The Moral Self and Moral Duties

J. Everett, J. Skorburg, and J. Savulescu
PsyArXiv
Created on 6 Jan 20

Abstract

Recent research has begun treating the perennial philosophical question, “what makes a person the same over time?” as an empirical question. A long tradition in philosophy holds that psychological continuity and connectedness of memories are at the heart of personal identity. More recent experimental work, following Strohminger & Nichols (2014), has suggested that persistence of moral character, more than memories, is perceived as essential for personal identity. While there is a growing body of evidence supporting these findings, a critique by Starmans & Bloom (2018) suggests that this research program conflates personal identity with mere similarity. To address this criticism, we explore how loss of someone’s morality or memories influence perceptions of identity change, and perceptions of moral duties towards the target of the change. We present participants with a classic ‘body switch’ thought experiment and after assessing perceptions of identity persistence, we present a moral dilemma, asking participants to imagine that one of the patients must die (Study 1) or be left alone in a care home for the rest of their life (Study 2). Our results highlight the importance of the continuity of moral character, suggesting lay intuitions are tracking (something like) personal identity, not just mere similarity.

The research is here.

Whither Bioethics Now?: The Promise of Relational Theory

Susan Sherwin and Katie Stockdale
International Journal of Feminist 
Approaches to Bioethics 10 (1): 7-29. 2017.

Abstract

This article reflects on the work of feminist bioethicists over the past ten years, reviewing how effective feminists have been in using relational theory to reorient bioethics and where we hope it will go from here. Feminist bioethicists have made significant achievements using relational theory to shape the notion of autonomy, bringing to light the relevance of patients' social circumstances and where they are situated within systems of privilege and oppression. But there is much work to be done to reorient bioethics so that it is capable of addressing some current public health challenges. We argue that relational theory holds promise for beginning this work.

Here is an excerpt:

One reason to think that it is important to see feminist relational theory as the shaping sensibility through which other normative concepts and ideals can be understood is that a relational lens enables us to see the ways in which the very possibility of solidarity can depend on whether social, political, and economic circumstances make possible the choices and actions that are constitutive of solidarity. For example, drawing upon feminist conceptions of relational personhood and autonomy, author Susan Sherwin (2012) points out that the choices and actions available to individuals are bound up with the choices and actions of agents at other levels of human organization, such as international bodies, corporations, social groups, and governments. Since moral responsibility is limited to what agents actually can choose and do, moral responsibilities across all levels of human organization are intertwined and thus also relational.

The article is here.

Ethical research — the long and bumpy road from shirked to shared

Sarah Franklin

Nature.com
Originally posted October 29, 2019

Here is an excerpt:

Beyond bewilderment

Just as the ramifications of the birth of modern biology were hard to delineate in the late nineteenth century, so there is a sense of ethical bewilderment today. The feeling of being overwhelmed is exacerbated by a lack of regulatory infrastructure or adequate policy precedents. Bioethics, once a beacon of principled pathways to policy, is increasingly lost, like Simba, in a sea of thundering wildebeest. Many of the ethical challenges arising from today’s turbocharged research culture involve rapidly evolving fields that are pursued by globally competitive projects and teams, spanning disparate national regulatory systems and cultural norms. The unknown unknowns grow by the day.

The bar for proper scrutiny has not so much been lowered as sawn to pieces: dispersed, area-specific ethical oversight now exists in a range of forms for every acronym from AI (artificial intelligence) to GM organisms. A single, Belmont-style umbrella no longer seems likely, or even feasible. Much basic science is privately funded and therefore secretive. And the mergers between machine learning and biological synthesis raise additional concerns. Instances of enduring and successful international regulation are rare. The stereotype of bureaucratic, box-ticking ethical compliance is no longer fit for purpose in a world of CRISPR twins, synthetic neurons and self-driving cars.

