Deep brain stimulation (DBS) has in some cases been associated with significant psychological effects and/or personality change. These effects occur sometimes as acute changes experienced intraoperatively or during the initial setting of the stimulator and sometimes as longer term progressive changes in the months following surgery. Sometimes they are the intended outcome of treatment, and in other cases they are an unintended side-effect. In all of these circumstances some patients and caregivers have described the psychological effects of DBS as frightening (...) or disconcerting. I trace the source of these negative reactions to the fear that stimulation-related psychological and personality changes represent a threat to personal identity and agency. This issue has implications both for philosophical theories of personal identity and agency and for clinical concerns. A narrative account of personal identity is developed to illuminate the nature of the threat to identity and agency DBS potentially poses, and to suggest steps that might be taken to mitigate and avoid these threats. (shrink)

Moral enhancement is a topic that has sparked much current interest in the world of bioethics. The possibility of making people ‘better,’ not just in the conventional enhancement sense of improving health and other desirable qualities and capacities, but by making them somehow more moral, more decent, altogether better people, has attracted attention from both advocates 1 2 and sceptics 3 alike. The concept of moral enhancement, however, is fraught with difficult questions, theoretical and practical. What does it actually mean (...) to be ‘more moral’? How would moral enhancement be defined and would it necessarily, as some have claimed, make the world a better or safer place? How would or could such enhancement be achieved safely and without undue constraint on personal liberty and autonomy? On this subject, a recent paper by Crockett et al 4 investigating the effects of the neurotransmitter serotonin on moral decision-making provides an intriguing scientific basis for examining what might or might not constitute moral enhancement. The study involved treatment with citalopram, a drug that increases the action of serotonin in the brain, and subsequent analysis of participants' decision-making behaviour in two different situations involving moral dilemmas: the well-known ‘Trolley Problem’ 5 and the ‘Ultimatum Game’. 6 The researchers found that citalopram promoted what they call ‘prosocial behaviour’, increasing the participants' aversion to causing direct harm to others: in the first scenario, they were less likely to select the option that required killing one in order to save five, and in the second, less likely to reject unfair offers at the expense of others. The Crockett study is fascinating both for its insight into human behaviour and because it appears to demonstrate that, at least on some accounts of moral behaviour, serotonin may in fact be a …. (shrink)

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

The neurosciences not only challenge assumptions about the mind’s place in the natural world but also urge us to reconsider its role in the normative world. Based on mind-brain dualism, the law affords only one-sided protection: it systematically protects bodies and brains, but only fragmentarily minds and mental states. The fundamental question, in what ways people may legitimately change mental states of others, is largely unexplored in legal thinking. With novel technologies to both intervene into minds and detect mental activity, (...) the law should, we suggest, introduce stand alone protection for the inner sphere of persons. We shall address some metaphysical questions concerning physical and mental harm and demonstrate gaps in current doctrines, especially in regard to manipulative interferences with decision-making processes. We then outline some reasons for the law to recognize a human right to mental liberty and propose elements of a novel criminal offence proscribing severe interventions into other minds. (shrink)

Direct brain intervention based mental capacity restoration techniques-for instance, psycho-active drugs-are sometimes used in criminal cases to promote the aims of justice. For instance, they might be used to restore a person's competence to stand trial in order to assess the degree of their responsibility for what they did, or to restore their competence for punishment so that we can hold them responsible for it. Some also suggest that such interventions might be used for therapy or reform in criminal legal (...) contexts-i.e. to make non-responsible and irresponsible people more responsible. However, I argue that such interventions may at least sometimes fail to promote these responsibility-related legal aims. This is because responsibility hinges on other factors than just what mental capacities a person has-in particular, it also hinges on such things as authenticity, personal identity, and mental capacity ownership-and some ways of restoring mental capacity may adversely affect these other factors. Put one way, my claim is that what might suffice for the restoration of competence need not necessarily suffice for the restoration of responsibility, or, put another way, that although responsibility indeed tracks mental capacity it may not always track restored mental capacities. (shrink)

