The thrust of this paper is that there is an existential relationship between beauty and identity and that identity alteration through the beautification of the body and the mind can produce a new human either for good or for bad.
The paper observes that human beauty is multidimensional. There is an outer beauty as well as an inner beauty. Outer beauty relates to human’s physical appearance, while inner beauty is connected to human inner (psychological, ethical, spiritual) nature. If carefully and reflectively juxtaposed, outer and inner beauty can function harmoniously to produce a human being who is capable of living a good life.   However, human beings are agential beings who are capable of initiating and carrying out actions that can enable them alter their identities, either for good or for bad. Within the physical, bodily realm, identity can be altered through many forms of bodily beautification, such as skin bleaching, piercings, tattooing, and cosmetic surgeries, making use of technologically derived chemical agents. In many instances, such identity alteration produces a being of double consciousness in the Duboisian sense; a person of split personality who can no longer say precisely who s/he is. In some other instances, attempts to alter bodily identity through beautification by cosmetic surgery has led to premature death.  On the other hand, within the realm of the inner, minded realm, identity can be altered through the molding and beautification of one’s character, resulting in the creation of a new human being who is capable of using his/her new found identity to change the world and humanity for the better.

Key words: Beauty, identity, identity alteration, double consciousness, good life
 

The development of new technologies and practices in reproductive medicine is progressing at previously unforeseen speeds, making procedures from the pages of science fiction seem increasingly plausible. However, a common thread which runs through many of these developments – from advances in in vitro fertilisation and the increasing acceptance of gestational surrogacy, to research into stem cell-derived gametes and gene editing – is a heavy emphasis on the significance of genetic parenthood. In this paper, I argue that this trend has reinforced what Mertes describes as “the dogma that genetic parenthood is ‘the best kind of parenthood’” (2014, p. 747). I aim to show that this dogma is partly grounded in the widespread, uncritical acceptance of a certain model of reproduction, described in recent literature as the ‘fetal container’ model of reproduction (Baron, 2018; Finn, 2018; Kingma, forthcoming). The fertilized gametes (and later, embryo or foetus) have frequently been imagined by bioethicists and philosophers of parenthood as the object to which gestation happens, while the significance of gestation itself has been overlooked.  Gamete-centric views of reproduction ground accounts which construe parenthood or parental responsibility as primarily determined by ownership of, or control over, gametes (Page, 1985; Weinberg, 2008); they are central to accounts which deny the legitimacy or morality of gamete donation on the grounds that genetic progenitors are inescapably intertwined with, and obligated to, their offspring (Brandt, 2017; Velleman, 2008); and they ground work which argues that individuals have a right to ‘genetic privacy’ where this is understood as a right not to have part of one’s genetic code replicated through reproduction (Räsänen, 2017). This type of argument is particularly relevant given recent events; in 2017, the UK High Court ruled against a father’s claim for damages after his former partner became pregnant using frozen embryos the couple had previously made from their gametes. The couple had already had a child together before separating – did the man in question have a right not to have his genetic material used for a second child?

In this paper, I propose an account according to which parenthood is considered the outcome of a procreative venture, upon which individuals or couples (or indeed larger groups) may embark together. I follow the approaches of Millum (2010) and Purvis (2012) in recognising parental work performed prior to the birth of a child as morally significant; however, I move away from views of parental rights and responsibilities as accruing on the basis of individual actions, and emphasise the notion of reproduction as a joint venture. On this view, gamete contribution and fertilisation are understood as minor – though obviously necessary – parts of a significantly longer and more complex process during which a child is brought into being. These parts may be considered analogous with other minor though necessary parts of the process, including various possible medical interventions and different stages of gestation and labour. Finally, I discuss the ramifications of this account for ethical questions surrounding gamete donation, surrogacy, and new reproductive technologies.
 

