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Tesink V, Douglas T, Forsberg L, Ligthart S, Meynen G. Right to mental integrity and neurotechnologies: implications of the extended mind thesis. JOURNAL OF MEDICAL ETHICS 2024; 50:656-663. [PMID: 38408854 PMCID: PMC11503137 DOI: 10.1136/jme-2023-109645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/14/2024] [Indexed: 02/28/2024]
Abstract
The possibility of neurotechnological interference with our brain and mind raises questions about the moral rights that would protect against the (mis)use of these technologies. One such moral right that has received recent attention is the right to mental integrity. Though the metaphysical boundaries of the mind are a matter of live debate, most defences of this moral right seem to assume an internalist (brain-based) view of the mind. In this article, we will examine what an extended account of the mind might imply for the right to mental integrity and the protection it provides against neurotechnologies. We argue that, on an extended account of the mind, the scope of the right to mental integrity would expand significantly, implying that neurotechnologies would no longer pose a uniquely serious threat to the right. In addition, some neurotechnologies may even be protected by the right to mental integrity, as the technologies would become part of the mind. We conclude that adopting an extended account of the mind has significant implications for the right to mental integrity in terms of its protective scope and capacity to protect against neurotechnologies, demonstrating that metaphysical assumptions about the mind play an important role in determining the moral protection provided by the right.
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Affiliation(s)
- Vera Tesink
- Department of Philosophy, Faculty of Humanities, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Thomas Douglas
- Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, UK
- Jesus College, University of Oxford, Oxford, UK
| | - Lisa Forsberg
- Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, UK
| | - Sjors Ligthart
- Department of Criminal Law, Tilburg University, Tilburg, Netherlands
- Willem Pompe Institute for Criminal Law and Criminology and UCALL, Utrecht University, Utrecht, Netherlands
| | - Gerben Meynen
- Department of Philosophy, Faculty of Humanities, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Willem Pompe Institute for Criminal Law and Criminology and UCALL, Utrecht University, Utrecht, Netherlands
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De Marco G, Simons J, Forsberg L, Douglas T. What makes a medical intervention invasive? JOURNAL OF MEDICAL ETHICS 2024; 50:226-233. [PMID: 37722810 DOI: 10.1136/jme-2023-109301] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/27/2023] [Indexed: 09/20/2023]
Abstract
The classification of medical interventions as either invasive or non-invasive is commonly regarded to be morally important. On the most commonly endorsed account of invasiveness, a medical intervention is invasive if and only if it involves either breaking the skin ('incision') or inserting an object into the body ('insertion'). Building on recent discussions of the concept of invasiveness, we show that this standard account fails to capture three aspects of existing usage of the concept of invasiveness in relation to medical interventions-namely, (1) usage implying that invasiveness comes in degrees, (2) that the invasiveness of an intervention can depend on the characteristics of the salient alternative interventions, and (3) that medical interventions can be invasive in non-physical ways. We then offer the beginnings of a revised account that, we argue, is able to capture a wider range of existing usage. Central to our account is a distinction between two properties: basic invasiveness and threshold invasiveness We end by assessing what the standard account gets right, and what more needs to be done to complete our schematic account.
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Affiliation(s)
- Gabriel De Marco
- Faculty of Philosophy, Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
| | - Jannieke Simons
- Julius Centre for Health Sciences and Primary Care, Department of Bioethics and Health Humanities, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Lisa Forsberg
- Faculty of Philosophy, Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
- Somerville College, University of Oxford, Oxford, UK
| | - Thomas Douglas
- Faculty of Philosophy, Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
- Jesus College, University of Oxford, Oxford, UK
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Douglas T. An Intuitive, Abductive Argument for a Right against Mental Interference. THE JOURNAL OF ETHICS 2024; 29:133-154. [PMID: 40051574 PMCID: PMC11880129 DOI: 10.1007/s10892-024-09476-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 02/07/2024] [Indexed: 03/09/2025]
Abstract
Several authors have recently claimed that we each possess a right against interference with our minds. However, it remains unclear how this claim is to be justified. I offer a novel argument in defence of it. The argument is intuitive-appealing centrally to intuitions regarding cases-and abductive-taking the form of an inference to the best explanation; I offer a series of cases involving intuitively wrongful interventions, argue that five somewhat promising attempts to account for the wrongfulness of these interventions leave some of this wrongfulness unexplained, and show that my proposed alternative explanation, which invokes a right against mental interference, can account for this residual wrongfulness.
