained professional workers in healthcare ful-
fill the principle of nonmaleficence by relying on 
their extensive training, following strict protocols, 
and practicing wise judgment to ensure nonmalefi-
cence for their patients; this also includes obtaining 
medications and supplies from a trusted, formal 
source such as a pharmaceutical company. One 
could also argue that Beauchamp and Childress’ 
“due care” refers to taking the proper, rather than bi-
ohacked, medication. Due to the lack of testing and 
regulation of DIY insulin in its current state, people 
cannot ensure the same degree of nonmaleficence 
as when taking a formally produced drug, present-
ing significant risks. On a small scale, those who syn-
thesize and take biohacked insulin aim to benefit 
themselves, disqualifying these actions from serving 
as activism. However, the DIY synthesis of insulin, au-
tomated insulin delivery (AID) devices, and the 
spread of the movement using social media allow bi-
ohacking to serve as a form of activism and as a tool 
to promote change in diabetes treatment.  
         There is a distinction between type 1 and 
type 2 diabetes. Type 2 diabetes often develops due 
to lifestyle factors, whereas type 1 diabetes is mainly 
caused by genetics and typically affects people 
throughout their lives, starting from an early age. 
These conditions force type 1 diabetics to continu-
ously rely on the healthcare system and create a vul-
nerability that allows pharmaceutical companies to 
capitalize on patients with no control over their life-
long disease. Frustration in the healthcare system 
and the status of diabetes treatment has led to the 

#WEARENOTWAITING movement, which consists pri-
marily of type 1 diabetic individuals who advocate 
for increased access to insulin delivery technology 
through making their own AID devices. One advo-
cate, Timothy Omer, has had type 1 diabetes for 
more than 22 years and currently works to develop a 
novel Artificial Pancreas System. He describes the re-
ality of being a type 1 diabetic:  

The most modern accessible technology for type 1 diabetes 
management is an insulin pump, which provides a constant 
supply of insulin, as well as a self-funded continuous glucose 
monitor, which provides real-time feedback of the patient’s 
blood sugar levels. These devices provide many functions 
and high volumes of data, all of which are very welcome and 
useful, but such systems always fail with regards to patient 
expectations to understand and process all of this infor-
mation. As a result, patients become overwhelmed by a feel-
ing of judgement by healthcare professionals, the vast 
amounts of ensuing information, and alert and alarm 
“shouts” from their devices when they have failed at being a 
“good diabetic”, as well as with their own disappointment of 
their body letting them down.[9] 

Omer demonstrates that he and others are tired of 
waiting for a change in how type 1 diabetes treat-
ment is approached. This frustration has pushed 
them to engage in biohacking in order to regain 
agency over their health condition. The physical act 
of making the AID device empowers patients to feel 
as though they are regaining power after years of 
feeling controlled by the healthcare system, and the 
low prices of this equipment make it increasingly fi-
nancially accessible and allow it to act as a catalyst 
for the spread of the movement. One prime exam-
ple is one mother’s model of a DIY artificial pancreas 
for her daughter: “Sydney, now 15, is still using an 
updated version of that DIY system, which, because 
a fellow DIYer donated the pump, cost only $250 to 
make…Apple Inc. and Eli Lilly & Co. have hired 
DIYers, and Medtronic’s latest FDA-approved prod-
uct can now do most of the things the Farnsworths’ 
system can—for $7,000, before insurance…”[6] Not 
only is the act of making one’s device (previously re-
served for healthcare professionals) shocking,  
but the significantly lower prices allow the 
#WEARENOTWAITING movement to draw media atten-
tion and gain support. Although only a tiny portion 
of the population lives with type 1 diabetes, almost 