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Sex reassignment surgery is something of a commonplace today. Indeed, it might be argued that the spectre of persons born either male or female turning (or being turned) into the opposite sex has become almost routine to the point where countries such as Thailand and Brazil have become major Meccas to people from all walks of life and from around the globe for this sort of medical intervention. These developments have often occurred in tandem with activities the nature of which some, rightly or wrongly, may describe as somewhat ‘on the seedier side.’ These include pornography and prostitution centred around so-called ‘ladyboys’ and ‘trannies.’ Again, perhaps not coincidentally, Thailand and Brazil have emerged as the major, though not the sole, locations where such practices have proliferated.  Much attention, both within and without academia, has been devoted to the topic of ‘transgenderism,’ resulting in a variety of discourses both factual and fictional in nature, ranging from medical and psychological treatises to works of literature, movies and televised series. A recent example of the last category which is currently attracting much attention is called I am Jazz, a series devoted to the trials and tribulations of a teenager of that name who, though born a male, currently self-identifies as a trans-gender individual and is keen to undergo sex reassignment surgery, an operation which, even as I write, has not been without serious and, to this point at least, unresolved, complications.

Some individuals, of course, have for a variety of reasons chosen not to go this far and have resisted the lure of making fundamental and irreversible anatomical changes (e.g. castration). Instead, they have opted to allow their bodies to remain basically ‘as is’ and have contented themselves with behaving, dressing, etc. in the manner of the opposite sex, often to the point where it is difficult, if not impossible, to know that a given individual who may appear to be one sex is in fact, biologically speaking, the opposite. The early ’90s movie The Crying Game immediately springs to mind in this respect, not least the scene where the ostensibly female love-interest of the chief protagonist undresses and, in so doing, reveals the presence of a a fairly formidable penis where a vagina ought normally to be, much to the shock of her would-be lover.

My interest in all this is largely epistemological (though there are ethical ramifications, these are beyond the scope of this short presentation). To be precise, I am keen to understand the intellectual reaction which androgynous figures provoke in the male viewer especially and, in particular, his attempt to come to terms with and, above all, make sense of this specific instantiation of the phenomenon of hybridity. Drawing on Graeme Nicholson’s equation of seeing with a form of reading, my argument is that, in the course of his psychical maturation, the male has almost always been socialised in such a way that his vision is inevitably ensconced in a theoretical problematic (what Luce Irigaray, pace Lacan, terms an ‘imaginary’) which, precisely because organised around the primacy of the phallus, is predicated upon the existence of binary opposites. Such a predisposition to see the world entirely in terms of dichotomies consequently informs the male’s apprehension and articulation of the Real, is responsible for his angst in the face of blurred boundaries and, last but not least, informs the Procrustean measures taken that are designed to reinstall binary opposites precisely where these latter are most menaced by what, in Derridean terms, may be called the ‘play of difference.’
 

There exists a growing need and dependence on technology in assisting human beings to solve problems more efficiently. From the execution of mathematical calculations to performing precise medical operations, machines offer efficient solutions to many challenges. But, are machines capable of assisting humanity to understand itself? Considering David Mitchel’s words in Cloud Atlas, “To be is to be perceived, and so to know thyself is only possible through the eyes of the other …” one wonders about the possibility of creating humanity outside of humanity; that is, replicate our consciousness for knowing ourselves. Programmers have already began replicating human behaviour in engineering artificial intelligence. Caleb Chung, an animatronics designer, has programmed into the Furby and Pleo toys the ability to simulate human emotion. The toys also exhibit human sociological behaviour and react to various stimuli in very human/humanlike ways. This raises the question of our responsibility towards certain high-level programmes which are designed to mimic human sentience and intelligence. Are we morally obligated to do no harm to that which feels? How can we use technology to develop empathy and to shape the human social culture? Outside of animatronics, there are other types of technology which can positively affect human social culture. Immersive virtual reality creates the illusion of presence, giving one the illusion or the sensation that one is a part of the programme generated reality. The advantages of these technology are immense, especially in the field of psychology. For example, with avatars, or one’s computer self, the avatar can be created to give someone the experience of being someone other than him or herself. If the user is a slim person, the avatar may be chubby, thereby giving the user an awareness of what it might be like to navigate the world as through different means. Of course, we will have to question the possible negative implications of these technologies and determine mitigation.

