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  1. Towards a Concept of Embodied Autonomy: In what ways can a Patient’s Body contribute to the Autonomy of Medical Decisions?Jonathan Lewis & Søren Holm - 2023 - Medicine, Health Care and Philosophy 26 (3):451-463.
    “Bodily autonomy” has received significant attention in bioethics, medical ethics, and medical law in terms of the general inviolability of a patient’s bodily sovereignty and the rights of patients to make choices (e.g., reproductive choices) that concern their own body. However, the role of the body in terms of how it can or does contribute to a patient’s capacity for, or exercises of their autonomy in clinical decision-making situations has not been explicitly addressed. The approach to autonomy in this paper (...)
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  • Autonomy, procedural and substantive: a discussion of the ethics of cognitive enhancement.Igor D. Bandeira & Enzo Lenine - 2022 - Medicine, Health Care and Philosophy 25 (4):729-736.
    As cognitive enhancement research advances, important ethical questions regarding individual autonomy and freedom are raised. Advocates of cognitive enhancement frequently adopt a procedural approach to autonomy, arguing that enhancers improve an individual’s reasoning capabilities, which are quintessential to being an autonomous agent. On the other hand, critics adopt a more nuanced approach by considering matters of authenticity and self-identity, which go beyond the mere assessment of one’s reasoning capacities. Both positions, nevertheless, require further philosophical scrutiny. In this paper, we investigate (...)
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  • Patient Autonomy, Clinical Decision Making, and the Phenomenological Reduction.Jonathan Lewis & Søren Holm - 2022 - Medicine, Health Care and Philosophy 25 (4):615-627.
    Phenomenology gives rise to certain ontological considerations that have far-reaching implications for standard conceptions of patient autonomy in medical ethics, and, as a result, the obligations of and to patients in clinical decision-making contexts. One such consideration is the phenomenological reduction in classical phenomenology, a core feature of which is the characterisation of our primary experiences as immediately and inherently meaningful. This paper builds on and extends the analyses of the phenomenological reduction in the works of Husserl, Heidegger, and Merleau-Ponty (...)
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  • From Self‐Determination to Offspring‐Determination? Reproductive Autonomy, Procrustean Parenting, and Genetic Enhancement.Jon Rueda - 2021 - Theoria 88 (6):1086-1110.
    Emerging reprogenetic technologies may radically change how humans reproduce in the not-so-distant future. One foreseeable consequence of disruptive innovations in the procreative domain is an increase in the reproductive autonomy of intended parents. Regarding the prospective parental liberty of enhancing non-health–related traits of the offspring, one controversy has particularly dominated the literature. Does parents' choice of genetically enhancing the traits of their descendants compromise children's future personal autonomy? In this article, I will analyse the main arguments which posit that reprogenetic (...)
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  • Nonconsensual neurocorrectives, bypassing, and free action.Gabriel De Marco - 2021 - Philosophical Studies 179 (6):1953-1972.
    As neuroscience progresses, we will not only gain a better understanding of how our brains work, but also a better understanding of how to modify them, and as a result, our mental states. An important question we are faced with is whether the state could be justified in implementing such methods on criminal offenders, without their consent, for the purposes of rehabilitation and reduction of recidivism; a practice that is already legal in some jurisdictions. By focusing on a prominent type (...)
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  • Revisiting Moral Bioenhancement and Autonomy.Ji-Young Lee - 2021 - Neuroethics 14 (3):529-539.
    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, (...)
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  • Doctor, please make me freer: Capabilities enhancement as a goal of medicine.Jon Rueda, Pablo García-Barranquero & Francisco Lara - 2021 - Medicine, Health Care and Philosophy (3):409-419.
    Biomedical innovations are making possible the enhancement of human capabilities. There are two philosophical stances on the role that medicine should play in this respect. On the one hand, naturalism rejects every medical intervention that goes beyond preventing and treating disease. On the other hand, welfarism advocates enhancements that foster subjective well-being. We will show that both positions have considerable shortcomings. Consequently, we will introduce a third characterization in which therapies and enhancements can be reconciled with the legitimate objectives of (...)
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  • Safeguarding Vulnerable Autonomy? Situational Vulnerability, The Inherent Jurisdiction and Insights from Feminist Philosophy.Jonathan Lewis - 2021 - Medical Law Review 29 (2):306-336.