Bioethics evolves, as does any other branch of knowledge. The post-millennial trend has been to become more global, less canonical and more reflexive. The field no longer relies on philosophically derived mandates codified into textbook formulas. Instead, it functions as a dashboard of pragmatic instruments, and is less expert-driven, more interdisciplinary, less multipurpose and more bespoke. In the wake of the ‘turn to dialogue’ in science, bioethics often looks more like public engagement — and vice versa. Policymakers, polling companies and government quangos tasked with organizing ethical consultations on questions such as mitochondrial donation (‘three-parent embryos’, as the media would have it) now perform the evaluations formerly assigned to bioethicists.

The info is here.

Cryonics: Medicine, Or The Modern Mummy?

Patrick Lin

Forbes.com

Originally posted July 8, 2019

Here is an excerpt:

Meanwhile, others argued that death is a natural and necessary part of the circle of life.  Ecologically, keeping people around long past their “natural lives” may upset an already fragile balance, potentially exacerbating overpopulation, resource consumption, waste, and so on.

This is to suggest that cryonics isn’t just a difference in degree from, say, saving heart-attack victims, but it becomes a difference in kind.  It’s not an incremental improvement, as medicine makes in slowly raising average lifespans, but it's potentially a radical disruption with major systemic effects.

Culturally, Joseph Weizenbaum— who was a MIT computer science professor and creator of ELIZA—wrote, “Our death is the last service we can provide to the world:  Would we not go out of the way, the following generations would not need to re-create human culture.  Culture would become fixed, unchangeable and die.  And with the death of culture, humanity would also perish.”

Beyond external effects, the desire for more life may express bad character.  Wanting more than one’s fair share—of life or anything else—seems egotistical and expresses ingratitude for what we already have.  If not for death, we might not appreciate our time on earth.  We appreciate many things, such as beauty and flowers, not despite their impermanence but because of it.

The info is here.

An Ethical Obligation for Bioethicists to Utilize Social Media

Herron, PD
Hastings Cent Rep. 2019 Jan;49(1):39-40.
doi: 10.1002/hast.978.

Here is an excerpt:

Unfortunately, it appears that bioethicists are no better informed than other health professionals, policy experts, or (even) elected officials, and they are sometimes resistant to becoming informed. But bioethicists have a duty to develop our knowledge and usefulness with respect to social media; many of our skills can and should be adapted to this area. There is growing evidence of the power of social media to foster dissemination of misinformation. The harms associated with misinformation or “fake news” are not new threats. Historically, there have always been individuals or organized efforts to propagate false information or to deceive others. Social media and other technologies have provided the ability to rapidly and expansively share both information and misinformation. Bioethics serves society by offering guidance about ethical issues associated with advances in medicine, science, and technology. Much of the public’s conversation about and exposure to these emerging issues occurs online. If we bioethicists are not part of the mix, we risk yielding to alternative and less authoritative sources of information. Social media’s transformative impact has led some to view it as not just a personal tool but the equivalent to a public utility, which, as such, should be publicly regulated. Bioethicists can also play a significant part in this dialogue. But to do so, we need to engage with social media. We need to ensure that our understanding of social media is based on experiential use, not just abstract theory.

Bioethics has expanded over the past few decades, extending beyond the academy to include, for example, clinical ethics consultants and leadership positions in public affairs and public health policy. These varied roles bring weighty responsibilities and impose a need for critical reflection on how bioethicists can best serve the public interest in a way that reflects and is accountable to the public’s needs.

CRISPR in China: Why Did the Parents Give Consent?

Dena Davis
The Hastings Center
Originally posted December 7, 2018

The global scientific community has been unanimous in condemning Chinese scientist He Jiankui, who announced last week that he used the gene-editing technology called CRISPR to make permanent, heritable changes to the genes of two baby girls who were born this month in China. Criticism has focused on Dr. He’s violation of worldwide acknowledgement that CRISPR has not been proven to be safe and ready to use in humans. Because CRISPR edits the actual germline, there are safety implications not only for these two girls, but for their progeny. There is also fear, expressed by the American Society for Reproductive Medicine, that this one renegade scientist could spark a backlash that would result in overly restrictive regulation.

Largely missing from the discussion is whether the twins’ parents understood what was happening and the unproven nature of the technology.  Was the informed consent process adequate, and if so, why on earth would they have given their consent?

