Vojin Rakic

The effective collection and management of personal data of rapidly migrating populations is important for ensuring adequate healthcare and monitoring of a displaced peoples’ health status. With developments in ICT data sharing capabilities, electronic personal health records (ePHRs) are increasingly replacing less transportable paper records. ePHRs offer further advantages of improving accuracy and completeness of information and seem tailored for rapidly displaced and mobile populations. Various emerging initiatives in Europe are seeking to develop migrant‐centric ePHR responses. This paper highlights their importance and benefits, but also identifies a number of significant ethical, legal and social issues (ELSI) and challenges to their design and implementation, regarding (1) the kind of information that should be stored, (2) who should have access to information, and (3) potential misuse of information. These challenges need to be urgently addressed to make possible the beneficial use of ePHRs for vulnerable migrants in Europe.

An ‘Information Centre’ has recently been established by law which has the power to collect, collate and provide access to the medical information forall patients treated by the National Health Service in England, whether in hospitals or by General Practitioners. This so-called ‘care.data’ scheme has given rise to major and ongoing controversies. We will sketch the background of the scheme and look at the responses it has elicited from citizens and medical professionals. In Autumn 2013, NHS England set up a care.data website where citizens could record their concerns regarding the collection of health-related data by the Information Centre. We have reviewed all the comments on this website up until June 2015. We have also analysed the readers’ comments on the coverage of the care.data scheme in one of the main national UK newspapers. When discussing the responses of citizens, we will make a distinction between the problems that citizens detect and the solutions they propose. The solutions that are being perceived as the most relevant ones can be summarized as follows: citizens wish to further the common good without being manipulated into doing it, while at the same time being safeguarded against various abuses. The issue of trust turns out to figure prominently. Our analysis of reactions to the scheme in no way pretends to be exhaustive, yet it provides various relevant insights into the concerns identified by citizens as well as medical professionals. These concerns, moreover, have a more general relevance in relation to other contexts of medical data-mining as well as biobank research. Our analysis also offers important pointers as to how those concerns might be addressed.

This book deals with good, evil, happiness and morally enhanced post-humans. It offers a succinct historical elaboration of philosophical stances towards morality and happiness, focusing on Kant's ideas in particular. Human augmented ethical maturity in a futuristic version of Kant’s Ethical Commonwealth implies, among else, voluntary moral bio-enhancement ; consequently, more happiness – as morality and happiness are in a circularly supportive relationship; ultimate morality. UM is in its own way a universal morality. In line with the contention that Kant’s vision of the future of humanity is one of a cosmopolitan moral order in which humans act virtuously in the broadest possible community, that is, humanity, it is justified to conclude that successful VMBE is conducive to Kant’s vision. In this context the book is of great interest to a broad audience, such as those interested in VMBE and novel conceptions of morality, and those with an interest in the historical development of morality and happiness, in philosophy and in post-humanity.

This book offers an innovative approach to moral enhancement. We, as humans, have a moral duty to be as good as we can be. Hence, moral bio-enhancement, if effective and safe, is our moral duty. However, it has to be voluntary because if it is made compulsory, human freedom would be curtailed. As freedom is an essential component of humanness, compulsory MBE would infringe upon our humanness. An essential question is; what will motivate humans to subject themselves voluntarily to MBE?The book argues - and supports by using empirical/experimental evidence - that morality and happiness operate in a circularly supportive relationship that applies to most humans most of the time: the better they are, the happier they will be; the happier they are, the better they will be. Hence, the grounding rationale for MBE ought not to be the prevention of “ultimate harm” based on compulsory MBE, but human happiness based on voluntary MBE. The primary objective of the book is to provide the readers with an original view on moral enhancement, whilst proposing a novel conception of moral enhancement that is informed by new biotechnological developments.

The paper represents an empirical study of public attitudes towards moral bioenhancement. Moral bioenhancement implies the improvement of moral dispositions, i.e. an increase in the moral value of the actions or character of a moral agent. The views of bioethicists and scientists on this topic are present in the ongoing debate, but not the view of the public in general. In order to bridge the gap between the philosophical debate and the view of the public, we have examined attitudes towards moral bioenhancement. The participants were people from Serbia older than 15, who voluntarily completed an online questionnaire. The questionnaire consisted of a brief introduction to moral bioenhancement, seven general questions, 25 statements about participants’ attitudes towards moral bioenhancement, and five examples of moral dilemmas. The questionnaire also included questions which were used to reveal their preference of either deontology, or utilitarianism. Participants were asked to what degree they agree or disagree with the statements. The results showed that the means used to achieve moral enhancement, the level of education, and preference for deontology or utilitarianism do have an impact on public attitudes. Using exploratory factor analysis, we isolated four factors that appear to drive the respondents' attitudes toward moral bioenhancement, we named: general—closeness, fear of change, security, and voluntariness. Each factor in relationship to other variables offers new insights that can inform policies and give us a deeper understanding of the public attitudes. We argue that looking into different facets of attitudes towards moral bioenhancement improves the debate, and expands it.

Various kinds of human bioenhancement represent a major topic of contention in both bioethics and futures studies. Moral enhancement is one of them. It will be argued that voluntary moral bio-enhancement should be based on an opt out moral enhancement scheme. Such a scheme would avoid the challenges of a voluntary moral enhancement opt in scheme. The former has a proper place in a minimal state. It will be explained why such a state can be called Utopia. The concept of voluntary opt out moral enhancement in Utopia will be highlighted in detail.

