Using material from the Pfizer sponsored website providing health information on erectile dysfunction to potential Swedish Viagra customers (www.potenslinjen.se), this article explores the public image of masculinity in relation to sexual health and the cultural techniques for creating pharmaceutical appeal. We zoom in on the targeted ideal users of Viagra, and the nationalized, racialized and sexualized identities they are assigned. As part of Pfizer’s marketing strategy of adjustments to fit the local consumer base, the ways in which Viagra is promoted (...) for the Swedish setting is telling of what concepts of masculinity are so stable and unassailable that they can withstand the association with a drug that is, in essence, an acknowledgement of ‘failed’ masculinity and ‘dysfunctional’ sexuality. With comparative national examples, this study presents an interdisciplinary take on the ‘glocalized’ cultural imaginary of Viagra, and the masculine subject positions it engenders. (shrink)

The importance of online social spaces is growing. New Web 2.0 resources allow the creation of social networks by any netizen with minimal technical skills. These communities can be extremely narrowly focussed. In this paper, I identify two potential costs of membership in narrowly focussed virtual communities. First, that narrowly focussed communities can polarise attitudes and prejudices leading to increased social cleavage and division. Second, that they can lead sick individuals to revel in their illness, deliberately indulging in their disease (...) and denying the edicts of the medical profession. I specifically examine illness communities centred on the now defunct Multiple Personality Disorder. I highlight these potential problems and point to some technologies that may help combat them. (shrink)

In an intriguing essay, G. A. Cohen has defended a conservative bias in favour of existing value. In this paper, we consider whether Cohen’s conservatism raises a new challenge to the use of human enhancement technologies. We develop some of Cohen’s suggestive remarks into a new line of argument against human enhancement that, we believe, is in several ways superior to existing objections. However, we shall argue that on closer inspection, Cohen’s conservatism fails to offer grounds for a strong sweeping (...) objection to enhancement, and may even offer positive support for forms of enhancement that preserve valuable features of human beings. Nevertheless, we concede that Cohen’s arguments may suggest some plausible and important constraints on the modality of legitimate and desirable enhancements. (shrink)

In this article, I examine children's reported experiences with stimulant drug treatments for attention deficit hyperactivity disorder in light of bioethical arguments about the potential threats of psychotropic drugs to authenticity and moral agency. Drawing on a study that involved over 150 families in the USA and the UK, I show that children are able to report threats to authenticity, but that the majority of children are not concerned with such threats. On balance, children report that stimulants improve their capacity (...) for moral agency, and they associate this capacity with an ability to meet normative expectations. I argue that although under certain conditions stimulant drug treatment may increase the risk of a threat to authenticity, there are ways to minimise this risk and to maximise the benefits of stimulant drug treatment. Medical professionals in particular should help children to flourish with stimulant drug treatments, in good and in bad conditions. (shrink)

In his 1993 novel Headhunter, Canadian author Timothy Findley describes the tendency of some medical practitioners to put scientific interests above the therapeutic needs of the individual. As the book's title and name of the main character Dr. Kurtz attest, Findley reflects the colonialist teleology found in Heart of Darkness as an analogue for the therapeutic zeal shown by many of the physicians in Headhunter. In the novel, such zeal is especially problematic when it is combined with so-called enhancement technologies, (...) since enhancement, like colonialism, can be based in the prejudices of the practitioner and/or the dominant society, rather than in the needs of the patient. To counter therapeutic zeal, Findley, like Conrad, proposes an ethics of restraint in which the practitioner's empathy outweighs his or her desire for scientific discovery. (shrink)

PurposeSince the 1980s we have witnessed a soaring “extra-therapeutic” use of psycho-pharmacology. But there is also an increasing interest in invasive methods of neuroenhancement that can be subsumed under the term “brain engineering”. The present article aims to identify key issues raised by those forms of neuro-technical enhancement (e.g., deep brain stimulation, brain-computer interfaces, memory chips, neurobionic interventions). First it distinguishes different forms of neuroenhancement, then describes features of those methods and finally discusses their ethical implications.MethodsThe article is based on (...) an in-depth literature study and an ethical assessment of the current and emerging forms of neuroenhancement.ResultsFrom a medical and normative perspective, psycho-pharmacological enhancement and nonpharmacological enhancement by brain engineering demonstrate considerable differences. Many arguments in favour of nonpharmacological enhancement fall short, for they fail to sufficiently consider the medical, anthropological and socio-cultural context. In many respects unsecured use is confronted with considerable risks.ConclusionsResearch on invasive forms of neuroenhancement partly takes place in the fields of (nano-)technology and military, to which health care experts and medical ethicists do not have easy access. This raises the danger of misjudging trends and developmental tendencies. Thus medicine and medical ethics must a priori thematize the goals and risks linked to these questions as well as participate discursively right from the beginning. (shrink)