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everyone can relate to feeling frustrated or upset at 
high medical costs. Also, regardless of social class 
and safety factors, people would favor lower 
healthcare costs, making it easy for the  
#WEARENOTWAITING movement to draw support. Pre-
viously, pharmaceutical companies held power to 
impose high prices, knowing that patients would 
likely try to obtain these devices or medications at all 
costs. However, if biohacking continues to grow, it 
could provide an alternative way for people to ob-
tain medicines, threatening the long-held domina-
tion of the healthcare system. This change would 
represent a revolution in the way people view 
healthcare, allowing biohacking insulin on a large 
scale to serve as activism. Further, biohacking not 
only democratizes medicine by making it increas-
ingly financially accessible but also simplifies science 
so that people without advanced degrees can intel-
lectually comprehend the processes, fulfilling Beau-
champ and Childress’ principle of distributive jus-
tice. They indicate: “distribution of all rights and re-
sponsibilities in society, including, for example, civil 
and political rights.”[1] Perhaps it is time to provide 
patients who suffer from these lifelong conditions, 
rather than the monopolistic healthcare system, a 
greater say in their treatment; biohacking offers 
them the opportunity to do so.  
 

3 DIY EPIPEN 
Although biohacking insulin and EpiPens 

are similar in that they are critical to the lives of those 
with diabetes and life-threatening allergies, EpiPens 
differ from insulin regarding cost, safety, and the 
main ethical principles that pertain to situations in 
which one requires these medications. Biohacking 
insulin requires the actual medicine to be synthe-
sized while biohacking EpiPens does not. In contrast, 
only the injector is made for EpiPens. This cost differ-
ence would lead to varying levels of accessibility. For 
instance, synthesizing insulin requires not only 
chemicals that could prove unattainable for many 
but it also requires the intellectual and scientific 
knowledge and ability to synthesize this medication. 
This process can be contrasted with that of the DIY 
EpiPen, which can be made using “off-the-shelf” 
parts for as low as $30, making the process intellec- 

tually more accessible to those without a scientific 
background.[4] One prominent distinction between 
DIY insulin and EpiPen is that the epinephrine in a 
DIY EpiPen can still come from a formal supplier, re-
sulting in differences regarding safety. While DIY in-
sulin contains a risk of poisoning oneself, the use of 
formally produced epinephrine in DIY EpiPens re-
duces the risk of physical harm to individuals in com-
parison. Although diabetes and allergies are both 
chronic conditions, there is the distinction of EpiPens 
as necessary upon exposure to an allergen to pre-
vent immediate death. Beauchamp and Childress 
highlight this concept in their principle of benefi-
cence, which includes “Rescue persons in danger.”[1] 
People with diabetes need insulin over time to pro-
long their lives, but the immediate necessity of an 
EpiPen upon exposure to an allergen makes the 
danger of being without the life-saving device more 
imminent. The low costs, intellectual accessibility, 
and relative safety of these DIY EpiPens combined 
with the inherent, natural compulsion for humans to 
help other humans in cases of immediate need pro-
mote the DIY EpiPen movement as a form of activ-
ism.  

In 2016, the price increase in the Mylan Ep-
iPen received media attention and backlash from 
consumers. The increasing prices had been an issue, 
increasing from “…$103.50 for a set. By July 2013, 
the price was up to $264.50, and it rose 75 percent 
to $461 by last May. This May the price spiked again 
to $608.61…”[11] As a response to these prices, Four 
Thieves Vinegar, a biohacking group founded in 
2015, posted a YouTube video demonstrating how 
to inject oneself with a homemade epinephrine 
auto-injector and published a list of materials on how 
to do so. Donovan states that “shortly after the re-
lease of the video, other biohacker groups and 
DIYers began offering epinephrine auto-injector al-
ternatives online. ProgressTH (an international de-
sign lab) released a statement announcing the de-
velopment of a 3D concept for an at-home alterna-
tive auto-injector, which would be printed for as little 
as $3 in materials.”[2] Although these biohackers pri-
marily publicize their methods to help those with life-
threatening allergies stay safe, they expose the 
healthcare industry’s issues and demonstrate the 