We respond to a number of objections raised by John Harris in this journal to our argument that we should pursue genetic and other biological means of morally enhancing human beings (moral bioenhancement). We claim that human beings now have at their disposal means of wiping out life on Earth and that traditional methods of moral education are probably insufficient to achieve the moral enhancement required to ensure that this will not happen. Hence, we argue, moral bioenhancement should be sought (...) and applied. We argue that cognitive enhancement and technological progress raise acute problems because it is easier to harm than to benefit. We address objections to this argument. We also respond to objections that moral bioenhancement: (1) interferes with freedom; (2) cannot be made to target immoral dispositions precisely; (3) is redundant, since cognitive enhancement by itself suffices. (shrink)

In Beyond Humanity a leading philosopher offers a powerful and controversial exploration of urgent ethical issues concerning human enhancement.

This paper identifies human enhancement as one of the most significant areas of bioethical interest in the last twenty years. It discusses in more detail one area, namely moral enhancement, which is generating significant contemporary interest. The author argues that so far from being susceptible to new forms of high tech manipulation, either genetic, chemical, surgical or neurological, the only reliable methods of moral enhancement, either now or for the foreseeable future, are either those that have been in human and (...) animal use for millennia, namely socialization, education and parental supervision or those high tech methods that are general in their application. By that is meant those forms of cognitive enhancement that operate across a wide range of cognitive abilities and do not target specifically ‘ethical’ capacities. The paper analyses the work of some of the leading contemporary advocates of moral enhancement and finds that in so far as they identify moral qualities or moral emotions for enhancement they have little prospect of success. (shrink)

Opponents of biomedical enhancement often claim that, even if such enhancement would benefit the enhanced, it would harm others. But this objection looks unpersuasive when the enhancement in question is a moral enhancement — an enhancement that will expectably leave the enhanced person with morally better motives than she had previously. In this article I (1) describe one type of psychological alteration that would plausibly qualify as a moral enhancement, (2) argue that we will, in the medium-term future, probably be (...) able to induce such alterations via biomedical intervention, and (3) defend future engagement in such moral enhancements against possible objections. My aim is to present this kind of moral enhancement as a counter-example to the view that biomedical enhancement is always morally impermissible. (shrink)

As the President's Council on Bioethics emphasized in a recent report, rapid growth of biotechnologies creates increasingly many possibilities for enhancing human traits. This article addresses the claim that enhancement via biotechnology is inherently problematic for reasons pertaining to our identity. After clarifying the concept of enhancement, and providing a framework for understanding human identity, I examine the relationship between enhancement and identity. Then I investigate two identity-related challenges to biotechnological enhancements: (1) the charge of inauthenticity and (2) the charge (...) of violating inviolable core characteristics. My thesis is that a lucid, plausible understanding of human identity largely neutralizes these charges, liberating our thinking from some seductive yet unsound objections to enhancement via biotechnology. (shrink)

Marya Schechtman takes issue with analytic philosophy's emphasis on the first sort of question to the exclusion of the second.

Recently there has been some discussion concerning a particular type of enhancement, namely ‘moral enhancement’. However, there is no consensus on what precisely constitutes moral enhancement, and as a result the concept is used and defined in a wide variety of ways. In this article, we develop a clarificatory taxonomy of these definitions and we identify the criteria that are used to delineate the concept. We think that the current definitions can be distinguished from each other by the criteria used (...) for determining whether an intervention is indeed moral enhancement. For example, some definitions are broad and include moral enhancement by any means, while other definitions focus only on moral enhancement by means of specific types of intervention. Moreover, for some definitions it suffices for an intervention to be aimed or intended to morally enhance a person, while other definitions only refer to ‘moral enhancement’ in relation to interventions that are actually effective. For all these differences in definitions we discuss some of their implications. This shows that definitions are significantly less descriptive and more normative than they are regularly portrayed to be. We therefore hope that the taxonomy developed in this paper and the comments on the implications for the normative debate of the variety of definitions will provide conceptual clarity in a complex and highly interesting debate. (shrink)

