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 (...) that a Kantian conception of autonomy is more effective in addressing these issues, as it specifies the key features that inform an intelligible account of moral worth and moral law. A consideration of these features is typically lacking in the arguments advanced by contenders in these debates. Guided by a Kantian framework, I argue that moral bioenhancement projects directed at affecting moral autonomy are not as promising as they appear, for both metaphysical and empirical reasons. (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)

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.

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 (...) for autonomous agency, and analyzing how the latter can be protected from threats posed by the use of cognitive artifacts, I argue that autonomous agency is essentially tied to conscious experience and intentionality, which in turn can only be attributed to the human part of any extended cognitive system. I present both theoretical (conceptual) and practical arguments against recognizing the entire extended system, composed of one human and an artifact, as an autonomous agent. (shrink)

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 (...) declines. In this paper, we discuss the predominant challenges of the space environment for human health and argue that development and deployment of a human enhancement policy, initially confined to astronauts – for the purpose of future human space programmes is a rational solution to these challenges. (shrink)

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 (...) enhancement could be at odds with the child's future autonomy. I will argue that these objections are ill-founded. Moreover, I will present other arguments that show that reprogenetic technologies can enhance the autonomy of future children. Autonomy enhancement is a plausible and pro tanto desirable application of emerging reprogenetic technologies. (shrink)

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 (...) medicine inasmuch as they improve the capabilities that enable the freedom to pursue personal well-being. (shrink)

The ethics of human enhancement has been a hotly debated topic in the last 15 years. In this debate, some advocate examining science fiction stories to elucidate the ethical issues regarding the current phenomenon of human enhancement. Stories from science fiction seem well suited to analyze biomedical advances, providing some possible case studies. Of particular interest is the work of screenwriter Andrew Niccol (Gattaca, S1m0ne, In Time, and Good Kill), which often focuses on ethical questions raised by the use of (...) new technologies. Examining the movie In Time (2011), the aim of this paper is to show how science fiction can contribute to the ethical debate of human enhancement. In Time provides an interesting case study to explore what could be some of the consequences of radical life-extension technologies. In this paper, we will show how arguments regarding radical life-extension portrayed in this particular movie differ from what is found in the scientific literature. We will see how In Time gives flesh to arguments defending or rejecting radical life-extension. It articulates feelings of unease, alienation and boredom associated with this possibility. Finally, this article will conclude that science fiction movies in general, and In Time in particular, are a valuable resource for a broad and comprehensive debate about our coming future. (shrink)

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 (...) impulsivity can serve to undermine an agent’s autonomy. I then explain that we are already able to reduce impulsivity through the use of pharmacological interventions, as is evidenced by the use of Methylphenidate in the treatment of ADHD. (shrink)

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 (...) provide a deeper discussion of the role of cognition and reasoning abilities in philosophical concepts of autonomy, as discussed in the mentioned paper. In doing so, we wish to demonstrate that using reasoning abilities as the common denominator in different accounts of autonomy in the context of enhancement does not do justice to the highly complex interrelations between cognition, reasoning abilities and autonomy. Neither should this way of arguing be accepted as a basis to call for practical outcomes, such as funding research into e. g. genetic cognitive enhancements, if the examined concepts of autonomy are taken seriously. (shrink)

Volume 19, Issue 7, July 2019, Page 34-36.