Keywords: Artificial Intelligence, Programming Sentience, Neuroscience, Mimicking Human Behaviour, Animatronics, Mimic
 

One of the many concerns raised by the possibility of moral neuroenhancement concerns whether or not such enhancement may give rise to cases not appropriately accounted for by our existing moral responsibility practices. If an agent undertakes such enhancement, and then performs a laudable deed, is she less praiseworthy for having done so on account of the enhancement? May there be cases where it is an agent’s responsibility to undertake enhancement, and thus she would be blameworthy for failing to do so? In this work, I pursue clarity on questions of this sort. I do so by examining the relationship between moral neuroenhancement and a leading theory of moral responsibility present in the literature – the actual-sequence mechanism account of moral responsibility (AS). First, what is meant by moral neuroenhancement is clarified, and secondly the AS is explained. This done, I then turn to the interaction between these two elements. According to AS, an agent is responsible – usually praiseworthy or blameworthy in the sense of open to reactive attitudes – for a given conduct, X, when X is the result of an actual-sequence mechanism that is (1) suitably reasons-responsive and (2) belongs to the agent. Thus, the consequences of moral neuroenhancement for the presence and attribution of responsibility, and by extension I will argue its permissibility, is determined by whether or not such enhancement leaves the enhanced sufficiently reasons-responsive, and whether or not it can be said to remove the enhanced’s ownership of the actual-sequence mechanism. Equipped with these criteria, I then draw up and unpack a taxonomy of the different potential cases: (1a) where the enhancement subverts reasons-responsiveness, (1b) where the enhancement promoted reasons-responsiveness, (1c) where the enhancement leaves reasons-responsiveness unchanged, (2a) where the enhancement renders the actual-sequence mechanism no longer the agent’s, (2b) where the enhancement facilitates the agent’s ownership of the actual-sequence mechanism, and (2c) where the enhancement has no bearing on the agent’s ownership of the mechanism. In the course of discussing these possibilities, I will counter some objections that have been advanced against moral neuroenhancement, such as that it undermines the proper development of virtue. In conclusion, I will contend that moral neuroenhancement – provided that it does not override the enhanced’s reasons-responsiveness nor remove her ownership of the actual-sequence mechanism – is always permissible, in many cases normatively desirable, and in some cases – when the threat of harm resulting from the absence of enhancement is sufficiently great – even required.

 

Over the last two decades, the philosopher-turned-neuroscientist Joshua Greene has argued that the empirical findings of psychology and cognitive neuroscience have implications for ethics. While Greene has published across an impressively wide spectrum of journals, and thus used a variety of techniques, the general thrust of his thesis has always remained the same: recent empirical findings in the brain sciences not only support the consequentialist outlook; they also undermine deontology. In ethics, a characteristically consequentialist judgment focuses on the overall best consequences, often ignoring any strict rules or duties. A characteristically deontological judgment, on the other hand, is one that puts much heavier emphasis on such rules, rights, duties, and obligations. To say that one ought not break a rule no matter what is a characteristically deontological judgment.
While Greene uses a few different strategies to support his thesis, this paper will look closely at only one of his arguments. Specifically, I will be focusing on an argument put forward in Greene’s article, “Beyond Point-and Shoot Morality.” This argument contends that we ought to trust our manual, conscious reasoning system more than our automatic, emotional system when confronting unfamiliar problems; and because cognitive neuroscience has shown that consequentialist judgments are generated by the manual system and deontological judgments are generated by the automatic system, we ought to lean towards consequentialism when facing difficult moral problems. In this paper, I critically one of the premises of this argument. In particular, I ask what exactly an unfamiliar problem is and whether difficult moral dilemmas can be classified as unfamiliar. After exploring several different possible interpretations of familiarity and unfamiliarity, I conclude that the concepts are too problematic to be philosophically convincing, and thus should be abandoned.

 

