Jan-Hendrik Heinrichs

Brain age prediction is a relatively new tool in neuro-medicine and the neurosciences. In research and clinical practice, it finds multiple use as a marker for biological age, for general health status of the brain and as an indicator for several brain-based disorders. Its utility in all these tasks depends on detecting outliers and thus failing to correctly predict chronological age. The indicative value of brain age prediction is generated by the gap between a brain’s chronological age and the predicted age, the brain age gap (BAG). This article shows how the clinical and research use of brain age prediction tacitly pathologizes the states that it is sensitive to. It will be argued that the tacit character of this transformation conceals the need for its explicit justification.

Artificial intelligence (AI) is a powerful tool for several healthcare tasks. AI tools are suited to optimize predictive models in medicine. Ethical debates about AI’s extension of the predictive power of medical models suggest a need to adapt core principles of medical ethics. This article demonstrates that a popular interpretation of the principle of justice in healthcare needs amendment given the effect of AI on decision-making. The procedural approach to justice, exemplified with Norman Daniels and James Sabin’saccountability for reasonablenessconception, needs amendment because, as research into algorithmic fairness shows, it is insufficiently sensitive to differential effects of seemingly just principles on different groups of people. The same line of research generates methods to quantify differential effects and make them amenable for correction. Thus, what is needed to improve the principle of justice is a combination of procedures for selecting just criteria and principles and the use of algorithmic tools to measure the real impact these criteria and principles have. In this article, the author shows that algorithmic tools do not merely raise issues of justice but can also be used in their mitigation by informing us about the real effects certain distributional principles and criteria would create.

Will brain imaging technology soon enable neuroscientists to read minds? We cannot answer this question without some understanding of the state of the art in neuroimaging. But neither can we answer this question without some understanding of the concept invoked by the term “mind reading.” This article is an attempt to develop such understanding. Our analysis proceeds in two stages. In the first stage, we provide a categorical explication of mind reading. The categorical explication articulates empirical conditions that must be satisfied if mind reading is to be achieved. In the second stage, we develop a metric for judging the proficiency of mind reading experiments. The conception of mind reading that emerges helps to reconcile folk psychological judgments about what mind reading must involve with the constraints imposed by empirical strategies for achieving it.

Who is responsible for the events and consequences caused by using artificially intelligent tools, and is there a gap between what human agents can be responsible for and what is being done using artificial intelligence? Both questions presuppose that the term ‘responsibility’ is a good tool for analysing the moral issues surrounding artificial intelligence. This article will draw this presupposition into doubt and show how reference to responsibility obscures the complexity of moral situations and moral agency, which can be analysed with a more differentiated toolset of moral terminology. It suggests that the impression of responsibility gaps only occurs if we gloss over the complexity of the moral situation in which artificial intelligent tools are employed and if—counterfactually—we ascribe them some kind of pseudo-agential status.

Neuroenhancement concerns the improvement of a person’s mental properties, abilities, and performance. The various techniques of neuroenhancement offer new opportunities of such improvement, but also come with substantive perils. Neuroenhancement thus involves significant normative challenges for individual persons as well as for society as a whole. This expert report provides a concise overview of the contemporary debate on neuroenhancement. It discusses the definition, techniques and targets of neuroenhancement and examines arguments for and against it at the level of individual persons, social interaction, and social policy.

Unterschiedlichste Anwendungsformen künstlicher Intelligenz bestimmen schon heute den Alltag vieler Menschen – von Einsatz von KI-Systeme in Finanzgeschäften über die Vergabe von Studienplätzen bis hin zur Steuerung von Pflegerobotern, Autos und Waffensystemen. Diese vielfältigen neuen Möglichkeiten und Visionen wecken einerseits Hoffnungen auf persönlichen und gesellschaftlichen Nutzen und Fortschritt; andererseits rufen sie aber auch Bedenken, Ängste und gelegentlich auch grundsätzliche Ablehnung hervor. Angesichts dieser Ambivalenz sind ethische Analysen gefordert, die ausloten, wie ein verantwortungsvoller Umgang mit KI gestaltet werden sollte. Der Band greift viele dieser Probleme auf und unterzieht sie einer eingehenden philosophischen Analyse. Die Auseinandersetzung ist nach klassischen Teilbereichen der Philosophie gegliedert, aus deren Perspektive heraus jeweils spezielle Teilaspekte oder einzelne Anwendungsformen von KI beleuchtet werden. Das Themenspektrum reicht entsprechend von Fragen der Handlungstheorie und Philosophie des Geistes über wissenschaftstheoretische Problemstellungen bis hin zu ethischen Fragen die beispielsweise den Einsatz von KI in der Medizin und im Wirtschafts- und Arbeitsleben betreffen. In Auseinandersetzung mit aktuellen Debatten werden eigenständige Positionen entwickelt.

