We propose to expand the conversation around moral enhancement from direct brain-altering methods to include technological means of modifying the environments and media through which agents can achieve moral improvement. Virtual Reality (VR) based enhancement would not bypass a person’s agency, much less their capacity for reasoned reflection. It would allow agents to critically engage with moral insights occasioned by a technologically mediated intervention. Users would gain access to a vivid ‘experience machine’ that allows for embodied presence and immersion in (...) a virtual world that meaningfully replicates relevant aspects of real life. We explore how VR can train empathy and foster moral growth in complex ways that would be inaccessible even for traditional moral education. Virtual Reality Perspective Taking is a unique medium for making empathy more reflective. (shrink)

This chapter examines the possibility of using AI technologies to improve human moral reasoning and decision-making, especially in the context of purchasing and consumer decisions. We characterize such AI technologies as artificial ethics assistants (AEAs). We focus on just one part of the AI-aided moral improvement question: the case of the individual who wants to improve their morality, where what constitutes an improvement is evaluated by the individual’s own values. We distinguish three broad areas in which an individual might think (...) their own moral reasoning and decision-making could be improved: one’s actions, character, or other evaluable attributes fall short of one’s values and moral beliefs; one sometimes misjudges or is uncertain about what the right thing to do is in particular situations, given one’s values; one is uncertain about some fundamental moral questions or recognizes a possibility that some of one’s core moral beliefs and values are mistaken. We sketch why one might think that AI tools could be used to support moral improvement in those areas, and describe two types of assistance: preparatory assistance, including advice and training supplied in advance of moral deliberation; and on-the-spot assistance, including on-the-spot advice and facilitation of moral functioning over the course of moral deliberation. Then, we turn to some of the ethical issues that AEAs might raise, looking in particular at three under-appreciated problems posed by the use of AI for moral self-improvement: namely, reliance on sensitive moral data; the inescapability of outside influences on AEAs; and AEA usage prompting the user to adopt beliefs and make decisions without adequate reasons. (shrink)

The potential of memory modification techniques (MMTs) has raised concerns and sparked a debate in neuroethics, particularly in the context of identity and authenticity. This paper addresses the question whether and how MMTs influence authenticity. I proceed by drawing two distinctions within the received views on authenticity. From this, I conclude that an analysis of MMTs based on a dual-basis, process view of authenticity is warranted, which implies that the influence of MMTs on authenticity crucially depends on the specifics of (...) how memory modification would eventually work. Therefore, I continue with a systematic analysis of possible properties of MMTs in which I distinguish between the dimensions of memories and the kinds of experiences that can be modified as well as the properties of the process of memory modification. The impact of MMTs on authenticity is analyzed regarding the possible properties of MMTs and based on a narrative approach to authenticity which fulfills the requirements of a dual-basis, process view of authenticity. Lastly, I explore the potential of MMTs to shift the balance between self-discovery and self-creation within authenticity and thereby alter the concept itself as well as the value of authenticity. (shrink)

Some have claimed that moral bioenhancement undermines freedom and authenticity – thereby making moral bioenhancement problematic or undesirable – whereas others have said that moral bioenhancement does not undermine freedom and authenticity – thereby salvaging its ethical permissibility. These debates are characterized by a couple of features. First, a positive relationship is assumed to hold between these agency-related concepts and the ethical permissibility of moral bioenhancement. Second, these debates are centered around individualistic conceptions of agency, like free choice and authenticity, (...) which hail from an atomistic tradition of autonomy. My view is that emphasizing individualistic conceptions of autonomy do not provide particularly strong foundations on which to argue about the issue of the permissibility of moral bioenhancement. This is because individualistic autonomy is not the kind of agency-related consideration we ought to value. Instead, I propose that we investigate the relationship between moral bioenhancement and a more relational kind of autonomy. Focusing on this latter relationship, on my view, clarifies the potential for moral bioenhancement to support or enhance people’s autonomy. (shrink)