The info is here.

Debate ethics of embryo models from stem cells

Nicolas Rivron, Martin Pera, Janet Rossant, Alfonso Martinez Arias, and others
Nature
Originally posted December 12, 2018

Here are some excerpts:

Four questions

Future progress depends on addressing now the ethical and policy issues that could arise.

Ultimately, individual jurisdictions will need to formulate their own policies and regulations, reflecting their values and priorities. However, we urge funding bodies, along with scientific and medical societies, to start an international discussion as a first step. Bioethicists, scientists, clinicians, legal and regulatory specialists, patient advocates and other citizens could offer at least some consensus on an appropriate trajectory for the field.

Two outputs are needed. First, guidelines for researchers; second, a reliable source of information about the current state of the research, its possible trajectory, its potential medical benefits and the key ethical and policy issues it raises. Both guidelines and information should be disseminated to journalists, ethics committees, regulatory bodies and policymakers.

Four questions in particular need attention.

Should embryo models be treated legally and ethically as human embryos, now or in the future?

Which research applications involving human embryo models are ethically acceptable?

How far should attempts to develop an intact human embryo in a dish be allowed to proceed?

Does a modelled part of a human embryo have an ethical and legal status similar to that of a complete embryo?

The info is here.

An evaluative conservative case for biomedical enhancement

John Danaher
British Journal of Medical Ethics
Volume 42, 9 (2018)

Abstract

It is widely believed that a conservative moral outlook is opposed to biomedical forms of human enhancement. In this paper, I argue that this widespread belief is incorrect. Using Cohen's evaluative conservatism as my starting point, I argue that there are strong conservative reasons to prioritise the development of biomedical enhancements. In particular, I suggest that biomedical enhancement may be essential if we are to maintain our current evaluative equilibrium (ie, the set of values that undergird and permeate our current political, economic and personal lives) against the threats to that equilibrium posed by external, non-biomedical forms of enhancement. I defend this view against modest conservatives who insist that biomedical enhancements pose a greater risk to our current evaluative equilibrium, and against those who see no principled distinction between the forms of human enhancement.

Conclusion

In conclusion, despite the widespread belief that conservative moral principles are opposed to human enhancement, there are in fact strong reasons to think that human enhancement has conservative potential. This is because technological development does not take place in a vacuum. One cannot consider the effects of biomedical enhancement technology in isolation from other trends in technological progress. When this is done, it becomes apparent that AI, robotics and information technology are developing at a rapid pace and their widespread deployment could undermine much of our current evaluative equilibrium. Biomedical enhancement may be necessary, not merely desirable, if we are to maintain that equilibrium.

The info is here.

23andMe's Pharma Deals Have Been the Plan All Along

Megan Molteni
www.wired.com
Originally posted August 3, 2018

Here is an excerpt:

So last week’s announcement that one of the world’s biggest drugmakers, GlaxoSmithKline, is gaining exclusive rights to mine 23andMe’s customer data for drug targets should come as no surprise. (Neither should GSK’s $300 million investment in the company). 23andMe has been sharing insights gleaned from consented customer data with GSK and at least six other pharmaceutical and biotechnology firms for the past three and a half years. And offering access to customer information in the service of science has been 23andMe’s business plan all along, as WIRED noted when it first began covering the company more than a decade ago.

But some customers were still surprised and angry, unaware of what they had already signed (and spat) away. GSK will receive the same kind of data pharma partners have generally received—summary level statistics that 23andMe scientists gather from analyses on de-identified, aggregate customer information—though it will have four years of exclusive rights to run analyses to discover new drug targets. Supporting this kind of translational work is why some customers signed up in the first place. But it’s clear the days of blind trust in the optimistic altruism of technology companies are coming to a close.

“I think we’re just operating now in a much more untrusting environment,” says Megan Allyse, a health policy researcher at the Mayo Clinic who studies emerging genetic technologies. “It’s no longer enough for companies to promise to make people healthy through the power of big data.”

The info is here.

Double time limit for embryo research, say ethics experts

Science News
August 7, 2018

Currently, research on embryos is limited in many countries to a maximum period of 14 days after their fertilisation in the lab.