“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 (...) is aligned with traditional theories that conceive autonomy in terms of an individual’s capacities for, and exercises of rational reflection. However, at the same time, this paper extends these accounts by arguing that autonomy is, in part, embodied. Specifically, by drawing on phenomenological conceptions of the experience of autonomy, we argue that, in principle, the body is a necessary component of the capacity for autonomy. Secondly, through the presentation of two different cases, we highlight ways in which a patient’s body can contribute to the autonomy of treatment choices. Ultimately, we hope to encourage others to explore additional conditions under which a concept of embodied autonomy should be employed in medical decision making, how its underlying principles might be operationalised in clinical situations, and its consequences for approaches to patient autonomy in healthcare practice, policy, and law. (shrink)

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 (...) in order to identify and explain its implications for our current understanding of the principle of respect for patient autonomy and the norms of clinical decision making. (shrink)

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 (...) problems that arise when the courts and health care practitioners respond to the vulnerability of capacitous adults on the basis of such an opposition. It will be shown that not only does the common law approach to vulnerability fail to adequately capture the autonomy of capacitous vulnerable adults, the conception of vulnerability and autonomy in oppositional terms leads to objectionably paternalistic health care responses that undermine the autonomy of vulnerable patients as well as clinical and legal interventions that violate their autonomy. In response, the second aim of this paper is to show that the concepts of autonomy and vulnerability are necessarily entwined and, on that basis, the focus should be on promoting the autonomy of capacitous vulnerable adults where possible. In order to make this case, the paper explains the limitations of standard approaches to the autonomy of vulnerable adults and, in their place, offers a conception of legitimate, self-authorised autonomy that is fundamentally dependent on intersubjective practices of recognition. (shrink)

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 (...) a more complete understanding of autonomy and its relation to cognitive enhancement. By drawing a distinction between the capacity for autonomy and the exercise and achievement of autonomy and by exploring the possible effects of cognitive enhancement on both competence and authenticity conditions for autonomy, the paper identifies and explains which dimensions of autonomy can and cannot, in principle, be enhanced via direct cognitive interventions. This allows us to draw conclusions regarding the limits of cognitive enhancement as a means for enhancing autonomy. (shrink)

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, (...) the content of rational, hence autonomous, choices is quite restricted. Further, advocates do not clearly indicate their relative emphasis between the often conflicting goals of maximizing benefit and avoiding harm. In practice, their construction of harms is highly expansive, for disabilities include any constraints that “rational” people would decline if it were technically possible to do so. For advocates, this means that where enhancement measures are available, those constraints become avoidable limitations, and not to remove them is to harm. The centrality of harm-avoidance and their ideal utilitarian frame entail sociopolitical requirements that enhancement defenders disallow when trumpeting autonomy in the vein of individual choice. Advocates have thus not done enough to support the claim that their views are wholly separate from earlier eugenics. (shrink)

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.

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 (...) offenders in our sentencing practices would amount to: that it involves not interfering with offenders’ capacities for rationality and autonomy, that it should not undermine offenders’ prospect of reform, and that it amounts to treating offenders as if opaque. I then critically discuss whether any of these accounts plausibly imply that mandating neurointerventions to some offenders is necessarily morally wrong. I argue that they do not. (shrink)

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, (...) at least sometimes, oblige trial-incompetent defendants to receive competency-restoring treatments. The paper then discusses whether three prominent arguments (and their variations) offered by legal scholars against using non-consensual treatment to restore trial competence provide grounds for thinking there to be a general moral prohibition against these treatments. I argue that they do not. (shrink)

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 (...) of, I then critically discuss variations of four plausible arguments against a proposal of using them on cognitive gifted offenders related to autonomy, harm, narrative identity, and a right to mental self-determination. I argue that none of these concerns should have us reject the use of cognitive diminishments. (shrink)

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 (...) value-neutral in respect of patient decision-making both by its proponents and in statute. A straightforward evaluative model of capacity assessment which wears its values on its sleeves and is biased against what are called ‘serious prudential mistakes’ avoids these rational and practical problems. (shrink)

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 (...) proper moral reasoning, prudence, and whether proposed methods of moral bioenhancement could facilitate the cultivation of this virtue within the psyches of moral agents. I conclude that certain means of bioenhancement may serve to augment the ability to reason prudentially and assist moral agents to align their wills with their higher-order rational desires, though such means require those higher-order desires to already have been formulated independently. (shrink)