In his ‘Moral Enhancement, Freedom, and What We Value in Moral Behaviour’,1 David DeGrazia sets out to defend moral bioenhancement from a number of critics, me prominently among them. Here he sets out his stall: "Many scholars doubt what I assert: that there is nothing inherently wrong with MB. Some doubt this on the basis of a conviction that there is something inherently wrong with biomedical enhancement technologies in general. Chief among their objections are the charges that biomedical enhancement is (...) unnatural, use of biomedical enhancements evinces an insufficient appreciation for human “giftedness”, and biomedical enhancements pose a threat to personal identity. Elsewhere I have attempted to neutralize these objections. Here I will address a set of concerns that are directed at MB in particular and appeal to the nature and value of human freedom."Let me make clear at once that I do not believe there is anything inherently wrong with MB. I have been an advocate for human enhancement for over 30 years writing four books defending such enhancements.2–⇓4 The most recent of these published in 2007 covers much the same ground as Allen Buchanan's 2011 book cited by DeGrazia,5 but, unlike Buchanan, I do not define enhancements in terms of the intention or the motivation of those who produce them but rather in terms of their effect. I must also make clear that, like DeGrazia, I have also, for a very long time, attempted to neutralise objections 1–3 listed in the above passage.2–⇓4DeGrazia introduces his critique of my approach like this: "I will construe Harris’ argument and similar arguments as directed entirely at motivation-based MB—though I will hereafter omit the qualifier, “motivation-based.” (Certainly, these arguments do not apply to embryo selection, which … ". (shrink)

Deep brain stimulation is a well-accepted treatment for movement disorders and is currently explored as a treatment option for various neurological and psychiatric disorders. Several case studies suggest that DBS may, in some patients, influence mental states critical to personality to such an extent that it affects an individual’s personal identity, i.e. the experience of psychological continuity, of persisting through time as the same person. Without questioning the usefulness of DBS as a treatment option for various serious and treatment refractory (...) conditions, the potential of disruptions of psychological continuity raises a number of ethical and legal questions. An important question is that of legal responsibility if DBS induced changes in a patient’s personality result in damage caused by undesirable or even deviant behavior. Disruptions in psychological continuity can in some cases also have an effect on an individual’s mental competence. This capacity is necessary in order to obtain informed consent to start, continue or stop treatment, and it is therefore not only important from an ethical point of view but also has legal consequences. Taking the existing literature and the Dutch legal system as a starting point, the present paper discusses the implications of DBS induced disruptions in psychological continuity for a patient’s responsibility for action and competence of decision and raises a number of questions that need further research. (shrink)

Neuroscience has dramatically increased understanding of how mental states and processes are realized by the brain, thus opening doors for treating the multitude of ways in which minds become dysfunctional. This book explores questions such as when is it permissible to alter a person's memories, influence personality traits or read minds? What can neuroscience tell us about free will, self-control, self-deception and the foundations of morality? The view of neuroethics offered here argues that many of our new powers to read (...) ,alter and control minds are not entirely unparalleled with older ones. They have, however, expanded to include almost all our social, political and ethical decisions. Written primarily for graduate students, this book will appeal to anyone with an interest in the more philosophical and ethical aspects of the neurosciences. (shrink)

Some argue that humans should enhance their moral capacities by adopting institutions that facilitate morally good motives and behaviour. I have defended a parallel claim: that we could permissibly use biomedical technologies to enhance our moral capacities, for example by attenuating certain counter-moral emotions. John Harris has recently responded to my argument by raising three concerns about the direct modulation of emotions as a means to moral enhancement. He argues that such means will be relatively ineffective in bringing about moral (...) improvements, that direct modulation of emotions would invariably come at an unacceptable cost to our freedom, and that we might end up modulating emotions in ways that actually lead to moral decline. In this article I outline some counter-intuitive potential implications of Harris' claims. I then respond individually to his three concerns, arguing that they license only the very weak conclusion that moral enhancement via direct emotion modulation is sometimes impermissible. However I acknowledge that his third concern might, with further argument, be developed into a more troubling objection to such enhancements. (shrink)

