Abstract:An integrated and principled neuroethics offers ethical guidelines able to transcend conventional and medical reliance on normality standards. Elsewhere we have proposed four principles for wise guidance on human transformations. Principles like these are already urgently needed, as bio- and cyberenhancements are rapidly emerging. Context matters. Neither “treatments” nor “enhancements” are objectively identifiable apart from performance expectations, social contexts, and civic orders. Lessons learned from disability studies about enablement and inclusion suggest a fresh way to categorize modifications to the body (...) and its performance. The term “enhancement” should be broken apart to permit recognition of enablements and augmentations, and kinds of radical augmentation for specialized performance. Augmentations affecting the self, self-worth, and self-identity of persons require heightened ethical scrutiny. Reversibility becomes the core problem, not the easy answer, as augmented persons may not cooperate with either decommissioning or displacement into unaccommodating societies. We conclude by indicating how our four principles of self-creativity, nonobsolescence, empowerment, and citizenship establish a neuroethics beyond normal that is better prepared for a future in which humans and their societies are going so far beyond normal. (shrink)

The debate over the propriety of cognitive enhancement evokes both enthusiasm and worry. To gain further insight into the reasons that people may have for endorsing or eschewing pharmacological enhancement, we used empirical tools to explore public attitudes towards PE of twelve cognitive, affective, and social domains. Participants from Canada and the United States were recruited using Mechanical Turk and were randomly assigned to read one vignette that described an individual who uses a pill to enhance a single domain. After (...) reading the vignette, participants were asked how comfortable they were with the individual using the enhancement. People were significantly more comfortable when they read about enhancement of certain CAS domains than others. We found a modest negative correlation between comfort level and the degree to which the PE was perceived as changing core features of the person. We also found a modest correlation between comfort level and the degree to which the PE was perceived as improving success in life. Finally, using a sequential mixed method technique, we found that participants who felt uncomfortable about PE use overwhelmingly focused on a lack of need and, to a lesser degree, expressed concerns about safety; those who felt comfortable about PE use most frequently mentioned the safety of the pill and its ability to provide a positive outcome. The data provide novel insights into public enthusiasms and concerns over the use of PE. (shrink)

The debate on the ethical aspects of moral bioenhancement focuses on the desirability of using biomedical as opposed to traditional means to achieve moral betterment. The aim of this paper is to systematically review the ethical reasons presented in the literature for and against moral bioenhancement.

Debate concerning human enhancement often revolves around the question of whether there is a common “nature” that all human beings share and which is unwarrantedly violated by enhancing one’s capabilities beyond the “species-typical” norm. I explicate Thomas Aquinas’s influential theory of human nature, noting certain key traits commonly shared among human beings that define each as a “person” who possesses inviolable moral status. Understanding the specific qualities that define the nature of human persons, which includes self-conscious awareness, capacity for intellective (...) thought, and volitional autonomy, informs the ethical assessment of various forms of enhancement. Some forms of cognitive and physical enhancement may be desirable from the perspective of what constitutes the “flourishing” of human persons in our fundamental nature; while other forms of enhancement, such as emotive or so-called “moral” enhancement, run the risk of detracting from human flourishing when evaluated from the virtue-theoretic perspective Aquinas promotes. (shrink)

The enhancement of human traits has received academic attention for decades, but only recently has moral enhancement using biomedical means – moral bioenhancement (MB) – entered the discussion. After explaining why we ought to take the possibility of MB seriously, the paper considers the shape and content of moral improvement, addressing at some length a challenge presented by reasonable moral pluralism. The discussion then proceeds to this question: Assuming MB were safe, effective, and universally available, would it be morally desirable? (...) In particular, would it pose an unacceptable threat to human freedom? After defending a negative answer to the latter question – which requires an investigation into the nature and value of human freedom – and arguing that there is nothing inherently wrong with MB, the paper closes with reflections on what we should value in moral behaviour. (shrink)