    The High Court continues to exercise its inherent jurisdiction to make declarations about interventions into the lives of situationally vulnerable adults with mental capacity. In light of protective responses of health care providers and the courts to decision-making situations involving capacitous vulnerable adults, this paper has two aims. The first is diagnostic. The second is normative. The first aim is to identify the harms to a capacitous vulnerable adult’s autonomy that arise on the basis of the characterisation of situational vulnerability (...)
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  • Genetic Enhancement and the Child’s Right to an Open Future.Davide Battisti - 2020 - Phenomenology and Mind 19 (19):212.
    In this paper, I analyze the ethical implications of genetic enhancement within the specific framework of the “child’s right to an open future” argument (CROF). Whilst there is a broad ethical consensus that genetic modifications for eradicating diseases or disabilities are in line with – or do not violate – CROF, there is huge disagreement about how to ethically understand genetic enhancement. Here, I analyze this disagreement and I provide a revised formulation of the argument in the specific field of (...)
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  • Autonomy and the Limits of Cognitive Enhancement.Jonathan Lewis - 2021 - Bioethics 35 (1):15-22.
    In the debates regarding the ethics of human enhancement, proponents have found it difficult to refute the concern, voiced by certain bioconservatives, that cognitive enhancement violates the autonomy of the enhanced. However, G. Owen Schaefer, Guy Kahane and Julian Savulescu have attempted not only to avoid autonomy-based bioconservative objections, but to argue that cognition-enhancing biomedical interventions can actually enhance autonomy. In response, this paper has two aims: firstly, to explore the limits of their argument; secondly, and more importantly, to develop (...)
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  • Can Prudence Be Enhanced?Jason T. Eberl - 2018 - Journal of Medicine and Philosophy 43 (5):506-526.
    Some bioethicists have argued that moral bioenhancement, complementing traditional means of enhancing individuals’ moral dispositions, is essential if we are to survive as a species. Traditional means of moral enhancement have historically included civil legislation, socially recognized moral exemplars, religious teachings and disciplines, and familial upbringing. I explore the necessity and feasibility of pursuing methods of moral bioenhancement as a complement to such traditional means, grounding my analysis within a virtue-theoretic framework. Specifically, I focus on the essential intellectual virtue for (...)
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  • The Posthuman as Hollow Idol: A Nietzschean Critique of Human Enhancement.Ciano Aydin - 2017 - Journal of Medicine and Philosophy 42 (3):304-327.
    In this paper, the author aims to show that transhumanists are confused about their own conception of the posthuman: transhumanists anticipate radical transformation of the human through technology and at the same time assume that the criteria to determine what is “normal” and what is “enhanced” are univocal, both in our present time and in the future. Inspired by Nietzsche’s notion of the Overhuman, the author argues that the slightest “historical and phenomenological sense” discloses copious variations of criteria, both diachronic (...)
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  • Would Moral Enhancement Limit Freedom?Antonio Diéguez & Carissa Véliz - 2019 - Topoi 38 (1):29-36.
    The proposal of moral enhancement as a valuable means to face the environmental, technological and social challenges that threaten the future of humanity has been criticized by a number of authors. One of the main criticisms has been that moral enhancement would diminish our freedom. It has been said that moral enhancement would lead enhanced people to lose their ‘freedom to fall’, that is, it would prevent them from being able to decide to carry out some morally bad actions, and (...)
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  • Free Will as a Psychological Accomplishment.Eddy Nahmias - 2016 - In David Schmidtz & Carmen Pavel (eds.), The Oxford Handbook of Freedom. New York: Oxford University Press.
    I offer analyses of free will in terms of a complex set of psychological capacities agents possess to varying degrees and have varying degrees of opportunities to exercise effectively, focusing on the under-appreciated but essential capacities for imagination. For an agent to have free will is for her to possess the psychological capacities to make decisions—to imagine alternatives for action, to select among them, and to control her actions accordingly—such that she is the author of her actions and can deserve (...)
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  • Nowa liberalna eugenika: krytyczny przegląd argumentów przeciwko biomedycznemu poprawianiu ludzkiej kondycji fizycznej lub umysłowej.Tomasz Żuradzki - 2014 - Diametros 42:204-226.