This article investigates how human life is conceptualized in the design and use of digital assistants and how this conceptualization feeds back into the life really lived. It suggests that a specific way of conceptualizing human life — namely as a set of tasks to be optimized — is responsible for the much-criticized information hunger of these digital assistants. The data collection of digital assistants raises not just several issues of privacy, but also the potential for improving people’s degree of self-determination, because the optimization model of daily activity is genuinely suited to a certain mode of self-determination, namely the explicit and reflective setting, pursuing, and monitoring of goals. Furthermore, optimization systems’ need for generation and analysis of data overcomes one of the core weaknesses in human capacities for self-determination, namely problems with objective and quantitative self-assessment. It will be argued that critiques according to which digital assistants threaten to reduce their users’ autonomy tend to ignore that the risks to autonomy are derivative to potential gains in autonomy. These critiques are based on an overemphasis of a success conception of autonomy. Counter to this conception, being autonomous does not require a choice environment that exclusively supports a person’s “true” preferences, but the opportunity to engage with external influences, supportive as well as adverse. In conclusion, it will be argued that ethical evaluations of digital assistants should consider potential gains as well as potential risks for autonomy caused by the use of digital assistants.

Do biomedical interventions raise special moral concerns? A rising number of prominent authors claim that at least in the case of biomedical enhancement they do not. Treating biomedical enhancements different from non-biomedical ones, they claim, amounts to unjustified biomedical exceptionalism. This article vindicates the familiar thesis that biomedical enhancement raises specific concerns. Taking a close look at the argumentative strategy against biomedical exceptionalism and provides counterexamples showing that the biomedical mode of interventions raises concerns not relevant otherwise. In particular, biomedical interventions throughout raise concerns of informed consent, which only rarely turn up in comparable non-biomedical interventions.

In the debate about actions in virtual environments two interdependent types of question have been pondered: What is a person doing who acts in a virtual environment? Second, can virtual actions be evaluated morally? These questions have been discussed using examples from morally dubious computer games, which seem to revel in atrocities. The examples were introduced using the terminology of “virtual murder” “virtual rape” and “virtual pedophilia”. The terminological choice had a lasting impact on the debate, on the way action types are assigned and on how moral evaluation is supposed to be conducted. However, this terminology and its theoretical consequences, while sometimes resulting in correct results, lead to absurd results when applied across the board. It will be suggested that these absurd consequences can be avoided by a different answer to the question what people in virtual worlds are doing. Alleged virtual actions are first and foremost the creation and modification of data-structures and the resulting output in computer hardware. Such modifications of data structure and imagery can be performed with different intentions, purposes and styles, which will influence the type and moral evaluation of a user’s actions. This reinterpretation allows for a more complex analysis of the moral reasons for praiseworthiness or blameworthiness of actions in virtual environments. This analysis takes not just harm and effects on character into account but the peculiar ways in which speech acts can be morally wrong: e.g. agitatory, deceptive, bullshitting.

Der Beitrag widmet sich der Frage, welche Rolle Ausstiegsmöglichkeiten für die Bedingungen gelungener Lebensführung spielen: Gehört die Möglichkeit zu Ablehnung und Ausstieg zu den Bestandteilen oder gar auf den sich auch der Ausstieg aus Gruppen zurückführen lässt. Verzicht auf Partizipation umfasst dabei sowohl den Ausstieg aus Praktiken, an denen man bereits teilnimmt – also Exit im engeren Sinne, als auch die Verweigerung des Einstieges in Praktiken, an denen Teilnahme erwartet wird oder nur möglich ist. Es ist also eine umfassendere Kategorie als Exit. Im Beitrag wird gezeigt, warum die Möglichkeit des Verzichts auf die Teilnahme an konkreten sozialen Praktiken eine Bedingung des guten Lebens in einer Gesellschaft und gleichzeitig für diese Gesellschaft als Ganzes vorteilhaft ist.

