Thomas Douglas

In this chapter I examine how expected-value theory might inform responses to what I call the dual-use problem. I begin by defining that problem. I then outline a procedure, which invokes expected-value theory, for tackling it. I first illustrate the procedure with the aid of a simplified schematic example of a dual-use problem, and then describe how it might also guide responses to more complex real-world cases. I outline some attractive features of the procedure. Finally, I consider whether and how the procedure might be amended to accommodate various criticisms of it.

According to a number of influential views in penal theory, 1 one of the primary goals of the criminal justice system is to rehabilitate offenders. Rehabilitativemeasures are commonly included as a part of a criminal sentence. For example, in some jurisdictions judges may order violent offenders to attend anger management classes or to undergo cognitive behavioural therapy as a part of their sentences. In a limited number of cases, neurointerventions — interventions that exert a direct biological effect on the brain — have been used as aids to rehabilitation, typically being imposed as part of criminal sentences, separate treatment orders, or conditions of parole. Examples of such interventions include medications intended to attenuate addictive desires in substance-abusing offenders and agents intended to suppress libido in sex offenders.This chapter reviews some of the ethical issues raised by the use of neurointerventions as aids to rehabilitation.

Violence risk assessment tools are increasingly used within criminal justice and forensic psychiatry, however there is little relevant, reliable and unbiased data regarding their predictive accuracy. We argue that such data are needed to (i) prevent excessive reliance on risk assessment scores, (ii) allow matching of different risk assessment tools to different contexts of application, (iii) protect against problematic forms of discrimination and stigmatisation, and (iv) ensure that contentious demographic variables are not prematurely removed from risk assessment tools.

A central tenet of medical ethics holds that it is permissible to perform a medical intervention on a competent individual only if that individual has given informed consent to the intervention. However, in some circumstances it is tempting to say that the moral reason to obtain informed consent prior to administering a medical intervention is outweighed. For example, if an individual’s refusal to undergo a medical intervention would lead to the transmission of a dangerous infectious disease to other members of the community, one might claim that it would be morally permissible to administer the intervention even in the absence of consent. Indeed, as we shall discuss below, there are a number of examples of public health authorities implementing compulsory or coercive measures for the purposes of infectious disease control (IDC). The plausibility of the thought that non-consensual medical interventions might be justified when performed for the purpose of IDC raises the question of whether such interventions might permissibly be used to realize other public goods. In this article we focus on one possibility: whether it could be permissible to non-consensually impose certain interventions that alter brain states or processes through chemical or physical means on serious criminal offenders. We shall suggest that some such interventions might be permissible if they safely and effectively serve to facilitate the offender’s rehabilitation and thereby prevent criminal recidivism.

While geoengineering may counteract negative effects of anthropogenic climate change, it is clear that most geoengineering options could also have some harmful effects. Moreover, it is predicted that the benefits and harms of geoengineering will be distributed unevenly in different parts of the world and to future generations, which raises serious questions of justice. It has been suggested that a compensation scheme to redress geoengineering harms is needed for geoengineering to be ethically and politically acceptable. Discussions of compensation for geoengineering harms, however, sometimes presume geoengineering has presented new and unique challenges to compensation that cannot be readily accommodated by existing compensation practices. The most explicit formulation of this view was recently presented by Toby Svoboda and Peter J. Irvine, who argued that two forms of uncertainty in geoengineering — namely, ethical uncertainty and scientific uncertainty — make it immensely difficult to devise an ethically and politically satisfactory compensation scheme for geoengineering harms. In this paper, we argue against the view that geoengineering presents new and unique challenges relating to compensation. More specifically, we show that placing these challenges within the broader context of anthropogenic climate change reveals them to be less serious and less specific to geoengineering than some appear to believe.

This article presents a model for regulating cognitive enhancement devices. Recently, it has become very easy for individuals to purchase devices which directly modulate brain function. For example, transcranial direct current stimulators are increasingly being produced and marketed online as devices for cognitive enhancement. Despite posing risks in a similar way to medical devices, devices that do not make any therapeutic claims do not have to meet anything more than basic product safety standards. We present the case for extending existing medical device legislation to cover CEDs. Medical devices and CEDs operate by the same or similar mechanisms and pose the same or similar risks. This fact coupled with the arbitrariness of the line between treatment and enhancement count in favour of regulating these devices in the same way. In arguing for this regulatory model, the paper highlights potential challenges to its implementation, and suggests solutions.