The profound changes in personality, mood, and other features of the self that neural interventions can induce can be disconcerting to patients, their families, and caregivers. In the neuroethical debate, these concerns are often addressed in the context of possible threats to the narrative self. In this paper, I argue that it is necessary to consider a dimension of impacts on the narrative self which has so far been neglected: neural interventions can lead to a loss of meaning of actions, (...) feelings, beliefs, and other intentional elements of our self-narratives. To uphold the coherence of the self-narrative, the changes induced by neural interventions need to be accounted for through explanations in intentional or biochemical terms. However, only an explanation including intentional states delivers the content to directly ascribe personal meaning, i.e., subjective value to events. Neural interventions can deprive events of meaning because they may favor a predominantly biochemical account. A loss of meaning is not inherently negative but it can be problematic, particularly if events are affected one was not prepared or willing to have stripped of meaning. The paper further examines what it is about neural interventions that impacts meaning by analyzing different methods. To which degree the pull towards a biochemical view occurs depends on the characteristics of the neural intervention. By comparing Deep Brain Stimulation, Prozac, Ritalin, psychedelics, and psychotherapy, the paper identifies some main factors: the rate of change, the transparency of the causal chain, the involvement of the patient, and the presence of an acute phenomenological experience. (shrink)

Entry on "Neuroenhancement" in the Routledge Encyclopedia of Philosophy Online.

Every day, millions of people use mobile phones, play video games and surf the Internet. It is thus important to determine how technologies like these change what people think and how they behave. This is a central issue in the study of persuasive technologies. ‘Persuasive technologies’—henceforth ‘PTs’—are digital technologies, such as mobile apps, video games and virtual reality systems, that are deployed for the explicit purpose of changing attitudes and/or behaviours, without using coercion, deception or extreme forms of psychological manipulation (...) (such as hypnosis or indoctrination), and without exerting a direct (not psychologically mediated) physical effect on the brain. Typically PTs employ strategies such as prompting, information provision and encouragement... (shrink)

The formation of the World Anti-Doping Agency in 1999 was spurred by the 1998 revelation of widespread use in professional cycling of erythropoietin. The drug was supposedly a real danger. The long-term consequences were unknown, but rumor said it made athletes’ blood thick as jam with clots and other circulatory fatalities likely consequences. Today the fear of EPO has dampened. However, new scientific avenues such as ‘neuro-doping’ have replaced EPO as emergent and imagined threats to athletes and to the integrity (...) of sport. In this paper, we analyze the alleged threat from ‘neuro-doping’ in the following steps: First, we outline an understanding of ‘neuro-doping’ in a narrow sense, which we then put into context by looking at the phenomenon in a broader sense. Second, we highlight examples of societal perceptions of sport and science in order to shed light on where the concern for ‘neuro-doping’ comes from. Third, we address the more general fear of technology as a root for this concern. Fourth, we examine the evidence for the performance enhancing capacities of ‘neuro-doping’, where after we look at the obstacles for a ban on this technology. We conclude the analysis by stating that at present ‘neuro-doping’ cannot be considered a threat to the integrity of sport. Finally, however, we put this conclusion into perspective by examining what the most reasonable response would be if in the future neuro-stimulation techniques becomes an effective performance-enhancing mean in sport. (shrink)

This chapter addresses the claim that, as new types of neurointervention get developed allowing us to enhance various aspects of our mental functioning, we should work to prevent the use of such interventions from ever becoming the “new normal,” that is, a practice expected—even if not directly required—by employers. The author’s response to that claim is that, unlike compulsion or most cases of direct coercion, indirect coercion to use such neurointerventions is, per se, no more problematic than the pressure people (...) all find themselves under to use modern technological devices like computers or mobile phones. Few people seem to believe that special protections should be introduced to protect contemporary Neo-Luddites from such pressures. That being said, the author acknowledges that separate factors, when present, can indeed render indirect coercion to enhance problematic. The factors in question include lack of safety, fostering adaptation to oppressive circumstances, and having negative side effects that go beyond health. Nonetheless, the chapter stresses that these factors do not seem to be necessary correlates of neuroenhancement. (shrink)

The moral enhancement of human beings is a constant theme in the history of humanity. Today, faced with the threats of a new, globalised world, concern over this matter is more pressing. For this reason, the use of biotechnology to make human beings more moral has been considered. However, this approach is dangerous and very controversial. The purpose of this article is to argue that the use of another new technology, AI, would be preferable to achieve this goal. Whilst several (...) proposals have been made on how to use AI for moral enhancement, we present an alternative that we argue to be superior to other proposals that have been developed. (shrink)

