This chapter addresses the claim that, as new types of neurointervention get developed allowing us to enhance various aspects of our mental functioning, we should work to prevent the use of such interventions from ever becoming the “new normal,” that is, a practice expected—even if not directly required—by employers. The author’s response to that claim is that, unlike compulsion or most cases of direct coercion, indirect coercion to use such neurointerventions is, per se, no more problematic than the pressure people (...) all find themselves under to use modern technological devices like computers or mobile phones. Few people seem to believe that special protections should be introduced to protect contemporary Neo-Luddites from such pressures. That being said, the author acknowledges that separate factors, when present, can indeed render indirect coercion to enhance problematic. The factors in question include lack of safety, fostering adaptation to oppressive circumstances, and having negative side effects that go beyond health. Nonetheless, the chapter stresses that these factors do not seem to be necessary correlates of neuroenhancement. (shrink)

Gilbert and colleagues are to be commended for drawing our attention to the need for a sounder empirical basis, and for more careful reasoning, in the context of the neuroethics debate on Deep Brain Stimulation and its potential impact on the dimensions of personality, identity, agency, authenticity, autonomy and self. While acknowledging this, this extended commentary critically examines their claim that the real-world relevance of the conclusions drawn in the neuroethics literature is threatened by the fact that the concepts at (...) the center of the discussion have “weak empirical grounding”. First, I show that while some possible understandings of multifaceted concepts like identity, authenticity and autonomy may indeed be unsuitable for a purely empirical inquiry, this is not the case of all of them. Secondly, I call into question the authors’ apparent suggestion that reliance on constructs involving an irreducibly normative dimension makes for a suboptimal state of affairs, and that they should ideally be replaced with substitutes taken from the language of neuroscience or social science in order to ensure an adequate empirical grounding for the debate. Such a suggestion, I argue, commits the authors to a controversial reductionist view in metaethics that the valid empirical concerns they raise in the rest of their article do not presuppose, and which could potentially us lead to lose sight of important ethical considerations. (shrink)

In this paper, I will look at the relationship between Weitz’s claim that art is an “open” concept and Dickie’s institutional theory of art, in its most recent form. Dickie’s theory has been extensively discussed, and often criticized, in the literature on aesthetics, yet it has rarely been observed – to my knowledge at least – that the fact that his theory actually incorporates, at least to some extent, Weitz’s claim about the “openness” of the concept of art, precisely accounts (...) for what I take to be the main flaws in the theory. In what follows I present arguments for that claim, looking briefly at the position of both authors with respect to the concept of art, then showing how they relate to each other, and what implications this has for Dickie’s institutional theory, and more generally for the traditional project of characterising art. (shrink)

One objection to enhancement technologies is that they might lead us to live inauthentic lives. Memory modification technologies (MMTs) raise this worry in a particularly acute manner. In this paper I describe four scenarios where the use of MMTs might be said to lead to an inauthentic life. I then undertake to justify that judgment. I review the main existing accounts of authenticity, and present my own version of what I call a “true self” account (intended as a complement, rather (...) than a substitute, to existing accounts). I briefly describe current and prospective MMTs, distinguishing between memory enhancement and memory editing . Moving then to an assessment of the initial scenarios in the light of the accounts previously described, I argue that memory enhancement does not, by its very nature, raise serious concerns about authenticity. The main threat to authenticity posed by MMTs comes, I suggest, from memory editing. Rejecting as inadequate the worries about identity raised by the President’s Council on Bioethics in Beyond Therapy , I argue instead that memory editing can cause us to live an inauthentic life in two main ways: first, by threatening its truthfulness, and secondly, by interfering with our disposition to respond in certain ways to some past events, when we have reasons to respond in such ways. This consideration allows us to justify the charge of inauthenticity in cases where existing accounts fail. It also gives us a significant moral reason not to use MMTs in ways that would lead to such an outcome. (shrink)

