Browsing by Author "Dubljevic, Veljko"

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Open Access
Autonomy and justice in neuroethics of cognitive enhancement
(2014) Dubljevic, Veljko; Misselhorn, Catrin (Prof. Dr.)
A great number of existing, emerging and hypothetical technologies offers the possibility of neuroenhancement of human beings, promising (or threatening) to drastically change the lives of citizens. Among them are so called „smart drugs” - psychopharmacological interventions that allegedly boost brain power, and „neuroprosthesis“ - electromagnetic interventions in the brain in the form of interface with computers or even artificial means of augmenting cognition, new brain stimulation technologies that combat pain and control mental focus, and even highly sophisticated neuroimplants with special sensory input or electro-mechanical output. The debate on enhancement in neuroethics, the field of applied ethics analyzing the social, legal and ethical challenges of these technologies, had been sidetracked to a metaphysical argument about human nature. Most arguments against enhancement tend to concentrate on the issue of authenticity or what it means to live according to human nature. The pro-enhancement arguments are broadly utilitarian, and furthered by the claim that human brains are no more than tools among other tools of cognition, and even that human beings are “natural born cyborgs”. The issue of distributive justice has been evoked on both sides, although without specific content to the conception of justice that should be applied. The questions of what implications does neuroenhancement have for individual and especially to political autonomy are so far rather left unanswered. This dissertation conducts an in-depth case by case analysis of existing and emerging cognitive neuroenhancement technologies while extending and applying Rawls' concept of autonomy and conception of distributive justice, in order to formulate a distinct approach in neuroethics that would be political and not metaphysical. The primary objective of this research is to contribute toward answering the question: What public policies would be legitimate and effective in the context of use of cognitive enhancement drugs and devices by healthy adults in a democratic society? More specifically, the dissertation extends and applies Rawls's principles of justice and autonomy by confronting their normative requirement with contemporary empirical findings that might challenge or even undermine them. Then, sufficiently updated Rawlsian notions of autonomy and justice are used in a case-by-case analysis of existing pharmaceutical (Modafinil, Methylphenidate and Amphetamines) cognitive enhancement technologies. In the case-by-case analysis, by drawing on empirical findings on safety and efficacy, long term effects and prevalence, arguments for and against the use of a given technology are discussed and a corresponding policy approaches and models analyzed. The appropriate approach (discourage use) and model (economic disincentives model) are specified and further analyzed in the context of existing legal regulation (including international treaties) of stimulant drugs. The principles, approach and model are then also applied in a case-by-case analysis of existing electro-magnetic (transcranial magnetic stimulation and transcranial direct current stimulation) cognitive enhancement technologies. The differences between the regulatory framework in stimulant drugs and devices are analyzed, along with currently available evidence on safety and efficacy and danger profiles, before tentative conclusions about policy are made. The analysis of particular cases is then tested against general objections to a Rawlsian framework, and more specific objections to the Rawsian idea of public reason. Finally, concrete objections to the policy proposals and conclusions in specific cases of existing pharmacological and electro-magnetic cognitive enhancement technologies are reviewed and refuted.