In this article, I explore select case studies of Parkinson patients treated with deep brain stimulation in light of the notions of alienation and authenticity. While the literature on DBS has so far neglected the issues of authenticity and alienation, I argue that interpreting these cases in terms of these concepts raises new issues for not only the philosophical discussion of neuro-ethics of DBS, but also for the psychological and medical approach to patients under DBS. In particular, I suggest that (...) the experience of alienation and authenticity varies from patient to patient with DBS. For some, alienation can be brought about by neurointerventions because patients no longer feel like themselves. But, on the other hand, it seems alienation can also be cured by DBS as other patients experience their state of mind as authentic under treatment and retrospectively regard their former lives without stimulation as alienated. I argue that we must do further research on the relevance of authenticity and alienation to patients treated with DBS in order to gain a deeper philosophical understanding, and to develop the best evaluative criterion for the behavior of DBS patients. (shrink)

One objection to enhancement technologies is that they might lead us to live inauthentic lives. Memory modification technologies (MMTs) raise this worry in a particularly acute manner. In this paper I describe four scenarios where the use of MMTs might be said to lead to an inauthentic life. I then undertake to justify that judgment. I review the main existing accounts of authenticity, and present my own version of what I call a “true self” account (intended as a complement, rather (...) than a substitute, to existing accounts). I briefly describe current and prospective MMTs, distinguishing between memory enhancement and memory editing . Moving then to an assessment of the initial scenarios in the light of the accounts previously described, I argue that memory enhancement does not, by its very nature, raise serious concerns about authenticity. The main threat to authenticity posed by MMTs comes, I suggest, from memory editing. Rejecting as inadequate the worries about identity raised by the President’s Council on Bioethics in Beyond Therapy , I argue instead that memory editing can cause us to live an inauthentic life in two main ways: first, by threatening its truthfulness, and secondly, by interfering with our disposition to respond in certain ways to some past events, when we have reasons to respond in such ways. This consideration allows us to justify the charge of inauthenticity in cases where existing accounts fail. It also gives us a significant moral reason not to use MMTs in ways that would lead to such an outcome. (shrink)

Because of the important benefits that biomedical research offers to humans, some have argued that people have a general moral obligation to participate in research. Although the defense of such a putative moral duty has raised controversy, few scholars, on either side of the debate, have attended to the social context in which research takes place and where such an obligation will be discharged. By reflecting on the social context in which a presumed duty to participate in research will obtain, (...) this article shows that decontextualized discussions of this putative moral obligation are problematic. (shrink)

Our knowledge of the human brain and the influence of pharmacological substances on human mental functioning is expanding. This creates new possibilities to enhance personality and character traits. Psychopharmacological enhancers, as well as other enhancement technologies, raise moral questions concerning the boundary between clinical therapy and enhancement, risks and safety, coercion and justice. Other moral questions include the meaning and value of identity and authenticity, the role of happiness for a good life, or the perceived threats to humanity. Identity and (...) authenticity are central in the debate on psychopharmacological enhancers. In this paper, I first describe the concerns at issue here as extensively propounded by Carl Elliott. Next, I address David DeGrazia’s theory, which holds that there are no fundamental identity-related and authenticity-related arguments against enhancement technologies. I argue, however, that DeGrazia’s line of reasoning does not succeed in settling these concerns. His conception of identity does not seem able to account for the importance we attach to personal identity in␣cases where personal identity is changed through enhancement technology. Moreover, his conception of authenticity does not explain the reason why we find inauthentic values objectionable. A broader approach to authenticity can make sense of concerns about changes in personal identity by means of enhancement technologies. (shrink)