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Affiliation(s)
- Thomas Douglas
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
- Jesus College, University of Oxford, Oxford, UK
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Goering S, Brown T, Klein E. Neurotechnology ethics and relational agency. PHILOSOPHY COMPASS 2021; 16:e12734. [PMID: 34531923 PMCID: PMC8443241 DOI: 10.1111/phc3.12734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Novel neurotechnologies, like deep brain stimulation and brain-computer interface, offer great hope for treating, curing, and preventing disease, but raise important questions about effects these devices may have on human identity, authenticity, and autonomy. After briefly assessing recent narrative work in these areas, we show that agency is a phenomenon key to all three goods and highlight the ways in which neural devices can help to draw attention to the relational nature of our agency. Drawing on insights from disability theory, we argue that neural devices provide a kind of agential assistance, similar to that provided by caregivers, family, and others. As such, users and devices participate in a kind of co-agency. We conclude by suggesting the need for developing relational agency-competencies-skills for reflecting on the influence of devices on agency, for adapting to novel circumstances ushered in by devices, and for incorporating the feedback of loved ones and others about device effects on agency.
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Affiliation(s)
- Sara Goering
- Department of Philosophy and Center for Neurotechnology, University of Washington, Seattle, Washington, USA
| | - Timothy Brown
- Department of Philosophy and Center for Neurotechnology, University of Washington, Seattle, Washington, USA
| | - Eran Klein
- Department of Philosophy and Center for Neurotechnology, University of Washington, Seattle, Washington, USA
- Department of Neurology, Oregon Health and Sciences University, Portland, Oregon, USA
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Coin A, Dubljević V. The Authenticity of Machine-Augmented Human Intelligence: Therapy, Enhancement, and the Extended Mind. NEUROETHICS-NETH 2020. [DOI: 10.1007/s12152-020-09453-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Douglas T, Forsberg L, Pugh J. Compulsory medical intervention versus external constraint in pandemic control. JOURNAL OF MEDICAL ETHICS 2020; 47:medethics-2020-106435. [PMID: 32820018 PMCID: PMC8639959 DOI: 10.1136/medethics-2020-106435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/30/2020] [Accepted: 07/12/2020] [Indexed: 05/27/2023]
Abstract
Would compulsory treatment or vaccination for COVID-19 be justified? In England, there would be significant legal barriers to it. However, we offer a conditional ethical argument in favour of allowing compulsory treatment and vaccination, drawing on an ethical comparison with external constraints-such as quarantine, isolation and 'lockdown'-that have already been authorised to control the pandemic in this jurisdiction. We argue that, if the permissive English approach to external constraints for COVID-19 has been justified, then there is a case for a similarly permissive approach to compulsory medical interventions.
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Affiliation(s)
- Thomas Douglas
- Oxford Uehiro Centre for Practical Ethics, Oxford University, Oxford, Oxfordshire, UK
- Jesus College, Oxford, Oxfordshire, UK
- Faculty of Philosophy, University of Oxford, Oxford, Oxfordshire, United Kingdom
| | - Lisa Forsberg
- Oxford Uehiro Centre for Practical Ethics, Oxford University, Oxford, Oxfordshire, UK
- Faculty of Law, Oxford University, Oxford, Oxfordshire, UK
- Somerville College, Oxford, Oxfordshire, UK
| | - Jonathan Pugh
- Oxford Uehiro Centre for Practical Ethics, Oxford University, Oxford, Oxfordshire, UK
- Faculty of Philosophy, University of Oxford, Oxford, Oxfordshire, United Kingdom
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Gilbert F, Cook M, O’Brien T, Illes J. Embodiment and Estrangement: Results from a First-in-Human "Intelligent BCI" Trial. SCIENCE AND ENGINEERING ETHICS 2019; 25:83-96. [PMID: 29129011 PMCID: PMC6418065 DOI: 10.1007/s11948-017-0001-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 10/31/2017] [Indexed: 05/21/2023]
Abstract
While new generations of implantable brain computer interface (BCI) devices are being developed, evidence in the literature about their impact on the patient experience is lagging. In this article, we address this knowledge gap by analysing data from the first-in-human clinical trial to study patients with implanted BCI advisory devices. We explored perceptions of self-change across six patients who volunteered to be implanted with artificially intelligent BCI devices. We used qualitative methodological tools grounded in phenomenology to conduct in-depth, semi-structured interviews. Results show that, on the one hand, BCIs can positively increase a sense of the self and control; on the other hand, they can induce radical distress, feelings of loss of control, and a rupture of patient identity. We conclude by offering suggestions for the proactive creation of preparedness protocols specific to intelligent-predictive and advisory-BCI technologies essential to prevent potential iatrogenic harms.