This paper argues for a revised concept of authenticity entailing two demands that must be balanced. The first demand moves authenticity from the position of a strictly self-regarding virtue towards the position of a fully social virtue, acknowledging the crucial feature of steadiness, i.e. self-consistency, as being precisely what we ‘naturally’ lack. Nevertheless, the value of personal authenticity in a modern, open society comes from the fact that it brings about not only steadiness, but also the public development of a (...) variety of existential options that can be understood as Millian ‘original experiments in living’. Thus the second demand of authenticity is a demand for ‘experimental’ authenticity which covers the whole spectrum of technologies of the self, from Nietzschean ‘brief habits’, to the use of enhancement technologies. (shrink)

Scientific progress in recent neurofeedback research may bring about a new type of moral neuroenhancement, namely, neurofeedback-based moral enhancement; however, this has yet to be examined thoroughly. This paper presents an ethical analysis of the possibility of neurofeedback-based moral enhancement and demonstrates that this type of moral enhancement sheds new light on the moral enhancement debate. First, I survey this debate and extract the typical structural flow of its arguments. Second, by applying structure to the case of neurofeedback-based moral enhancement, (...) I examine the ethical, legal, and social issues to show that this technique is unique and traditionalist, which makes it compatible with almost all our conservative notions, so that it, accordingly, can be seen as an ethically acceptable option. Third, by rejecting the premise in the moral enhancement debate that bio/neuro-enhancement has its unique ELSI that traditional methods would never create, I demonstrate that, by virtue of its traditional or conservative features, neurofeedback-based moral enhancement can be incorporated into the traditional moral education network. Finally, I conclude that, being a part of the traditional moral education network, neurofeedback-based moral enhancement can be a unique and ethically acceptable option of moral neuroenhancement. (shrink)

In this chapter, we introduce the notion of “moral neuroenhancement,” offering a novel definition as well as spelling out three conditions under which we expect that such neuroenhancement would be most likely to be permissible (or even desirable). Furthermore, we draw a distinction between first-order moral capacities, which we suggest are less promising targets for neurointervention, and second-order moral capacities, which we suggest are more promising. We conclude by discussing concerns that moral neuroenhancement might restrict freedom or otherwise “misfire,” and (...) argue that these concerns are not as damning as they may seem at first. (shrink)

:In this article, we consider contexts or domains in which moral bioenhancement interventions possibly or most likely will be implemented. By looking closely at similar or related existing practices and their relevant ethical frameworks, we hope to identify ethical considerations that are relevant for evaluating potential moral bioenhancement interventions. We examine, first, debates on the proper scope of moral education; second, proposals for identifying early risk factors for antisocial behaviour; and third, the difficult balancing of individual freedom and third party (...) concerns in psychiatry. In imagining moral bioenhancement in practice, we observe that unlike other forms of enhancement, moral enhancement fundamentally asks how the interests and preferences of the individual and the interests of others should be weighed. Highly diverse domains such as education, mental health, and the judicial domain might be involved, and moral bioenhancement might challenge existing institutional settings. Given these highly varied contexts and domains, it appears unlikely that there will be a distinct set of practices that will be referred to as “moral bioenhancement.”. (shrink)

Deep brain stimulation has been of considerable interest to bioethicists, in large part because of the effects that the intervention can occasionally have on central features of the recipient’s personality. These effects raise questions regarding the philosophical concept of authenticity. In this article, we expand on our earlier work on the concept of authenticity in the context of deep brain stimulation by developing a diachronic, value-based account of authenticity. Our account draws on both existentialist and essentialist approaches to authenticity, and (...) Laura Waddell Ekstrom’s coherentist approach to personal autonomy. In developing our account, we respond to Sven Nyholm and Elizabeth O’Neill’s synchronic approach to authenticity, and explain how the diachronic approach we defend can have practical utility, contrary to Alexandre Erler and Tony Hope’s criticism of autonomy-based approaches to authenticity. Having drawn a distinction between the authenticity of an individual’s traits and the authenticity of that person’s values, we consider how our conception of authenticity applies to the context of anorexia nervosa in comparison to other prominent accounts of authenticity. We conclude with some reflections on the prudential value of authenticity, and by highlighting how the language of authenticity can be invoked to justify covert forms of paternalism that run contrary to the value of individuality that seems to be at the heart of authenticity. (shrink)