: The idea of enhancing our mental functions through medical means makes many people uncomfortable. People have a vague feeling that altering our brains tinkers with the core of our personalities and the core of ourselves. It changes who we are, and doing so seems wrong, even if the exact reasons for the unease are difficult to define. Many of the standard arguments against neuroenhancements—that they are unsafe, that they violate the distinction between therapy and enhancements, that they undermine equality, (...) and that they will be used coercively—fail to show why the use of any such technologies is wrong in principle. Two other objections—the arguments that such changes undermine our integrity and that they prevent us from living authentic lives—will condemn only a few of the uses that are proposed. The result is that very few uses of these drugs are morally suspect and that most uses are morally permissible. (shrink)

In researching the biomedically-engineered drug Neulasta (filgrastim), a breast cancer patient becomes aware of the extent to which knowledge about the development and marketing of drugs influences her decisions with regard to treatment. Time spent on understanding the commercial interests of insurers and pharmaceutical companies initially thwarts but ultimately aids the healing process. This first-person narrative calls for physicians to recognize that the alignment of commercial interests transgresses the patient’s humanity.

In researching the biomedically-engineered drug Neulasta, a breast cancer patient becomes aware of the extent to which knowledge about the development and marketing of drugs influences her decisions with regard to treatment. Time spent on understanding the commercial interests of insurers and pharmaceutical companies initially thwarts but ultimately aids the healing process. This first-person narrative calls for physicians to recognize that the alignment of commercial interests transgresses the patient’s humanity.

Disease-mongering in the case of sexual problems has some special elements. These include that discussions of sex provoke embarrassment and reveal a lack of knowledge on the part of both clinician and patient, the aggressiveness of Big Pharma in the face of the huge profitability of sexual products; and the socially constructed nature of sexual satisfaction. These special elements engender concern for the prospects for patient empowerment and the convergence of patient-clinician power in the consulting room. Consequently, political action to (...) raise public and professional awareness about the realities of commercialisation and conflict of interest, and to resist further medicalisation may be as warranted for concerned scholars as academic analyses, at least at the present time. (shrink)

Intellectual autonomy has long been identified as an epistemic virtue, one that has been championed influentially by Kant, Hume and Emerson. Manifesting intellectual autonomy, at least, in a virtuous way, does not require that we form our beliefs in cognitive isolation. Rather, as Roberts and Wood note, intellectually virtuous autonomy involves reliance and outsourcing to an appropriate extent, while at the same time maintaining intellectual self-direction. In this essay, I want to investigate the ramifications for intellectual autonomy of a particular (...) kind of epistemic dependence: cognitive enhancement. Cognitive enhancements involve the use of technology and medicine to improve cognitive capacities in healthy individuals, through mechanisms ranging from smart drugs to brain-computer interfaces. With reference to case studies in bioethics, as well as the philosophy of mind and cognitive science, it is shown that epistemic dependence, in this extreme form, poses a prima facie threat to the retention of intellectual autonomy, specifically, by threatening to undermine our intellectual self-direction. My aim will be to show why certain kinds of cognitive enhancements are subject to this objection from self-direction, while others are not. Once this is established, we’ll see that even some extreme kinds of cognitive enhancement might be not merely compatible with, but constitutive of, virtuous intellectual autonomy. (shrink)

In this paper I present and compare the ideas behind naturalistic theories of health on the one hand and phenomenological theories of health on the other. The basic difference between the two sets of theories is no doubt that whereas naturalistic theories claim to rest on value neutral concepts, such as normal biological function, the phenomenological suggestions for theories of health take their starting point in what is often named intentionality: meaningful stances taken by the embodied person in experiencing and (...) understanding her situation and taking action in the world.Although naturalism and phenomenology are fundamentally different in their approach to health, they are not necessarily opposed when it comes to understanding the predicament of ill persons. The starting point of medical investigations is what the patient feels and says about her illness and the phenomenological investigation should include the way diagnoses of different diseases are interpreted by the person experiencing the diseases as an embodied being. Furthermore, the two theories display similarities in their emphasis of embodiment as the central element of health theory and in their stress on the alien nature of the body displayed in illness. Theories of biology and phenomenology are, indeed, compatible and in many cases also mutually supportive in the realm of health and illness. (shrink)

_Phenomenological insights into health issues relating to bodily self-experience, normality and deviance, self-alienation, and objectification._.

After establishing that the requirement that those criminals who stand for execution be mentally competent can be given a recognizably retributivist rationale, I suggest that not only it is difficult to show that executing the incompetent is more cruel than executing the competent, but that opposing the execution of the incompetent fits ill with the recent abolitionist efforts on procedural concerns. I then propose two avenues by which abolitionists could incorporate such opposition into their efforts.