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dire need for change, qualifying them as accidental 
activists. The cost of biohacked EpiPens is meager 
compared to traditional EpiPen costs, ranging from 
$600 to $700; even those without financial strain 
would likely consider it an option to save money. 
However, these videos demonstrate how cheap the 
materials in the EpiPen are. Suppose an average per-
son were to figure out a way to produce the injector 
as cheaply as $3. In that case, corporations almost 
certainly have ways to make them even cheaper, ex-
posing the inflated prices. Companies that manufac-
ture these devices could charge less and still make a 
profit, but they choose not to as a way to capitalize 
on people’s vulnerability. Instead, this selfishness 
forces people to risk harming themselves using a bi-
ohacked injector to save their lives. The shocking 
idea of producing one’s own EpiPen resulted in the 
idea’s spread through the media, which would only 
result in positive reinforcement for the movement’s 
growth. Increasing numbers of posts and videos on 
the media pertaining to DIY EpiPens normalizes the 
concept and reduces its stigma. As a result, more 
people are likely to try to make their own EpiPens, 
further propagating the movement. For the rest of 
society, this movement’s media attention raises the 
question of what other medications corporations are 
overcharging for, sparking frustration against the 
healthcare industry, and fueling a more significant 
activist movement.  

In financial terms, saving money through 
producing one’s EpiPens would prevent a person 
from potentially overspending beyond his or her re-
sources, fitting under the bioethical principle of be-
neficence. Beauchamp and Childress also empha-
size the physical aspects of beneficence:  

…a person X has a determinate obligation of beneficence 
towards person Y if and only if each of the following condi-
tions is satisfied (assuming X is aware of the relevant facts):  

1. Y is at risk of significant loss of or damage to life or 
health or some other major interest.  

2. X’s action is needed (singly or in concert with others) 
to prevent this loss or damage.  

3. X’s action (singly or in concert with others) has a high 
probability of preventing it.  

4. X’s action would not present significant risks, costs, 
or burdens to X.  

5. The benefit that Y can be expected to gain outweighs 
any harms, costs, or burdens that X is likely to incur.[1]  

In biohacking, however, X and Y would usu-
ally be the same person, and in certain instances, a 
parent and child (a concept that I will later explore). 
Number 1 is satisfied by a person being in anaphy-
lactic shock, and number 2 represents an EpiPen’s 
nature. Yet, the other points must be examined. Re-
garding numbers 3 and 5, one could argue that DIY 
epinephrine injectors have high risks compared to 
those formally produced. For instance, Willingham 
states, “A syringe doesn’t offer the benefit and safety 
advantage of a well-calibrated dose, and it carries 
the risk of injection into a vein, instead of muscle, 
which can be fatal.” With an untrained individual ad-
ministering a medical technique that he or she does 
not have formal training in, there are risks. Yet, the 
necessary medication must be administered to pa-
tients with diabetes or allergies in the case of immi-
nent death. Strikingly, the fourth idea is one of the 
main benefits of biohacking.  For one person, the 
cost of EpiPens for her son was “more than her mort-
gage payment,” and “her older son…just carries 
around expired EpiPens.”[13] Parents are forced to 
make the difficult decision of risking their child’s life 
or overstretching their financial needs, and biohack-
ing allows them to prevent both. The high and unat-
tainable costs of insulin and EpiPens create desper-
ation in patients, resulting in the sense of hopeless-
ness that prices will become unattainable and ulti-
mately an overwhelming fear of death without the 
medication. Desperation often pushes people to do 
things they would not otherwise consider, such as 
synthesizing their own medicines. Biohacking serves 
as a form of activism: while trying to save their own 
lives, biohackers also promote change in the way 
people view the severity of high healthcare costs. Bi-
ohacking’s attention, especially when spread using 
social media, allows others to support the move-
ment and promote social and economic change, 
qualifying biohackers as activists. In the hands of the 
healthcare system, people often have no choice but 
to follow the rules and policies put in place. How-
ever, biohacking allows these individuals to act and 
change the status quo. Therefore, biohacking serves 
as a physical representation of the changes people 
have wanted to make in the healthcare system. Alt-
hough the act of biohacking does not directly result 



  ARESTY  RUTGERS UNDERGRADUATE RESEARCH JOURNAL, VOLUME I, ISSUE III 
 
 
 

in fair healthcare practices and prices, perhaps its 
shocking nature is enough to generate attention and 
support to move towards change.  