Almost 50 years ago, Shulamith Firestone declared the uneven distribution of reproductive labour to be the source of women’s oppression. Ectogenesis, she concluded, would be the key to women’s liberation. This paper argues the contrary: we should reject ectogenesis because it relies on and perpetuates a problematic view of pregnancy that is rooted in a harmful patriarchal system, which rather than liberating women, serves to devalue them. Historically, we, as a society, tend to outsource work we do not value. Just as cleaning, once outsourced to the housemaid, is now delegated to machines (such as ‘Henry the Hoover’), so too is gestation being passed down the ranks: from gestational mother, to surrogate mother, and now, to artificial wombs. For those privileged enough to have the choice, why use your own womb when you can use the womb of a surrogate? And now, why use the womb of a surrogate when you can use an artificial one? Certainly, there are multiple reasons not to do so, some of which derive from the negative effects that ectogenesis may have on the foetus. But the reasons this paper focuses on are not foetus-centred, nor do such reasons locate the wrongness of ectogenesis in its instrumental consequences. Rather, this paper argues that ectogenesis is intrinsically wrong due to a misunderstanding of pregnancy that is both biologically and morally dubious, which, as is shown in this paper, can be demonstrated through a metaphysical analysis of pregnancy.
To this end, this paper aims to make the connection between ectogenesis and surrogacy and, in turn, explain the devaluing of gestation via an exploration of the metaphysics of pregnancy. In considering the metaphysical relationship between the foetus and the gestational mother during pregnancy, we can see how or why it might be that practices such as ectogenesis arise. Furthermore, by articulating various models for understanding the metaphysical relationship between foetus and gestator, we can see how one model – the Container model, whereby the mother is merely a container for the foetus – may be presupposed in underlying how we conceive of ectogenesis favourably, and how according to another model – the Parthood model whereby the foetus is a proper part of the mother – we may conceive of ectogenesis unfavourably. Under the assumption of the Container model, we are more likely to think that any container will suffice, even an artificial one. Yet under the assumption of the Parthood model, we are less likely to treat the gestator as fungible given the parthood nature of the relationship between the foetus and what is gestating it. Since, as this paper argues, we ought to value gestation and conceive of pregnancy on a Parthood model, we should not welcome reproductive technologies that perpetuate the undervaluing of gestation and disruption of the relationship between foetus and gestator. In conclusion, artificial wombs simply will not do – not in playing the role of the gestator, nor in securing women’s liberation. Good things may come from ectogenesis, certainly, but those ends do not justify the means.
 

Many different kinds of new medical technology make use of predictive analytics in order to promote better health outcomes. Predictive analytics applies what I will call a predictive algorithm that is informed by big data on data about an individual to make predictions about the individual. When used in the healthcare sector, predictive analytics can help patients monitor their health-conditions and enable better self-medication, and it can improve the accuracy of medical diagnoses. However, it has recently been proven that unless the algorithm used to make predictions provides perfectly accurate predictions or the sought-after property (e.g. a health condition) is evenly distributed across groups, the predictive algorithm will violate at least one of three fairness axioms. Either (i) the algorithm correctly identifies the relevant property (e.g. a health condition) more often in one subgroup (e.g. men) than another (e.g. women); (ii) the algorithm produces more positive false findings of the property for one subgroup; or (iii) the algorithm produces more negative false findings for one subgroup. Otherwise put, predictive algorithms are in many contexts inherently discriminatory and exhibit the characteristics of wrongful discrimination that is non-intentional, but which results in different impacts on individuals based on what subgroup they belong to. This paper outlines and explores different responses to this problem: should we abandon predictive algorithms, compromise on equality in correct predictions across subgroups, or accept inequality between subgroups with respect to false findings? With reference to how the alternative costs of abandoning predictive algorithms are high and the results risk being even worse in terms of wrongful discrimination, that option is discarded as undesirable. The paper instead presents three ethical principles that should be universally applied to promote algorithmic fairness in relation to new health technology: (1) Transparency: those who promote the use of predictive algorithms should be aware of the unintended differences in impact and also be transparent to the affected community about these unintended differences; (2) Dominance: an algorithm that is better with respect to one of the three dimensions of fairness and worse with respect to none is better overall; and (3) Priority to the worse off: an algorithm that is relatively better for members of a worse-off subgroup is preferable to an algorithm that is relatively better for members of a better-off subgroup. Yet, the paper concludes that all-things-considered judgments about the fairness of predictive algorithms are context-dependent. They depend on the what is predicted, and what the negative consequences of false findings are.
 

Over the past decade or more, we have seen an explosion in the interest in family history research and genealogy, especially with a number of online portals such as Ancestry.com offering ‘rare’ looks into the historical record using the region’s most ancient documents now collected and scanned for consumption by anyone who can trace their roots to the Caribbean (and beyond). A parallel development has been the popularity of TV series (and even reality game shows), which leverage this interest to trace the genealogical journeys of (mostly) celebrities. The commercial marketing of a variety of DNA testing kits that advertise their ability to help you uncover your long lost roots has boosted all of these developments, and particularly for African-descended peoples whose ancestors may have been brought to the Americas in the trans-Atlantic Slave Trade. This paper looks at some of the perceptions of this kind of research and exposes the fault lines at the frontline of Caribbean people’s growing interest, but also distrust of this technology and asks can we really ever know who we are? Using some of the existing scientific, ethical and anthropological research in this area as well as interviews with persons who have contemplated or completed DNA testing I will start to survey some of the motivations and conclusions of people who have taken an interest in genealogical DNA testing in the region.
 