It is commonly thought that when a patient is unable to make a treatment decision for herself, patient autonomy should be respected by consulting the views of a patient surrogate, normally either the next-of-kin or a person previously designated by the patient. On one view, the task of this surrogate is to make the treatment decision that the patient would have made if competent. But this so-called ‘substituted judgment standard’ (SJS) has come in for has come in for a good deal of criticism recently. For instance, some question whether surrogates are able to reliably predict what the patient would have chosen. Others wonder how respecting a patient's counter-factual, rather than actual, choices is supposed to respect her autonomy. Such concerns have lead some to reject the SJS and argue for alternative characterisations of the role of surrogate decision-makers.

It is plausible that we have moral reasons to become better at conforming to our moral reasons. However, it is not always clear what means to greater moral conformity we should adopt. John Harris has recently argued that we have reason to adopt traditional, deliberative means in preference to means that alter our affective or conative states directly—that is, without engaging our deliberative faculties. One of Harris’ concerns about direct means is that they would produce only a superficial kind of moral improvement. Though they might increase our moral conformity, there is some deeper kind of moral improvement that they would fail to produce, or would produce to a lesser degree than more traditional means. I consider whether this concern might be justified by appeal to the concept of moral worth. I assess three attempts to show that, even where they were equally effective at increasing one’s moral conformity, direct interventions would be less conducive to moral worth than typical deliberative alternatives. Each of these attempts is inspired by Kant’s views on moral worth. Each, I argue, fails

This chapter reviews recent philosophical and neuroethical literature on the morality of moral neuroenhancements. It first briefly outlines the main moral arguments that have been made concerning moral status neuroenhancements. These are neurointerventions that would augment the moral status of human persons. It then surveys recent debate regarding moral desirability neuroenhancements: neurointerventions that augment that the moral desirability of human character traits, motives or conduct. This debate has contested, among other claims (i) Ingmar Persson and Julian Savulescu’s contention that there is a moral imperative to pursue the development of moral desirability neuroenhancements, (ii) Thomas Douglas’ claim that voluntarily undergoing moral desirability neuroenhancements would often be morally permissible, and (iii) David DeGrazia’s claim that moral desirability neuroenhancements would often be morally desirable. The chapter discusses a number of concerns that have been raised regarding moral desirability neuroenhancements, including concerns that they would restrict freedom, would produce only a superficial kind of moral improvement, would rely on technologies that are liable to be misused, and would frequently misfire, resulting in moral deterioration rather than moral improvement.

Selection against embryos that are predisposed to develop disabilities is one of the less controversial uses of embryo selection technologies. Many bio-conservatives argue that while the use of ESTs to select for non-disease-related traits, such as height and eye-colour, should be banned, their use to avoid disease and disability should be permitted. Nevertheless, there remains significant opposition, particularly from the disability rights movement, to the use of ESTs to select against disability. In this article we examine whether and why the state could be justified in restricting the use of ESTs to select against disability. We first outline the challenge posed by proponents of ‘liberal eugenics’. Liberal eugenicists challenge those who defend restrictions on the use of ESTs to show why the use of these technologies would create a harm of the type and magnitude required to justify coercive measures. We argue that this challenge could be met by adverting to the risk of harms to future persons that would result from a loss of certain forms of cognitive diversity. We suggest that this risk establishes a pro tanto case for restricting selection against some disabilities, including dyslexia and Asperger's syndrome.

David DeGrazia tentatively defends what he calls the Interests Model of moral status (see page 135).1 On this model all sentient beings have the same moral status, though some are owed more than others in virtue of having more or stronger interests. The proponent of this model can accept, say, that one should normally save the life of a human in preference to that of a dog. But she denies that we should save the human because he has higher moral status. Instead, the human should be saved because he has more at stake—he may, for example, have a stronger interest in continued existence. In defending the Interests Model, DeGrazia cuts against the grain of recent theorising on moral status, which has instead favoured what he calls the Respect Model.