 

4 AUTONOMY: TWO DIFFERENT TYPES? 
Autonomy, among Beauchamp and Chil-

dress’ four principles of biomedical ethics, requires 
more examination due to the distinction between 
the traditional definition of autonomy and medical 
autonomy. Biohackers’ ability to synthesize their in-
sulin and EpiPens grants them a powerful sense of 
independence that they did not previously have; 
they are autonomous in its traditional sense, mean-
ing independent. However, Beauchamp and Chil-
dress identify medical autonomy: “…in terms of nor-
mal choosers who act (1) intentionally, (2) with un-
derstanding, and (3) without controlling influences 
that determine their action…a broad continuum ex-
ists on which autonomy goes from being fully pre-
sent to being wholly absent.”[1] In medicine, auton-
omy must involve the patient demonstrating under-
standing of a treatment or procedure, and medical 
professionals must adequately inform their patients. 
However, when people become biohackers due to 
desperation, they face no obligation to understand 
the risks of their actions thoroughly. Without being 
medically autonomous, biohackers are inhibited 
from acting ethically when examined with Beau-
champ and Childress’ model. The nature of biohack-
ing facilitates impulsivity: “The ways in which DIY bi-
ology is ‘governed’ or ‘regulated’ takes a distinctive 
form: rather than being top-down it is bottom-up; ra-
ther than being defined by institutions or policymak-
ers, it is collectively and openly negotiated by a large 
group of people…”[7] Because biohacking relies on 
the public to regulate themselves rather than formal 
rules, it can be easily misused, proving extremely 
dangerous. On the other hand, though, many ad-
vancements in science have begun with experimen-
tation, leading to ideas that may take many years for 
the public to accept. Perhaps biohacking is just one 
of these ideas that currently seems outlandish. As 
the concept continues to gain momentum and more 
safety measures are enacted, biohacking can be the 
next stage of scientific development.  

 

5 APPLICATIONS OF AUTONOMY 
The high costs of necessary technology 

combined with the monopolistic nature of diabetic 
health care can cause people to feel powerless at the 
hands of the healthcare system. As a result, making 
their own technology grants them a feeling of finan-
cial and personal autonomy. Currently, there is little 
to no formal regulation preventing this self-experi-
mentation. Although there are no proper laws 
against biohacking insulin devices in the United 
States, the German model serves as an example of 
the current regulations: “Healthcare professionals 
must point out the dangers that may arise when us-
ing a DIY AID system and should clearly distance 
themselves from the use of an open system and not 
encourage patients to use the system.”[8] Of course, 
healthcare professionals are worried about their pa-
tients, but they also benefit from higher medications 
and treatment costs. Healthcare professionals fail to 
advocate for cheaper alternatives, leaving patients 
with no one to fight for them. Patients must engage 
in activism to promote the change they want, and bi-
ohacking is one way for them to do so. The lack of 
limitation from governments, healthcare profession-
als, and finances grants patients autonomy from a bi-
omedical ethics perspective. Many patients who feel 
“overwhelmed” by the health care system are now 
free from this feeling. Beauchamp and Childress 
state: “We encounter many problems of autonomy 
in medical contexts because of the patient’s de-
pendent condition and the medical professional’s 
authoritative position… In these instances, the pa-
tient’s autonomy may be compromised because the 
physician has assumed an unwarranted degree of 
authority over his or her patient.”[1] Not only do 
health care professionals hold authority over pa-
tients under the traditional health care system, but 
the healthcare industry controls the price and distri-
bution of insulin and devices. However, health care 
professionals lack the right to prevent patients from 
making and using DIY AID systems. Therefore, when 
juxtaposed with the legal inability of healthcare pro-
fessionals to prevent patients from using DIY biology 
to create their AID systems, patients are now free 
from what they feel is domination by the health care 
system.   



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6 AUTONOMY OF PARENTS & CHILDREN 
The issue of people using biohacking on 

themselves is less controversial than people per-
forming biohacking on others. Specifically, the case 
of parents using biohacked medicine and devices 
on their children sparks controversy. Because the 
children are dependent, they do not have the au-
thority to refuse their parents nor the resources to 
obtain the medication for themselves through for-
mal means. The extent to which parents must follow 
the principles of biomedical ethics must be exam-
ined. For instance, Beauchamp and Childress iden-
tify negligence as a subcategory of nonmaleficence: 
“Negligence is the absence of due care. In the pro-
fessions, it involves a departure from the profes-
sional standards that determine due care in a given 
set of circumstances. The term negligence covers 
two types of situations: (1) intentionally imposing 
risks of harm that are unreasonable (advertent negli-
gence or recklessness) and (2) unintentionally, but 
carelessly, imposing risks of harm (inadvertent negli-
gence).”[1] If parents do not attempt to obtain the in-
sulin or EpiPen their child needs through formal 
means or biohacking, this could be regarded as neg-
ligent. Just as medical professionals are required to 
follow the widely agreed-upon rules and procedures 
to ensure the safety of their patients, a parallel can 
be drawn to the parents, in which they are expected 
to provide their children with the safest medications 
possible—those produced by formal institutions. 
Therefore, parents synthesizing pharmaceuticals us-
ing biohacking could also be considered negligent, 