Authenticity has recently emerged as an important issue in discussions of mental disorder. We show, on the basis of personal accounts and empirical studies, that many people with psychological disorders are preoccupied with questions of authenticity. Most of the data considered in this paper are from studies of people with bipolar disorder and anorexia nervosa. We distinguish the various ways in which these people view the relationship between the disorder and their sense of their authentic self. We discuss the principal (...) modern ac-counts of authenticity within the analytic philosophical tradition. We argue that accounts based on autonomous, or wholehearted, endorsement of personal characteris-tics fail to provide an adequate analysis of authenticity in the context of mental disorder. Significant elements of true self accounts of authenticity are required. The concept of authenticity is a basic one that can be of particular value, in the context of self-development, to people with mental disorder and to others experiencing substantial inner conflict. (shrink)

Many believe that the treatment-enhancement distinction marks an important ethical boundary that we should use to shape public policy on biomedical interventions. A common justification for this purported normative force appeals to the idea that, whereas treatments respond to genuine medical needs, enhancements can only satisfy mere preferences or “expensive tastes”. This article offers a critique of that justification, while still accepting the TED as a conceptual tool, as well as some of the key ethical axioms endorsed by its proponents. (...) I begin by laying out the TED, the practical implications that tend to be drawn from it, and the justification just sketched for these implications. Using examples drawn from preventive medicine, biomedical technology, and other categories of biomedical interventions, I then go on to challenge both the presupposition of a fundamental dichotomy between treatments and enhancements, and the assumption that enhancements – barring rare exceptions – cannot serve legitimate medical needs. Finally, I consider some ways in which supporters of the TED might try re-formulating the distinction to blunt the force of my critique. I conclude that such a move cannot fully succeed, and that while the TED does have some degree of normative force, it nevertheless cannot play the role that its advocates expect from it. Seeking to justify a general presumption against enhancements based on the rationale I critique here would mean ignoring their various potential benefits, including medical or therapeutic, and would reflect a prejudice – which I refer to as “treatment fetishism”. (shrink)

Worldwide populations are aging with economic development as a result of public health initiatives and advances in therapeutic discoveries. Since 1850, life expectancy has advanced by 1 year for every four. Accompanying this change is the rapid development of anti‐aging science. There are three schools of thought in the field of aging science. One perspective is the life course approach, which considers that aging is a good and natural process to be embraced as a necessary and positive aspect of life, (...) where the aim is to improve the quality of existing lifespan and “compress” morbidity. Another view is that aging is undesirable, and that rejuvenation and indeed immortality are possible since the biological basis of aging is understood, and therefore, strategies are possible for engineering negligible senescence. Finally, a hybrid approach is that life span can be extended by anti‐aging medicines but with uncertain effects on health. While these advances offer much promise, the ethical perspectives are seldom discussed in cross‐disciplinary settings. This article discusses some of the key ethical issues arising from recent advances in biogerontology. (shrink)

Volume 20, Issue 7, July 2020, Page 114-116.

Entry on "Authenticity" for the fourth edition of the Encyclopedia of Bioethics, edited by Bruce Jennings. Discusses the concept in the context of end-of-life decision-making, human enhancement, and the treatment of mental disorder.

This article responds to Neil Levy's recent suggestion that: (1) the use of pharmaceutical enhancers can be understood as promoting our authenticity, no matter which of the two main contemporary conceptions of authenticity we adopt; and that (2) we do not need to decide between these two rival models (the ‘self-discovery’ and the ‘self-creation’ conception) in order to assess the common worry that enhancements will undermine our authenticity. Levy's core argument is based on a comparison between cases of people with (...) ‘Gender Identity Disorder’ (GID) seeking sex reassignment surgery, and cases of enhancement via pharmaceuticals. While conceding the plausibility of Levy's claim (1), I offer reasons to resist (2), by pointing out structural differences between GID cases and some paradigmatic cases of pharmacological enhancement. I argue that these differences prevent the latter sort of cases from counting as authenticity-promoting on the self-discovery view. I conclude that Levy's proposed way of ‘breaking the stalemate’ in this debate is unsuccessful: we cannot avoid settling the dispute between the two models if we are to adequately address the authenticity worry about pharmacological enhancement. (shrink)

Volume 20, Issue 8, August 2020, Page 25-27.