Opponents of biomedical enhancement often claim that, even if such enhancement would benefit the enhanced, it would harm others. But this objection looks unpersuasive when the enhancement in question is a moral enhancement — an enhancement that will expectably leave the enhanced person with morally better motives than she had previously. In this article I (1) describe one type of psychological alteration that would plausibly qualify as a moral enhancement, (2) argue that we will, in the medium-term future, probably be able to induce such alterations via biomedical intervention, and (3) defend future engagement in such moral enhancements against possible objections. My aim is to present this kind of moral enhancement as a counter-example to the view that biomedical enhancement is always morally impermissible.

The last 12 years have seen historically high levels of interest in biosecurity among life scientists, science policymakers, and academic experts on science and security policy. This interest was triggered by the 9/11 terrorist attacks, the ‘anthrax letters’ attack of the same year, and two virology papers, published early last decade, that were thought to raise serious biosecurity concerns.1 Ethicists have come relatively late to the game, but, in recent years, a lively debate has developed on ethical issues raised by biosecurity policy, and, more generally, on the ethics of producing and disseminating ‘dangerous’ biomedical knowledge. Unsurprisingly, this debate has taken on increased sense of urgency over the last 18 months as the journals Science and Nature, the United States National Science Advisory Board for Biosecurity, and the World Health Organization, among others, have been considering whether and how to publish two academic papers reporting means of enhancing the transmissibility of H5N1 influenza, or ‘bird flu’ .We hope that this issue of the Journal of Medical Ethics will substantially advance the emerging ethical debate in this area. The issue features five articles on the ethics of biosecurity: a feature article, by Allen Buchanan and Maureen Kelley ; three brief replies to this article, by Michael Selgelid , Thomas May , and Nicholas King ; and a stand-alone paper by Nicholas Evans , which discusses the recent H5N1 controversy and analyses the appeals to scientific freedom that have been made by some of its protagonists. In this ‘concise argument’, I can, regrettably, comment only on the Buchanan and Kelley piece.Buchanan and Kelley on the framing of the biosecurity debateBuchanan and Kelley aim to broaden and reframe the existing debate on biosecurity. They begin by noting that "science policy … "

One role of research ethics committees is to assess the ethics of proposed health research. In some countries, RECs are also instructed to assess its legality. However, in other countries they are explicitly instructed not to do so. In this paper, I defend the claim that public policy should instruct RECs not to assess the legality of proposed research . I initially defend a presumption in favour of the Claim, citing reasons for making research institutions solely responsible for assessing the legality of their own research. I then consider three arguments against the Claim which may over-ride this presumption—namely, that policy should instruct RECs to assess the legality of research because doing so would minimise the costs of assessing the legality of research, whether research is legal may partly determine whether it is ethical and whether research is legal may constitute evidence for whether it is ethical. I reject the first two arguments and note that whether the third succeeds depends on the answer to a more fundamental question about the appropriate nature of REC ethical deliberation. I end with a brief discussion of this question, tentatively concluding that the third argument also fails

Nicholas Agar argues, that enhancement technologies could be used to create post-persons—beings of higher moral status than ordinary persons—and that it would be wrong to create such beings.1 I am sympathetic to the first claim. However, I wish to take issue with the second.Agar's second claim is grounded on the prediction that the creation of post-persons would, with at least moderate probability, harm those who remain mere persons. The harm that Agar has in mind here is a kind of meta-harm: the harm of being made more susceptible to being permissibly harmed—more liable to harm. Agar suggests that, if post-persons existed, mere persons could frequently be permissibly sacrificed in order to provide benefits to the post-persons. For instance, perhaps they could be permissibly used in lethal medical experiments designed to develop medical treatments for post-persons. By contrast, he suggests that mere persons typically cannot be permissibly sacrificed to provide benefits to other mere persons. He thus claims that mere persons would be more liable to sacrifice if post-persons existed than they are in the absence of post-persons. The creation of post-persons would make them worse off in at least this one respect.Agar then argues that, since this meta-harm imposed on mere persons would not be compensated, it would be wrong to create post-persons. It is here that I believe his argument begins to go awry. According to the concept of compensation that Agar deploys , a harm imposed on X is compensated just in …