Technology could be used to improve morality but it could do so in different ways. Some technologies could augment and enhance moral behaviour externally by using external cues and signals to push and pull us towards morally appropriate behaviours. Other technologies could enhance moral behaviour internally by directly altering the way in which the brain captures and processes morally salient information or initiates moral action. The question is whether there is any reason to prefer one method over the other? In (...) this article, I argue that there is. Specifically, I argue that internal moral enhancement is likely to be preferable to external moral enhancement, when it comes to the legitimacy of political decision-making processes. In fact, I go further than this and argue that the increasingly dominant forms of external moral enhancement may already be posing a significant threat to political legitimacy, one that we should try to address. Consequently, research and development of internal moral enhancements should be prioritised as a political project. (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)

Moral bioenhancement presents the possibility of enhancing morally desirable emotions and dispositions. While some scholars have proposed that moral bioenhancement can produce virtue, we argue that within a virtue ethics framework moral bioenhancement cannot reliably produce virtue. Moreover, on a virtue ethics framework, the pursuit of moral bioenhancement carries moral risks. To make this argument, we consider three aspects of virtue—its motivational, rational, and behavioral components. In order to be virtuous, we argue, a person must (i) take pleasure in doing (...) the right thing and have the correct motivational attitudes; (ii) reason correctly about what is called for in a particular ethical dilemma; and (iii) intentionally and continuously practice and cultivate virtues. These dimensions of morality—in short: precisely those emphasized in a virtue ethics framework—cannot be consistently or reliably met using existing moral bioenhancement technology. (shrink)

This issue of The Journal of Medicine and Philosophy is unified by a theme of what contributes to and detracts from patient well-being. I highlight this unifying thread through five of this issue’s contributions, dividing them according to whether they are predominantly about what diminishes or enhances the well-being of patients. Three of them are more directly relevant to whether certain actions diminish well-being, and two of them touch more closely on what promotes well-being. Although these papers are generally focused (...) on what is good or detrimental for patients, their insights are also relevant to the nature of human flourishing. (shrink)

Can Artificial Intelligence be more effective than human instruction for the moral enhancement of people? The author argues that it only would be if the use of this technology were aimed at increasing the individual's capacity to reflectively decide for themselves, rather than at directly influencing behaviour. To support this, it is shown how a disregard for personal autonomy, in particular, invalidates the main proposals for applying new technologies, both biomedical and AI-based, to moral enhancement. As an alternative to these (...) proposals, this article proposes a virtual assistant that, through dialogue, neutrality and virtual reality technologies, can teach users to make better moral decisions on their own. The author concludes that, as long as certain precautions are taken in its design, such an assistant could do this better than a human instructor adopting the same educational methodology. (shrink)

Goering and colleagues (2017) acknowledge closed-loop neural devices have the potential to undermine agency. Indeed, the authors observe that “the agent using the device may . . . sometimes doubt whether she is the author of her action, given that the device may operate in ways that are not transparent to her” (65). Still, the authors ultimately argue that closed-loop neural devices may be construed as supporting agency, especially when we view agency from a relational perspective. The reason? We often (...) manifest our agency in relation with others. For example, family and close friends sometimes step in to support us in setting and achieving our aims. In a similar way, then, the authors argue that “we can imagine [a closed-loop] device stepping in to support the user in achieving her aim” (67). Closed-loop neural devices, in other words, can be construed as supporting one’s agency in much the same way as other people can be seen as supporting one’s agency. The authors thus conclude that when we view agents from a relational perspective, closed-loop neural devices may be viewed as supporting rather than undermining agency. I largely agree with the authors’ conclusion. I also believe, however, that their discussion can be clarified by distinguishing three kinds of agency and viewing closed-loop neural devices from the perspective of each. By thinking carefully about agency, we can see more clearly the ways in which it is undermined by closed-loop neural devices, as well as the way in which these devices may support agency. (shrink)

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)

How should ethics help decide the morality of enhancing morality? The idea of morally enhancing the human brain quickly emerged when the promise of cognitive enhancement in general began to seem realizable. However, on reflection, achieving moral enhancement must be limited by the practical challenges to any sort of cognitive modification, along with obstacles particular to morality’s bases in social cognition. The objectivity offered by the brain sciences cannot ensure the technological achievement of moral bioenhancement for humanity-wide application. Additionally, any (...) limited moral enhancement will not easily fulfil ethical expectations. Three hypothetical scenarios involving putative moral enhancement help illustrate why. Philosophical concerns about the “Does-Must Dichotomy” and the “Factor-Cause Plurality,” as I label them, forbid easy leaps from views about morality on to conclusions about ways to enhance morality, and then further on to ethically justifying those enhancements. A modest and realistic approach to moral enhancement emerges from exploring these issues. (shrink)

David Chalmers (2022) argues that reality as we encounter it in virtual reality (VR) and augmented reality (AR) is just as real as the everyday physical world. We may not agree with Chalmers’s prop...

