Human dignity—is it a useful concept in bioethics, one that sheds important light on the whole range of bioethical issues, from embryo research and assisted reproduction, to biomedical enhancement, to care of the disabled and the dying? Or is it, on the contrary, a useless concept—at best a vague substitute for other, more precise notions, at worst a mere slogan that camouflages unconvincing arguments and unarticulated biases?

Does human enhancement threaten our dignity as some prominent commentators have asserted? Or could our dignity perhaps be technologically enhanced? After disentangling several different concepts of dignity, this essay focuses on the idea of dignity as a quality, a kind of excellence admitting of degrees and applicable to entities both within and without the human realm. I argue that dignity in this sense interacts with enhancement in complex ways which bring to light some fundamental issues in value theory, and that (...) the effects of any given enhancement must be evaluated in its appropriate empirical context. Yet it is possible that through enhancement we could become better able to appreciate and secure many forms of dignity that are overlooked or missing under current conditions. I also suggest that in a posthuman world, dignity as a quality could grow in importance as an organizing moral/aesthetic idea. (shrink)

As our knowledge of the functional and pharmacological architecture of the nervous system increases, we are getting better at treating cognitive and affective disorders. Along with the ability to modify cognitive and affective systems in disease, we are also learning how to modify these systems in health. “Cosmetic neurology,” the practice of intervening to improve cognition and affect in healthy individuals, raises several ethical concerns. However, its advent seems inevitable. In this paper I examine this claim of inevitability by reviewing (...) the evolution of another medical practice, cosmetic surgery. Cosmetic surgery also enhances healthy people and, despite many critics, it is practiced widely. Can we expect the same of cosmetic neurology? The claim of inevitability poses a challenge for both physicians and bioethicists. How will physicians reconsider their professional role? Will bioethicists influence the shape of cosmetic neurology? But first, how did cosmetic surgery become common? (shrink)

Why has autonomy been a leading idea in philosophical writing on bioethics, and why has trust been marginal? In this important book, Onora O'Neill suggests that the conceptions of individual autonomy so widely relied on in bioethics are philosophically and ethically inadequate, and that they undermine rather than support relations of trust. She shows how Kant's non-individualistic view of autonomy provides a stronger basis for an approach to medicine, science and biotechnology, and does not marginalize untrustworthiness, while also explaining why (...) trustworthy individuals and institutions are often undeservingly mistrusted. Her arguments are illustrated with issues raised by practices such as the use of genetic information by the police or insurers, research using human tissues, uses of new reproductive technologies, and media practices for reporting on medicine, science and technology. Autonomy and Trust in Bioethics will appeal to a wide range of readers in ethics, bioethics and related disciplines. (shrink)

Andrews Reath presents a selection of his best essays on various features of Kant's moral psychology and moral theory, with particular emphasis on his conception of rational agency and his conception of autonomy. Together the essays articulate Reath's original approach to Kant's views about human autonomy, which explains Kant's belief that objective moral requirements are based on principles we choose for ourselves. With two new papers, and revised versions of several others, the volume will be of great interest to all (...) students and scholars of Kant and of moral philosophy. (shrink)

In this book, Allen Wood investigates Kant's conception of ethical theory, using it to develop a viable approach to the rights and moral duties of human beings. By remaining closer to Kant's own view of the aims of ethics, Wood's understanding of Kantian ethics differs from the received 'constructivist' interpretation, especially on such matters as the ground and function of ethical principles, the nature of ethical reasoning and autonomy as the ground of ethics. Wood does not hesitate to criticize and (...) modify Kant's conclusions when they seem inconsistent with his basic principles or fail to make the best use of the resources Kantian principles make available. Of special interest are the book's treatment of such topics as freedom of the will, the state's role in securing economic justice, sexual morality, the justification of punishment, and the prohibition on lying. (shrink)