Existing debate on procreative selection focuses on the well-being of the future child. However, selection decisions can also have significant effects on the well-being of others. Moreover, these effects may run in opposing directions; some traits conducive to the well-being of the selected child may be harmful to others, whereas other traits that limit the child’s well-being may preserve or increase that of others. Prominent selection principles defended to date instruct parents to select a child, of the possible children they could have, likely to have a good (or nonbad) life, but they do not instruct parents to independently take the well-being of others into account. We refer to these principles as individualistic selection principles. We propose a new selection principle—Procreative Altruism—according to which parents have significant moral reason to select a child whose existence can be expected to contribute more to (or detract less from) the well-being of others than any alternative child they could have. We present the case for adopting Procreative Altruism alongside any of the major individualistic selection principles proposed to date and defend this two-principle model against a range of objections

Several authors have speculated that (1) the pharmaceutical, genetic or other technological enhancement of human mental capacities could result in the creation of beings with greater moral status than persons, and (2) the creation of such beings would harm ordinary, unenhanced humans, perhaps by reducing their immunity to permissible harm. These claims have been taken to ground moral objections to the unrestrained pursuit of human enhancement. In recent work, Allen Buchanan responds to these objections by questioning both (1) and (2). I argue that Buchanan’s response fails. However, I then outline an alternative response. This response starts from the thought that, though moral status-increasing human enhancements might render ordinary, unenhanced humans less immune to permissible harm, they need not worsen the overall distribution of this immunity across beings. In the course of the argument I explore the relation between mental capacity and moral status and between moral status and immunity to permissible harm

The prospect of using genome technologies to modify the human germline has raised profound moral disagreement but also emphasizes the need for wide-ranging discussion and a well-informed policy response. The Hinxton Group brought together scientists, ethicists, policymakers, and journal editors for an international, interdisciplinary meeting on this subject. This consensus statement formulated by the group calls for support of genome editing research and the development of a scientific roadmap for safety and efficacy; recognizes the ethical challenges involved in clinical reproductive applications of genome editing but, importantly, rejects the idea that human reproductive germline modification is necessarily morally unacceptable; and highlights the importance of meaningful engagement in discussions of genome editing and the development of regulation and oversight mechanisms to govern future uses of such technologies.

Reproductive genetic technologies allow parents to decide whether their future children will have or lack certain genetic predispositions. A popular model that has been proposed for regulating access to RGTs is the ‘genetic supermarket’. In the genetic supermarket, parents are free to make decisions about which genes to select for their children with little state interference. One possible consequence of the genetic supermarket is that collective action problems will arise: if rational individuals use the genetic supermarket in isolation from one another, this may have a negative effect on society as a whole, including future generations. In this article we argue that RGTs targeting height, innate immunity, and certain cognitive traits could lead to collective action problems. We then discuss whether this risk could in principle justify state intervention in the genetic supermarket. We argue that there is a plausible prima facie case for the view that such state intervention would be justified and respond to a number of arguments that might be adduced against that view

Robert Sparrow has recently raised the possibility that stem cell technology could in the future be used to create multiple generations of embryos in the laboratory before transferring one embryo to a woman’s womb to create a pregnancy. Sparrow argues that any children produced in this way would be genetic orphans—they would lack living genetic parents—and explores the possible moral implications of this. A number of other authors have raised objections to Sparrow’s moral claims, but his descriptive claim remains unchallenged. In this chapter, we challenge it, arguing that Sparrow’s imagined technology could be performed in such a way that the children produced would have living genetic parents.