We outline an argument favoring voluntary moral bioenhancement as a response to existential risks humanity exposes itself to. We consider this type of enhancement a solution to the antithesis between the extinction of humanity and the imperative of humanity to survive at any cost. By opting for voluntary moral bioenhancement; we refrain from advocating illiberal or even totalitarian strategies that would allegedly help humanity preserve itself. We argue that such strategies; by encroaching upon the freedom of individuals; already inflict a degree of existential harm on human beings. We also give some pointers as to the desirable direction for morally enhanced post-personhood.

Rakić has serious misgivings about Wiseman's inability to frame ethical issues in the context of transcending existing realities with the aim of achieving what we believe is morally right. This inability to think beyond the present is misguided in ethics. He also criticizes Wiseman for making the unimaginative and unsubstantiated assumption that moral bioenhancement technologies have reached their zenith already. Rakić argues that MBE will become more effective in the time to come, that it ought to be optional for every free individual, and that it should be directed at enhancing our motivation to act in line with how we believe we ought to act. He concedes however that the enhancement of our motivation to act morally can only be effective in a limited number of morally unambiguous cases. In response, Wiseman argues that Rakić's reflections epitomize a way of articulating MBE that is unhelpful, misguidedly optimistic, and missing the most important things needing discussion. Such reflections are based on inappropriate metaphors, a too future-oriented view detached from basic realities, and a false sense of what is possible on the global level should MBE be applied. Such ways of thinking about MBE are misguided from the outset, and indicative of the enthusiasm for a discourse in need of realignment. This should take the form of a more modest, synergistic outlook acutely aware of the inexorable limitations imposed on MBE by the internal complexity of moral goods, human agents, and the contexts in which moral action occurs.

:This article continues and expands differences I have with Ingmar Persson and Julian Savulescu concerning issues of moral bioenhancement and free will. They have criticized my conception of voluntary moral bioenhancement, claiming that it ignores the extent to which freedom is a matter of degree. Here, I argue that freedom as a political concept is indeed scalar in nature, but that freedom of the will is to be understood as a threshold concept and therefore not as subject to degree. Consequently, I contend, by asserting that freedom is a matter of degree, that Persson and Savulescu have not undermined my arguments favoring voluntary moral enhancement. In addition, I add three further arguments against compulsory moral bioenhancement.

It will be argued that humans have a rational self-interest in voluntarily opting to subject themselves to moral bioenhancement. This interest is based on the fact that goodness appears to be conducive to happiness. Those who understand that will be more inclined to opt for safe and effective moral bioenhancement technologies that have the potential to augment our motivation to become better. The more people decide to follow this path, the likelier it is that states will adopt suitable policies that incentivize moral bioenhancement. Hence, goodness, happiness and state incentivized moral bioenhancement can operate in a circularly supportive fashion.

During the previous years, Harris Wiseman has devoted substantial attention to my stance on voluntary moral bioenhancement. He argued that he has been influenced by that position, but nonetheless criticized it. I haven’t replied to his criticisms yet and wish to do so now. One of the reasons is to avoid my position being misrepresented. By replying to Wiseman’s criticisms, I also wish to clarify those issues in my standpoint that might have given rise to some of the misinterpretations. With the same purpose in mind, I will demarcate my concept of voluntary moral bioenhancement from related standpoints, in particular from Persson and Savulescu’s notion of compulsory moral bioenhancement that, as I argued, diminishes our freedom. Furthermore, I will consider the possibility of adding another essential element to my position—one that I have not discussed in my earlier publications. It is designed to propose a novel explanation of why humans would be motivated to opt for voluntary moral bioenhancement if its outcome is not a lowering of the likelihood of “Ultimate Harm” or a milder form of self-destruction of humanity. This explanation will be based on the conception that an increase in happiness, rather than Ultimate Harm prevention, might be the grounding rationale for moral bioenhancement.

I discuss the argument of Persson and Savulescu that moral enhancement ought to accompany cognitive enhancement, as well as briefly addressing critiques of this argument, notably by John Harris. I argue that Harris, who believes that cognitive enhancement is largely sufficient for making us behave more morally, might be disposing too easily of the great quandary of our moral existence: the gap between what we do and what we believe is morally right to do. In that regard, Persson and Savulescu's position has the potential to offer more. However, I question Persson and Savulescu's proposal of compulsory moral enhancement, proposing the alternative of voluntary moral enhancement.

The question will be raised whether oxytocin can serve as an effective moral enhancer. Different types of moral enhancement will be addressed, one of them being compulsory moral enhancement. It will be argued that oxytocin cannot serve as an effective moral enhancer if its use is being made compulsory. Hence, compulsory administration of oxytocin does not result in genuine moral enhancement. In order to demonstrate this, a stipulation of the main potentially beneficial outcomes of using oxytocin as a moral enhancer will be offered, as well as a discussion of objections to the notion that oxytocin can be an effective moral enhancer. It will be concluded that mandatory administration of oxytocin is ineffective because of a combination of two reasons: mandatory administration of oxytocin renders moral reflection practically superfluous; without moral reflection the beneficial outcomes of the use of oxytocin do not outweigh its drawbacks to the degree that we could speak of effective moral enhancement.

I will discuss four major perspectives on cognitive enhancement and morality: 1) cognitive enhancement is morally impermissible because humans are not supposed to alter what God has ordained or nature has shaped; 2) cognitive enhancement is our moral duty, because a cognitively upgraded human is a better human; 3) cognitive enhancement is morally permissible only if it is preceded by moral enhancement; 4) cognitive enhancement is morally permissible only if it is a means to moral enhancement. I shall argue that the first three perspectives are less cogent than the fourth. The fourth perspective integrates cognitive and moral enhancement into one whole. I will denote it by E.