This dissertation focuses on the concept of authenticity and its implications for our projects of self-creation, particularly those involving the use of "enhancement technologies". After an introduction to the concept of authenticity and the enhancement debate in the first part of the thesis, part 2 considers the main analyses of authenticity in the contemporary philosophical literature. It begins with those emphasizing _self-creation_, and shows that, despite their merits, such views cannot adequately deal with certain types of cases, which require a (...) third option, “true self” accounts, emphasizing _self-discovery_. However, it is argued that in their existing versions, accounts of this third sort are also unsatisfactory. Part 3 of the thesis proposes a new account of the "true self" sort, intended to improve upon existing ones. Common problematic assumptions about the concept of the true self are critiqued, after which a new analysis of that concept is presented, based on seven different conditions. Two specific definitions of authenticity, respectively emphasizing self-expression and the preservation of one's true self, are provided, and its relation to various associated notions, such as integrity or sincerity, are examined. Finally, part 4 looks at the implications of the previous parts for the enhancement debate. In particular, it discusses the prospect of technologically enhancing our personality and mood dispositions. Do such interventions always threaten our authenticity, as some worry? A negative answer is provided to that question. Various potential pitfalls hinted at by the inauthenticity worry are discussed and acknowledged. It is, however, argued that such enhancements could still in principle be used in a fully authentic manner, and that they have the potential to bring about genuine improvements in our mood but also to our moral capacities and our affective rationality more generally. (shrink)

This paper deals with a specific version of metaethical moral relativism, known as “speaker-relativism”. It starts by explaining the position, focussing on the views of two prominent contemporary relativists, Gilbert Harman and James Dreier. Both authors draw an analogy between ethics and modern physics: just as Einstein showed that judgments about time or mass were always relative to a specific frame of reference, Dreier and Harman argue that “absolutist” judgments about moral rightness or wrongness need to be reinterpreted as relative (...) to some particular moral system. They also claim that this analogy allows us to salvage ordinary moral talk. I consider a number of possible objections to their argument, beginning with one, concerning the possibility of moral disagreement, which I think can be successfully answered, and then presenting two criticisms that I take to be more problematic for the relativist. I argue that despite its initial appeal, Harman and Dreier’s suggestion regarding our use of moral language seems to be a source of confusion in certain cases of moral disagreement, and does not appear able to preserve specifically moral normativity – which leads me to conclude that it is best viewed as a variant of an error theory about morality, rather than as the distinct metaethical position it purports to be. (shrink)

This article briefly replies to commentaries by Ilina Singh and Peter Lucas on our original piece titled "Mental Disorder and the Concept of Authenticity". In response to Lucas, we argue that those who face questions of authenticity in the context of mental disorder cannot avoid the dilemma between the "self-discovery" and "self-creation" approaches. In response to Singh, we suggest some ways in which the concept of authenticity might be of relevance to clinicians.

The treatment of children diagnosed with attention deficit/hyperactivity disorder with stimulant drugs has been a subject of controversy for many years, both within and outside bioethics, and the controversy is still very much alive. In her feature article , Ilina Singh, a major contributor to that debate in recent years, brings fresh empirical evidence to bear on it. She uses new data to deal with two key ethical concerns that have been raised about the practice. First, does medicating children with (...) ADHD compromise their capacity for autonomous moral agency? And second, does it pose a threat to their ‘authentic self’? A related question is whether medication for ADHD is being used as an instrument of social control, forcing children to adapt to environments that they find oppressive.Whereas previous research by Singh examined the attitudes of parents of boys diagnosed with ADHD,1 this article draws from a series of interviews with children from the UK and USA, including those who were taking drugs for ADHD. The conclusions that Singh reaches can be characterised as cautiously optimistic. The data, she thinks, indicate that ‘a majority of children are not victims of stimulant drugs’. Rather than experiencing their use of such drugs as undermining their capacity for moral agency, children tend to report that the medication renders them better able to control their responses in potentially challenging situations. In addition, most of the children did not perceive the medication as a threat to their authenticity. Singh nevertheless accepts that such a threat might be real in certain cases, and suggests ways in which the threat might be mitigated. In particular, she suggests—plausibly, I think—that medical professionals could play a key role by spending more time listening to children in order to get …. (shrink)