This article will examine how the notion of emotional authenticity is intertwined with the notions of naturalness and artificiality in the context of the recent debates about ‘neuro-enhancement’ and ‘neuro-psychopharmacology.’ In the philosophy of mind, the concept of authenticity plays a key role in the discussion of the emotions. There is a widely held intuition that an artificial means will always lead to an inauthentic result. This article, however, proposes that artificial substances do not necessarily result in inauthentic emotions. The (...) literature provided by the philosophy of mind on this subject usually resorts to thought experiments. On the other hand, the recent literature in applied ethics on ‘enhancement’ provides good reasons to include real world examples. Such case studies reveal that some psychotropic drugs such as antidepressants actually cause people to undergo experiences of authenticity, making them feel ‘like themselves’ for the first time in their lives. Beginning with these accounts, this article suggests three non-naturalist standards for emotions: the authenticity standard, the rationality standard, and the coherence standard. It argues that the authenticity standard is not always the only valid one, but that the other two ways of assessing emotions are also valid, and that they can even have repercussions on the felt authenticity of emotions. In conclusion, it sketches some of the normative implications if not ethical intricacies that accompany the enhancement of emotions. (shrink)

Extreme human enhancement could result in “posthuman” modes of being. After offering some definitions and conceptual clarification, I argue for two theses. First, some posthuman modes of being would be very worthwhile. Second, it could be very good for human beings to become posthuman.

Motivational enhancement of any kind can be conceived of either as a way to reduce the need for effort, or as a change in the subjective perception of effort. However, in both cases, effort is not all that matters. In the evaluation of praiseworthy conduct, the practical goals pursued by the subject, their dedication, and the discernment they exercise are equally important. I further argue that not only in terms of the general purpose, but also in terms of the means (...) employed for human enhancement, we cannot, in fact, establish significant differences between the traditional technology of the self and biomedical technologies for enhancing motivation. There are two key features they all share. The traditional techniques of the self also aim at the gradual reduction of effort through their steady practice, and they are all mental conditioning and self-conditioning techniques based on repetition and training. (shrink)

New medical technologies promise to allow us to transform our core characteristics. Some see these technologies as filled with promise. Others see them as filled with existential risk. David DeGrazia argues that personal identity concerns raised by opponents to enhancement technology fail to impugn attempts by autonomous agents to bring about enhancements with which they autonomously identify. In advancing this argument DeGrazia evaluates five supposedly inviolable core narrative characteristics, concluding that none of these characteristics are in fact inviolable so long (...) as the individual contemplating transformation autonomously identifies with the change they decide to make. Employing insights gleaned from LA Paul’s recent work on the subject of transformative experiences I will argue that at least for some transformations, the prospects for autonomous identification are slim at best. The upshot will be that many of the core narrative traits discussed by DeGrazia will be inviolable in practice, if not in principle. (shrink)

Supernumerary robotic limbs are innovative devices in the field of wearable robotics which can provide humans with unprecedented sensorimotor abilities. However, scholars have raised awareness of the ethical issues that would arise from the large adoption of technologies for human augmentation in society. Most negative attitudes towards such technologies seem to rely on an allegedly clear distinction between therapy and enhancement in the use of technological devices. Based on such distinction, people tend to accept technologies when used for therapeutic purposes (...) (e.g., prostheses), but tend to raise issues when similar devices are used for upgrading a physical or cognitive ability (e.g., supernumerary robotics limbs). However, as many scholars have pointed out, the distinction between therapy and enhancement might be theoretically flawed. In this paper, we present an alternative approach to the ethics of supernumerary limbs which is based on two related claims. First, we propose to conceive supernumerary limbs as tools that necessarily modify our psychological and bodily identity. At the same time, we stress that such a modification is not ethically bad in itself; on the contrary, it drives human interaction with the environment. Second, by comparing our view with the extended mind thesis, we claim that the mediation through tools is crucial for the formation of novel meanings and skills that constitute human interaction with the world. We will relate the latter claim to enactivism as a helpful theoretical perspective to frame issues related to artificial limbs and, more in general, to technologies for augmentation. Based on this approach, we finally sketch some suggestions for future directions in the ethics of supernumerary limbs. (shrink)