Fabiano argues that virtue theory offers the best “safety framework” for mitigating the risks of moral enhancement (1). He advances five desiderata for an ideal safety framework and then explains how virtue theory satisfies each. Among these desiderata is the “preservation of identity” (1). Fabiano argues that moral enhancement can safely preserve personal identity when carried out within the framework of virtue theory. We suggest Fabiano's argument for this conclusion falls short, since contra Fabiano’s claim, enhancing virtues may not preserve—and (...) could even damage—personal identity. We draw on three sources of evidence: 1) virtue theory scholarship that argues for the importance of habituation for virtue formation, 2) Focquaert and Schermer’s (2015) distinction between active and passive enhancement and attendant endorsement of more active paths to virtue enhancement, and 3) empirical research suggesting that technologies which support moral enhancements may have damaging effects on personal identity. (shrink)

To gain insight into the reasons that the public may have for endorsing or eschewing pharmacological moral enhancement for themselves or for others, we used empirical tools to explore public attitudes towards these issues. Participants from the United States were recruited via Amazon’s Mechanical Turk and were randomly assigned to read one of several contrastive vignettes in which a 13-year-old child is described as bullying another student in school and then is offered an empathy-enhancing program. The empathy-enhancing program is described (...) as either involving taking a pill or playing a video game on a daily basis for four weeks. In addition, participants were asked to imagine either their own child bullying another student at school, or their own child being bullied by another student. This resulted in a 2 × 2 between-subjects design. In an escalating series of morally challenging questions, we asked participants to rate their overall support for the program; whether they would support requiring participation; whether they would support requiring participation of children who are at higher risk to become bullies in the future; whether they would support requiring participation of all children or even the entire population; and whether they would be willing to participate in the program themselves. We found that people were significantly more troubled by pharmacological as opposed to non-pharmacological moral enhancement interventions. The results indicate that members of the public for the greater part oppose pharmacological moral bioenhancement, yet are open to non-biomedical means to attain moral enhancement. [248 words]. (shrink)

Consider that an individual improves her capacities by neuroscientific means. It turns out that, besides altering her in the way(s) she intended, the enhancement also changes her personality in significant way(s) she did not foresee. Yet the person endorses her new self because the neuroenhancement she underwent changed her. Can the person’s approval of her new personality be autonomous? While questions of autonomy have already gathered a significant amount of attention in philosophical literature on human enhancement, the problem just described—henceforth (...) referred to as the question whether selfvalidating neuroenhancement can be autonomous—would not appear to have received due consideration. This article takes a step towards remedying the shortage. I start by explicating the main points of departure of its argument. In the subsequent sections of the article, I consider several possible reasons for deeming self-validating neuroenhancement incompatible with autonomy. On the basis of the consideration, I propose that self-validating neuroenhancement can be autonomous. (shrink)

Recently some bioethicists and neuroscientists have argued for an imperative of chemical cognitive enhancement. This imperative is usually based on consequentialist grounds. In this paper, the topic of cognitive self-enhancement is discussed from a Kantian point of view in order to shed new light on the controversial debate. With Kant, it is an imperfect duty to oneself to strive for perfecting one’s own natural and moral capacities beyond one’s natural condition, but there is no duty to enhance others. A Kantian (...) approach does not directly lead to a duty of chemical cognitive self-enhancement, but it also does not clearly rule out that this type of enhancement can be an appropriate means to the end of self-improvement. The paper shows the benefits of a Kantian view, which offers a consistent ideal of self-perfection and teaches us a lesson about the crucial relevance of the attitude that underlies one’s striving for cognitive self-improvement: the lesson of treating oneself as an end in itself and not as mere means to the end of better output. (shrink)

