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Enhancement

Cochlear Implants and Minority Cultures

17 Jan, 13 | by Iain Brassington

A bit more on the cochlear implant thing that I’ve been mentioning off and on for the past couple of months.  William Mager posted a link to something a little while ago on why some members of the deaf community are against CIs.  This attitude had always puzzled me.  Anyway, this, by Christina Hartmann, is the thing to which he linked.

Not wanting one yourself, I can understand easily enough.  Not wanting one for your children based on uncertainty about their benefit, I can understand.  But being against them in principle?  Couldn’t get my head around that.  It always seemed a bit wilfully isolationist – a bit identity-politics.  Hartmann’s contribution, I think, makes things a bit clearer.

Without ASL, there is no Deaf community. We band together not because of our “hearing loss” but because of a common language.  Like English, Bengali, French, American Sign Language (ASL) informs the cultural underpinnings of the Deaf community. Deaf history shows the importance of ASL to Deaf people. It’s not something we’ll give up easily and gladly.

In the 1800s and early 1900s, many educators tried to eradicate ASL in favor of oralism. They wanted to assimilate deaf people into the “mainstream” community. Many deaf people suffered because of this. They received marginal education because they couldn’t understand the spoken language. One of the older deaf men that I knew in my childhood couldn’t get a job better than a janitor because he received no valuable education from his oral school.  They just tried to teach him how to talk, to no avail.

Amidst all of this, a vibrant community emerged. People would converge at Deaf schools and churches just for a chance to use their own language with someone else. A feeling of kinship grew in face of oppression. (Yes, trying to abolish a language and forcibly integrate people is oppression.)  Many Deaf people throughout history fought very hard for the right to sign and live on their own terms.  One example is the Gallaudet protests of the 1980s. The thought that this hard-earned culture will disappear because parents don’t want to learn ASL sparks abject fear and anger in many Deaf people.

And why not?  Wouldn’t you be angry if someone told you that your culture is outdated and irrelevant now?

This last sentence or two seems to me to be important.  CIs reduce the need for ASL (or BSL); SL sustains a culture; therefore CIs erode that culture. more…

Crime and the Less-Polluted City Solution

10 Jan, 13 | by Iain Brassington

People who listen to Today may have heard an article in the prime 8:10 slot on the 9th about the correlation between a drop in the use of leaded petrol, and a drop in violent crime rates.  (Mother Jones actually beat the BBC, having published a piece on the same research last week: I meant to post something then, but was buried by other stuff.)

The nub of the story is this: that violent crime has been falling in the past few years, and though this pattern seems to lag about 20 years behind a fall in the use of lead in petrol, the fit is pretty good: a decline in leaded petrol predicts a decline in violent crime by about two decades – which is just about the time that we might expect would elapse between the formation of the brain and the highest likelihood of violent behaviour in humans.  Neat.  The Mother Jones piece provides lots of links to the relevant research – links to this (from 1999), and this (from 2007), and this (from 2012).

If the lead hypothesis is sound, it seems to be ethically interesting in a couple of ways. For one thing, it opens the way to at least some antisocial behaviour to be seen as being symptomatic of a deeper public health problem.  That’s interesting enough as it is, but – admittedly – it might be little more than interesting, on the grounds that leaded petrol is pretty much a thing of the past anyway (Wikipedia says that, as of 2011, leaded petrol was widely available only in 7 countries).

But the other way in which it’s interesting has to do with arguments about so-called “moral enhancement”. more…

Cochlear Implant: On!

14 Dec, 12 | by Iain Brassington

A few weeks ago, I linked to a post on William Mager’s blog in which he said (a) that he was about to have a cochlear implant fitted, and (b) that he’d write about the experience as it progressed.

I don’t know how many readers of this blog followed the link or subscribed; for those who didn’t, I thought I’d just point you in the direction of the latest update.  In short: the implant was fitted; it was turned on; it was… unexpected.  Not completely pleasant from the word go, and a little odd.  But also… well:

I spent an hour yesterday walking round the house tapping different surfaces with a wooden drumstick. Before, with a hearing aid, I’d have heard these taps simply as a ‘tap’ sound. But I had a eureka moment when I realised that tapping a wooden stick on a wooden surface sounded different in pitch and tone to tapping on a glass surface, or a metal surface. Of course, I knew that was the case – but this was the first time ever, EVER… that I’d actually heard that and been able to distinguish so clearly between the different sounds.

That has to be a little bit magical, doesn’t it?

On the other hand, what he can hear is limited.  And so

[n]ow I’m sitting in a world of silence, punctuated by random, violent bursts of sounds that I’ve never heard or experienced quite in the same way before.