where “due care” includes obtaining official medi-
cine. The barriers to this situation should not be dis-
regarded. Perhaps it is the pharmaceutical or insur-
ance companies that are fostering this negligence, 
and they should therefore bear more responsibility. 
Biohacking also introduces an additional risk of harm 
for the children. For instance, the German laws for 
DIY AID systems indicate that “People who build DIY 
AID systems and transfer them to other patients are 
liable to prosecution under the Medical Devices Act 
in Germany. The placing on the market and commis-
sioning of such a system are prohibited. The person 
who builds and transfers the system is responsible 
under the Product Liability Act.”[8] When biohacking 
for their children, parents take on additional ethical 
responsibility that, not being healthcare profession-
als, they may not be able to uphold. These parents 
likely never wanted this responsibility, but healthcare 
conditions forced them to act. These drastic 
measures show the public how dire the situation is 
and characterize these parents as activists.  

 

7 CONCLUSION 
The spread of biohacking techniques 

through social media and the internet can alter sci-
ence and medicine, resulting in biohacking serving 
as a form of activism. One primary example of 
change brought about after the increase in biohack-
ing is the reduced costs of the EpiPen, including the 
“release of a generic version of its device at about 
half the cost (about $340) of the brand name Ep-
iPen…CVS also announced that the manufacturer 
would provide a $100 coupon for much of its finan-
cially insecure population to reduce the out-of-
pocket cost to about $10 per prescription.”[2] It is 
possible that the media attention received by bio-
hackers threatened pharmaceutical companies, as 
these companies feared losing profit as more peo-
ple attempted to biohack. Nevertheless, the bio-
hackers who spearheaded the DIY EpiPen move-
ment achieved social and economic change, alt-
hough they risked their lives in the process, repre-
senting activism. Perhaps these corporations will, in 
the future, be wary before imposing high and unat-
tainable prices on consumers for fear of driving 
more people to biohack.  If increasingly accepted by 

RESULTS INDICATE 
THAT MOST STATE-

FUNDED PRE-
SCHOOL PRO-

GRAMS HAVE A 
LONG WAY TO GO 

IF INCREASINGLY ACCEPTED BY 

THE PUBLIC, BIOHACKING CAN 

DRASTICALLY CHANGE THE WAY 

PEOPLE VIEW THE RELATIONSHIP 

BETWEEN PATIENTS AND THE 

HEALTHCARE SYSTEM. 



  ARESTY  RUTGERS UNDERGRADUATE RESEARCH JOURNAL, VOLUME I, ISSUE III 
 
 
 

the public, biohacking can drastically change the 
way people view the relationship between patients 
and the healthcare system. Dyson proposes the fu-
ture of biohacking:  

There will be do-it-yourself kits for gardeners who will use 
genetic engineering to breed new varieties of roses and or-
chids. Also kits for lovers of pigeons and parrots and lizards 
and snakes to breed new varieties of pets. Breeders of dogs 
and cats will have their kits too…Few of the new creations will 
be masterpieces, but a great many will bring joy to their cre-
ators and variety to our fauna and flora. The final step in the 
domestication of biotechnology will be biotech games, de-
signed like computer games for children down to kindergar-
ten age but played with real eggs and seeds rather than with 
images on a screen. Playing such games, kids will acquire an 
intimate feeling for the organisms that they are growing. The 
winner could be the kid whose seed grows the prickliest cac-
tus, or the kid whose egg hatches the cutest dinosaur.[3] 

Dyson emphasizes the idea that biohacking 
will “bring joy” and that eventually, people will per-
form biohacking for pleasure, in contrast to some-
thing that is currently performed out of desperation. 

