In its last opinion(1) published in February 2014, the French National Consultative Ethics Committee (CCNE) wonders about the ethical issues raised by the resort to techniques of neuro-improvement in non-ill subjects. Olivier Rey, head of research at CNRS (2), delivers his analysis on this opinion.
Why delivering now an opinion on the theme of neuro-improvement in France? What is the scientific context?
The World Health Organization states in the Preamble of its Constitution adopted in 1946: “Health is a state of complete physical, mental and social welfare and is not only an absence of illness or disability”. This way defined, health is not, as before, a normal state to which are opposed pathological states, but an edenic ideal. Meanwhile, the technical advances still provide us with new intervention means. The encounter between, from one hand, the research of an even better “health”, and from another hand, the techno-scientific development, leads logically to want not only to cure the diseases or disabilities, but also to improve the performance of anybody. The theme of “neuro-improvement” is thus a highly topical subject.
According to you, what form does take the questions raised by the neuro-improvement?
The idea of neuro-improvement generates two types of questions:
• First of all, some improvements can be envisaged and are these improvements real improvements? Some functions can certainly be simulted.
But is it to the detriment of other functions (which would adversely affect health as a general balance), and with, eventually, harmful effects (which would adversely affect health as lasting balance)?
• Secondly, is the research of these improvements opportune? Isn’t there a risk to widen even further the inequalities between human beings, at a moment when the inequalities represent already serious threats on the cohesion of societies? Does it not divert the attention and efforts of questions which would be really urgent to treat for the welfare of humanity? It seems that the CCNE, in its pinion, mentions each of these questions, and is fairly reflecting on. However this final conclusion, with its calls for scientific question and ethical watch function, is disappointing: While pretending to take into account performed investigations, it comes as cancelling their scope.
The CCNE does not adopt a position on the medium and long term effects. Nevertheless can we sketch out the features of the perspective?
It seems at least presumptuous to pretend improving considerably and durably the human being, in others words to succeed in doing much better by the technique than what the natural evolution made. As the survival in old age has never been a reproductive advantage, we can suppose that improvements are possible regarding old age, on which the selection pressure is not exerted. Regarding youth, the thing is more questionable, and an improvement in a field has certainly its downside in another one. Having said that, it is not because the advantages to be expected from the improvement techniques are limited that they will not be hardly carried out. Thus the main effect is an even further extension of the fight. We will have to fight to access techniques deemed to give the advantage in the battle.
The opinion of the CCNE mentions the thinking of posthumanism and its ancestor transhumanism How do you define these terms?
Transhumanism, it is the transposition in the field of biology of the Nietzsche’s idea that the man is a way, a bridge between animal and superman.
For Nietzsche, the difference between the man and the super man is essentially moral.
The difference between the man and the transhuman or the posthuman is in the area of capacities and is made by technical means. The natural evolution gave the man some faculties, which allow him elaborating effective techniques. It would be the appropriate time, for the man, to use these techniques to accelerate and pilot his proper evolution, towards a superior alive form.
Is it a chance or a danger for the man?
I think that the fabulous predictions of supporters of trans or posthumanisn are not intended to be achieved. However, they are not without effect. With an increasing world population over 7 billions with above all a life mode as the one since the middle of 80’s, the humanity consumes the renewable natural resources quicker than these are susceptible to reconstitute (we would already need half additional planet so that this current consumption rate is perennial), we are running into major difficulties within this century. To avoid large scale disasters, it would be urgent to retrieve the sense of proportion, to accept the finiteness of life in a word already finished.
Here is the biggest danger of trans or posthumanism. To divert the attention of burning issues which deserve all our attention, to fuel fantasy of super power when we would accept to limit the power and assume a common destiny, to delude oneself with fantasies when it is time to face reality, to promise to humanity an escape outside itself when it should above all reform itself to continue to live and better live.
1 – Directive 122 of the French National Consultative Ethics Committee « Resort to biomedical techniques in view to ‘neuro-improvement in non-ill person:ethical issues »
2 – First in mathematical centre Laurent Schwartz (1989-2008), then in the Center of research in applied epistemology (2009-2012), today at the Institute of history and philosophy of sciences and techniques. Olivier Rey already pusblished on sciences and techniquesl subjects, as for instance Itinéraire de l’égarement (2003) ou Une folle solitude : Le fantasme de l’homme auto-construit (2006)
The opinion 122 of the CCNE in summary
“Resort to biomedical techniques in view of ‘neuro-improvement’ in non-ill person: ethical issues”
CIRCUMVENT THE REFLECTION
The “biomedical neuro-improvement” = the resort by non-ill subjects to biomedical techniques (medicines and medical devices) diverted from their use in therapy or in research in a supposed pyscho-cognitive improvement.
MAIN ETHICAL ISSUES RAISED by the neuro-improvement
• The one who resort to neuro-improvement thinks he is free and in the exercise of an individual choice whereas in reality he suffers the pressure of his socio-economic environment seeking competitiveness and cult of performance implementing an often implicit coercion.
• The risk of the emergence of an “improved class” which would impair the equality of chances and success. This inequality would be also on the global level.
• Creation of new weaknesses. What will be the “normality”? Will the non-augmented be in the category of pathologic?
• Wondering about the role we want to give to medicine: traditional prevention, diagnosis and treatment of pathologies or extending these fields to welfare?
SUMMARY OF CONCLUSIONS AND RECOMMENDATIONS OF THE CCNE
Questions on research, health, medicine and social protection
• The studies of cognitive research in non-ill subject showed an improvement of some parameters of psycho-cognitive functions. But this improvement is instable, modest, fragmented and punctual creating an important gap between the expected and perceived advantage and the reality.
Recommendation: The CCNE advices to have a great rigor when carrying out studies and an extreme caution when interpreting, using and communicating the results.
• The long term benefice/risk ratio is totally unknown, with a risk of addiction detected.
Recommendation: The CCNE has reservations on resorting to these techniques, highly discouraged in children, adolescents and vulnerable persons.
• Data in France are inexistant
Recommendation: The CCNE advises to perform observation studies to implement prevention and regulation measures on medicines and medical devices and on tools for non-medical transcranial brain stimulation.
• The extension of the field of the medicine to neuro-improvement raises the question to know which medicine we want: Does it have to remain in its traditional role of prevention, diagnosis and treatment of diseases, or does it have to extend its intervention field?
Warning: The CCNE warns on the distortion of health priorities; worsen risk in case of public funding commitment.
• Inform, particularly health professionals, of issues of biomedical neuro-improvement.
Questioning on person and life in society
• The CCNE motivates to consider the person as a whole and not in a fragmented way in function of its capacities:
“The power to live of a person does not relate to its unique conditions or to the unique functioning of its brain…”
Warning: The CCNE warns on a possible fragmentation of the functions of the person and asks not to reduce the human complexity. “The sense of self could not be reduced to the measure of capacities or to seek performances”
• Implementation of an ethical watch function