But ethicists Dr John Appleby of Lancaster University with Professor Dr Annelien Bredenoord of University Medical Center Utrecht believe the current limit is "no longer adequate for current scientific developments."

Dr Appleby and Professor Dr Bredenoord said: "The 14 day rule has been a very successful example of international science regulation, but it should not become a dogma in itself and it should be revisited when no longer fit to purpose."

Until recently, scientists have not been able to culture and sustain embryos in vitro as long as (or beyond) 14 days but this has now changed.

"There are both scientific and ethical reasons to extent the 14 day rule to for example 28 days. Extending the window for embryo research to 28 days would allow scientists to reveal a new in-depth chapter of knowledge about the developmental processes that take place in embryos."

The info is here.

Could Moral Enhancement Interventions be Medically Indicated?

Sarah Carter
Health Care Analysis
December 2017, Volume 25, Issue 4, pp 338–353

Abstract

This paper explores the position that moral enhancement interventions could be medically indicated (and so considered therapeutic) in cases where they provide a remedy for a lack of empathy, when such a deficit is considered pathological. In order to argue this claim, the question as to whether a deficit of empathy could be considered to be pathological is examined, taking into account the difficulty of defining illness and disorder generally, and especially in the case of mental health. Following this, Psychopathy and a fictionalised mental disorder (Moral Deficiency Disorder) are explored with a view to consider moral enhancement techniques as possible treatments for both conditions. At this juncture, having asserted and defended the position that moral enhancement interventions could, under certain circumstances, be considered medically indicated, this paper then goes on to briefly explore some of the consequences of this assertion. First, it is acknowledged that this broadening of diagnostic criteria in light of new interventions could fall foul of claims of medicalisation. It is then briefly noted that considering moral enhancement technologies to be akin to therapies in certain circumstances could lead to ethical and legal consequences and questions, such as those regarding regulation, access, and even consent.

The paper is here.

Breakthrough as scientists grow sheep embryos containing human cells

Nicola Davis
The Guardian
Originally published February 17, 2018

Growing human organs inside other animals has taken another step away from science-fiction, with researchers announcing they have grown sheep embryos containing human cells.

Scientists say growing human organs inside animals could not only increase supply, but also offer the possibility of genetically tailoring the organs to be compatible with the immune system of the patient receiving them, by using the patient’s own cells in the procedure, removing the possibility of rejection.

According to NHS Blood and Transplant, almost 460 people died in 2016 waiting for organs, while those who do receive transplants sometimes see organs rejected.

“Even today the best matched organs, except if they come from identical twins, don’t last very long because with time the immune system continuously is attacking them,” said Dr Pablo Ross from the University of California, Davis, who is part of the team working towards growing human organs in other species.

Ross added that if it does become possible to grow human organs inside other species, it might be that organ transplants become a possibility beyond critical conditions.

The information is here.

Humans 2.0: meet the entrepreneur who wants to put a chip in your brain

Zofia Niemtus
The Guardian
Originally posted December 14, 2017

Here are two exerpts:

The shape that this technology will take is still unknown. Johnson uses the term “brain chip”, but the developments taking place in neuroprosthesis are working towards less invasive procedures than opening up your skull and cramming a bit of hardware in; injectable sensors are one possibility.

It may sound far-fetched, but Johnson has a track record of getting things done. Within his first semester at university, he’d set up a profitable business selling mobile phones to fellow students. By age 30, he’d founded online payment company Braintree, which he sold six years later to PayPal for $800m. He used $100m of the proceeds to create Kernel in 2016 – it now employs more than 30 people.

(cut)

“And yet, the brain is everything we are, everything we do, and everything we aspire to be. It seemed obvious to me that the brain is both the most consequential variable in the world and also our biggest blind spot as a species. I decided that if the root problems of humanity begin in the human mind, let’s change our minds.”

The article is here.

