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Ethics of enhancement technology

Final Report Summary - ETHENTECH (Ethics of enhancement technology)

Executive Summary:

The FP7 project ETHENTECH that was run in 2009-2012 had as its main objective to take substantially further both the ethical evaluation and the public discussion of two important emerging fields of micro- and nanobiotechnology: neurological implants and the potential for human functional enhancement. In addition to moral investigations with the traditional tools of philosophical inquiry we have performed public deliberation exercises using two innovative procedures, convergence seminars and Democs games. The major ethical issues in current uses of neuroimplants were found to be:

• Safety issues.
• Risks of unwanted changes in personality.
• (Negative as well as positive) effects on human cultures and subcultures of new ways to achieve individual improvement.

Hypothetical future devices may give rise to additional ethical problems, such as privacy infringements, involuntary military use, a drift in our view of what it means to be a normal human being, and aggravation of social inequalities in the form of inequalities between people who can and cannot afford performance-enhancing implants.

A particularly interesting category of enhancements are moral enhancements, i.e. enhancements that lead to moral improvements in human behaviour. Non-technological moral enhancement through education is in principle uncontroversial, but moral enhancements by pharmacological or surgical means appears to be much more controversial. Strong arguments have been put forward against moral enhancement, such as risks of unintended side effects, undermining of human freedom, and diminished sense of personal responsibility on lack of adequate enhancement. On the other hand, if it could be shown that moral enhancement would make our societies more harmonious and solidaric and enable us to be happier and better connected to our fellow beings, then proposals for such enhancements would deserve serious consideration.

The use of unrealistic scenarios has made the discussion on enhancement much more polarized than it need have been. We have proposed a general framework that combines several argumentative techniques in assessing the realism and the policy relevance of claims of future technological developments.

It emerged clearly from our deliberative procedures that the therapeutic/enhancement distinction was essential for the moral judgments of the participants. However, there was considerable disagreement on where the limit should be drawn. In our view it is clear that this distinction cannot be determined once and for all by a group of experts. It is in fact socially negotiated, and it changes over time. What we need, therefore, is social mechanisms for continuously discussing where the line should be drawn and achieving a temporary consensus that may have to be adjusted in response to new developments. Such mechanisms are currently not in place.

The general public often frames ethical issues very differently from how specialists do. Three prominent features that distinguish lay ethics from professional ethics are: (a) less separation of factual issues from ethical issues, (b) no division between ethics and rationality, and (c) the use of a "free mixture" of deontological, utilitarian and virtue-ethical argumentation.

In our view it should not be taken for granted that the deductive and uni-theoretical approach of dominant traditions in academic ethics is superior to the approach of lay ethics that mixes patterns of thinking that professional ethicists often claim that we have to choose between. The conventional wisdom in moral philosophy is that ethical inquiry should consist in finding an eternally valid ethical theory from which answers to all ethical questions can be derived. An alternative view we have started to develop in this project sees ethics as obtained from a process of social innovation rather than a process of discovery. This alternative view is more consonant with the lay-ethical approach. It also has important implications for crucial issues concerning the position of ethics as a human enterprise: the role of ethical expertise will be more limited and that of laypeople reflecting ethically on new moral problems such as those arising with new technologies will become more important.

Judging by our studies of Christian theological approaches to enhancement, there are reasons to believe that in the European context, religious views on enhancement will largely be sceptical. Such views will be based on the idea of the human body as something given than it may be deeply wrong to change in fundamental ways.

Laypeople’s ethical reflections on future technologies are currently largely theory-less since the dominant frameworks and models in moral theory do not ascribe much of a role to them. We have taken some steps in the direction of developing theoretical support for lay ethics in the areas of neuroimplants and human enhancement. In particular, we have done this by proposing a new view on the proper relationship between ethical and rationality considerations and by developing a virtue ethical approach to human enhancement that does justice to the considerations that laypeople tend to consider to be crucial in discussions of human enhancement.

Project Context and Objectives:

The main objective of this ETHENTECH project was to take substantially further forward both the ethical evaluation and public discussion of two important emerging fields of micro- and nanobiotechnology which pose very significant ethical and societal issues of public concern: neurological implants and the potential for human functional enhancement. Neural implants are a major new class of medical devices, which create an interface between nerve tissues and nano- or micro-scale probes. The aim is to enable a patient’s nervous system to communicate with new devices that replace or supplement a malfunctioning organ, for example to restore hearing or eyesight or to treat degenerative disorders such as Parkinson’s disease. Human functional enhancement technology refers to a wide range of converging technologies which have the potential to enable significant modification of the systems of the human body beyond what might be seen as medical purposes.

Both fields were recently cited by the European Group on Ethics in Sciences and New Technologies (EGE) as requiring European guidelines. They constitute important challenges about potential dual use (i.e. for differing purposes which may be considered either desirable or undesirable) and currently lack an adequate ethical framework. They were also identified in the scoping study on nanobioethics in the FP6 Nano2Life European Network of Excellence, the FP6 NanoBio- RAISE expert working group on human enhancement and in the joint horizon scanning workshops held by these two programmes.

The EGE highlighted these two areas in its Opinion 21 on nanomedicine to require ethical further study and to need guidelines because of a blurring of the distinction between medical and non-medical uses.