In this updated edition of his outstanding introduction to Kant, Paul Guyer uses Kant’s central conception of autonomy as the key to his thought. Beginning with a helpful overview of Kant’s life and times, Guyer introduces Kant’s metaphysics and epistemology, carefully explaining his arguments about the nature of space, time and experience in his most influential but difficult work, _The Critique of Pure Reason_. He offers an explanation and critique of Kant’s famous theory of transcendental idealism and shows how much (...) of Kant’s philosophy is independent of this controversial doctrine. He then examines Kant’s moral philosophy, his celebrated ‘categorical imperative’ and his theories of duty, freedom of will and political rights. This section of the work has been substantially revised to clarify the relation between Kant’s conceptions of "internal" and "external" freedom. In his treatments of Kant’s aesthetics and teleology, Guyer focuses on their relation to human freedom and happiness. Finally, he considers Kant’s view that the development of human autonomy is the only goal that we can conceive for both natural and human history. Including a chronology, glossary, chapter summaries and up-to-date further reading, _Kant, second edition _is an ideal introduction to this demanding yet pivotal figure in the history of philosophy, and essential reading for all students of philosophy. (shrink)

Commentators on the work of Immanuel Kant have long held that his later "critical" writings are a radical rejection of his earlier, less celebrated efforts. In this pathbreaking book, Susan Shell demonstrates not only the developmental unity of Kant's individual writings, but also the unity of his work and life experience. Shell argues that the central animating issues of Kant's lifework concerned the perplexing relation of spirit to body. Through an exacting analysis of individual writings, Shell maps the philosophical contours (...) of Kant's early intellectual struggles and their relation to his more mature thought. The paradox of mind in matter and the tensions it generates—between freedom and determinacy, independence and community, ideal and real—are shown to inform the whole of his work. Shell's fresh, penetrating analysis of the precritical works will surely catapult them to new prominence in Kant studies. Shell's critique goes further to consider the context of contemporary intellectual life. She explores the fascinating realm of Kant's sexual and medical idiosyncracies, linking them to the primary concerns of his critical philosophy. She develops a sure-to-be controversial treatment of the connection between Kant's philosophy and his chronic hypochondria, and illuminates previously unforeseen connections in a remarkable convergence of life and thought, with important theoretical and practical implications for modern times. (shrink)

Some say moral bioenhancements are urgent and necessary; others say they are misguided or simply will not work. I examine a class of arguments claiming that moral bioenhancements are problematic because they are self-subverting. On this view, trying to make oneself or others more moral, at least through certain means, can itself be immoral, or at least worse than the alternatives. The thought here is that moral enhancements might fail not for biological reasons, but for specifically morally self-referential reasons. I (...) argue that moral bioenhancements, in a restricted set of cases, are self-subverting such that they are impermissible. Further, some moral bioenhancements would result in agents who are less admirable than they might have been through other means. (shrink)

Understanding the ethics of enhancement begins with getting clear about the concept, as well as the factors likely to move people to pursue biomedical enhancement. This article first considers the usefulness of the distinction between therapy and enhancement for understanding the ethics of enhancement. Once the conceptual underbrush has been cleared away, we can move on to ethics. The next section examines critically a number of arguments that have been offered to defend biomedical enhancement, or, at least, to claim that (...) efforts to deter it are either ethically or practically mistaken. Finally, the article considers a set of arguments that take the ethics of enhancement to be a serious matter and that gives reasons to question whether some biomedical enhancements, for some purposes, may be ethically suspect. (shrink)

In discussions of the ethics of human gene therapy, it has become standard to draw a distinction between the use of human gene transfer techniques to treat health problems and their use to enhance or improve normal human traits. Some dispute the normative force of this distinction by arguing that it is undercut by the legitimate medical use of human gene transfer techniques to prevent disease - such as genetic engineering to bolster immune function, improve the efficiency of DNA repair, (...) or add cellular receptors to capture and process cholesterol. If disease prevention is a proper goal of medicine, these critics argue, and the use of gene transfer techniques to enhance human health maintenance capacities will help achieve that goal, then the “treatment/enhancement‘ distinction cannot define the limits of legitimate gene therapy. In this paper, I argue that a line can be drawn between prevention and enhancement for gene therapy (and thus between properly medical and nonmedical uses of gene therapy), but only if one is willing to accept two rather old-fashioned claims: 1) Some health problems are best understood as if they were entities in their own right, reifiable as processes or parts in a biological system, with at least as much ontological objectivity and theoretical significance as the functions that they inhibit. 2) Legitimate preventive genetic health care should be limited to efforts to defend people from attack by these more robust pathological entities, rather than changing their bodies to evade social injustices. (shrink)