The transhumanist literature encompasses diverse nonnovel positions on questions of disability and obligation reflecting long-running political philosophical debates on freedom and value choice, complicated by the difficulty of projecting values to enhanced beings. These older questions take on a more concrete form given transhumanist uses of biotechnologies. This paper will contrast the views of Hughes and Sandberg on the obligations persons with "disabilities" have to enhance and suggest a new model. The paper will finish by introducing a distinction between the (...) responsibility society has in respect of the presence of impairments and the responsibility society has not to abandon disadvantaged members, concluding that questions of freedom and responsibility have renewed political importance in the context of enhancement technologies. (shrink)

Can advances in neuroscience be harnessed to enhance human moral capacities? And if so, should they? De Grazia explores these questions in ‘Moral Enhancement, Freedom, and What We Value in Moral Behaviour’.1 Here, I offer a neuroscientist's perspective on the state of the art of moral bioenhancement, and highlight some of the practical challenges facing the development of moral bioenhancement technologies.The science of moral bioenhancement is in its infancy. Laboratory studies of human morality usually employ highly simplified models aimed at (...) measuring just one facet of a cognitive process that is relevant for morality. These studies have certainly deepened our understanding of the nature of moral behaviour, but it is important to avoid overstating the conclusions of any single study. De Grazia cites several purported examples of ‘non-traditional means of moral enhancement’, including one of my own studies. According to De Grazia, we showed that ‘selective serotonin reuptake inhibitors as a means to being less inclined to assault people’. In fact, our findings are a bit more subtle and nuanced than implied in the target article, as is often the case in neuroscientific studies of complex human behaviour. In our study, we tested the effects of the selective serotonin reuptake …. (shrink)

It is not the purpose of this article to evaluate the techno-scientific claims of the transhumanists. Instead, I question seriously the nature of the ethics and morals they claim can, or soon will, be manipulated artificially. I argue that while the possibility to manipulate human behavior via emotional processes exists, the question still remains concerning the content of morality. In other words, neural moral enhancement does not capture the fullness of human moral psychology, which includes moral capacity and moral content. (...) In this article, I revisit the debate between Hume and Kant concerning the role of emotions and reason in moral philosophy. I do so with reference to the work of philosopher Alasdair McIntyre. His moral philosophy has long stood as an essential text in virtue ethics, which constitutes the basis for my critique of the promise to engineer virtues (what I call “neural moral enhancement”). First, I outline three specific shifts that occurred in the history of Western moral philosophy in order to contextualize current debates on the nature of morality/moral agency. Second, I summarize MacIntyre's critique of contemporary moral philosophy and show its relevance to an assessment of neural moral enhancement. Finally I argue that moral neuroenhancement is a one-dimensional conceptualization of moral agency that does not reflect the fullness of human moral psychology. It envisions a world in which individual moral capacities will be enhanced and controlled but says nothing about the nature of the morality. (shrink)

Personal identity has been the focus of philosophical and ethical debate for centuries. During the last decades, dif erent techniques for intervening in the brain, and hence our mind, are being developed and rei ned. Neuromodulation techniques, such as direct stimulation of the brain via implanted electrodes , target the brain’s capacity for reorganization to exert their ef ects and might directly or indirectly inl uence our mental states. In this paper, we investigate whether the possibility of altering our personal (...) identity provides a valid argument against neuromodulation research and treatment for severe, treatment-refractory neurological or neuropsychiatric conditions. Since narrative rather than numerical identity is at stake when considering neuromodulation research and treatment, our paper focuses on narrative identity changes. We argue that arguments against this kind of research and treatment for neuropsychiatric conditions based upon the possibility of narrative identity changes are ethically unconvincing. (shrink)

Elizabeth Fenton has criticised an earlier article by the authors in which the claim was made that, by providing humankind with means of causing its destruction, the advance of science and technology has put it in a perilous condition that might take the development of genetic or biomedical techniques of moral enhancement to get out of. The development of these techniques would, however, require further scientific advances, thus forcing humanity deeper into the danger zone created by modern science. Fenton argues (...) that the benefits of scientific advances are undervalued. The authors believe that the argument rather relies upon attaching a special weight to even very slight risks of major catastrophes, and attempt to vindicate this weighting. (shrink)