En este ensayo, evaluaremos el problema de la identidad personal en el contexto del transhumanismo. En primer lugar, en contra de la tesis de que el transhumanismo representa una amenaza a la persistencia de la identidad personal argumentaremos lo siguiente: los individuos humanos que son personas no tienen características esenciales. En segundo lugar, con la ayuda del primer episodio de la segunda temporada de la serie de ciencia ficción Black Mirror, defenderemos la tesis de que hay propiedades que realmente importan (...) en el problema de la identidad personal: las propiedades relacionales(esta tesis tiene como consecuencia que nuestros seres queridos son irremplazables, incluso por duplicados exactos). Finalmente, concluiremos que el uso de las tecnologías de mejoramiento humano no representa una amenaza a la identidad personal de un individuo en tanto que no altera sus propiedades relacionales importantes. (shrink)

Tackling climate change is one of the most demanding challenges of humanity in the 21st century. Still, the efforts to mitigate the current environmental crisis do not seem enough to deal with the increased existential risks for the human and other species. Persson and Savulescu have proposed that our evolutionarily forged moral psychology is one of the impediments to facing as enormous a problem as global warming. They suggested that if we want to address properly some of the most pressing (...) problems that cause catastrophic harm to our existence, we should enhance our moral behavior by biomedical means. The objective of this paper is, precisely, to reflect on whether a Moral Bio-Enhancement (henceforth MBE) program would be a viable option to confront the climate emergency. To meet this goal, I will propose the Ultimate Mostropic (hereafter UM) thought experiment, a hypothetical situation where we have already discovered the UM, an available, safe (without any deleterious secondary effects), extremely cheap and effective pill to enhance our cognitive, affective and motivational abilities related to morality. After briefly presenting the main argument of Persson and Savulescu regarding MBE and climate change, I will point out some of the difficulties that make MBE a daunting but exciting philosophical and scientific debate. In order to overcome these complications, I will describe the UM thought experiment, which involves two scenarios of the MBE program: (a) the state-driven, compulsory and universal enterprise, and (b) the initiative of voluntary individuals. I will show that the shortcomings of MBE programs through the UM in both scenarios make Persson and Savulescu’s proposal a not appealing pathway to mitigate climate change. In the final section, I will suggest that an inaccurate attribution of responsibilities underlies their proposal and that the collective inaction problem should be redirected primarily through a reinforcement of the political nature of the solutions. (shrink)

The necessity of origin suggests that a person’s identity is determined by the particular pair of gametes from which the person originated. An implication is that speculative scenarios concerning how we might otherwise have been had our gametic origins been different are dismissed as being metaphysically impossible. Given, however, that many of these speculations are intelligible and commonplace in the discourses of competent speakers, it is overhasty to dismiss them as mistakes. This paper offers a way of understanding these speculations (...) that does not commit them to incoherence but aims to make the best sense of what they are expressing. Using the philosophical framework of two‐dimensional semantics, it proposes that the speculative scenarios are best analysed as epistemic possibilities, rather than as metaphysical possibilities. It then explores some implications of this analysis for the ethical challenges associated with the non‐identity problem. (shrink)

What would my life have been like if I had been born more intelligent? Or taller? Or a member of the opposite sex? Or a non-biological being? It is plausible that some of these questions make sense, while others stretch the limits of sense making. In addressing questions of how I might have been, genetic essentialism is popular, but this article argues that genetic essentialism, and other versions of origin essentialism for organisms, must be rejected. It considers the prospects for (...) counterpart theory and shows how counterpart theory can be used to illuminate volitional accounts of identity as proposed by Harry Frankfurt. This enables one to make sense of claims that, say, being gay, or Deaf, or Black, can be essential to someone's identity. The discussion is then extended to show how it can be made applicable to the transworld identity theorist who denies that individuals possess essential properties. (shrink)

When it comes to caring about and helping those in need, our imaginations tend to be weak and our motivation tends to be parochial. This is a major moral problem in view of how much unmet need there is in the world and how much material capacity there is to address that need. With this problem in mind, the present paper will focus on genetic means to the enhancement of a moral capacity—a disposition to altruism—and of a cognitive capacity that (...) facilitates use of the moral capacity: the ability to grasp vividly the needs of individuals who are unknown and not present. I will address two questions, with more extensive attention to the first question. First, assuming we had excellent reason to believe that the enhancements were safe, effective, and available to all who desired them, would seeking these enhancements be inherently morally acceptable—that is, free of inherent wrongness? Second, would it be wise for a society to pursue these enhancements? I will defend an affirmative answer to the first question while leaving the second question open. (shrink)