    Celem artykułu jest krytyka kilku popularnych argumentów przeciwko wykorzystywaniu współczesnych osiągnięć biomedycznych do poprawiania ludzkiej kondycji fizycznej lub umysłowej. Na przykładzie prac Habermasa, Sandela, Fukuyamy omówię trzy argumenty tego typu odwołujące się do: 1) autonomii; 2) życia jako daru; 3) naturalnej równowagi. Na koniec pokażę, że sprzeciw względem niektórych propozycji biomedycznego polepszenia kondycji ludzkiej może być wynikiem swoistego błędu poznawczego, który psychologowie określają jako efekt status quo.
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  • Enhancing Autonomy by Reducing Impulsivity: The Case of ADHD.Jonathan Pugh - 2014 - Neuroethics 7 (3):373-375.
    In a recent article in this journal, Schaefer et al. argue that it might be possible to enhance autonomy through the use of cognitive enhancements. In this article, I highlight an example that Schaefer et al. do not acknowledge of a way in which we already seem to be using pharmacological agents in a manner that can be understood as enhancing an agent’s autonomy. To make this argument, I begin by following other theorists in the philosophical literature in claiming that (...)
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  • Using artificial intelligence to enhance patient autonomy in healthcare decision-making.Jose Luis Guerrero Quiñones - forthcoming - AI and Society:1-10.
    The use of artificial intelligence in healthcare contexts is highly controversial for the (bio)ethical conundrums it creates. One of the main problems arising from its implementation is the lack of transparency of machine learning algorithms, which is thought to impede the patient’s autonomous choice regarding their medical decisions. If the patient is unable to clearly understand why and how an AI algorithm reached certain medical decision, their autonomy is being hovered. However, there are alternatives to prevent the negative impact of (...)
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  • Advance Medical Decision-Making Differs Across First- and Third-Person Perspectives.James Toomey, Jonathan Lewis, Ivar R. Hannikainen & Brian D. Earp - 2024 - AJOB Empirical Bioethics 15 (4):237-245.
    Background Advance healthcare decision-making presumes that a prior treatment preference expressed with sufficient mental capacity (“T1 preference”) should trump a contrary preference expressed after significant cognitive decline (“T2 preference”). This assumption is much debated in normative bioethics, but little is known about lay judgments in this domain. This study investigated participants’ judgments about which preference should be followed, and whether these judgments differed depending on a first-person (deciding for one’s future self) versus third-person (deciding for a friend or stranger) perspective. (...)
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  • Capturing and Promoting the Autonomy of Capacitous Vulnerable Adults.Jonathan Lewis - 2021 - Journal of Medical Ethics 47 (12):e21.
    According to the High Court in England and Wales, the primary purpose of legal interventions into the lives of vulnerable adults with mental capacity should be to allow the individuals concerned to regain their autonomy of decision making. However, recent cases of clinical decision making involving capacitous vulnerable adults have shown that, when it comes to medical law, medical ethics and clinical practice, vulnerability is typically conceived as opposed to autonomy. The first aim of this paper is to detail the (...)
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  • Neuroenhancement.Alexandre Erler & Cynthia Forlini - 2020 - Routledge Encyclopedia of Philosophy Online.
    Entry on "Neuroenhancement" in the Routledge Encyclopedia of Philosophy Online.
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  • Why Human Enhancement is Necessary for Successful Human Deep-space Missions.Konrad Szocik & Martin Braddock - 2019 - The New Bioethics 25 (4):295-317.
    While humans have made enormous progress in the exploration and exploitation of Earth, exploration of outer space remains beyond current human capabilities. The principal challenges lie in current space technology and engineering which includes the protection of astronauts from the hazards of working and living in the space environment. These challenges may lead to a paradoxical situation where progress in space technology and the ability to ensure acceptable risk/benefit for human space exploration becomes dissociated and the rate of scientific discovery (...)
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  • The values and rules of capacity assessments.Binesh Hass - 2022 - Journal of Medical Ethics 48 (11):816-820.
    This article advances two views on the role of evaluative judgment in clinical assessments of decision-making capacity. The first is that it is rationally impossible for such assessments to exclude judgments of the values a patient uses to motivate their decision-making. Predictably, and second, attempting to exclude such judgments sometimes yields outcomes that contain intractable dilemmas that harm patients. These arguments count against the prevailing model of assessment in common law countries—the four abilities model—which is often incorrectly advertised as being (...)