Some argue that humans should enhance their moral capacities by adopting institutions that facilitate morally good motives and behaviour. I have defended a parallel claim: that we could permissibly use biomedical technologies to enhance our moral capacities, for example by attenuating certain counter-moral emotions. John Harris has recently responded to my argument by raising three concerns about the direct modulation of emotions as a means to moral enhancement. He argues that such means will be relatively ineffective in bringing about moral improvements, that direct modulation of emotions would invariably come at an unacceptable cost to our freedom, and that we might end up modulating emotions in ways that actually lead to moral decline. In this article I outline some counter-intuitive potential implications of Harris' claims. I then respond individually to his three concerns, arguing that they license only the very weak conclusion that moral enhancement via direct emotion modulation is sometimes impermissible. However I acknowledge that his third concern might, with further argument, be developed into a more troubling objection to such enhancements

In several jurisdictions, sex offenders may be offered chemical castration as an alternative to further incarceration. In some, agreement to chemical castration may be made a formal condition of parole or release. In others, refusal to undergo chemical castration can increase the likelihood of further incarceration though no formal link is made between the two. Offering chemical castration as an alternative to further incarceration is often said to be partially coercive, thus rendering the offender’s consent invalid. The dominant response to this objection has been to argue that any coercion present in such cases is compatible with valid consent. In this article, we take a different tack, arguing that, even if consent would not be valid, offering chemical castration will often be supported by the very considerations that underpin concerns about consent: considerations of autonomy. This is because offering chemical castration will often increase the offender’s autonomy, both at the time the offer is made and in the future

Comment on "The ethical 'elephant' in the death penalty 'room'". Arguments in defense of the death penalty typically fall into one of two groups. Consequentialist arguments point out beneficial aspects of capital punishment, normally focusing on deterrence, while non-consequentialist arguments seek to justify execution independently of its effects, for example, by appealing to the concept of retribution. Michael Keane's target article "The ethical 'elephant' in the death penalty 'room'" should, we believe, be read as an interesting new consequentialist defense of physician involvement in capital punishment.

:Many critics of bioenhancement go to considerable lengths to establish the existence of reasons against pursuing bioenhancements but do little to establish the absence of reasons in favor. This suggests that they accept what Allen Buchanan has called the conclusive reasons view. According to this view, our reasons against bioenhancement are obviously decisive, so there is no need to balance them against countervailing reasons. Buchanan criticizes the CRV by showing that the reasons most commonly adduced against bioenhancement are not decisive, or, at least, not obviously so.In this article, I suggest that both Buchanan and the authors to whom he is responding underestimate the strength of the case for the CRV. There are, I argue, harm-based reasons against bioenhancement that provide stronger support to the CRV than the reasons that have most often been adduced by critics of enhancement. However, I then argue that even these harm-based reasons are not obviously decisive. Thus, I ultimately agree with Buchanan about the falsity of the CRV, though I disagree with him about the reasons for its falsity.

Principles of procreative beneficence (PPBs) hold that parents have good reasons to select the child with the best life prospects. Sparrow (2010) claims that PPBs imply that we should select only female children, unlesswe attach normative significance to “normal” human capacities. We argue that this claim fails on both empirical and logical grounds. Empirically, Sparrow’s argument for greater female wellbeing rests on a selective reading of the evidence and the incorrect assumption that an advantage for females would persist even when a serious gender imbalance is obtained. Logically, PPBs cite only pro tanto reasons and allow that the good of an individual child could be outweighed by other morally relevant considerations, such as those which take collectively suboptimal outcomes into account. There is thus no need to attach value to the “normal.”

One prevalent type of slippery slope argument has the following form: (1) by doing some initial act now, we will bring it about that we subsequently do some more extreme version of this act, and (2) we should not bring it about that we do this further act, therefore (3) we should not do the initial act. Such arguments are frequently regarded as mistaken, often on the grounds that they rely on speculative or insufficiently strong empirical premises. In this article I point out another location at which these arguments may go wrong: I argue that, in their standard form, the truth of their empirical premises constitutes evidence for the falsity of their normative premises. If we will, as predicted, do the further act in the future, this gives us at least a prima facie reason to believe that the performance of this further act would be good, and thus something we should try to bring about. I end by briefly assessing the dialectic implications of my argument. I delineate a subset of slippery slope arguments against which my objection may be decisive, consider how the proponents of such arguments may evade my objection by adding further premises, and examine the likely plausibility of these additional premises.