ETHENTECH tackled both the above specific subjects and these more underlying issues by focused research involving a combination of expert ethical analysis and reflection, and public engagement activities. The combination allowed an important cross-comparison between lay public and expert perspectives, respectively by empirical and normative methodologies. It resulted in policy-relevant conclusions concerning the ethical and societal impact of the future development and use of neural-implants, in particular on their use for non-therapeutic purposes, and of related areas of human enhancement. In addition, the project has established two well-developed, thoroughly tested and dynamic models for participative discussion procedures for human implants and enhancement. These models can be used to facilitate the discussions and for framing the relevant ethical issues in neighbouring areas such as other applications of nanotechnologies, e.g. other new medical technologies with enhancement potentials (such as neuro-pharmaceuticals), surveillance technologies, new developments in biotechnology, new technologies with dual (military/civilian) use.

ETHENTECH has grown out of the co-operation of the partners in Nanobio-RAISE and from the work of the Ethical, Legal and Social Advisory Board (ELSA) of the EC Network of Excellence Nano2Life. The empirical work with publics used two deliberative models to enable the public discussions to deal with specifically framed questions, namely convergence seminars and Democs card games. Furthermore, a special cultural focus was put on religious ethical viewpoints.

The following lessons learned during the Nanobio-RAISE project have been instructive when designing ETHENTECH. Incorporating this knowledge and using it as a point of departure will greatly enhance the value and effectiveness of the current project.

1) The framework for discussions that emerges from academic approaches to ethics needs to be supplemented with other framings of the issues, including a focus on what we may call “lay ethics”, i.e. the ways in which lay people discuss ethics. In ETHENTECH we intend therefore to use both approaches, each of which has its particular strengths and weaknesses. While many of the issues in human enhancement remain relatively far off, some are already imminent. A process of deliberation with lay publics in Europe needs to begin, and experience in other fields indicates that such a process will take time.

2) To assist the European Commission to arrive at policy judgements, different viewpoints need to be taken into account, as part of a social process in Europe aimed at developing our capacity to deal ethically with the challenges posted by new technologies, such as neurological implants and human enhancement. The Nanobio-RAISE Working Group on human enhancement identified the religious dimension as especially important, but it has so far largely been absent in ethical discussion of these issues. It is important partly because the challenges posed to basic norms concerning the human person (for example, how far these are considered to be “given” and immutable, and how these might be adaptable) are deeply religious questions.

3) A third lesson confirmed from the seminars and other activities of the Nanobio-RAISE project is that general public do not frame ethical issues in the same way as specialists do. Whereas the specialist discourse focuses almost exclusively on very specific issues, the lay discussions tend to home in on more general technology-related concerns, such as whether nanotechnology will on balance be good or bad for humanity, or whether and how new technologies under early development should be subject to governmental regulation.

This is problematic since it means that publics engage with the issues in unspecific forms and it becomes difficult for them to uncover the particular ethical problems. To ensure that the discussions carried out in the convergence seminars are as productive and focused as possible, the groups will discuss specific applications rather than wider issues such as nanobiotechnologies in general. All the scenarios to be developed for use in ETHENTECH were thus intended to stimulate a discussion on the detailed topics we have identified above, rather than a more general discussion on nanobiotechnological developments.

Project Results:

This is summarized in the Final Report, Sections 2-5.

Potential Impact:

The overall impact of this project has been in addressing the societal and ethical issues that are likely to arise as a result of the development of nanotechnology in general and nanotechnological neuroimplants and human enhancement in particular. It has previously proven difficult to establish effective discussion models which can capture the relevant ethical and social aspects and risks to be addressed in emerging new technologies. Achieving this is necessary for the responsible development of new technologies. In part, the current state of affairs is a result of an insufficient focus on related areas such as biotechnology. There are many lessons to be learned by studying the development of, and public response to, biotechnology as well as other neighbouring fields and it is intended to incorporate this knowledge in our analysis. Drawing on the experiences from the European biotechnology debate we have contributed to enabling a quicker, pro-active and responsible response to the probable public, media and political concerns.

The project has brought together key players in the relevant fields including moral philosophy, nanotechnology, neuroimplant surgery, religious ethics, ethics of technology, implant ethics, bioethics, medical ethics and philosophy of risk. It is of great importance for the social validity and economic value of nanotechnology research sponsored by the European Commission that the areas selected do not raise deep conflicts because of violation of ethical and social standards and thereby risk of rejection by societies. It is quite clear that one such area is the modification and enhancement of the human body and its systems, for both medical and non-medical/lifestyle purposes. Given the sensitive nature of the topic it has been essential to create this broad intellectual base where different value perspectives are explored. As a result the outcome of ETHENTECH can contribute to policy development and procedures for responsible development of nanotechnology both within the EU and outside it.

To help frame the central ethical issues at hand two deliberative models have been introduced, one which is tailored to capture the broader issues and one the more detailed issues. Combining the two models will facilitate and encourage the dialogue between the general public and specialists both on a national as well as an EU level. By bringing out the concerns of lay-people as well as religious ethicists the models will assist in articulating consensus and absence of consensus between the various stakeholders involved in the process. The differences in opinion and ethical concerns between the lay-people and those of the professional ethicists have been systematised and methodological conclusions drawn. The lessons learned in ETHENTECH will subsequently serve as recommendations for future research, policy actions, deliberative processes and procedures and co-operative research processes on the European arena in the years to come.

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