Dangers of neglecting non-financial conflicts of interest in health and medicine

Wiersma M, Kerridge I, Lipworth W.
Journal of Medical Ethics 
Published Online First: 24 November 2017.
doi: 10.1136/medethics-2017-104530

Abstract

Non-financial interests, and the conflicts of interest that may result from them, are frequently overlooked in biomedicine. This is partly due to the complex and varied nature of these interests, and the limited evidence available regarding their prevalence and impact on biomedical research and clinical practice. We suggest that there are no meaningful conceptual distinctions, and few practical differences, between financial and non-financial conflicts of interest, and accordingly, that both require careful consideration. Further, a better understanding of the complexities of non-financial conflicts of interest, and their entanglement with financial conflicts of interest, may assist in the development of a more sophisticated approach to all forms of conflicts of interest.

The article is here.

Changing genetic privacy rules may adversely affect research participation

Hayley Peoples
Baylor College of Medicine Blogs
Originally posted May 26, 2017

Do you know your genetic information? Maybe you’ve taken a “23andMe” test because you were curious about your ancestry or health. Maybe it was part of a medical examination. Maybe, like me, you underwent testing and received results as part of a class in college.

Do you ever worry about what could happen if your information landed in the wrong hands?

If you do, you aren’t alone. We’ve previously written about legislation affecting genetic privacy and public resistance to global data sharing, and the dialog about growing genetic privacy concerns only continues.

Wired.com recently ran an interesting piece on the House Health Plan and its approach to pre-existing conditions. While much about how a final, Senate-approved Affordable Care Act repeal and replace plan will address pre-existing conditions is still speculation, it brings up an interesting question – with respect to genetic information, will changing rules about pre-existing conditions have a chilling effect on research participation?

The information is here.

Are There Non-human Persons? Are There Non-person Humans?

Glenn Cohen | TEDxCambridge
Published October 24, 2017



If we want to live a moral life, how should we treat animals or complex artificial intelligence? What kinds of rights should non-humans have? Harvard Law Professor and world-renowned bioethics expert Glenn Cohen shares how our current moral vocabulary may be leading us into fundamental errors and how to face the complex moral world around us. Glenn Cohen is one of the world’s leading experts on the intersection of bioethics and the law, as well as health law. He is an award-winning speaker and writer having authored more than 98 articles and chapters appearing in countless journals and gaining coverage on ABC, CNN, MSNBC, PBS, the New York Times and more. He recently finished his role as one of the project leads on the multi-million dollar Football Players Health Study at Harvard aimed at improving NFL player health.

Ray Kurzweil on Turing Tests, Brain Extenders, and AI Ethics

Nancy Kaszerman
Wired.com
Originally posted November 13, 2017

Here is an excerpt:

There has been a lot of focus on AI ethics, how to keep the technology safe, and it's kind of a polarized discussion like a lot of discussions nowadays. I've actually talked about both promise and peril for quite a long time. Technology is always going to be a double-edged sword. Fire kept us warm, cooked our food, and burned down our houses. These technologies are much more powerful. It's also a long discussion, but I think we should go through three phases, at least I did, in contemplating this. First is delight at the opportunity to overcome age-old afflictions: poverty, disease, and so on. Then alarm that these technologies can be destructive and cause even existential risks. And finally I think where we need to come out is an appreciation that we have a moral imperative to continue progress in these technologies because, despite the progress we've made—and that's a-whole-nother issue, people think things are getting worse but they're actually getting better—there's still a lot of human suffering to be overcome. It's only continued progress particularly in AI that's going to enable us to continue overcoming poverty and disease and environmental degradation while we attend to the peril.

And there's a good framework for doing that. Forty years ago, there were visionaries who saw both the promise and the peril of biotechnology, basically reprogramming biology away from disease and aging. So they held a conference called the Asilomar Conference at the conference center in Asilomar, and came up with ethical guidelines and strategies—how to keep these technologies safe. Now it's 40 years later. We are getting clinical impact of biotechnology. It's a trickle today, it'll be a flood over the next decade. The number of people who have been harmed either accidentally or intentionally by abuse of biotechnology so far has been zero. It's a good model for how to proceed.

The article is here.

