Two clusters of essays in this issue of The Journal of Medicine and Philosophy provide a critical gaze through which to explore central moral, phenomenological, ontological, and political concerns regarding human moral agency and personal responsibility. The first cluster challenges common assumptions in bioethics regarding the voluntariness of human actions. The second set turns the debate towards morally responsible choice within the requirements of distributive justice. The force of their collective analysis leaves us with a well-founded basis critically to approach (...) any account of bioethics or health policy that is insufficiently attentive to the central challenges of human freedom and responsible free choice. (shrink)

Bioconservative bioethicists (e.g., Kass, 2002, Human Dignity and Bioethics, 297–331, 2008; Sandel, 2007; Fukuyama, 2003) offer various kinds of philosophical arguments against cognitive enhancement—i.e., the use of medicine and technology to make ourselves “better than well” as opposed to merely treating pathologies. Two notable such bioconservative arguments appeal to ideas about (1) the value of achievement, and (2) authenticity. It is shown here that even if these arguments from achievement and authenticity cut ice against specifically pharmacologically driven cognitive enhancement, they (...) do not extend over to an increasingly viable form of technological cognitive enhancement – namely, cognitive enhancement via augmented reality. An important result is that AR-driven cognitive enhancement aimed at boosting performance in certain cognitive tasks might offer an interesting kind of “sweet spot” for proponents of cognitive enhancement, allowing us to pursue many of the goals of enhancement advocates without running into some of the most prominent objections from bioconservative philosophers. (shrink)

Moral enhancement proposals struggle to be both plausible and ethically defensible while nevertheless interestingly distinct from both cognitive enhancement as well as (mere) moral education. Brian Earp (_Royal Institute of Philosophy Supplement_ 83:415–439, 12 ) suggests that a promising middle ground lies in focusing on the (suitably qualified) use of psychedelics as _adjuncts_ to moral development. But what would such an adjunctive use of psychedelics look like in practice? In this paper, I draw on literature from three areas where techniques (...) for moral development have been discussed: psychotherapy (e.g., Overholser 2010; Burns 1980) education (e.g., Uhl and Lütge, 2018), and AI-assisted enhancement (e.g., Lara and Deckers, _Neuroethics_ 13(3):275–287, 17 ) in order to propose more concrete ways in which to use psychedelics as adjuncts to moral development. It is shown that in each of these areas, we can see that _trusting_ relationships (e.g., Baier 1986; Hawley 2019) between the facilitator and the agent will very plausibly maximize the success of this type of moral enhancement. Finally, I appeal to literature on informed consent for use of psychedelics (e.g., Smith and Sisti, _Journal of Medical Ethics_, 22 ; Johnson et al., _The Journal of Psychopharmacology_ 22(6):603–20, 23 ) and on the therapeutic relationship in psychotherapy (e.g., Dryden and Reeves 2013; Horvath et al. 2011) to outline concrete suggestions for facilitating dimensions of trust most likely to maximize the benefits of (adjunctive) psychedelic moral enhancement. The result is a newly detailed practical proposal for how we might best facilitate moral enhancement by using drugs as adjuncts to moral development. (shrink)

The paper represents an empirical study of public attitudes towards moral bioenhancement. Moral bioenhancement implies the improvement of moral dispositions, i.e. an increase in the moral value of the actions or character of a moral agent. The views of bioethicists and scientists on this topic are present in the ongoing debate, but not the view of the public in general. In order to bridge the gap between the philosophical debate and the view of the public, we have examined attitudes towards (...) moral bioenhancement. The participants were people from Serbia older than 15, who voluntarily completed an online questionnaire. The questionnaire consisted of a brief introduction to moral bioenhancement, seven general questions, 25 statements about participants’ attitudes towards moral bioenhancement, and five examples of moral dilemmas. The questionnaire also included questions which were used to reveal their preference of either deontology, or utilitarianism. Participants were asked to what degree they agree or disagree with the statements. The results showed that the means used to achieve moral enhancement, the level of education, and preference for deontology or utilitarianism do have an impact on public attitudes. Using exploratory factor analysis, we isolated four factors that appear to drive the respondents' attitudes toward moral bioenhancement, we named: general—closeness, fear of change, security, and voluntariness. Each factor in relationship to other variables offers new insights that can inform policies and give us a deeper understanding of the public attitudes. We argue that looking into different facets of attitudes towards moral bioenhancement improves the debate, and expands it. (shrink)

In their recent bookUnfit for the Future, Persson and Savulescu make a heartfelt plea for the increasing necessity of “moral enhancement”, interventions that improve human capacities for moral behaviour.3They argue that, with all the technological advances of the 20thand 21stcenturies, the sheer scope of horror that humans can now potentially wreak on their neighbours or the world is staggering. Hence, we are morally obliged to use interventions at our disposal to prevent such atrocities. However, as we learn more about human (...) behaviour and decision-making, the argument that we are morally obligated to morally enhance our friends, neighbours, or countrymen starts to fall apart. For us to be more moral requires more than sharpening our reasoning capacities so that we can more effectively recognise what is better or increasing personal motivation so that we are more likely to do what is good. It requires that we all agree on what the good is and how to achieve it, and that there are no social, cultural, physical, or psychological impediments that prevent us from recognising the good or acting on it. To illustrate my position, I use the phenomenon of self-radicalised terrorists as a case study. In particular, I focus on how historians, psychologists, sociologists, criminologists, and political scientists understand the process of self-radicalisation, who self-radicalises, and why, and what all this tells us about it should be “treated”. Part of my purpose in working my way through this case study is to demonstrate that many philosophers misunderstand or over-simplify the science behind so-called immoral actions; consequently, their discussions of whether to enhance someone's morality miss their mark. (shrink)

In this article, I argue that as we learn more about how we might intervene in the brain in ways that impact human behavior, the scope of what counts as “moral behavior” becomes smaller and smaller because things we successfully manipulate using evidence-based science are often things that fall outside the sphere of morality. Consequently, the argument that we are morally obligated to morally enhance our neighbors starts to fall apart, not because humans should be free to make terrible choices, (...) but because morality is not something subject to such manipulation. To illustrate my argument, I shall use the rise of veteran diversion courts in the United States as a putative instance of an intervention designed to change human behavior for the better. Part of my purpose in working my way through this case study is to demonstrate that many philosophers have the psychology of immoral action wrong. (shrink)