It is tempting to argue that Kantian moral philosophy justifies prohibiting both human germ-line genetic engineering and non-therapeutic genetic engineering because they fail to respect human dignity. There are, however, good reasons for resisting this temptation. In fact, Kant’s moral philosophy provides reasons that support genetic engineering—even germ-line and non-therapeutic. This is true of Kant’s imperfect duties to seek one’s own perfection and the happiness of others. It is also true of the categorical imperative. Kant’s moral philosophy does, however, provide (...) limits to justifiable genetic engineering. (shrink)

There are a number of premises underlying much of the vigorous debate on pharmacological cognitive enhancement. Among these are claims in the enhancement literature that such drugs exist and are effective among the cognitively normal. These drugs are deemed to enhance cognition specifically, as opposed to other non-cognitive facets of our psychology, such as mood and motivation. The focus on these drugs as cognitive enhancers also suggests that they raise particular ethical questions, or perhaps more pressing ones, compared to those (...) raised by other kinds of neuroenhancement. Finally, the use of these drugs is often claimed to be significant and increasing. Taken together, these premises are at the heart of the flurry of debate on pharmacological cognitive enhancement. In this article, it is argued that these are presumptions for which the evidence does not hold up. Respectively, the evidence for the efficacy of these drugs is inconsistent; neurologically it makes little sense to distinguish the cognitive from non-cognitive as separate targets of pharmacological intervention; ethically, the questions raised by cognitive enhancement are in fact no different from those raised by other kinds of neuroenhancement; and finally the prevalence rates of these drugs are far from clear, with the bulk of the claims resting on poor or misrepresented data. Greater conceptual clarity along with a more tempered appreciation of the evidence can serve to deflate some of the hype in the associated literature, leading to a more realistic and sober assessment of these prospective technologies. (shrink)

In this paper, I argue that cognitive enhancement cannot be epistemically beneficial since getting things right in particular and epistemic agency in general both presuppose a kind of achievement. Drawing on Aristotle’s ethics, I distinguish four categories of actions: caused, attributable, responsible, and creditable. I conclude that to the extent that cognitive enhancement is incompatible with the latter category it undermines rather than strengthens autonomous agency in the realm of cognition.

Much disease and disability is the result of lifestyle behaviours. For example, the contribution of imprudence in the form of smoking, poor diet, sedentary lifestyle, and drug and alcohol abuse to ill-health is now well established. More importantly, some of the greatest challenges facing humanity as a whole – climate change, terrorism, global poverty, depletion of resources, abuse of children, overpopulation – are the result of human behaviour. In this chapter, we will explore the possibility of using advances in the (...) cognitive sciences to develop strategies to intentionally manipulate human motivation and behaviour. While our arguments apply also to improving prudential motivation and behaviour in relation to health, we will focus on the more controversial instance: the deliberate targeted use of biomedicine to improve moral motivation and behaviour. We do this because the challenge of improving human morality is arguably the most important issue facing humankind (Persson and Savulescu, forthcoming). We will ask whether using the knowledge from the biological and cognitive sciences to influence motivation and behaviour erodes autonomy and, if so, whether this makes it wrong. (shrink)

Cognitive neuroenhancement involves the use of medical interventions to improve normal cognitive functioning such as memory, focus, concentration, or willpower. In this paper I give a Kantian argument defending the use of CNE in science, scholarly research, and creative fields. Kant’s universal law formulation of the categorical imperative shows why enhancement is morally wrong in the familiar contexts of sports or competitive games. This argument, however, does not apply to the use of CNE in higher education, scholarly or scientific research, (...) or creative endeavors such as visual art, fiction or poetry, or musical composition. This is because performance in these areas is embedded within practices that differ in morally significant ways from competitive practices. This important difference provides good reason to think that there is nothing morally wrong with the use of CNE in these areas. My approach is not simply to assume a full-fledged Kantian ethical theory and apply it straight away to the enhancement issue but to establish a reflective equilibrium between our moral intuitions, moral principles that support those intuitions, and the nature of the practices involved. (shrink)