This paper explores the differences between bringing about self-change by way of antidepressants versus psychotherapy from an ethical point of view, taking its starting point in the concept of authenticity. Given that the new antidepressants (SSRIs) are able not only to cure psychiatric disorders but also to bring about changes in the basic temperament structure of the person—changes in self-feeling—does it matter if one brings about such changes of the self by way of antidepressants or by way of psychotherapy? Are (...) antidepressants a less good alternative than psychotherapy because antidepressants are in some way less authentic than psychotherapy? And, if so, what does this mean exactly? In this paper I try to show that the self-change brought about by way of antidepressants challenges basic assumptions of authentic self-change that are deeply ingrained in our Western culture: that changes in self should be brought about by laborious ‘self-work’ in which one explores the deep layers of the self (the unconscious) and comes to realise who one really is and should become. To become oneself has been held to presuppose such a journey. While the assumed importance of self-work appears to be badly founded on closer inspection, the notions of exploring and knowing oneself appear to be more promising in fleshing out an ethical distinction between psychopharmacological and psychotherapeutic practice with the help of the concept of authenticity. Psychotherapy, to a much greater extent than psychopharmacological interventions, involves the whole profile of the self in its attempts to effect a change, not only in the temperament but also in the character of the person in question, and this is important from an ethical point of view. In the article, the concepts of self-change, authenticity, temperament and character are presented and used in order to understand and flesh out the relevant ethical differences between the practice of psychotherapy and the use of antidepressants. Looping, collective effects of psychopharmacological self-change in a cultural context are also considered in this context. (shrink)

While deep brain stimulation (DBS) for patients with Parkinson's disease has typically raised ethical questions about autonomy, accountability and personal identity, recent research indicates that we need to begin taking into account issues surrounding the patients’ feelings of authenticity and alienation as well. In order to bring out the relevance of this dimension to ethical considerations of DBS, I analyse a recent case study of a Dutch patient who, as a result of DBS, faced a dilemma between autonomy and authenticity. (...) This case study is meant to point out the normatively meaningful tension patients under DBS experience between authenticity and autonomy. (shrink)

The last 10 years has seen the development and deployment of new biotechnologies not just as potential treatments but also as potential enhancements. The definition and differentiation of treatment from enhancement is an ongoing clinical, ethical and social debate that ranges across a proliferating number of convergent technologies. Many of these innovations will ‘come-on-line’ as present generations of young people will be reaching adulthood and considering parenthood. This paper reports on a project that explored the possibilities for human enhancement with (...) young people in order to gather their attitudes towards enhancement and the types of arguments/reasoning they employ when thinking about the possibilities and the techniques. The project focused on if/how distinctions are made between treatment and enhancement, between the different techniques that might be used for enhancement and perceptions of risks and benefits. The young people’s viewpoints, their methods of reasoning and underlying values are compared with those of bioethicists writing on the topic. (shrink)

Since the first sex reassignment operations were performed, individual sex has come to be, to some extent at least, a technological artifact. The existence of sperm sorting technology, and of prenatal determination of fetal sex via ultrasound along with the option of termination, means that we now have the power to choose the sex of our children. An influential contemporary line of thought about medical ethics suggests that we should use technology to serve the welfare of individuals and to remove (...) limitations on the opportunities available to them. I argue that, if these are our goals, we may do well to move towards a “post sex” humanity. Until we have the technology to produce genuine hermaphrodites, the most efficient way to do this is to use sex selection technology to ensure that only girl children are born. There are significant restrictions on the opportunities available to men, around gestation, childbirth, and breast-feeding, which will be extremely difficult to overcome via social or technological mechanisms for the foreseeable future. Women also have longer life expectancies than men. Girl babies therefore have a significantly more “open” future than boy babies. Resisting the conclusion that we should ensure that all children are born the same sex will require insisting that sexual difference is natural to human beings and that we should not use technology to reshape humanity beyond certain natural limits. The real concern of my paper, then, is the moral significance of the idea of a normal human body in modern medicine. (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)