One of the reasons why moral enhancement may be controversial, is because the advantages of moral enhancement may fall upon society rather than on those who are enhanced. If directed at individuals with certain counter-moral traits it may have direct societal benefits by lowering immoral behavior and increasing public safety, but it is not directly clear if this also benefits the individual in question. In this paper, we will discuss what we consider to be moral enhancement, how different means may (...) be used to achieve it and whether the means we employ to reach moral enhancement matter morally. Are certain means to achieve moral enhancement wrong in themselves? Are certain means to achieve moral enhancement better than others, and if so, why? More specifically, we will investigate whether the difference between direct and indirect moral enhancement matters morally. Is it the case that indirect means are morally preferable to direct means of moral enhancement and can we indeed pinpoint relevant intrinsic, moral differences between both? We argue that the distinction between direct and indirect means is indeed morally relevant, but only insofar as it tracks an underlying distinction between active and passive interventions. Although passive interventions can be ethical provided specific safeguards are put in place, these interventions exhibit a greater potential to compromise autonomy and disrupt identity. (shrink)

Ist es moralisch verantwortbar, Menschen mit technischen Eingriffen zu verbessern? Der Aufsatz versucht diese Frage zu beantworten, indem zwei Gefahren für Verbesserungswillige beleuchtet werden: der Verlust der Menschlichkeit und der unerwünschte Wandel der individuellen Persönlichkeit. Sodann wird ein „Liberalismus mit Auffangnetz“ als Lösung des Problems vorgestellt, die eine unterschiedliche Bewertung von reversiblen und irreversiblen Eingriffen vornimmt. Im letzten Schritt wird überprüft, wie weit diese Konzeption auch anwendbar ist, wenn Eltern ihre Kinder verbessern lassen wollen, also ein „informed consent“ nicht vorausgesetzt (...) werden kann. Dabei werden Argumente zurückgewiesen, die Habermas gegen eine Verbesserung von Kindern vorgebracht hat. (shrink)

Human heritable genome editing (HHGE) involves editing the genes of human gametes and/or early human embryos. Whilst ‘identity’ is a key concept underpinning the current HHGE debate, there is a lack of inclusive analysis on different concepts of ‘identity’ which renders the overall debate confusing at times. This paper first contributes to reviewing the existing literature by consolidating how ‘identity’ has been discussed in the HHGE debate. Essentially, the discussion will reveal an ontological and empirical understanding of identity when different (...) types of identity are involved. Here, I discuss genetic, numerical, qualitative and narrative and how each of them is relevant in the HHGE context. Secondly, given the different types of identity, the paper explores how we could navigate these different interpretations of identity in a way that promotes an inclusive and informed discussion between primary stakeholders and the general public in the HHGE debate. Here, I argue for and refine a multi-faceted concept of identity as a suitable framework for discussing the ethical and societal implications of HHGE because it not only could integrate different understandings of identity but also highlight the interconnectedness between these different understandings. (shrink)

The paper discusses criticisms against pharmacological cognitive enhancement from a liberal perspective. The criticisms point to the consequences of cognitive enhancement in third parties and in the agents, as well as in independent values. According to the article, these criticisms are not convincing. On the contrary, it argues that under certain assumptions there are good reasons in favor of free access to cognitive enhancement.

Decisions about brain surgery pose existential challenges because they are often decisions about life or death, and sometimes about possible personality changes. Therefore they require rigorous neuroethical consideration. However, we doubt whether metaphysical interpretations of ambiguous statements of patients are useful for deriving ethical and legal conclusions. Particularly, we question the application of psychological theories of personal identity on neuroethical issues for several reasons. First, even the putative “standard view” on personal identity is contentious. Second, diverse accounts of personal identity (...) have been introduced into the neuroethical debate, which are incompatible. Third, the criteria for “diagnosing” the supposed changes in “identity” are ambiguous and indeterminate. Fourth, the metaphysical theories of personal identity imply highly questionable ethical and legal revisions, namely the denial of advance directives, particularly of Ulysses contracts, and, for patients with brain cancer, even therapeutic nihilism.We discuss three examples in which ideas from the personal identity debate in metaphysics are straightforwardly applied to discuss ethical issues of neurosurgery. We discuss revisions of the current medico-legal practice that have been proposed on grounds of psychological theories of personal identity. We argue that the established status quo in law and clinical practice is beneficial to the patients concerned. Furthermore, it is metaphysically neutral, which is an important principle of liberal, democratic, pluralistic societies.We recommend a pragmatic approach: empirical research on personality changes arising from brain disorders or interventions, comprehensive information about risks of personality changes, and advance directives, particularly Ulysses contracts. (shrink)