Stimulant drugs, transcranial magnetic stimulation, brain-computer interfaces, and even genetic modifications are all discussed as forms of potential cognitive enhancement. Cognitive enhancement can be conceived as a benefit-seeking strategy used by healthy individuals to enhance cognitive abilities such as learning, memory, attention, or vigilance. This phenomenon is hotly debated in the public, professional, and scientific literature. Many of the statements favoring cognitive enhancement (e.g., related to greater productivity and autonomy) or opposing it (e.g., related to health-risks and social expectations) rely (...) on claims about human welfare and human flourishing. But with real-world evidence from the social and psychological sciences often missing to support (or invalidate) these claims, the debate about cognitive enhancement is stalled. In this paper, we describe a set of crucial debated questions about psychological and social aspects of cognitive enhancement (e.g., intrinsic motivation, well-being) and explain why they are of fundamental importance to address in the cognitive enhancement debate and in future research. We propose studies targeting social and psychological outcomes associated with cognitive enhancers (e.g., stigmatization, burnout, mental well-being, work motivation). We also voice a call for scientific evidence, inclusive of but not limited to biological health outcomes, to thoroughly assess the impact of enhancement. This evidence is needed to engage in empirically informed policymaking, as well as to promote the mental and physical health of users and non-users of enhancement. (shrink)

Gilbert et al. have raised important questions about the empirical grounding of neuroethical analyses of the apparent phenomenon of Deep Brain Stimulation ‘causing’ personality changes. In this paper, we consider how to make neuroethical claims appropriately calibrated to existing evidence, and the role that philosophical neuroethics has to play in this enterprise of ‘evidence-based neuroethics’. In the first half of the paper, we begin by highlighting the challenges we face in investigating changes to PIAAAS following DBS, explaining how different trial (...) designs may be of different degrees of utility, depending on how changes to PIAAAS following DBS are manifested. In particular, we suggest that the trial designs Gilbert et al. call for may not be able to tell us whether or not DBS directly causes changes to personality. However, we suggest that this is not the most significant question about this phenomenon; the most significant question is whether these changes should matter morally, however they are caused. We go on to suggest that neuroethical analyses of novel neuro-interventions should be carried out in accordance with the levels of evidence hierarchy outlined by the Centre for Evidence-Based Medicine, and explain different ways in which neuroethical analyses of changes to PIAAAS can be evidence-based on this framework. In the second half of the paper, we explain how philosophical neuroethics can play an important role in contributing to mechanism-based reasoning about potential effects on PIAAAS following DBS, a form of evidence that is also incorporated into the CEBM levels of evidence hierarchy. (shrink)

Neuroscientific research in relation to antisocial behavior has strongly grown in the last decades. This has resulted in a better understanding of biological factors associated with antisocial behavior. Furthermore several neuroscientific instruments and interventions have been developed that have a relatively low threshold for use in the criminal justice system to contribute to prevention or reduction of antisocial and criminal behavior. When considering implementation in the criminal justice system, ethical aspects of the use of neuroscientific instruments and interventions need to (...) be taken into account. With respect to ethics in relation to neurocriminology much of the literature focuses on identifying and debating risks and value conflicts. This is important and necessary, but the positive contribution of neuroscientific applications may therefore get less attention in the ethical literature. Yet, ethicists can help criminal justice researchers and practitioners to identify ways in which neuroscience could add positively to important values in offender rehabilitation. It is argued that this role of ethicists in interdisciplinary teams deserves more emphasis. As an illustration, this contribution focuses on how neuroscientific knowledge, instruments and interventions may contribute to autonomy of offenders. (shrink)

Moral agential neuroenhancement can transform us into better people. However, critics of MB raise four central objections to MANEs use: It destroys moral freedom; it kills one moral agent and replaces them with another, better agent; it carries significant risk of infection and illness; it benefits society but not the enhanced person; and it’s wrong to experiment on nonconsenting persons. Herein, I defend MANE’s use for prisoners of war fighting unjustly. First, the permissibility of killing unjust combatants entails that, in (...) cases where MANE is equally or more likely as termination to reduce moral recidivism in unjust combatants, then MANE is morally justified. Second, the relevant infections and illnesses caused by MANE are less bad than death, so MANE leaves unjust POWs better off than the alternative. Third, just as incarceration is often permissible despite benefitting society but not the incarcerated, the same holds for unjust POWs. Fourth, we should accept a broader construal of “benefit” that includes moral benefits. Thus, 3 and 4 are false when applied to unjust POWs. Fifth, medical experimentation likely to help nonconsenting persons is sometimes permissible. Because MANE is likely to help unjust POWs irrespective of their consent or lack thereof, its use is permissible. Sixth, basic principles of proper medical care support the use of MANE on unjust POWs as pro tanto morally obligatory. I conclude that militaries should therefore begin to employ MANE for unjust POWs. (shrink)