Can an artificially intelligent tool be a part of a human’s extended mind? There are two opposing streams of thought in this regard. One of them can be identified as the externalist perspective in the philosophy of mind, which tries to explain complex states and processes of an individual as co-constituted by elements of the individual’s material and social environment. The other strand is normative and explanatory atomism which insists that what is to be explained and evaluated is the behaviour of individuals. In the present contribution, it is argued that counterintuitive results turn up once atomism tries to appropriate insights from psychological externalism and holism. These results are made visible by technological innovations, especially artificially intelligent systems, but they do not result from these innovations alone. They are rather implicit in situated cognition approaches which join both theoretical strands. This has repercussions for explanatory as well as ethical theorising based on situated cognition approaches. It is a fairly rare constellation that new technological options, namely artificial intelligence, raise doubts concerning a philosophical theory, namely extended mind theory.

This is the second paper in a three-part series on the state of the enhancement debate. We report current trends and give an overview of established positions in the field of neuroenhancement. Unlike a number of articles on the bioethics of enhancement, we try to highlight connections between the contemporary debate and established positions in philosophical ethics. This specific perspective inspired the breakdown of our three-part series into consequentialist, deontological and virtue-ethical arguments.

ZusammenfassungDie Frage nach der Gerechtigkeit im Gesundheitswesen wird aus der Perspektive einer allgemeinen Theorie der Gerechtigkeit betrachtet. Diese Theorie ist ein Befähigungsansatz, der zwischen 1) der Grundversorgung aller Bürger mit Grundbefähigungen, 2) einem gerechten Anteil an den Früchten gesellschaftlicher Kooperation und 3) individuell erstrebten Gütern und Leistungen differenziert. Die Anwendung dieser Theorie reagiert auf charakteristische Probleme der Allokation im Gesundheitssektor: den prinzipiell ungedeckten Bedarf, die mangelnde Zurechenbarkeit des Bedarfes und die asymmetrische Informationsstruktur zwischen Patienten und Leistungserbringern.

Diese Studie widmet sich der Grundfrage der Politischen Philosophie nach der richtigen Beschaffenheit der grundlegenden gesellschaftlichen und politischen Institutionen, ihre methodische Problemstellung besteht in der Verbindung von philosophischen und ökonomischen Theorieperspektiven. Das Buch vollzieht eine kritische Analyse der wichtigsten klassischen und modernen Ansätze dazu und überführt diese Kritik in einen konstruktiven Entwurf, der wesentlich auf die Theorie der Grundbefähigungen zurückgreift. Dieses auf Amartya Sen und Martha Nussbaum zurückgehende Konzept knüpft die Legitimation eines Staatswesens an die Bedingung, dass es jedem seiner Bürger ein bestimmtes Minimum an realen Lebensmöglichkeiten garantiert oder zumindest um dessen Garantierung bemüht ist. Die Hauptthese des Buches lässt sich so zusammenfassen, dass die Frage »Equality of what?« für den modernen Sozialstaat weder mit dem Konzept eines für alle garantierten Nutzenminimums noch mit dem Konzept eines für alle garantierten Mindesteinkommens beantwortet werden kann, sondern mit dem Konzept eines garantierten Minimums an Grundbefähigungen, d. h. an realen Lebensoptionen, über die ein Individuum verfügen kann.

