Abstract
The prospects of neuro-enhancement have generated a large range of philosophical and ethical debates. The possibility of pediatric neuro-enhancement—using technology and pharmaceuticals to enhance children’s cognitive or emotive capacities—is particularly complicated for a number of reasons. One of the main reasons is that children (at least young children) are not autonomous and can therefore not possibly consent to any interventions. Nonetheless, parents can potentially make decisions to enhance the capacities of their children.
In this chapter I investigate ethical issues of pediatric neuro-enhancement and neuro-enhancement in elderly with diminishing autonomy. I argue that the similarities and differences between the philosophical and ethical questions that arise in the respective cases show how complicated neuro-enhancement in non-autonomous persons is. In particular, I look at three issues: (1) What kinds of autonomy are diminished or underdeveloped, and how does that affect the moral permissibility of neuro-enhancement? (2) What role does the concept of “an open future” play? (3) What does it mean to look out for “the best interest” of a child or a non-autonomous elderly person, and how does it translate to the permissibility of neuro-enhancement? I argue that the difference in how we conceptualize the non-autonomy of children and that of elderly affects the permissibility of neuro-enhancement. I conclude that, as long as we make sure that a person becomes autonomous enough to pursue her own autonomy as a condition and as an ideal, her best interests have been looked after in terms of autonomy.
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Notes
- 1.
Betzler (2015), arguing for the duty of parents to enhance their children’s “capacity for autonomy,” holds a similar position regarding what is to be enhanced. However, she takes a somewhat different approach, focusing on enhancing (while she is still a child) the child’s inherent ability to form virtues essential for autonomy (e.g., authenticity). This is an interesting angle on pediatric autonomy enhancement and is as far as I am concerned compatible with the approach I am putting forth in this chapter.
- 2.
In this paper I use dementia as an example of a condition that typically occurs in elderly populations and that diminishes a person’s autonomy.
- 3.
To be clear, I take it that these technologies are to be considered therapeutical and as such do not qualify as “enhancements.” This is of course debatable, as is the validity of the very distinction between therapy and enhancement itself. However, such matters cannot be discussed at length here.
- 4.
Note that the arguments at this point are to be read as depictions of lines of thought. As such, they are not airtight and do contain hidden premises, etc. For our purposes, however, they are sufficient.
- 5.
One may question some formulations regarding the normative permissibility of a given action in this example and examples on following pages (e.g., “it ought to be permissible”). The intention is to keep the arguments limited to statements that are normatively charged (ought) and that are made about hypothetical law and policy (permissible). Discussions about to what extent morally correct actions in general should be allowed according to law or policy, or what current legal and policy documents say about neuro-enhancement, can unfortunately not be had within the scope of this chapter.
- 6.
This could be an enhancement brought about by “overstimulation” using the treatment technology or by different means. The treatment that brings the elderly person back to an autonomous state is, at this point, not to be regarded as an enhancement.
- 7.
For a more elaborate discussion on authenticity and pediatric enhancement, see Betzler (2015).
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Acknowledgments
I would like to sincerely thank Saskia Nagel, Gregor Hörzer, the participants of the research week on pediatric neuro-enhancement in Osnabrück 2016, and two anonymous reviewers for extensive and deep feedback, discussions, and comments.
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Lyreskog, D.M. (2019). Neuro-enhancement at the Margins of Autonomy: In the Best Interest of Children and Elderly?. In: Nagel, S. (eds) Shaping Children. Advances in Neuroethics. Springer, Cham. https://doi.org/10.1007/978-3-030-10677-5_4
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