Japanese doctor who exposed a drug too good to be true calls for morality and reforms

Tomoko Otake
Japan Times
Originally posted November 15, 2017

Here is an excerpt:

Kuwajima says the Diovan case is a sobering reminder that large-scale clinical trials published in top medical journals should not be blindly trusted, as they can be exploited by drugmakers rushing to sell their products before their patents run out.

“I worked at a research hospital and had opportunities to try new or premarket drugs on patients, so I knew from early on that Diovan and the same class of drugs called ARB wouldn’t work, especially for elderly patients,” Kuwajima recalled in a recent interview at Tokyo Metropolitan Geriatric Hospital, where he has retired from full-time practice but still sees patients two days a week. “I had a strong sense of crisis that hordes of elderly people — whose ranks were growing as the population grayed — would be prescribed a drug that didn’t work.”

Kuwajima said he immediately found the Diovan research suspicious because the results were just too good to be true. This was before Novartis admitted that it had paid five professors conducting studies at their universities a total of ¥1.1 billion in “research grants,” and even had Shirahashi, a Novartis employee purporting to be a university lecturer, help with statistical analyses for the papers.

The article is here.

Tiny human brain organoids implanted into rodents, triggering ethical concerns

Sharon Begley
STAT News
Originally posted November 6, 2017

Here is an excerpt:

He and his colleagues discussed the ethics of implanting human brain organoids into rats, including whether the animals might become too human. “Some of what people warn about is still science fiction,” he said. “Right now, the organoids are so crude we probably decrease” the rats’ brain function.

Ethicists argue that “not a problem now” doesn’t mean “never a problem.” One concern raised by the human brain organoid implants “is that functional integration [of the organoids] into the central nervous system of animals can in principle alter an animal’s behavior or needs,” said bioethicist Jonathan Kimmelman of McGill University in Montreal. “The task, then, is to carefully monitor if such alterations occur.” If the human implant gives an animal “increased sentience or mental capacities,” he added, it might suffer more.

Would it feel like a human trapped in a rodent’s body? Because both the Salk and Penn experiments used adult rodents, their brains were no longer developing, unlike the case if implants had been done with fetal rodent brains. “It’s hard to imagine how human-like cognitive capacities, like consciousness, could emerge under such circumstances,” Kimmelman said, referring to implants into an adult rodent brain. Chen agreed: He said his experiment “carries much less risk of creating animals with greater ‘brain power’ than normal” because the human organoid goes into “a specific region of already developed brain.”

The belief that consciousness is off the table is in fact the subject of debate. An organoid would need to be much more advanced than today’s to experience consciousness, said the Allen Institute’s Koch, including having dense neural connections, distinct layers, and other neuro-architecture. But if those and other advances occur, he said, “then the question is very germane: Does this piece of cortex feel something?” Asked whether brain organoids can achieve consciousness without sensory organs and other means of perceiving the world, Koch said it would experience something different than what people and other animals do: “It raises the question, what is it conscious of?”

The article is here.

Human Gene Editing Marches On

bioethics.net
Originally published October 6, 2017

Here is an excerpt:

In all three cases, the main biologic approach, and the main ethical issues, are the same.  The main differences were which genes were being edited, and how the embryos were obtained.

This prompted Nature to run an editorial to say that it is “time to take stock” of the ethics of this research.  Read the editorial here.  The key points:  This is important work that should be undertaken thoughtfully.  Accordingly, donors of any embryos or cells should be fully informed of the planned research.  Only as many embryos should be created as are necessary to do the research.  Work on embryos should be preceded by work on pluripotent, or “reprogrammed,” stem cells, and if questions can be fully answered by work with those cells, then it may not be necessary to repeat the studies on whole, intact human embryos, and if that is not necessary, perhaps it should not be done.  Finally, everything should be peer reviewed.

I agree that editing work in non-totipotent cells should be at all times favored over work on intact embryos, but if one holds that an embryo is a human being that should have the benefits of protections afforded human research subjects, then Nature’s ethical principles are rather thin, little more than an extension of animal use provisions for studies in which early humans are the raw materials for the development of new medical treatments.

The article is here.