This paper explores the impacts of neurological intervention on selfhood with reference to recipients’ claims about changes to their self-understanding following Deep Brain Stimulation for treatment of Parkinson’s Disease. In the neuroethics literature, patients’ claims such as: “I don’t feel like myself anymore” and “I feel like a machine”, are often understood as expressing threats to identity. In this paper I argue that framing debates in terms of a possible threat to identity—whether for or against the proposition, is mistaken and (...) occludes what is ethically salient in changes from DBS. Rather, by adopting a relational narrative approach to identity and autonomy, I show that the ethically salient issue from DBS is impacts on autonomous agency—whether one’s actions and beliefs are one’s own, and how DBS may hinder, or foster, embodied, relational autonomy competences. This approach recognizes that if sufficiently significant, impacts on autonomy competences may pose a threat to one’s ability to contribute to the process of authoring one’s own life and so pose a threat to identity formation. I argue this approach resolves the confusion in the literature about whether and how DBS threatens identity and provides a complex picture of how DBS may affect selfhood by disrupting narrative identity formation and revision, distorting agency and/or undermining autonomy. (shrink)

Since the 1990’s, the debate concerning the ethical, legal and societal aspects of ‘neuro-enhancement’ has evolved into a massive discourse, both in the public realm and in the academic arena. This ethical debate, however, tends to repeat the same sets of arguments over and over again. Normative disagreements between transhumanists and bioconservatives on invasive or radical brain stimulators, and uncertainties regarding the use and effectivity of nootropic pharmaceuticals dominate the field. Building on the results of an extensive European project on (...) responsible research and innovation in neuro-enhancement, we observe and encourage that the debate is now entering a new and, as we will argue, more realistic and societally relevant stage. This new stage concerns those technologies that enter the market as ostensibly harmless contrivances that consumers may use for self-care or entertainment. We use the examples and arguments of participants in NERRI debates to describe three case studies of such purportedly innocent ‘toys’. Based upon this empirical material, we argue that these ‘soft’ enhancement gadgets are situated somewhere in the boundary zone between the internal and the external, between the intimate and the intrusive, between the familiar and the unfamiliar, between the friendly and the scary and, in Foucauldian terms, between technologies of the self and technologies of control. Therefore, we describe their physiognomy with the help of a term borrowed from Jacques Lacan, namely as “extimate” technologies. (shrink)

Almost all jurisdictions where physician-assisted death is legal require that the requesting individual be competent to make medical decisions at time of assistance. The requirement of contemporary competence is intended to ensure that PAD is limited to people who really want to die and have the cognitive ability to make a final choice of such enormous import. Along with terminal illness, defined as prognosis of death within six months, contemporary competence is regarded as an important safeguard against mistake and abuse, (...) arguably the strongest objections to legalizing PAD.The insistence on contemporary competence is problematic. It means that someone who has dementia is ruled out as a candidate for PAD, even if she is terminally ill and suffering terrible and unrelievable pain. It also rules out individuals with strong and unwavering desires not to end their life in dementia. (shrink)