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 (...) the possibility to desire and carry out these bad actions is an essential ingredient of free will, which would thus be limited or destroyed—or so the argument goes. In this paper we offer an answer to this criticism. We contend that a morally enhanced agent could lose the ‘freedom to fall’ without losing her freedom for two reasons. First, because we do not consider that a morally well-educated person, for whom the ‘freedom to fall’ is a remote option, is less free than an evildoer, and there is no reason to suppose that bioenhancement introduces a significant difference here. Second, because richness in the amount of alternative possibilities of action may be restored if the stated loss is compensated with an improvement in sensitivity and lucidity that can lead to seeing new options and nuances in the remaining possible actions. (shrink)

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 (...) of view of free action, which I call bypassing views, this paper evaluates how such interventions may negatively impact the freedom of their subjects. The paper concludes that there will be a tension between the goals of rehabilitation and reduction of recidivism, on the one hand, and the negative impact such interventions may have on free action, on the other. Other things equal, the better that a particular intervention is at achieving the former, the more likely it is to result in the latter. (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)

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)

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 (...) genetic enhancement. First, I argue that CROF is not in contrast with every kind of enhancement. I subsequently discuss whether CROF requires some moral obligations to enhance progeny. My argument is that parents do not have the moral obligation to open as many options as possible for their children. Rather, they should provide them with a reasonable range of opportunities. Finally, I contend that the moral obligations required by CROF are directly dependent on what Allen Buchanan calls the ‘dominant cooperative framework’ in a given society. I conclude by claiming that, at present, parents are not morally obliged to genetically enhance their children since a non-enhanced person already might have access to a reasonable range of opportunities. However, the moral obligation to enhance progeny might arise if a structural modification of the dominant cooperative framework occurs. (shrink)

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 (...) the ethics of cognitive enhancement through the lenses of political and philosophical arguments about autonomy and freedom. In so doing, we contend that a substantive, relational account of individual autonomy offers a more holistic understanding of the ethical concerns of cognitive enhancement. (shrink)

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 (...) and synchronic, for what can be considered “normal” and “enhanced.” Radical transformation through technology does not simply enable us to become “stronger,” “smarter,” or “healthier,” but it can and often will also change the very standard or yardstick with which we measure what counts as “stronger,” “smarter,” or “healthier.” Put yet differently: new and emerging technologies are not neutral means but often bring about different and, from our current perspective, foreign standards for determining what are “normal” and “enhanced” capacities. Since the qualitative meanings of these terms are themselves not fixed, it is unintelligible and too reassuring to simply predict that new technologies will enhance human beings. (shrink)

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

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 (...) and autonomy as fundamentally opposed concepts or the failure to adequately acknowledge the conceptual relationship between them at common law. The second part of this aim is to draw upon developments in analytic feminist philosophy to illustrate how standard approaches to autonomy are ill-equipped to capture the autonomy issues of capacitous vulnerable adults when their decisions regarding care and treatment are at stake. The second (normative) aim is to develop an account of self-authorised, intersubjective autonomy on the basis of analytic feminist insights into the relational practices of recognition. This account not only attempts to capture the autonomy of capacitous vulnerable adults and account for the necessary harms to their autonomy that arise from standard common law responses to their situational vulnerability, it is also predicated on the distinctions between mental capacity, the satisfaction of conditions for informed consent and the exercise of autonomy, meaning that it is better placed to fulfil the primary aim of the inherent jurisdiction – to facilitate the autonomy of vulnerable adults with capacity. (shrink)

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 (...) credit or blame for them. For an agent to act of her own free will is for her to have had (reasonable) opportunity to exercise these capacities in making her decision and acting. There is a long philosophical tradition of treating free will as the set of capacities that, when properly functioning, allow us to make decisions that contribute to our leading a good or flourishing life. On this view, free will is a psychological accomplishment. Free will allows us to be the causal source of our actions in a way that is compatible with determinism and naturalism. (shrink)