All of us have personal ideals. We are committed to being good (enough) friends, parents, neighbors, teachers, citizens, human beings, and more. In this paper, I examine the thick and thin aspects of these ideals: (i) their substance (to internalize an ideal is to endorse a particular way of being) and (ii) their accountability to reason (to internalize an ideal is to assume that this is really a good way to be). In considering how these two aspects interact in the (...) ideal of rational agency, I address two philosophical debates that are generally conducted in isolation of each other: (i) debates over the anti-ideal of normative “fetishism” and (ii) debates over whether acting for a reason is acting “under the guise of the good.” In the final two sections of the paper, I further explore the relations among the thick and the thin. I note the role that coherence constraints play in the process whereby our ideals gain determinacy. At the same time, I argue, our ideals constrain the possibility and desirability of coherence. This has implications for a third debate: the debate over the possibility of moral dilemmas. (shrink)

Given the metaphysical and explanatory stalemate between Embedded and Extended cognition, different authors proposed moral arguments to overcome such a deadlock in favor of EXT. Farina and Lavazza attribute to EXT and EMB a substantive moral content, arguing in favor of the former by virtue of its progressiveness and inclusiveness. In this treatment, I criticize four of their moral arguments. In Sect. 2, I focus on the argument from legitimate interventions and on the argument from extended agency. Section 3 concerns (...) the argument from better protection and the argument from better treatment. Sections 4 and 5 are dedicated to counterarguments against each respectively. By distinguishing between EXT and the extended view, I argue that it is sufficient to use this second version for directly addressing and evaluating moral problems on normative grounds, independently of the causal or constitutive cognitive influence of the external resource on the agents’ minds. Moreover, I argue that the arguments and assumptions used by EXT theorists do not foster values of progressiveness and inclusiveness. To conclude, in Sect. 6, I show that the analysis of each argument converges on the conclusion that EXT does not have substantive moral content and implications per se, since they always depend on further assumptions. (shrink)

Certain of our traits are thought more central to who we are: they comprise ourindividual identity. What makes these traits privileged in this way? What accounts for theiridentity centrality? Although considerations of identity play a key role in many different areas of moral philosophy, I argue that we currently have no satisfactory account of the basis of identity centrality. Nor should we expect one. Rather, we should adopt an error theory: we should concede that there is nothing in reality corresponding (...) to the perceived distinction between the central and peripheral traits of a person. (shrink)

Medicalization occurs when an aspect of embodied humanity is scrutinized by the medical industry, claimed as pathological, and subsumed under medical intervention. Numerous critiques of medicalization appear in academic literature, often put forth by bioethicists who use a variety of “lenses” to make their case. Feminist critiques of medicalization raise the concerns of the politically disenfranchised, thus seeking to protect women—particularly natal sex women—from medical exploitation. This article will focus on three feminist critiques of medicalization, which offer an alternative narrative (...) of sickness and health. I will first briefly describe the philosophical origins of medicalization. Then, I will present three feminist critiques of medicalization. Liberal feminism, trans feminism, and crip feminism tend to regard Western medicine with a hermeneutics of suspicion and draw out potential harms of medicalization of reproductive sexuality, gender, and disability, respectively. While neither these branches of feminism—nor their critiques—are homogenous, they provide much-needed commentaries on phallocentric medicine. I will conclude the paper by arguing for the continual need for feminist critiques of medicalization, using uterus transplantation as a relevant case study. (shrink)

This article presents a critical analysis of the views of Michael Sandel on human enhancement in his book The Case Against Perfection (2007). Sandel argues that the use of biotechnologies for human enhancement is driven by a will to mastery or hybris, leading to an ‘explosion of responsibility’ and a disappearance of solidarity. I argue that Sandel is using a traditional concept of solidarity which leaves little room for individual differences and which is difficult to reconcile with the modern trend (...) towards individual autonomy and cultural heterogeneity. With reference to the sociology of Giddens, I argue that the ‘explosion of responsibility’ can be considered an expression of the insecurity in modern society and the need for reflexivity in personal and social life. I argue that the need for reflexivity is a driving social and cultural force behind the interest in human enhancement, and that this trend can go together with a commitment to take care of the needs of others. I agree with Sandel that there is a risk that human enhancement may develop into ‘hybris’, particularly when enhancement is driven by scientism and a naturalist reduction of human values to neurological processes. Enhancement based on scientism will threaten solidarity defined by Honneth as an interactive relationship aimed at the mutual recognition of individual identities in relation to a shared value horizon. I will call for a reflective approach in which human enhancement technologies are explored in the context of a ‘system of reference’. Such a reflective approach will help to protect against the hybris of scientism and to maintain solidarity with vulnerable groups. (shrink)