Aldous Huxley’s Brave New World is a famous dystopia, frequently called upon in public discussions about new biotechnology. It is less well known that 30 years later Huxley also wrote a utopian novel, called Island. This paper will discuss both novels focussing especially on the role of psychopharmacological substances. If we see fiction as a way of imagining what the world could look like, then what can we learn from Huxley’s novels about psychopharmacology and how does that relate to the (...) discussion in the ethical and philosophical literature on this subject? The paper argues that in the current ethical discussion the dystopian vision on psychopharmacology is dominant, but that a comparison between Brave New World and Island shows that a more utopian view is possible as well. This is illustrated by a discussion of the issue of psychopharmacology and authenticity. The second part of the paper draws some further conclusions for the ethical debate on psychopharmacology and human enhancement, by comparing the novels not only with each other, but also with our present reality. It is claimed that the debate should not get stuck in an opposition of dystopian and utopian views, but should address important issues that demand attention in our real world: those of evaluation and governance of enhancing psychopharmacological substances in democratic, pluralistic societies. (shrink)

Our present moral traits are unable to provide the level of large-scale co-operation necessary to deal with risks such as nuclear proliferation, drastic climate change and pandemics. In order to survive in an environment with powerful and easily available technologies, some authors claim that we need to improve our moral traits with moral enhancement. But this is prone to produce paradoxical effects, be self-reinforcing and harm personal identity. The risks of moral enhancement require the use of a safety framework; such (...) a framework should guarantee practical robustness to moral uncertainty, empirical adequacy, correct balance between dispositions, preservation of identity, and be sensitive to practical considerations such as emergent social effects. A virtue theory can meet all these desiderata. Possible frameworks incorporate them to variable degrees. The social value orientations framework is one of the most promising candidates. (shrink)

:Neuroprosthetic speech devices are an emerging technology that can offer the possibility of communication to those who are unable to speak. Patients with ‘locked in syndrome,’ aphasia, or other such pathologies can use covert speech—vividly imagining saying something without actual vocalization—to trigger neural controlled systems capable of synthesizing the speech they would have spoken, but for their impairment.We provide an analysis of the mechanisms and outputs involved in speech mediated by neuroprosthetic devices. This analysis provides a framework for accounting for (...) the ethical significance of accuracy, control, and pragmatic dimensions of prosthesis-mediated speech. We first examine what it means for the output of the device to be accurate, drawing a distinction between technical accuracy on the one hand and semantic accuracy on the other. These are conceptual notions of accuracy.Both technical and semantic accuracy of the device will be necessary for the user to have sufficient control over the device. Sufficient control is an ethical consideration: we place high value on being able to express ourselves when we want and how we want. Sufficient control of a neural speech prosthesis requires that a speaker can reliably use their speech apparatus as they want to, and can expect their speech to authentically represent them. We draw a distinction between two relevant features which bear on the question of whether the user has sufficient control: voluntariness of the speech and the authenticity of the speech. These can come apart: the user might involuntarily produce an authentic output or might voluntarily produce an inauthentic output. Finally, we consider the role of the interlocutor in interpreting the content and purpose of the communication.These three ethical dimensions raise philosophical questions about the nature of speech, the level of control required for communicative accuracy, and the nature of ‘accuracy’ with respect to both natural and prosthesis-mediated speech. (shrink)

Advances in reproductive technology have already revolutionized our culture in various ways, and future potential developments, particularly in genetics, promise more of the same. The practice of surrogacy threatens to upend the way we understand the family. Germline engineering of human embryos could, among other things, lead to the treatment of genetic diseases hitherto incurable; but the widespread use of such engineering could have broader ramifications for our culture, for better and for worse. Parents may eventually be able to select (...) for desirable traits in their offspring, whether by genetic modification at conception or by choosing to implant one of several genetically profiled embryos. Authors in this issue of The Journal of Medicine and Philosophy address some of the ethical implications of these technological and cultural changes. (shrink)

Selective serotonin reuptake inhibitors’ wide use, combined with the blurry limit between health and psychological illness, have led neuroscientists, clinicians and ethicists to envision the possibility of these medications’ use in non-clinical populations. This prospect has evoked ethical debates, which have often ignored the findings of the empirical literature. In this context, an evaluation of the empirical evidence for SSRIs’ personality enhancing effects is needed. The present paper examines SSRIs’ effects on healthy personality, including the Five Factor Model traits Neuroticism (...) and Extraversion, as well as some of their facets: Angry Hostility, Impulsiveness, Vulnerability, Warmth, Gregariousness and Assertiveness. The review encompasses investigations in healthy humans, human clinical populations, as well as relevant animal studies. Emerging data raise the possibility that SSRIs, when used by people without a currently diagnosable mental disorder, may reduce some facets of Neuroticism, especially Angry Hostility. On the other hand, very limited support exists for an SSRI-driven change in other Neuroticism facets, such as Impulsiveness, in healthy humans. An increase in Extraversion is possible, but currently available evidence is only indirect. Future research is needed, both to clarify methodological ambiguities in existing studies, and to answer unaddressed questions, such as ones of the stability, predictors, moderators, dose- and context-dependency of the effects. (shrink)