What I’m experiencing now isn’t hearing as I imagined it, or as I’ve known it for the last 30 years. It’s completely different, and it’s making me feel really tired and disconnected from everything. I’m finding it really hard to concentrate, to hold on to a specific thought for a long time. […]

Most disconcerting of all is the dawning realisation that what I thought I was hearing for the last 30 years of my life wasn’t actually hearing. It was just compressed, distorted garbage noise through a hearing aid. What I’m feeling in my head now is much, much closer to actual sound, but it isn’t sound.

I’m fairly confident in my hunch that being able to hear is on the whole preferable to not being able to hear; though there might be times when not hearing is preferable, being able to do so at least gives you the choice – which raises the intriguing possibility that someone with a device that he could used to switch his own hearing on or off might be, in that sense at least, very well off indeed: better off than someone with no ability to hear and someone with no ability not to.  (In just the same way, having a car is good all else being equal, even if there’re times when walking is preferable, because you have the option of using it.)

But still: it’s worth keeping in mind that the process of restoring – or instilling – hearing isn’t a straightforward leap from position A to more desirable position B.  There’s an ambiguity about it.  Even granted confidence that B is more desirable, we can’t take it for granted.

 

Enhancing the ill: The therapy-enhancement…

16 Nov, 12 | by David Hunter

This post is in effect a gauntlet, a challenge for those who are significantly bothered by enhancements, such that they think that enhancing would be unethical or at least that there is a significant ethical difference between the two, largely because I can’t really work out what the fuss is and would like someone to try and explain to me what worries them about enhancements and whether it applies in this case.

Therapy is usually distinguished from enhancement in the following manner – therapy is about restoring normal functioning whereas enhancement is about going beyond normal functioning. So for example I’m an asthmatic and sometimes I am prescribed steroids to enable my lungs to regain normal functioning. However if an otherwise healthy athlete took the same medication it would function as an enhancement, boosting them above normal performance.

Objectors to enhancement typically argue that there is a morally relevant difference between therapy and enhancement in that there are medical justifications to provide therapies on the grounds of justice/rights/equality but not enhancements. Hence there is a moral distinction because the state is obliged to provide (some) therapies but not, or at least the argument goes, enhancements.*1

And some commentators further argue that enhancements are unethical because of an array of reasons such as justice, risks, meddling with human nature and so on.

I want to suggest there is at least one class of enhancements where there is a solid medical justification to provide these. This is when something acts as both a therapy and an enhancement for someone – I’ll call these therapy-enhancements. A case will make it clearer which I’ll refer to as the Pinky & the Brain case.

Suppose we have someone who we will call Pinky who has a profoundly low IQ – let’s say 40, so low that they require substantial levels of state support to be able to live their life. Suppose there is a new drug A on the market that will increase the IQ of those with profoundly low IQ’s (and only those with these IQ’s) however it will increase their IQ’s significantly above species normal IQ levels of 100 to let’s say 160, hence transforming Pinky into Brain.*2 This seems to me to be a drug which is both providing a therapy since it raises them to a normal IQ and enhancing them as well since it raises them substantially beyond a normal IQ as well. If this drug is relatively speaking affordable – more cost effective than any present treatment they are getting then it seems to me obligatory that the state provide this despite it being an enhancement.*3

So this raises worries about how strong objections to enhancement can be, since if they are strong one might think we ought to forgo therapies that also enhance, which would seem to me to be unjust. We can strengthen this concern by considering a further case which raises questions for the strength of any morally relevant difference between therapy and enhancement.

Suppose that the pharma company who developed A, recognising the concerns some have about enhancement have developed a new drug B which like A raises the IQ of those with profoundly low IQ’s but unlike A it only raises them to the species norm of 100 – unfortunately due to the additional development costs, smaller market etc the company decides to charge twenty times the price of A. What should the state do, should it switch to B to avoid enhancing? I think clearly it ought not, and for me at least that intuition holds true until B is cheaper than or perhaps equal to A in price (in which case I’m vaguely indifferent but probably lean towards the free additional 60 IQ points). What this seems to show is that any normative force the distinction has is at best quite weak, easily over ruled by a slight increase in efficiency.

This doesn’t of course show that there is no morally relevant difference, merely that if there is one it is quite, quite weak.

*1 Of course this might be challenged since some things that look like things health care systems ought to provide such as vaccines seem to function more like enhancements than therapies.

*2 I’ll leave it up to you whether this increase in intellect induces what this lovely book (Soon I’ll be Invincible) refers to as Malign Hyper-Cognition Syndrome…

*3 Are there actual cases like this? I suspect the answer is probably yes – for example if a disabled athlete runs faster with their blades than they did before losing their legs this would be a case of a therapy-enhancement.

William Mager is having a Cochlear Implant.

9 Oct, 12 | by Iain Brassington

And he’s going to blog about the experience.