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  • Cognitive Diminishments and Crime Prevention: “Too Smart for the Rest of Us”?Sebastian Jon Holmen - 2022 - Neuroethics 15 (1):1-13.
    In this paper, I discuss whether it is ever morally permissible to diminish the cognitive abilities or capacities of some cognitively gifted offenders whose ability to commit their crimes successfully relies on them possessing these abilities or capacities. I suggest that, given such cognitive diminishments may prevent such offenders from re-offending and causing others considerable harm, this provides us with at least one good moral reason in favour of employing them. After setting out more clearly what cognitive diminishment may consist (...)
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  • Commentary: Freedom Means Self-Awareness and Self-Control: Bioenhancement Can Help.James Hughes - 2017 - Cambridge Quarterly of Healthcare Ethics 26 (3):394-397.
    The manipulation of sentiments and capacities for self-control can be combined in a program of posthuman character development that enhances flourishing and the subjective sense of free will. Indeed the faculties of self-awareness, deliberation, and self-control are the only referents this illusory concept of free will can be based on.
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  • Why Enhancing Autonomy Is Not a Question of Improving Single Aspects of Reasoning Abilities through Neuroenhancement.Orsolya Friedrich & Johannes Pömsl - 2017 - Neuroethics 10 (2):243-254.
    In a recent paper, Schaefer et al. proposed to enhance autonomy via improving reasoning abilities through cognitive enhancement [1]. While initially their idea additionally seems to elegantly avoid objections against genetic enhancements based on the value of autonomy, we want to draw attention to several problems their approach poses. First, we will show that it is not at all clear that safe and meaningful methods to genetically or pharmaceutically enhance cognition will be feasible any time soon. Second, we want to (...)
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  • Falling through the cracks: The plight of vulnerable adults with capacity.Jonathan Lewis - 2024 - Clinical Ethics 19 (3):205-206.
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  • Can self-validating neuroenhancement be autonomous?Jukka Varelius - 2020 - Medicine, Health Care and Philosophy 23 (1):51-59.
    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 (...)
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  • The Locus of Agency in Extended Cognitive Systems.Barbara Tomczyk - forthcoming - Journal for General Philosophy of Science / Zeitschrift für Allgemeine Wissenschaftstheorie:1-26.
    The increasing popularity of artificial cognitive enhancements raises the issue of their impact on the agent’s personal autonomy, and issues pertaining to how the latter is to be secured. The extended mind thesis implies that mental states responsible for autonomous action can be partly constituted by the workings of cognitive artifacts themselves, and the question then arises of whether this commits one to embracing an extended agent thesis. My answer is negative. After briefly presenting the main accounts on the conditions (...)
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  • Science fiction and human enhancement: radical life-extension in the movie ‘In Time’ (2011).Johann A. R. Roduit, Tobias Eichinger & Walter Glannon - 2018 - Medicine, Health Care and Philosophy 21 (3):287-293.
    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 (...)
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  • Upgrading Discussions of Cognitive Enhancement.Susan B. Levin - 2016 - Neuroethics 9 (1):53-67.
    Advocates of cognitive enhancement maintain that technological advances would augment autonomy indirectly by expanding the range of options available to individuals, while, in a recent article in this journal, Schaefer, Kahane, and Savulescu propose that cognitive enhancement would improve it more directly. Here, autonomy, construed in broad procedural terms, is at the fore. In contrast, when lauding the goodness of enhancement expressly, supporters’ line of argument is utilitarian, of an ideal variety. An inherent conflict results, for, within their utilitarian frame, (...)
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  • Respect, Punishment and Mandatory Neurointerventions.Sebastian Jon Holmen - 2020 - Neuroethics 14 (2):167-176.
    The view that acting morally is ultimately a question of treating others with respect has had a profound influence on moral and legal philosophy. Not surprisingly, then, some scholars forcefully argue that the modes of punishment that the states mete out to offenders should not be disrespectful, and, furthermore, it has been argued that obliging offenders to receive neurological treatment is incompatible with showing them their due respect. In this paper, I examine three contemporary accounts of what showing respect for (...)
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  • Could Genetic Enhancement Really Lead to Obsolescence?Gabriel Lázaro-Muñoz, Kristin M. Kostick & Peter Zuk - 2019 - American Journal of Bioethics 19 (7):34-36.
