Abstract
There is a remedy available for many of our ailments: Psychopharmacology promises to alleviate unsatisfying memory, bad moods, and low self-esteem. Bioethicists have long discussed the ethical implications of enhancement interventions. However, they have not considered relevant evidence from psychology and economics. The growth in autonomy in many areas of life is publicized as progress for the individual. However, the broadening of areas at one’s disposal together with the increasing individualization of value systems leads to situations in which the range of options asks too much of the individual. I scrutinize whether increased self-determination and unbound possibilities are really in a person’s best interests. Evidence from psychology and economics challenges the assumption that unlimited autonomy is best in all cases. The responsibility for autonomous self-formation that comes with possibilities provided by neuro-enhancement developments can be a burden. To guarantee quality of life I suggest a balance of beneficence, support, and respect for autonomy.
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Notes
It is remarkable that cosmetic surgery developed to be a treatment for the “inferiority complex”: a problem with self-esteem including exaggerated feelings of weakness and the belief that one cannot overcome one’s difficulties through appropriate effort. The inferiority complex is a concept introduced by Alfred Adler [9], who also described the process of compensation for physical disabilities or limitations. Interestingly, the same ideas can also be applied to cosmetic psychopharmacology.
See F. Gul and W. Pesendorfer [18] for exceptions to this principle on the basis of temptation and self-control problems. An agent has self-control if she/he is able to resist temptation. She/he can be worse off when alternatives are added to a set of options because decision-makers have to expend resources to remove alternatives. Usually people benefit from strict commitment, i.e. when they have a preference for a subset of alternatives over the set itself. In case of added alternatives, temptation occurs that requires costly self-control. The costs of self-control depend on how tempting the alternatives are: Some added options might be easily resisted; some require a lot of self-control to resist.
Daniel Kahneman [26] distinguishes between “hot” and “wistful” regret, where the former is mainly about actions in the recent past whereas the latter is dominated by thoughts about the distant past, often about inactions. However, while wistful regret might in fact be nostalgic, there still need not be a weakening over time. Long-term regret can be very painful, and related to deep sadness and despair.
Being well aware of the connotations this phrase has for readers familiar with the debate on free will, I assume for this context that people are free to decide in the sense we assume them to be in everyday life.
Within an extended research program on attribution theory and responsibility judgments, social psychologist Bernard Weiner shows that internal causal attributions tend to magnify affective reactions, whereas external causal attributions tend to have a dampening effect on emotional responses. Thus, if one makes internal, as opposed to external, causal attributions for failure, self-blame will more probably occur than when compared to blaming external factors [28].
Therefore, the discussion about responsibility must be extended. It is often mainly considered on the basis that people are less responsible for their actions as we learn the brain’s role in behavior—the free will debate takes this stance as its starting point. However, on the other hand, we need to consider that the responsibility of the individual also increases, as it lies in each person’s hands to exert oneself in the improvement of brain activity.
There are pressing questions concerning distributive justice and likewise on cultural aspects that need to be considered carefully. This cannot be done in the present article.
In a similar vein, Hans Jonas [31] concludes that ‘the very same movement which put us in possession of the powers that now have to be regulated by norms—the movement of modern knowledge called science [...] has by a necessary complementarity eroded the foundations from which norms could be derived. [...] First it was nature that was neutralized with respect to value, then man himself. Now we shiver in the nakedness of a nihilism in which near-omnipotence is paired with near-emptiness, greatest capacity with knowing least for which ends to use it.’ [31, p.22–23].
Jon Elster [39] brilliantly discusses the role of constraints in human life. He refers to the creation of constraints as “self-binding”, or “precommitment” being advantageous for the individual.
Even though there is a wide offering of consultants and counselors, these offers cannot provide the help people probably need. There are professionals who give instructions on how to live in a relationship, on how to rear children, on how to grieve, on how to realize a career, on how to eat, and how to exercise to name just a few. Still, this kind of mentoring falls short when it comes to the challenges of the existential problems posed by choice overload.
References
Parens, Erik (ed.). 1998. Enhancing human traits: Ethical and social implications. Washington: Georgetown University Press.
Kramer, Peter D. 1993. Listening to Prozac. The landmark book about antidepressants and the remaking of the self. New York: Penguin Books.
Knutson, Brian, et al. 1998. Selective alteration of personality and social behavior by serotonergic intervention. American Journal of Psychiatry 155: 373–379.
Elliott, Carl, and Tod Chambers (eds.). 2004. Prozac as a way of life. Chapel Hill: The University of North Carolina Press.
Giles, Jim. 2005. Beta-blockers tackle memories of horror. Nature 436: 448–449.
Slomka, Jacquelyn. 1997. Playing with propranolol. Hastings Center Report 22(4): 13–17.
Mintzes, Barbara, et al. 2003. How does direct-to-consumer advertising (DTCA) affect prescribing? A survey in primary care environments with and without legal DTCA. Canadian Medical Association Journal 169: 405–412.
