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Why Enhancing Autonomy Is Not a Question of Improving Single Aspects of Reasoning Abilities through Neuroenhancement

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Abstract

In a recent paper, Schaefer et al. proposed to enhance autonomy via improving reasoning abilities through (genetic) cognitive enhancement [1]. While initially their idea additionally seems to elegantly avoid objections against genetic enhancements based on the value of autonomy, we want to draw attention to several problems their approach poses. First, we will show that it is not at all clear that safe and meaningful methods to genetically or pharmaceutically enhance cognition will be feasible any time soon. Second, we want to provide a deeper discussion of the role of cognition and reasoning abilities in philosophical concepts of autonomy, as discussed in the mentioned paper. In doing so, we wish to demonstrate that using reasoning abilities as the common denominator in different accounts of autonomy in the context of enhancement does not do justice to the highly complex interrelations between cognition, reasoning abilities and autonomy. Neither should this way of arguing be accepted as a basis to call for practical outcomes, such as funding research into e. g. genetic cognitive enhancements, if the examined concepts of autonomy are taken seriously.

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Notes

  1. Savulescu and Persson used this technique to identify altruism as a core feature of morality: aiming to later enhance morality by enhancing altruism [8]. To support their analysis, they refer to Christianity, Confucianism, Buddhism and the moral philosophies of Arthur Schopenhauer and David Hume, which all seem to rely on altruism as a core feature of morality. Sparrow [36] has highlighted the irony of this particular paper by Savulescu and Persson, which justifies the need for biomedical moral enhancement to address the potential dangers that may result from implementation of the cognitive enhancement Savulescu and colleagues usually demand.

  2. As mentioned above, mental capacity or competence can be seen as decision-specific. With this in mind, one could argue for a context-sensitive threshold account where a person who doesn’t belong to any of the exemplary groups presented above still becomes momentarily incompetent, for example through distraction. Since many people get distracted sometimes, our rarity objection wouldn’t hold up in an account like that. Nevertheless, the relation between, say, momentary forgetfulness or distraction in a special context and cognitive enhancement is hard to measure – a person could be competent at a given moment due to cognitive enhancement, but also potentially due to the fact that she had a good night’s rest, she got helpful advice, or any other kind of circumstantial influence. We therefore want to present examples where links between general cognitive capacities (and their potential enhancements) and being above/below a competence threshold could be evaluated more clearly. We thank an anonymous reviewer for pressing us on this point.

  3. Schaefer et al. discuss this potential objection in their footnote 7: “One might reply that, as a matter of fact, relatively few people are below the relevant threshold, so autonomy enhancement is not relevant to the vast population. But such a view would implausibly imply that very few acts of deception, manipulation, restriction, and so on actually reduce autonomy.” [1] We will assess deception and manipulation as relevant factors to inhibit autonomy in our last section. However, focusing on those as an objection to our point raised here disguises the problems contained in their approach related to the use of such widely accepted intuitive conceptions of autonomy. The statement that few people below a threshold might be helped through CE is not equal to the statement that few acts of deception reduce autonomy. Schaefer et al.’s argument depends on showing which forms of deception would be preventable through CE, and must refute the possibility that CE might pose an even greater risk of deception. Levin [49] has pointed out similar problems in Schaefer et al.’s reasoning.

  4. Feinberg refers here to different notions of competence mentioned by Daniel Wikler. The sense mentioned above refers more to natural abilities than to legal powers. A conception of natural competence (“minimal relevant capacity for a task”) can also provide conditions to ascribe sovereign rights to individuals [37, p. 30]. Here we rather refer to a broader, or more natural understanding of a threshold conception of competence than to a legal one.

  5. We do not want to claim that cognitive insight and therapies that provide such insight are not effective in helping patients but rather point to cases where the person has enough cognitive insight, yet does not reach the expected level of coherence.

  6. We thank an anonymous reviewer for asking us to explore self-control as an executive function and a cognitive capacity more closely. Furthermore, Levin [49] discusses whether it is convincing to presume that reason is the source of higher order desires if lower order desires are only non-cognitive, and examines the relationship between them.

  7. Pugh discusses some other misunderstandings of Habermas’ arguments by supporters of enhancement with regard to “the arguments of negative freedom” and “the argument from natality” [37, p. 30].

  8. It should be noted that Levin attacks this line of reasoning, arguing that Schaefer et al. “isolate particular threads, for instance ‘deception and manipulation are bad,’ on which wide-ranging concurrence exists,” and thereby “they divert attention from highly controversial assumptions of their own.” [49, p. 61].

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Acknowledgement

We want to thank one of the anonymous reviewers who suggested to use the term “isolationism” instead of “reductionism”, which can be confusing given its common philosophical use. Our intention is to describe a problem encountered by the overlapping consensus method used by Schaefer et al. By extracting reasoning abilities as a core feature of very different accounts of autonomy, other relevant properties, conceptual ramifications, and potential real life consequences of these accounts can easily be blurred and disregarded.

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  1. Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University Munich, Lessingstraße 2, 80336, Munich, Germany

    Johannes Pömsl & Orsolya Friedrich

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Correspondence to Orsolya Friedrich.

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Johannes Pömsl and Orsolya Friedrich have contributed equally.

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Pömsl, J., Friedrich, O. Why Enhancing Autonomy Is Not a Question of Improving Single Aspects of Reasoning Abilities through Neuroenhancement. Neuroethics 10, 243–254 (2017). https://doi.org/10.1007/s12152-016-9299-y

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