Dieses Buch nimmt eine umfangreiche Erörterung des Willensbegriffs vor. Es beschreibt ausführlich die ideengeschichtlichen Entwicklungslinien verschiedener Willenskonzepte seit der Antike bis in die Gegenwart. Dabei liegt der Fokus darauf, ob eine Epoche überhaupt einen Willensbegriff hatte,und wozu sie ihn verwendete. Die Darstellung ist wesentlich einer systematischen Perspektive verpflichtet, die historische Entwicklungsstränge als Kontrastfolie nutzt, um gegenwärtige Willensansätze argumentativ zu diskutieren. Der ideengeschichtlich-systematische Überblick über verschiedene Willenskonzepte mündet in einer Präzisierung und Klärung, sowie letztlich einer Kritik der aktuellen Debatte um die Freiheit des Willens. Leitende Fragestellungen des Buches sind: Welche Funktionen und Stellungen nimmt der Begriff des ›Willens‹ – besonders in der Philosophie, Psychologie und den Neurowissenschaften – ein und wie verhalten sich diese Funktionen zur Alltagssprache in den lebensweltlichen Kontexten?

Dieses Buch untersucht die Art und Weise, wie wir zu gerechtfertigten moralischen Überzeugungen kommen. Moralische Überzeugungen werden in ähnlicher Weise gebildet und gerechtfertigt wie nicht-moralische. Daher können Erkenntnisse über epistemische Rechtfertigung auch helfen, ethische Rechtfertigung zu erklären. Ethische Rechtfertigung wird als der Versuch verstanden, in moralischen Fragen richtige Antworten zu finden, also moralische Erkenntnis zu gewinnen. Auf der Suche nach richtigen Antworten ist es in der Ethik wie in jeder anderen Disziplin am besten, sich zuverlässiger Verfahren zu bedienen. Mit dem Begriff eines zuverlässigen Verfahrens werden sowohl die axiomatisch-deduktiven Rechtfertigungsverfahren der rationalistischen Tradition als auch die induktiven, abduktiven und probabilistischen Gegenmodelle des Empirismus als gleichberechtigte Bestandteile ethischer Rechtfertigung behandelt. Welche Verfahren zuverlässig sind, lässt sich durch den Abgleich der Methodenapparate unterschiedlicher Disziplinen entscheiden. Exemplarisch werden einige Verfahren der rationalistischen wie auch der empiristischen Ethik auf Ihre Eignung als zuverlässige Verfahren evaluiert.

Das Buch bietet eine Gesamtdarstellung der noch relativ jungen Disziplin der Neuroethik. Es führt die derzeit separat geführten Diskussionen der forschungs- und medizinethisch ausgerichteten Ethik in den Neurowissenschaften mit der in professionellen und öffentlichen Diskussionen vernachlässigten alltäglichen Ethik des Umgangs mit Manipulationen des menschlichen Geistes jenseits von medizinischen und Forschungskontexten zusammen. Der Fokus liegt dabei auf den moralischen Implikationen der mechanischen Veränderung des menschlichen Geistes.

According to a prominent suggestion in the ethics of transcranial neurostimulation the effects of such devices can be treated as ethically on par with established, pre-neurotechnological alterations of the mind. This parity allegedly is supported by situated cognition theories showing how external devices can be part of a cognitive system. This article will evaluate this suggestion. It will reject the claim, that situated cognition theories support ethical parity. It will however point out another reason, why external carriers or modifications of the mental might come to be considered ethically on par with internal carriers. Section “Why Could There Be Ethical Parity between Neural Tissue and External Tools?” presents the ethical parity theses between external and internal carriers of the mind as well as neurotechnological alterations and established alterations. Section “Extended, Embodied, Embedded: Situated Cognition as a Relational Thesis” will elaborate the different situated cognition approaches and their relevance for ethics. It will evaluate, whether transcranial stimulation technologies are plausible candidates for situated cognition theses. Section “On the Ethical Relevance of Situated Cognition Theses” will discuss criteria for evaluating whether a cognitive tool is deeply embedded with a cognitive system and apply these criteria to transcranial brain stimulation technologies. Finally it will discuss the role diverse versions of situated cognition theory can play in the ethics of altering mental states, especially the ethics of transcranial brain stimulation technologies.