Physician-assisted suicide laws in Oregon and Washington require the person's current competency and a prognosis of terminal illness. In The Netherlands voluntariness and unbearable suffering are required for euthanasia. Many people are more concerned about the loss of autonomy and independence in years of severe dementia than about pain and suffering in their last months. To address this concern, people could write advance directives for physician-assisted death in dementia. Should such directives be implemented even though, at the time, the person (...) is no longer competent and would not be either terminally ill or suffering unbearably? We argue that in many cases they should be, and that a sliding scale which considers both autonomy and the capacity for enjoyment provides the best justification for determining when: when written by a previously well-informed and competent person, such a directive gains in authority as the later person's capacities to generate new critical interests and to enjoy life decrease. Such an extension of legalized death assistance is grounded in the same central value of voluntariness that undergirds the current more limited legalization. (shrink)

In this paper several meanings of ‘personal identity’ are distinguished. It is argued that the ontological questions of unity and persistence should not be analysed using the notion of a person but using the notion of a human organism. The notions of personhood and personality are used to describe the evaluative and normative aspects of being a person. Based on these conceptual distinctions the classical philosophical problem of personal identity is dissolved into four sets of problems. Then it is argued (...) that the ethical problems of intervening in the psyche of human beings should be discussed using the notions of personhood and personality, not unity or persistence. Finally, those ethical problems of interventions in the psyche of human beings directly related to personhood or personality are distinguished from more general ethical problems raised by these interventions. (shrink)

Ist es moralisch verantwortbar, Menschen mit technischen Eingriffen zu verbessern? Der Aufsatz versucht diese Frage zu beantworten, indem zwei Gefahren für Verbesserungswillige beleuchtet werden: der Verlust der Menschlichkeit und der unerwünschte Wandel der individuellen Persönlichkeit. Sodann wird ein „Liberalismus mit Auffangnetz“ als Lösung des Problems vorgestellt, die eine unterschiedliche Bewertung von reversiblen und irreversiblen Eingriffen vornimmt. Im letzten Schritt wird überprüft, wie weit diese Konzeption auch anwendbar ist, wenn Eltern ihre Kinder verbessern lassen wollen, also ein „informed consent“ nicht vorausgesetzt (...) werden kann. Dabei werden Argumente zurückgewiesen, die Habermas gegen eine Verbesserung von Kindern vorgebracht hat. (shrink)

Neuromodulation and narrative identity: the importance of relational autonomyIn this paper, I discuss the impact of psychological and relational changes after neuromodulation for movement- and psychiatric disorders and the need to adequately address the possibility of such changes in clinical contexts. Based on ), ) and ), I outline a relational narrative identity perspective that can inform and support medical-ethical decisions. The narrative identity theory by Marya Schechtman in combination with a focus on the relational aspects that impact and constitute (...) our identity, highlights the need to identify post-interventional identity changes both from the perspective of the patient, his or her family and loved ones and the medical team. I argue that a thorough informed consent process pre- and post-intervention and adequate psychological counseling allows for such identification and a step by step monitoring and guiding of the patient in this process. From a relational narrative perspective, neuromodulation does not by default pose a threat to our identity. However, this perspective highlights the need to take the relational autonomy of patients seriously and provide a substantial informed consent procedure and adequate psychological counseling. (shrink)