On Tuesday 6th November at around 7.30am I’ll be in a hospital room while a surgeon uses a marker pen to draw a line behind my ear. Soon after that, I’ll be wheeled into an operating theatre where they’ll make a small incision behind my ear, following the line of marker pen ink.

Once they’ve opened a flap of skin behind my ear, they’re going to drill into my skull, until they reach my inner ear. They’ll then hollow out a small cavity in the flesh beneath the ear flap, where they will insert a piece of technology worth about £10,000. Into the hole in my skull goes a tiny electrode extending all the way into my inner ear, with around 20 or more individual contacts stimulating my cochlear. Hopefully the general anaesthetic will do its job and I won’t feel any of this while it’s happening, because I’ve seen pictures of this procedure and it looks pretty painful.

[…]

When I’m switched on six weeks after the operation, I have no idea what will happen. Either I’ll feel a faint buzzing in my skull, or hear consonants for the first time. Either way, the hard work starts after that.

Subscribe!

He’s a film-maker in real life: so while you’re waiting for the next post, have a look at some of his films.  This one takes only a couple of minutes to show how there’s really very little that deaf people can’t do… er… so long as the… um… support is… as long as…  Yeah.  Watch it, anyway.

Mitochondrial Disease and the HFEA

20 Sep, 12 | by Iain Brassington

Readers are probably aware of the consultation that the HFEA launched this week on the use of mitochondrial replacement to prevent certain illnesses.  John Harris has a piece on it in The Guardian – and by gosh golly, he’s right*; the article is well worth a quick look.

My own ha’p’orth: some of the stuff in the consultation is a bit odd.  One of the sets of questions it asks has to do with what such a procedure would do to a child’s concept of identity.  But why is this a concern?  Suppose a child discovers that she’s been the recipient of a mitochondrial transplant: so what?  Why would that make the blindest bit of difference to her sense of identity?  Isn’t it wholly plausible that, if there is any impact, it’s not because of the source of the genes qua genes, but because of all the people around her telling her that it’s tremendously important and she should give a stuff?  But they might be wrong.  I’d stick my neck out and say that they probably are.  Genetic origins simply don’t matter.

(Ah – but if she’s brought up to think that they’re imporant, isn’t that enough to establish that they’re important to her – and so are important in some sense after all?  Well, no.  Imagine someone is brought up to think that the fortunes of West Ham United are important; they’ll be important to him.  But it doesn’t follow that they’re important; and it might be that, in treating them as important, our hapless Hammers fan ends up making himself much more miserable than he need be by worrying about things that don’t merit worry.  It could be that he ought not to think the football important.  The same applies to genes: if a person’s genetic origins are important to her, it doesn’t follow that they’re important, or that there’re no good reasons to think them less important.)

But lots of people seem to think that genes do matter, and so we get questions like this; and asking questions like this perpetuates the idea that it’s a question worth asking… and so it goes on.

*I’ve found myself saying that increasingly often of late.  Scary stuff.

CFP: “Neurotechnological Interventions: Therapy or Enhancement”

6 Sep, 12 | by Iain Brassington

Submissions (of 300 words max) are invited for inclusion at the TILT authors’ workshop on the theme of “Neurotechnological Interventions: Therapy or Enhancement” in Tilburg on 15-16th November 2012.  The workshop is part of the FP 7 RoboLaw project, and will lead to the publication of a volume with papers.

Abstracts shoud describe briefly how the paper that you intend to submit will shed new light on the traditional distinctions and arguments in the debate on human enhancement.  The use of casuistry from cognitive enhancement, neurotechnology or robotics is welcomed, but not a necessary condition.  Contributions from law, ethics, philosophy of technology, science and technology studies, economics and general regulation studies are especially appreciated, but scholars in the social sciences, science and technology should not hesitate to submit.

Although individual papers may take casuistry from the fields of neurotechnology and robotics as their starting point, the workshop papers and the volume to be published will primarily focus on some often returning fuzzy distinctions and arguments in the debate on human enhancement in general.  The distinction between therapy and enhancement itself is exemplary in this respect.  The distinction is often not meant to merely serve the theoretical purpose of creating definitional clarity; it is also often implicitly used to depict a class of actions  as morally unproblematic (therapy) and a class of actions as morally problematic (enhancement).  The distinction has of course been criticized  because of the blurred lines between therapy and enhancement as it builds on a presupposed vague notion of normal health conditions.  The implicit normative connotations, however, also tend to cause a lot of confusion.  In addition, many of the ethical concerns explicitly put forward in the general debate on human enhancement, especially those in which notions such as unnaturalness, cheating,  injustice, dignity et cetera occur, appear to be multilayered and often overlapping with other arguments.  In their clustered compound guise they can easily obfuscate original intuitions or emotions of indignation, but also block possibilities of resolution and agreement.  When they are meticulously analyzed and reduced to underlying constituents these arguments often become more persuasive or at least manageable.