It is often contended that certain enhancement technologies are acceptable, because they simply update traditional ways of pursuing the improvement of human capacities. This is not true with reference to moral bioenhancement, because of the radical difference between traditional and biotechnological ways of producing moral progress. These latter risk having serious negative effects on our moral agency, by causing a substantial loss of freedom and capacity of authentic moral behaviour, by affecting our moral identity and by imposing a standard conception (...) of moral personality. (shrink)

The paper critically engages with some of the normative arguments in Julian Savulescu and Ingmar Persson’s book Unfit for the Future. In particular, it scrutinizes the authors’ argument in denial of a moral right to privacy as well as their political proposal to alter humankind’s moral psychology in order to avert climate change, terrorism and to redress global injustice.

There is preliminary evidence, from case reports and investigational studies, to suggest that Deep Brain Stimulation could be used to treat some patients with Anorexia Nervosa. Although this research is at an early stage, the invasive nature of the intervention and the vulnerability of the potential patients are such that anticipatory ethical analysis is warranted. In this paper, we first show how different treatment mechanisms raise different philosophical and ethical questions. We distinguish three potential mechanisms alluded to in the neuroscientific (...) literature, relating to desire, control, and emotion, respectively. We explain why the precise nature of the mechanism has important implications for the patient’s autonomy and personal identity. In the second part of the paper, we consider practical dimensions of offering DBS to patients with AN in certain cases. We first discuss some limited circumstances where the mere offering of the intervention might be perceived as exerting a degree of coercive pressure that could serve to undermine the validity of the patient’s consent. Finally, we consider the implications of potential effects of DBS for the authenticity of the patient’s choice to continue using stimulation to ameliorate their condition. (shrink)

Medical interventions such as methadone treatment for drug addicts or “chemical castration” for sex offenders have been used in several jurisdictions alongside or as an alternative to traditional punishments, such as incarceration. As our understanding of the biological basis for human behaviour develops, our criminal justice system may make increasing use of such medical techniques and may become less reliant on incarceration. Academic debate on this topic has largely focused on whether offenders can validly consent to medical interventions, given the (...) coercive environment of the criminal justice system. Both sides in this debate share the assumption that administering medical interventions to offenders without their valid consent would be unethical. Recently, Thomas Douglas has mounted a formidable challenge to this “consent requirement”. Essentially, his argument rests on a comparison between prison and medical interventions. Douglas asks: if the state is entitled to impose a prison sentence on a criminal without the criminal’s consent, why is consent required for the imposition of a medical intervention? The most obvious way of defending the consent requirement against Douglas’s challenge appeals to the fact that incarceration merely interferes with the right to free movement, but medical interventions interfere with the right to bodily integrity. This argument rests on what Douglas calls the “robustness claim”—the claim that the right to bodily integrity is more robust than the right to freedom of movement. In other words, the right to freedom of movement loses its protective force in a wider range of circumstances than the right to bodily integrity. Douglas’s article seeks to undermine the robustness claim, by arguing that neither case-based intuitions, nor theoretical considerations support this claim. In this article, I will attempt to raise some doubts about Douglas’s challenge to the consent requirement and the robustness claim. (shrink)

For more than 20 years, Western science education has been incorporated into Tibetan Buddhist monastics’ training. In this time, there have been a number of fruitful collaborations between Buddhist monastics and neuroscientists, neurologists, and psychologists. These collaborations are unsurprising given the emphasis on phenomenological exploration of first-person conscious experience in Buddhist contemplative practice and the focus on the mind and consciousness in Buddhist theory. As such, Tibetan monastics may have underappreciated intuitions on the intersection of science, medicine, and ethics. Yet (...) despite their overlapping interests, Buddhist perspectives are largely absent in contemporary neuroethical analysis, apart from conceptual arguments for their relevance. This article attempts to fill this gap by presenting the results of eleven semi-structured interviews with Tibetan Buddhist monastics in India on three issues in neuroethics: identity and authenticity, enhancement, and disorders of consciousness. The results of this empirical study reinforce the conclusions of theoretical work on Buddhism and neuroethics while also identifying future areas of inquiry, including the importance of community, the challenges in acting from compassion, and the value of self-directed mental cultivation. (shrink)