    Volume 19, Issue 7, July 2019, Page 34-36.
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  • Ought the State Use Non-Consensual Treatment to Restore Trial Competence?Sebastian Jon Holmen - 2023 - Res Publica 29 (1):111-127.
    The important question of the legality of the state obliging trial incompetent defendants to receive competency-restoring treatment against their wishes, is one that has received much attention by legal scholars. Surprisingly, however, little attention has been paid to the, in many ways more fundamental, moral question of whether the state ought to administer such treatments. The aim of this paper is to start filling this gap in the literature. I begin by offering some reasons for thinking it morally acceptable to, (...)
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  • Dual use concerns in artificial intelligence and the neurosciences: How medical research can end up in war.Elisabeth Krauel & Andreas Frewer - forthcoming - Research Ethics.
    Dual Use Research of Concern (DURC) has been well analyzed regarding the life sciences. This article explores the topic of younger fields of medical research and their potential for misuse, especially in the military context. The areas of research considered are artificial intelligence, neurotechnology, and neuroenhancement. Each of these areas have brought forward highly promising new research. However, in light of the current armed conflicts in Europe and in the Middle East, there is a need to consider what the potential (...)
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  • More Autonomous or more Fenced-in? Neuroscientific Instruments and Intervention in Criminal Justice.Catharina H. de Kogel - 2018 - Neuroethics 12 (3):243-254.
    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 (...)
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  • Rozproszony system człowiek-artefakt jako autonomiczny sprawca. Racje i wątpliwości.Barbara Tomczyk - 2024 - Studia Philosophiae Christianae 60 (1):43-78.
    Zwolennicy poznania rozproszonego deklarują odchodzenie od indywidualizmu metodologicznego i poznawczego w stronę ujęcia systemowego, na gruncie którego poznanie traktowane jest jako własność całego szerokiego systemu, a nie pojedynczego człowieka. W artykule skupiam się na problemie sprawczości systemu człowiek-artefakt i wykazuję, że przyjęcie perspektywy indywidualistycznej jest przy jego rozpatrywaniu niezbędne, a ujmowanie go jako systemu rozproszonego nie stanowi przewagi wyjaśniającej. Analizy reprezentacji zewnętrznych, afordancji i dizajnu, przeprowadzone przez Witolda Wachowskiego w książce Poznanie rozproszone. Od heurystyk do mechanizmów (2022), nie odchodzą od (...)
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  • Place-Based Thoughtfulness and Decision-Making in Gene Editing and Genetic Selection.Andrew Crowden & Matthew Gildersleeve - 2024 - American Journal of Bioethics 24 (8):53-55.
    Volume 24, Issue 8, August 2024, Page 53-55.
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  • Attitudes Toward Cognitive Enhancement: The Role of Metaphor and Context.Erin C. Conrad, Stacey Humphries & Anjan Chatterjee - 2019 - American Journal of Bioethics Neuroscience 10 (1):35-47.
    The widespread use of stimulants among healthy individuals to improve cognition has received growing attention; however, public attitudes toward this practice are not well understood. We determined the effect of framing metaphors and context of use on public opinion toward cognitive enhancement. We recruited 3,727 participants from the United States to complete three surveys using Amazon’s Mechanical Turk between April and July 2017. Participants read vignettes describing an individual using cognitive enhancement, varying framing metaphors (fuel versus steroid), and context of (...)
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  • (1 other version)Kantian Challenges for the Bioenhancement of Moral Autonomy.Anna Frammartino Wilks - 2018 - Royal Institute of Philosophy Supplement 83:121-143.
    In the debate over moral bioenhancement, some object that biochemical, genetic, and neurological interventions aiming at enhancing moral agency threaten the autonomy of persons, as they compromise moral deliberation and motivation. Opponents of this view argue that such interventions may actually enhance autonomy itself, thereby increasing a person's capacity for moral agency. My aim is to explore the various senses of autonomy commonly appealed to in such controversies and to expose their limitations in resolving the central disputed issues. I propose (...)
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  • If Criminal Intentions Are Nonvoluntary, Mandatory Neurointerventions Might Be Permissible.Andrea Lavazza - 2018 - American Journal of Bioethics Neuroscience 9 (3):154-156.
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