Authors should email an abstract of their paper (relating to the theme and its elaboration) before 15 September, and upon acceptance on the basis of the abstract, a draft of the full draft paper (in .doc, .docx, or .pdf format) before 1 November 2012, so that the papers can be circulated in due time and the reviewers/ commentators can prepare themselves appropriately.  Only a limited number of external invited contributors to the volume can be reimbursed for their costs. Whether a paper will be included in the volume to be published will be decided after receiving the very final version of the paper after the author’s workshop.

Important Dates

Before 15 September: Send an email to anton.vedder{at}uvt.nl with a 300 words abstract of the paper you intend to submit

22 September: Notification of acceptance

Before 1 November: Submission of full paper

Before 8 November: Circulation of papers

15-16 November 2012: Workshop

7 December: Selected final papers to be handed in.

 

via Sheelagh McGuinness

Treating the Sex Offender

13 Jun, 12 | by Iain Brassington

This is an interesting story picked up by the BBC: drugs are being used to “suppress sexual thoughts and urges” among sex offenders in an experiment at HMP Whatton.

It is early days, and the number taking part is small – so far fewer than 60 – but the graphs illustrating such measures as prisoners’ strength of sexual urges, or time spent thinking about sex, all show a downward trend.

The Ministry of Justice is pleased with the initial evaluation of the scheme. The treatment will continue to be available to high-risk sex offenders who are assessed as being suitable, it says.

There’s all manner of questions raised by the prospect of using drugs to alter, reduce, or otherwise manipulate sex drive.   more…

Is Julian Savulescu Channelling Bryan Ferry?

24 May, 12 | by Iain Brassington

Specifically, I have in mind Roxy Music’s “Love is the Drug“.  (Annoyingly, I can’t get the video to embed.*)  And I don’t just mean Julian – I mean him, and Anders Sandberg, with Brian Earp somewhere in there too.

The thought crosses my mind because I’ve been reading this essay in New Scientist, which apparently prefigures a paper that’s soon to come out in Philosophy and Technology.  It deals with the possibility of using neurochemistry to maintain loving relationships.  The evolution of human emotions has not, they claim, kept up with the other changes that humans have undergone and caused over the past few hundred thousand years:

[I]n many ways we are stuck with the psychology and drives of our hunter-gatherer ancestors. We are not made for the world and institutions we have created for ourselves, including that of life-long marriage.

The suggestion is that, while there is no “love gland” that we could tweak, we do know enough about neurochemistry to be able to make a difference to the likelihood that a relationship will last.  With care, administering and manipulating things like oxytocin, dopamine and testosterone might allow us to alter our emotional landscape – allegedly for the better.

Convinced?

One of the worries that is articulated has to do with authenticity. more…

A Small Solution for a Big Problem?

28 Mar, 12 | by Iain Brassington

BioNews asked me to write something about Matthew Liao, Anders Sandberg and Rebacca Roache’s paper on engineering humanity to minimise global warming.  I’d been meaning to for a while, so this was the prod I needed.  Anyway: my take on their paper is here; but I thought I’d also reproduce it on this blog.  What follows is the version I submitted; it’s substantially the same, save for a few tweaks that BioNews made to conform with their house style.  (They didn’t like the Latin…)  I am massively grateful to the student who made the point about small people taking more steps to get anywhere.  I’d also like to think that the idea of making people smaller led me to Lilliput, thence to Gulliver, thence to the voyage to Laputa.  It didn’t.  I’m not that clever.  Laputa made its appearance quite unbidden.  But – hey, it works.

 *     *     *     *     *

There’s a part of Gulliver’s Travels where Gulliver visits the grand Academy at Lagado, wherein one of the academicians is trying to derive sunbeams from cucumbers.  It’s tempting to wonder at first glance whether there’s something of the Academy to Liao, Sandberg and Roache’s proposed strategy for combating climate change: that we could engineer humanity to be less of a drain on the environment.  Their paper, “Human Engineering and Climate Change” (forthcoming in Ethics, Policy and the Environment, with a pre-publication version here), has already attracted a reasonable amount of media interest, and it’s not hard to see why.  The headline proposal is that we could engineer people to be smaller, on the grounds that smaller people require less food and fuel: a population that is smaller on the whole would have less environmental impact.  (A small part of this – and I’m genuinely fond of this idea – is that heavier people wear out shoes and carpets more quickly, so are more resource-hungry.  On the other hand, as one of my students has pointed out, short people take more steps to get across the room; the carpet might actually suffer more.  Moreover, a small person has a greater surface-to-volume ratio, and so would lose heat more quickly, possibly requiring more central heating and more food.) more…

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