Although biohacking is still a new topic, the 
media attention it receives (coupled with its low 
costs) can lead to the democratization of healthcare 
and science. In its current state, biohacking presents 
a tempting option for those who seek to avoid the 
high costs of the traditional healthcare system. Yet, 
the risks of this unregulated experimentation deter 
many rationally thinking people. However, in the fu-
ture, if ethical and safety regulations are put in place, 
people begin devising new ways to use biohacking 
and posting these ideas on the media; biohacking 
can break financial and intellectual bounds. Alt-
hough the first amendment protects free speech, 
sites can employ community rules or rules of con-
duct to promote the safety of biohacking. No longer 
would people feel helpless under a system that con-
trols their health. If perfected and made applicable 
to more situations, biohacking could challenge the 
long-standing dominance of formal institutions and 
grant more power to the average person. In activism, 
people often seek the traditional definition of justice, 
which typically means fairness. Biohackers fall under 
this category and aim to achieve fair prices and ac-
cess to medications. However, just as there are mul-
tiple definitions of autonomy, there are also different 

forms of justice; Beauchamp and Childress define 
the concept of justice in a biomedical ethics context 
slightly differently. They describe their idea of mate-
rial justice: “…primarily our obligations are limited to 
fundamental needs. To say that someone has a fun-
damental need is to say that the person will be 
harmed or detrimentally affected in a fundamental 
way if that need is not fulfilled.”[1] Biohacking finally 
allows ordinary people to bring attention to the mes-
sage that their needs are not met. Although this pur-
pose was likely not intentional, by democratically 
synthesizing one’s medication, biohackers also fulfill 
the idea of justice from a biomedical ethics perspec-
tive, aside from simply seeking justice in its tradi-
tional sense.  

The idea of biohacking, or performing ex-
periments once only reserved to formal institutions, 
can be shocking and disturbing to many. Biohacking 
has the potential to go wrong and harm people. Yet, 
in the case of chronic medical conditions such as di-
abetes and allergies, biohacking offers a sense of 
control and a glimmer of hope for those put in a chal-
lenging financial and medical situation. When exam-
ining types of activism from rallies to boycotts to hun-
ger strikes, all of these examples share one common 
feature with biohacking: they are striking to the pub-
lic. Real, lasting change rarely comes from mundane 
activities, so perhaps the dangerous nature of bio-
hacking is critical to it serving as activism. Also, low 
costs and media attention aid in biohacking spread-
ing. When examining these applications of biomed-
ical ethics using Beauchamp and Childress’ model, 
many nuances prevent biohacking from serving as a 
straightforward solution to high healthcare costs. 
However, because their principles apply to tradi-
tional medicine rather than biohacked treatments, 
these principles should be updated to reflect the 
ethical concerns over the increasing popularity of bi-
ohacking. Without an exact code of instructions, bi-
ohackers are left to their own devices. Although bio-
hackers have developed their code of ethics consist-
ing of broad principles such as responsibility and 
transparency, this unofficial code resembles more of 
a list than rules for biohackers to follow. When juxta-
posed with Beauchamp and Childress’ model, the 
biohacker code of ethics is concise and nonspecific. 



  ARESTY  RUTGERS UNDERGRADUATE RESEARCH JOURNAL, VOLUME I, ISSUE III 
 
 
 

Therefore, perhaps it is time to develop a model of 
ethics for biohackers. Out of the four principles, be-
neficence, nonmaleficence, and justice can remain 
largely the same. However, due to the freedom 
granted by individuals performing biohacking on 
themselves, the principle of autonomy should be al-
tered to emphasize the importance of a complete 
understanding of risks and rewards before one per-
forms biohacking to ensure its ethical soundness as 
increasing numbers of people engage in biohacking 
in hopes of saving lives and promoting change∎  

8 REFERENCES  
[1] Beauchamp, Tom L., and Childress, James L. Principles of Bi-

omedical Ethics. 8th ed. Oxford University Press, 2019.  
[2]  Donovan, Matthew C. J. Pop-up Maktivism: A Case Study of 

Organizational, Pharmaceutical, and Biohacker Narratives. 
2019. Arizona State University. PhD dissertation. 