Cosmetic dentistry is a divisive discipline. Within discourses that raise questions of the purpose of the dental profession, cosmetic dentistry is frequently criticised on the basis of it being classified as a non‐therapeutic intervention. This article re‐evaluates this assertion through examination of ethics of care of the self, healthcare definitions and the social purpose of dentistry, finding the traditional position to be wanting in its conclusions. The slide of dentistry from a healthcare vocation towards being a predominantly business‐focused interaction between (...) clinician and consumer conflicts with traditional notions of dentistry as a profession. Whilst it is undeniable that cosmetic dental treatment particularly lends itself to the commercial paradigm, this is not exclusive to this area of professional practice. The cultural basis of dental appearance and the potential of the dental profession to exert coercive pressure upon the public to undergo treatment that is based upon social norms is discussed. This essay concludes that cosmetic dentistry is undeniably part of the professional purpose of 21st Century dentistry. However, the caveat that may be placed upon this, is that this status is conditional upon the professional conduct of dental practitioners remaining resilient to commercial practices not compatible with professional obligations. (shrink)

Moral bioenhancement is a topic that will only increase in controversy as neuroscience advances.

In this paper, I explore the questions of how and to what extent new antidepressants (selective serotonin-reuptake inhibitors, or SSRIs) could possibly affect the self. I do this by way of a phenomenological approach, using the works of Martin Heidegger and Thomas Fuchs to analyze the roles of attunement and embodiment in normal and abnormal ways of being-in-the-world. The nature of depression and anxiety disorders — the diagnoses for which treatment with antidepressants is most commonly indicated — is also explored (...) by way of this phenomenological approach, as are the basic structures of self-being. Special attention is paid in the analysis to the moods of boredom, anxiety and grief, since they play fundamental roles in depression and anxiety disorders and since their intensity and frequency appear to be modulated by antidepressants. My conclusion is that the effect of these drugs on the self can be thought of in terms of changes in self-feeling, or, more precisely, self-vibration of embodiment. I present the idea of a spectrum of bodily resonance, which extends from the normal resonance of the lived body, in which the body is able to pick up a wide range of different moods; continuing over various kinds of sensitivities, preferences and idiosyncrasies, in which certain moods are favored over others; to cases that we unreservedly label pathologies, in which the body is severely out of tune, or even devoid of tune and thus useless as a tool of resonance. Different cultures and societies favor slightly differently attuned self-styles as paradigmatic of the normal and good life, and the popularity of the SSRIs can therefore be explained, not only by defects of embodiment, but also by the presence of certain cultural norms in our contemporary society. (shrink)

This paper describes and discusses overlapping interests and concerns of art and bioethics and suggests that bioethics would benefit from opening to contributions from the arts. There is a description of recent events in bioethics that have included art, and trends in art that relate to bioethics. The paper outlines art exhibits and performances within two major international bioethics congress programs alongside a discussion of the work of leading hybrid and bio artists who experiment with material (including their own bodies) (...) at the ambiguous intersections between art, bio art and bioethics. Their work seeks to engage audiences in challenging ethical precepts and assumptions about life and existence. We consider the response of art and social theorists and compare these with the responses of bioethicists to comparable cases in bioethics. We note divergent views within the arts and within bioethics in relation to some pivotal questions including questions about what limits, if any, can apply in particular cases and on what basis. This approach allows for a transfer of information and perspectives, challenges assumptions in both art and bioethics and opens up a space for future exchange and dialogue along the shifting borders between these genres. (shrink)

Neurodevices that collect neural (or brain activity) data have been characterised as having the ability to register the inner workings of human mentality. There are concerns that the proliferation of such devices in the consumer-directed realm may result in the mass processing and commercialisation of neural data (as has been the case with social media data) and even threaten the mental privacy of individuals. To prevent this, some argue that all raw neural data should be conceptualised and regulated as “medical (...) data” even if it is collected from consumer-directed devices in obviously non-clinical settings. In this paper, we argue that without a clearer formulation of what does and does not count as medical data, this approach might also uncritically enlarge the scope for medical influence and an unwarranted medicalisation of everyday aspects of mental life. Indeed, if we were to accept the position that all neural data is medical data because it offers insights into personally sensitive information (such a person’s thoughts, emotions, or intentions) then this could even unnecessarily expand the boundaries of medical data to other forms of data that otherwise seem to be non-clinical. If all brain data (neural activity data) is considered to be medical data even when collected from consumer-directed devices then we might unintentionally reduce meaningful distinctions between what is and what is not rightfully in the purview of medicine. (shrink)