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Affiliation(s)
- F. Gilbert
- Centre for Sensorimotor Neural Engineering, Department of Philosophy, University of Washington, Seattle, WA USA
- National Core for Neuroethics, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC USA
- Australian Research Council DECRA Fellow, University of Tasmania, Hobart, Australia
| | - M. Cook
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
- Department of Neurology, St. Vincent’s Hospital, Melbourne, Australia
| | - T. O’Brien
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - J. Illes
- National Core for Neuroethics, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC USA
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Pham M, Goering S, Sample M, Huggins JE, Klein E. Asilomar survey: researcher perspectives on ethical principles and guidelines for BCI research. BRAIN-COMPUTER INTERFACES 2018. [DOI: 10.1080/2326263x.2018.1530010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Michelle Pham
- Department of Philosophy and Center for Neurotechnology, University of Washington, Seattle, WA, USA
| | - Sara Goering
- Department of Philosophy and Center for Neurotechnology, University of Washington, Seattle, WA, USA
| | - Matthew Sample
- Department of Philosophy and Center for Neurotechnology, University of Washington, Seattle, WA, USA
| | - Jane E. Huggins
- Department of Physical Medicine and Rehabilitation and Department of Biomedical Engineering and Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, USA
| | - Eran Klein
- Center for Sensorimotor Neural Engineering and Department of Philosophy, University of Washington, Seattle, WA, USA
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
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Lee J. Cochlear Implantation, Enhancements, Transhumanism and Posthumanism: Some Human Questions. SCIENCE AND ENGINEERING ETHICS 2016; 22:67-92. [PMID: 25962718 DOI: 10.1007/s11948-015-9640-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/09/2015] [Indexed: 05/28/2023]
Abstract
Biomedical engineering technologies such as brain-machine interfaces and neuroprosthetics are advancements which assist human beings in varied ways. There are exciting yet speculative visions of how the neurosciences and bioengineering may influence human nature. However, these could be preparing a possible pathway towards an enhanced and even posthuman future. This article seeks to investigate several ethical themes and wider questions of enhancement, transhumanism and posthumanism. Four themes of interest are: autonomy, identity, futures, and community. Three larger questions can be asked: will everyone be enhanced? Will we be "human" if we are not, one day, transhuman? Should we be enhanced or not? The article proceeds by concentrating on a widespread and sometimes controversial application: the cochlear implant, an auditory prosthesis implanted into Deaf patients. Cochlear implantation and its reception in both the deaf and hearing communities have a distinctive moral discourse, which can offer surprising insights. The paper begins with several points about the enhancement of human beings, transhumanism's reach beyond the human, and posthuman aspirations. Next it focuses on cochlear implants on two sides. Firstly, a shorter consideration of what technologies may do to humans in a transhumanist world. Secondly, a deeper analysis of cochlear implantation's unique socio-political movement, its ethical explanations and cultural experiences linked with pediatric cochlear implantation-and how those wary of being thrust towards posthumanism could marshal such ideas by analogy. As transhumanism approaches, the issues and questions merit continuing intense analysis.
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Affiliation(s)
- Joseph Lee
- Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
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Aparicio A. Immobilis in mobili: performing arts, BCI, and locked-in syndrome. BRAIN-COMPUTER INTERFACES 2015. [DOI: 10.1080/2326263x.2015.1100366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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12
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Clausen J. Bonding Brains to Machines: Ethical Implications of Electroceuticals for the Human Brain. NEUROETHICS-NETH 2013. [DOI: 10.1007/s12152-013-9186-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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