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What it means to be a medtech regulatory journalist
Published in Jack Wong, Raymond K. Y. Tong, Handbook of Medical Device Regulatory Affairs in Asia, 2018
If technology has changed so much in this timeframe, where will it lead to—buoyed by big data—over the next three decades? Where indeed? Aesthetic products—such as fillers and implants—are increasingly being regulated around the world as medical devices, and we are approaching a point where human enhancement devices—for example, some brain stimulation devices—are needing to be considered within the context of medical device rules. We are likely to have not only technological and regulatory issues ahead but some big ethical questions too. And all these matters will continue to pose a tough challenge to those involved.
Neuroprivacy and Cognitive Liberty
Published in L. Syd M Johnson, Karen S. Rommelfanger, The Routledge Handbook of Neuroethics, 2017
The debate over human enhancement centers on the value we put on “natural” processes, such as learning or behavioral reinforcement, and suspicions about bypassing them to directly modify brain function. Drawing on the body’s own resources or manipulating the external environment to effect change does not raise the same ethical concerns. Modifying brain functions with either psychopharmaceuticals or technologies such as brain–computer interfaces or brain stimulation is often suspect (Greely et al., 2008; Savulescu, 2009). What are the ethical implications of using a drug to alter personality or to improve normal human abilities or characteristics? What standards should exist? Will advances in psychopharmacology be used as forms of social control? Might this potentially contribute to a widening gap of social inequality, as only the wealthy can afford certain enhancements? Or, at the other extreme, might it encourage conformity of personality—would those who are a bit more irritable or irascible be encouraged or coerced to conform to a chemically induced standard of affect (Wolpe et al., 2007)?
Research
Published in Alastair V. Campbell, Bioethics, 2017
These constantly expanding possibilities for human enhancement can be divided into several categories: (1) physical enhancement (surgical or medical interventions which change both bodily appearance and physical capacities for strength, endurance and speed); (2) lifespan extension (drugs counteracting the physical and mental effects of aging, possibly enabling people to live for centuries rather than decades); (3) cognitive enhancement (increasing the mental capacities of attention, memory and possibly even reasoning power); (4) mood enhancement (reducing or eliminating altogether feelings of grief, shyness, low self-esteem and depression); and (5) moral enhancement (using drugs or genetic manipulation to make people more altruistic and less aggressive). At the extreme end of this quest for human perfectibility is the transhumanist movement, which looks towards a ‘posthuman’ future, when humans will have perfected their physical and mental abilities with the aid of nanotechnology and artificial intelligence, creating a perfectly engineered world of human contentment. (Some proponents of this view foresee an eternal survival of the individual, even after death of the body, through downloading one’s mind or personality onto a computer.)
Personhood, Welfare, and Enhancement
Published in The American Journal of Bioethics, 2022
As a first illustration of what I have in mind, consider one of the most straightforward forms of human enhancement: athletic enhancement. Who are athletes aiming to benefit when they choose performance-enhancing drugs? Themselves? Not if the athlete is a true Parfitian. A Parfitian athlete would be moved by the prospect of giving millions of sports fans a more enjoyable experience, or of giving more prize earnings to charity. Most athletes, of course, are not Parfitian. They report on motivations to obtain a “hero status” and financial gain without any further goal beyond their own benefit (see discussion in Desmond 2021, 38). Nonetheless, we could question here who precisely is intended to receive the future benefit from the athletic doping. Is it the future person—constituted of a rich interconnectedness of memories, values, experiences? Or, a socialized idealization of their future self that the athlete has constructed?
Human Germline Genome Editing: On the Nature of Our Reasons to Genome Edit
Published in The American Journal of Bioethics, 2022
It is, however, possible that improvements in the science of genome editing will increase its efficiency and thus decrease the risk of mosaicism in modified embryos (Davies 2019). Already, Ma, Marti-Gutierrez, Park, et al. (2017) have shown that co-injecting the sperm and CRISPR/Cas9 construct into the oocyte at the point of fertilization greatly reduces the percentage of the embryos produced that are mosaic. However, this experiment also suggested that introducing new genetic sequences into human embryos was more difficult than scientists had anticipated, with the embryos repairing the break introduced into the chromosome by the CRISPR/Cas9 construct using a maternal gene rather than the “repair” sequence carried by the construct as the researchers anticipated. If this proves to be the case, it may limit the potential of this technique for human enhancement in so far as enhancement may require introducing novel genes into the human genome. Whether it is the case or not, scientists will almost certainly have to check whether their genome editing has been successful by means of preimplantation genetic diagnosis before proceeding to implant a modified embryo into the womb of a woman. They will also need to check that the editing hasn’t produced “on-target” or “off-target” effects that might prevent the embryo from developing normally and/or be deleterious for the well-being of the person who would develop from the embryo (Adashi and Cohen 2020; Ormond et al. 2017). In all likelihood, then, genome editing embryos will involve modifying multiple embryos before choosing one or more to implant.
What Exactly “History Has Taught us”? Enhancing the Socio-Political Perspective in Neuroethics
Published in AJOB Neuroscience, 2022
Marcelo de Araujo, Murilo Vilaça
Varied perceptions of human enhancement technologies across the international landscape have another important implication for the use of a Rawlsian framework in neuroethics. Stringent regulation of new technologies in one country will not preclude its citizens from accessing human enhancement capabilities and services in countries with less stringent regulations. “Fertility tourism”, for instance, has become an important issue in bioethics, which suggests that, in time, “human enhancement tourism” might also emerge as a widespread practice. This entails questions of social justice at both domestic and international level, as human enhancement technologies might aggravate social inequality within and among countries. Whether or not the application of the Rawlsian framework to the international arena, as advanced by Rawls himself in his 1999 book The Law of People, would enable Dubljević and colleagues to address this issue successfully is unclear.