The ethics of human enhancement has been a hotly debated topic in the last 15 years. In this debate, some advocate examining science fiction stories to elucidate the ethical issues regarding the current phenomenon of human enhancement. Stories from science fiction seem well suited to analyze biomedical advances, providing some possible case studies. Of particular interest is the work of screenwriter Andrew Niccol (Gattaca, S1m0ne, In Time, and Good Kill), which often focuses on ethical questions raised by the use of (...) new technologies. Examining the movie In Time (2011), the aim of this paper is to show how science fiction can contribute to the ethical debate of human enhancement. In Time provides an interesting case study to explore what could be some of the consequences of radical life-extension technologies. In this paper, we will show how arguments regarding radical life-extension portrayed in this particular movie differ from what is found in the scientific literature. We will see how In Time gives flesh to arguments defending or rejecting radical life-extension. It articulates feelings of unease, alienation and boredom associated with this possibility. Finally, this article will conclude that science fiction movies in general, and In Time in particular, are a valuable resource for a broad and comprehensive debate about our coming future. (shrink)

Neurotechnologies that are currently applied to treat a range of neurological and psychiatric diseases were found to have a number of positive side effects on cognitive functioning in healthy individuals. Consequently, these neurotechnologies could in theory be used for cognitive enhancement purposes, for instance, the improvement of eyewitness memory. Improving the process of collecting eyewitness testimony would be of great value and is an example of cognitive enhancement for the common good. In this article, we discuss the epistemological and ethical (...) issues such use raises. These issues are not only critical to using neurotechnologies to improve eyewitness memory, but have a wider scope. By discussing enhancement for a purpose that is not primarily self-regarding or self-serving but potentially benefits the society as a whole, we reflect on the consequences of accepting enhancement for the common good for the acceptability of cognitive enhancement in general. (shrink)

The potential for genetic engineering of enhancements to complex human traits has been the subject of vigorous debate for a number of years. Most of the discussion has centered on the possible moral consequences of pursuing enhancements, especially those that might affect complex behaviours and components of personality. Little has been written on the actual process of implementing this technology. This paper presents a ‘thought experiment’ about the likely form of final preclinical testing for a technology to enhance intelligence as (...) a prototypical multiplex trait. The significance and the potential dangers of implementing enhancements in humans, especially to highly valued traits such as intelligence, would mandate a thorough programme of testing in animals, including non-human primates such as chimpanzees. The implications this would have for researchers, society and, most importantly, the animals themselves are discussed, and the paper concludes with a suggestion for a morally justifiable approach to resolve the tragic question of what to do with research animals who have a cognitive capacity that is close to that of humans. (shrink)

En el debate científico-ético contemporáneo en torno a la mejora humana biotecnológica, las nociones de identidad y dignidad humanas son utilizadas de forma habitual por parte del sector de pensamiento más conservador, para rechazar la aplicación de las nuevas tecnologías biomédicas sobre el ser humano con el objetivo de llevar a cabo una mejora de carácter no-terapéutico. Sin embargo, ¿sirven éstas como argumento para rechazar una mejora humana de carácter perfeccionador? En este artículo se analizará el significado de ambas nociones (...) en el debate bioético contemporáneo, así como la validez de su uso como argumento para rechazarla. (shrink)

ABSTRACT Some of the most compelling contemporary ethical questions surround 21st Century neuroscientific technologies. Among these, neurocognitive intervention technologies allow an unprecedented ability to alter thought. Concerns exist about their impact on individual freedom, behavior and personhood. They could also distort society, eroding core values of dignity, equality, and diversity. Potent laws are needed to anchor regulation in this rising field. The article explores how the long-neglected human right of Freedom of Thought might protect the integrity of the mind at (...) the legal system’s highest level. Sample cases illustrate how it could be given effect ethically and legally to set boundaries for neurocognitive intervention. (shrink)

Deberíamos usar las nuevas técnicas biomédicas para mejorar a los individuos? Si sabemos que la naturaleza humana contiene también características que podemos considerar no deseables entonces parece que no habría nada en sí mismo erróneo a la hora de alterarla. Algunos autores interesados en este tema hacen referencia a los daños que ello podría ocasionar a otros. Pero entonces, ¿la mejora moral podría funcionar como un contraejemplo a la idea de que la mejora biomédica es siempre moralmente impermisible? Puede que (...) lejos de estar ante algo meramente permisible, la mejora de nuestro carácter moral sea algo a lo que debamos aspirar. ¿Sería entonces obligatorio seleccionar los embriones con un nivel más alto de moralidad? (shrink)