This article seeks to situate pharmacological cognitive enhancement as part of a broader relationship between cultural understandings of the body-brain and the political economy. It is the body of the worker that forms the intersection of this relationship and through which it comes to be enacted and experienced. In this article, we investigate the imaginaries that both inform and are reproduced by representations of pharmacological cognitive enhancement, drawing on cultural sources such as newspaper articles and films, policy documents, and pharmaceutical (...) marketing material to illustrate our argument. Through analysis of these diverse cultural sources, we argue that the use of pharmaceuticals has come to be seen not only as a way to manage our brains, but through this as a means to manage our productive selves, and thereby to better manage the economy. We develop three analytical themes. First, we consider the cultural representations of the brain in connection with the idea of plasticity – captured most graphically in images of morphing – and the representation of enhancement as a desirable, inevitable, and almost painless process in which the mind-brain realizes its full potential and asserts its will over matter. Following this, we explore the social value accorded to productive employment and the contemporary ethos of working on or managing oneself, particularly in respect of improving one’s productive performance through cognitive enhancement. Developing this, we elaborate a third theme by looking at the moulding of the worker’s productive body-brain in relation to the demands of the economic system. (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)

Book review of the book Inquiring into Human Enhancement: Interdisciplinary and International Perspectives (2015), edited by Simone Bateman, Sylvie Allouche, Jean Gayon, Michela Marzano and Jérôme Goffette. Closing the summary of the book's chapters, the reviewer asks: when imagining HE for the future, especially in utopian directions, might we not seek to increase human wisdom, for instance, rather than just human intellect? Why are human enhancement visions so often limited by egotistical, if well-intended, desires that might go horribly wrong, as (...) in the story of Dr. Jekyll and Mr. Hyde? (shrink)

No artigo, abordo a ideia de melhoramento humano (MH), visando a contestar três frustrantes tendências dos seus críticos, a saber, as ideias de: (1) que a natureza humana será artificializada, sugerindo que estaremos diante de algo novo e incomparavelmente perigoso, bem como que ainda seja possível preservar uma separação radical entre natureza e técnica; (2) que é possível abordar e criticar o MH a partir de uma singularidade semântica; e, diretamente relacionada à anterior, (3) que há univocidade entre os defensores (...) do MH acerca de como os indivíduos devem lidar com os meios biotecnocientíficos disponibilizados, a saber, como uma ingênua e acrítica obrigação de melhorar. In this paper, I discuss the idea of human enhancement (HE). My goal is to refute three frustrating trends in the HE criticism, namely the ideas that: (1) human nature will become artificial, suggesting that we will be facing something new and uniquely dangerous, and that it is still possible to preserve a radical separation between nature and technique; (2) it is possible to address and criticize HE from a semantic uniqueness, which is directly related to the previous item; and (3) there is an univocity among the HE's defenders on how individuals should handle the available bio-techno-scientific tools made available, namely, as a naive and uncritical obligation to become enhanced. (shrink)

Disability activists influenced by queer theory and advocates of “human enhancement” have each disputed the idea that what is “normal” is normatively significant, which currently plays a key role in the regulation of pre-implantation genetic diagnosis (PGD). Previously, I have argued that the only way to avoid the implication that parents have strong reasons to select children of one sex (most plausibly, female) over the other is to affirm the moral significance of sexually dimorphic human biological norms. After outlining the (...) logic that generates this conclusion, I investigate the extent to which it might also facilitate an alternative, progressive, opening up of the notion of the normal and of the criteria against which we should evaluate the relative merits of different forms of embodiment. This paper therefore investigates the implications of ideas derived from queer theory for the future of PGD and of PGD for the future of queerness. (shrink)