Do we have a duty to use moral neurointerventions to correct deficits in our moral psychology? On their surface, these technologies appear to pose worrisome risks to valuable dimensions of the self, and these risks could conceivably weigh against any prima facie moral duty we have to use these technologies. Focquaert and Schermer :139–151, 2015) argue that neurointerventions pose special risks to the self because they operate passively on the subject’s brain, without her active participation, unlike ‘active’ interventions. Some neurointerventions, (...) however, appear to be relatively unproblematic, and some appear to preserve the agent’s sense of self precisely because they operate passively. In this paper, I propose three conditions that need to be met for a medical intervention to be considered low-risk, and I say that these conditions cut across the active/passive divide. A low-risk intervention must: pass pre-clinical and clinical trials, fare well in post-clinical studies, and be subject to regulations protecting informed consent. If an intervention passes these tests, its risks do not provide strong countervailing reasons against our prima facie duty to undergo the intervention. (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)

Utilitarianism has been able to respond to many of the objections raised against it by undertaking a major revision of its theory. Basically, this consisted of recognising that its early normative propositions were only viable for agents very different from flesh-and-blood humans. They then deduced that, given human limitations, it was most useful for everyone if moral agents did not behave as utilitarians and habitually followed certain rules. Important recent advances in neurotechnology suggest that some of these human limitations can (...) be overcome. In this article, after presenting some possible neuro-enhancements, we seek to answer the questions, first, of whether they should be accepted by a utilitarian ethic and, second, if accepted, to what extent they would invalidate the revision that allowed them to escape the objections. (shrink)

Riassunto: L’impianto cocleare è una neuroprotesi che consente un recupero parziale dell’udito nella persona sorda. Nonostante la sua generale efficacia nel contrastare alcuni dei problemi legati alla sordità, il suo utilizzo è stato fortemente osteggiato da quella parte della comunità sorda che vede nella sordità una forma di identità culturale e non una patologia. Questo articolo inquadra in una prospettiva neuroetica le preoccupazioni della comunità sorda – difficilmente comprensibili agli udenti – esaminando le analogie fra il rifiuto dell’IC e il (...) disagio che si osserva nella popolazione generale relativamente al Potenziamento Cognitivo. Nel PCog, individui sani insoddisfatti delle proprie prestazioni, o comunque desiderosi di migliorarle, ricorrono ad interventi artificiali per potenziare le proprie funzioni cognitive. L’analisi evidenzia come, nel rifiutare l’IC, la comunità sorda possa voler tutelare un insieme di valori non così diverso da quello che la comunità generale richiama spesso nelle sue preoccupazioni rispetto alla diffusione dei PCog. Parole chiave : Impianto cocleare; Potenziamento cognitivo; Sordità; Cultura sorda The cochlear implant as cognitive enhancement? A neuroethical perspective on some issues raised by the deaf community: The cochlear implant is a neuroprosthesis that allows for partial recovery of auditory function in individuals who are deaf. Despite its general efficacy, its use has been strongly opposed by a part of the deaf community that perceives deafness as a form of cultural identity, rather than a pathology. This article considers the concerns of the deaf community – which are often difficult for hearing people to understand – from a neuroethics perspective, proposing that such opposition to CI is analogous to the general population’s unease with regard to Cognitive Enhancement. CE allows healthy individuals who are unsatisfied with – or would like to improve – their performance to use artificial interventions that enhance cognitive functions. The analysis reveals that, when opposing CIs, the deaf community may be protecting a set of values similar to those that the general community often evokes when voicing concerns about CE diffusion. Keywords: Cochlear Implant; Cognitive Enhancement; Deafness; Deaf Culture. (shrink)

A considerable body of evidence now documents, beyond reasonable doubt, biological and health risk factors for crime and violence. Nevertheless, intervention and prevention efforts with offenders have avoided biological interventions, in part due to past misuses of biological research and the challenges that biological predispositions to crime raise. This article reviews the empirical literature on two biological intervention approaches, omega-3 supplementation and transcranial direct current stimulation. Emerging research on these relatively benign interventions suggests that increased omega-3 intake through dietary intervention (...) and prefrontal upregulation using non-invasive brain stimulation may show some initial promise in reducing antisocial behavior. The ethical issues related to mandated and offered biological interventions within the criminal justice system are discussed. (shrink)