[3]  Dyson, Freeman. “Our Biotech Future.” New York Review of 
Books, vol. 54, no, 12, 2007.  

[4]  Four Thieves Vinegar, accessed: 6 Dec. 2020,  
HTTPS://WWW.FOURTHIEVESVINEGAR.ORG 

[5]  Gallegos, Jenna E., et al. "The Open Insulin Project: A Case 
Study for 'Biohacked' Medicines." Trends in Biotechnology, 
vol. 36, no. 12, 2018, pp. 1211-1218. 

[6]  Kresge, Naomi and Cortez, Michelle. “The $250 Biohack 
That’s Revolutionizing Life With Diabetes.” Bloomberg, 2018.  

[7]  Landrain, Thomas et al. "Do-it-yourself biology: challenges 
and promises for an open science and technology move-
ment." Systems of Synthetic Biology, vol. 7, no. 3, 2013, pp. 
115-126.   

[8]  Oliver, Nick et al. “Open source automated insulin delivery: 
addressing the challenge.” Digital Medicine, no. 124, 2019. 

[9]  Omer, Timothy. “Empowered Citizen ‘Health Hackers’ Who 
are Not Waiting.” BMC Medicine, vol. 14, no. 118, 2016.  

[10] Osterath, Brigitte. “Do-It-Yourself Insulin: Biohackers Aim to 
Counteract Skyrocketing Prices.” DW, 2019,  
WWW.DW.COM/EN/DO-IT-YOURSELF-INSULIN-BIOHACKERS-AIM-TO-

COUNTERACT-SKYROCKETING-PRICES/A-48861257. 
[11] Parker-Pope, Tara and Peachman, Rachel Rabkin. “EpiPen 

Price Rise Sparks Concern for Allergy Sufferers.” The New 
York Times, 2016. 
HTTPS://WELL.BLOGS.NYTIMES.COM/2016/08/22/EPIPEN-PRICE-RISE-SPARKS-
CONCERN-FOR-ALLERGY-SUFFERERS 

[12] Rajkumar, S. Vincent. “The High Cost of Insulin in the United 
States: An Urgent Call to Action.” Mayo Clinic Proceedings, 
vol. 95, no. 1, 2020.  

[13] Willingham, Emily. “Why Did Mylan Hike EpiPen Prices 400? 
Because They Could.” Forbes, 2016. 

 HTTPS://WWW.FORBES.COM/SITES/EMILYWILLINGHAM/2016/08/21/WHY-
DID-MYLAN-HIKE-EPIPEN-PRICES-400-BECAUSE-THEY-COULD/ 

 
 
 

 
Julia Zheng is a junior at Rutgers University-New Brunswick pursuing a Bachelor of Science in Cell 
Biology and Neuroscience in the School of Arts and Sciences Honors Program with a minor in Psy-
chology. She conducted research for this paper in her Research in the Disciplines: Science, Medi-
cine, and Society course in Fall 2020. Julia is interested in science and medicine and has the goal 
of pursuing a career in the medical field as a physician. At Rutgers, Julia is President of the Bioethics 
Society, conducts research in Dr. Alexander Kusnecov's lab, and works as a part-time lecturer for 
the Physics Department. Outside of school, she works as a medical assistant and receptionist at a 
pediatrician's office and enjoys volunteering in her community. 

 

https://www.fourthievesvinegar.org/
http://www.dw.com/en/do-it-yourself-insulin-biohackers-aim-to-counteract-skyrocketing-prices/a-48861257
http://www.dw.com/en/do-it-yourself-insulin-biohackers-aim-to-counteract-skyrocketing-prices/a-48861257
https://well.blogs.nytimes.com/2016/08/22/epipen-price-rise-sparks-concern-for-allergy-sufferers
https://well.blogs.nytimes.com/2016/08/22/epipen-price-rise-sparks-concern-for-allergy-sufferers
https://www.forbes.com/sites/emilywillingham/2016/08/21/why-did-mylan-hike-epipen-prices-400-because-they-could/
https://www.forbes.com/sites/emilywillingham/2016/08/21/why-did-mylan-hike-epipen-prices-400-because-they-could/