Rosenthal, M., et al. 2002. Promotion of prescription drugs to consumers. New England Journal of Medicine 346: 498–505.
Adler, Alfred. 1907/1917. Study of Organ Inferiority and Its Physical Compensation. (Studie über Minderwertigkeit von Organen). New York: Nervous and Mental Diseases Publishing Co.
Farah, Martha J. 2005. Neuroethics: The practical and the philosophical. Trends in Cognitive Science 9: 34–40.
Gazzaniga, Michael S. 2005. The ethical brain. New York: Dana Press.
Illes, J. (ed.). 2006. Neuroethics. Defining the issues in theory, practice and policy. Oxford: Oxford University Press.
Levy, Neil. 2007. Neuroethics: Challenges for the 21st Century. Cambridge: Cambridge University Press.
Gillon, Raan. 2003. Ethics needs principles—four can encompass the rest—and respect for autonomy should be “first among equals”. Journal of Medical Ethics 29: 307–312.
O’Neil, Onora. 2002. Autonomy and trust in bioethics. Cambridge: Cambridge University Press.
Dworkin, Gerald. 1988. The theory and practice of autonomy. Cambridge: Cambridge University Press.
Seligman, M.E.P. 1975. Helplessness: On depression, development, and death. San Francisco: W.H. Freeman.
Gul, Faruk, and Wolfgang Pesendorfer. 2001. Temptation and self-control. Econometrica 69: 1403–1435.
von Neumann, John, and Otto Morgenstern. 1944. Theory of games and economic behavior. Princeton: Princeton University Press.
Tversky, Amos, and Daniel Kahneman. 1981. The framing of decisions and the psychology of choice. Science 211: 453–458.
Schwartz, Barry, et al. 2002. Maximizing versus satisficing: Happiness is a matter of choice. Journal of Personality and Social Psychology 83: 1178–1197.
Redelmeier, Donald A., and Eldar Shafir. 1995. Medical decision making in situations that offer multiple alternatives. Journal of the Amercian Medical Association 27: 302–305.
Iyengar, Sheena S., and Mark R. Lepper. 1999. Rethinking the value of choice: A cultural perspective on intrinsic motivation. Journal of Personality and Socical Psychology 76: 349–366.
Lane, Robert E. 2000. The loss of happiness in market democracies. New Haven: Yale University Press.
Gilovich, Thomas, and Victoria H. Medvec. 1995. The experience of regret: What, when, and why. Psychological Reviews 102: 379–395.
Kahneman, Daniel. 1995. Varieties of counterfactual thinking. In What might have been: The social psychology of counterfactual thinking, ed. N.J. Roese and J.M. Olson, 375–396. Mahwah: Erlbaum.
Hirschman, Albert O. 2002. Shifting involvements: Private interest and public action. Princeton: Princeton University Press.
Weiner, Bernard. 1980. Human motivation. New York: Holt, Rinehart, & Winston.
Giddens, Anthony. 2000. Runaway world. London: Routledge.
Giddens, Anthony. 1994. The transformation of intimacy. Sexuality, love and eroticism in modern societies. Cambridge: Polity Press.
Jonas, Hans. 1984. The imperative of responsibility: In search of an ethics for the technological age. Chicago: University of Chicago Press.
Schwartz, Barry. 2000. Self-determination: The tyranny of freedom. American Psychologist 55: 79–88.
Iyengar, Sheena S., and Mark R. Lepper. 2000. When choice is demotivating: Can one desire too much of a good thing? Journal of Personality and Social Psychology 79: 995–1006.
Keyes, Corey L.M. 2000. Subjective change and its consequences for emotional well-being. Motivation and Emotion 24: 67–84.
Riis, Jason, J.P. Simmons, and G.P. Goodwin. 2008. Preferences for psychological enhancements: The reluctance to enhance fundamental traits. Journal of Consumer Research 35: 495–508.
Rothman, Sheila, and David Rothman. 2003. The pursuit of perfection: The promise and perils of medical enhancement. New York: Pantheon Books.
Callahan, Daniel. 1984. Autonomy: A moral good, not a moral obsession. Hastings Center Report 14: 40–42.
Lane, Christopher. 2007. Shyness: How normal behaviour became a sickness. New Haven: Yale University Press.
Elster, Jon. 2000. Ulysses unbound. Cambridge: Cambridge University Press.
Acknowledgement
The German National Merit Foundation supported research for this paper. I kindly thank Erik Parens and an anonymous reviewer for helpful comments.
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Nagel, S.K. Too Much of a Good Thing? Enhancement and the Burden of Self-Determination. Neuroethics 3, 109–119 (2010). https://doi.org/10.1007/s12152-010-9072-6
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DOI: https://doi.org/10.1007/s12152-010-9072-6