Enhancement, the improvement of mental capacities with psychoactive substances and technologies has stimulated one of the largest debates in contemporary bioethics. Surprisingly few participants in this debate take note of the tendentious legal status of psychoactive pharmaceuticals as the primary means of enhancement. Enhancement technologies and substances have measurable effects on specific measurable cognitive functions. A major issue of contention in the debate is how to evaluate these effects, i. e. which theory of value to use. It is contested whether the pleasures and achievements resulting from the use of enhancement can be counted as such or can be ignored or devaluate by calling them fraudulent or inauthentic. The alleged and real benefits of enhancement are not expected to be evenly distributed, nor is it always clear whether enhancement is a zero-sum game or has benefits even for the non-users. This results in a complex structure of risks and benefits for individuals and groups, which needs to be broken down in detail.

Current debates in neuroethics engage with extremely diverse technologies, for some of which it is a point of contention whether they should be a topic for neuroethics at all. In this article, I will evaluate extended mind theory’s claim of being able to define the scope of neuroethics’ domain as well as determining the extension of an individual’s mind via its so-called trust and glue criteria. I argue that a) extending the domain of neuroethics by this manoeuvre endangers the theoretical consistency of neuroethics and b) the current state of the trust and glue criteria can introduce a bias towards overstating the relevance which representational devices have in characterising the field of neuroethics as compared to other technologies which are clearly of neuroethical relevance. As a remedy, I suggest a modification of the trust and glue criteria and a broader conception of cognition.

Reliabilism suffers from a problem with long sequences of justifications. The theory of justification provided in process reliabilism allows for an implausibly large extension of ‘justified belief’. According to process reliabilist theory, it is possible that a justifying cognitive process has an arbitrarily low probability of being successful and a justified belief an arbitrarily low probability of being true. This result violates reliabilism’s aims as well as our ordinary standards of justification.

Non-invasive brain stimulation promises innovative experimental possibilities for psychology and neurosci- ence as well as new therapeutic and palliative measures in medicine. Because of its good risk–benefit ratio, non-invasiveness and reversibility as well as its low effort and cost it has good chances of becoming a wide- spread tool in science, medicine and even in lay use. While most issues in medical and research ethics such as informed consent, safety, and potential for misuse can be handled with manageable effort, the real promise of brain stimulation does raise one prominent moral worry: it may lay the foundation of reliable, precise and stable manipulations of the mind. This article addresses this worry and concludes that it is not the possibility of manipulation, but the shift in our understanding of our mind which stands in need of careful consideration.

ZusammenfassungDie Frage nach der Gerechtigkeit im Gesundheitswesen wird aus der Perspektive einer allgemeinen Theorie der Gerechtigkeit betrachtet. Diese Theorie ist ein Befähigungsansatz, der zwischen 1) der Grundversorgung aller Bürger mit Grundbefähigungen, 2) einem gerechten Anteil an den Früchten gesellschaftlicher Kooperation und 3) individuell erstrebten Gütern und Leistungen differenziert. Die Anwendung dieser Theorie reagiert auf charakteristische Probleme der Allokation im Gesundheitssektor: den prinzipiell ungedeckten Bedarf, die mangelnde Zurechenbarkeit des Bedarfes und die asymmetrische Informationsstruktur zwischen Patienten und Leistungserbringern.

Abstract   When new methods of generating information about individuals leave the confined space of research application the possibility of morally dubious application arises. The current propagation of neuroscientific diagnostics leads to new possibilities of misuse and accordingly new needs for the protection of individual privacy emerge. While most current privacy discussion focuses on sensationalist applications which aim/claim to gather information about psychological traits or even the content of thoughts, the more sober but much more realistic endeavour to gather health data from research or medical imaging studies is widely neglected. I will try to answer the question if and in how far data from neuroscientific imaging technologies require special protection. Two developments form the background of the ethical discussion: the increased diagnostic power of neuroimaging techniques and the wider distribution of this technology beyond specialized medical offices and clinics. The first development is likely to broaden the scope of data, which are considered relevant for health care and related decisions. The latter is likely to widen the scope of persons who might have access to diagnostic results without at the time taking the role of a doctor towards the person diagnosed. I will argue that neuroimaging data are currently primarily medical data and that the associated standards of consent and confidentiality are worth protecting. Even nonmedical applications of neuroimaging technology inherit too much of the diagnostic power for which they were originally invented, for it to be advisable to drop the accompanying consent and confidentiality requirements.