Diagnosable individuals, caregivers, and clinicians typically embrace a biological conception of attention-deficit/hyperactivity disorder (ADHD), finding that medical treatment is beneficial. Scientists study ADHD phenomenology, interventions to ease symptoms, and underlying mechanisms, often with an aim of helping diagnosed people. Yet current understanding of ADHD, jointly influenced by science and society, has an unintended downside. Scientific and social influences have embedded negative values in the ADHD concept, and have simultaneously dichotomized ADHD diagnosable from non-diagnosable individuals. In social settings insistent on certain (...) types of success, the negative values associated with the diagnostic category are attributed to people in the dichotomized "ADHD" group. Devaluation, institutional restrictions on "success" definitions and endpoints, and limited options for achieving success jointly constitute institutionalized intolerance of ADHD. (shrink)

In this short think-piece we trace the newly emerging and rapidly expanding dimensions and dynamics of the “neuro-complex.” What this amounts to, we suggest, are a series of bio or neuro “convergences” of sorts regarding the brain and mental worlds, which in turn are traceable through what we term the bio-psych, pharma-psych, subjectivity-selves, wellness-enhancement, and the neuroculture-neurofutures relational nexuses. These issues are then illustrated through two brief case studies regarding brain scanning technologies and the problems and prospects of cognitive enhancement. (...) The paper concludes with some final reflections on these matters and a call for further research in this rich and challenging domain as the neuro-complex continues to expand in expected and unexpected, yet equally rich and fascinating, ways. (shrink)

Phenomenology provides a method for disability theorists to describe embodied subjectivity lacking within the social model of disability. Within the literature on body integrity identity disorder (BIID), dominant narratives of disability are influential, individual bodies are considered in isolation, and experiences of disabled people are omitted. Research on BIID tends to incorporate an individualist ontology. In this article, I argue that Merleau-Ponty's conceptualization of “being in the world,” which recognizes subjectivity as embodied and intersubjective, provides a better starting point for (...) research describing the experiences of those with BIID and amputees. (shrink)

This dissertation contributes to the development of philosophy of disability by drawing on disability studies, feminist philosophy, phenomenology, and philosophy of biology in order to contest epistemic and ontological assumptions about disability within biomedical ethics as well as within philosophical work on the body, demonstrating how philosophical inquiry is radically transformed when experiences of disability are taken seriously. In the first two chapters, I focus on epistemological and ontological concerns surrounding disability within biomedical ethics. Although disabled people and their advocates (...) have been quite vocal regarding their views on disability and in critiquing bioethicists’ approaches to issues that affect them, the interests, knowledge, and experiences of disabled people have had minimal impact on discussions within biomedical ethics textbooks. The risks of making problematic assumptions about disability are high within this subfield insofar as bioethicists impact practices within medical facilities, public policy, and, through student engagement with their texts in biomedical ethics courses, the views of potential health care professionals. All of these, in turn, affect the care provided to disabled people and potential/actual parents of disabled children. Chapter three raises ontological issues related to disability theory, examining the role of the impairment/disability distinction in framing discussions of the body as well as the status of experience. I discuss two approaches to incorporating subjective experiences of the body in disability, arguing that neither is sufficient. I examine debates within feminist theory on questions related to experience. I argue that a feminist phenomenological approach that builds on Merleau-Ponty’s work offers the best way to address bodily experiences in disability theory. The assumptions that disability theorists and Merleau-Ponty make about disability are often at odds. Chapter four points out the ableism in Merleau-Ponty’s use of a case study and considers some of the oversights within Phenomenology of Perception. In spite of my critique, I argue that his approach to phenomenology—with appropriate modifications—is useful not only for theorizing the experiences of disabled people but also for addressing other types of marginalized embodiment. Chapter five applies this method to body integrity identity disorder (BIID), arguing that combining Merleau-Ponty’s insights with those of disability theory allows us to address lived experiences of BIID and to identify assumptions about disability within research on this condition. (shrink)

The generic idea that the human should enhance seems uncontroversial. However, there is a great controversy about the meaning of enhance and the means that should be used. The possibilities of enhance humans through the use of biotechnology are a central theme of the current bioethical debate. Human Enhancement is the concept used to translate the idea that a biotransformation would generate a bioenhancement. In this article, we present a proposal for a factual-elementary framework of the generic concept of human (...) enhancement, in order to highlight the differences between a normative terminology and a descriptive terminology. Then, we contest the radical polarization that creates a harmful bias in the debate, arguing that what is at issue is a decision making based on non-universal value judgments. (shrink)