According to the care crisis in modern medicine, the existential needs of patients are not satisfied. Marcum (2012) believes that if physicians become virtuous, and implement their medical practices in agreement with prudent love, this crisis will be solved. He maintains that this idea has a profound implication for the premedical and medical education of medicines. He suggests that the curriculum of medical students must include some general humanities, specific medical humanities, and practical clinical courses. According to him, by so doing, physicians will become more virtuous and care crisis will be eased. Although this solution is partly acceptable, it does not completely figure out the problem.
In this paper, it is argued that the care crisis is to some extent due to the undeniable role of technologies in modern medicine, so even if all physicians were virtuous, the problem would to some extent continue to exist. Indeed, the advent of Imaging technologies affects physicians’ understanding of disease and diagnosis. Disease is now a materialistic thing detectable by technologies, and patients’ narratives are not a necessary part of physicians’ diagnosis. Physicians do not need to have a conversation with their patients since every disease can be detected by technologies. Therefore, technologies make a huge distance between physicians and patients, thereby exacerbating the care crisis which is the consequence of the poor relationship of physicians in association with their patients.
At the end of the paper, a comprehensive ethical approach including the evaluation of all contributing parts is proposed. According to this approach, health care system should be seen as a network whose components are physicians, patients, nurses, procedures, technologies and so on. The factors having an influence on the relationship between physician and patient should be recognized and evaluated. Especially, the influence of each technology and its mediation on the relationship between physicians and patients should be evaluated, and accordingly, new prescriptions about the system and its components and their relationships should be written. Technologies ought to be lain in a suitable relationship with other components in order not to harm the care value. The new network including various mentioned factors (especially technologies) should take into consideration the role of patients’ narrations and the importance of the relatedness between physicians and patients.

Keywords: Care Crisis, Modern Medicine, Virtuous physician, Medical Technologies, Systemic Ethics

 

Capabilities-based theories of human welfare have garnered considerable attention in recent years, evidenced by the oft-cited work of Martha Nussbaum and Amartya Sen. The purpose of my presentation is to argue for a general principle in the ethics of technological enhancement that is based on a capabilities-based understanding of human welfare. Towards this end, I first outline the merits of a capabilities-based framework and differentiate it from two other standard theories of welfare: hedonistic and desire-fulfillment theories. A capabilities-based account captures the importance of promoting an individual’s dispositions rather than realizations and permits both internal and external components of welfare. I then argue for a precise definition of capability as disposition which inheres in bearer as a whole and which provides benefit to the bearer when realized. Since capabilities are dispositions of the human being as a whole, this implies that technological advances must be carefully designed to provide global (directed towards the overall good of the human being), rather than local, benefits the human beings. For example, we ought not enhance human beings with increased vision without the proportional enhancement of the other relevant features of the human being, such as agility and mentation. From this I argue for a general, welfare-based principle: all capabilities ought to be enhanced in a systemic way, that gives due respect to the holistic nature of the human being in its design environment – if enhancement is to be performed at all. And, if enhancement is embraced following this principle, then such enhancement is morally permissible; it will promote human welfare, following the capabilities-based understanding of welfare.

 

When speaking of genetic modifications or genetic engineering in humans, most people’s immediate response is negative and reject the idea of it. The main focus of this paper will be advocating for germline therapy, which involves altering the genome of an unborn baby by inserting, deleting, or mutating a gene in its gametes, zygote, or embryo. Currently, the Council of Europe declared an absolute ban on any human germline intervention under the Oviedo Convention because they prioritize human rights and human dignity.” I will examine what motivates this ban and why we should consider lifting it. Considering a recent case of human intervention in deleting a gene responsible for HIV in twin babies, I believe that the scientist did not do something ethically wrong.
Germline therapy ought to be permissible if it can prevent genetic disorders that impede individuals from normal and available opportunities that allow for human flourishing. The genetic therapy I am talking about involves deleting certain genes that are believed to be responsible for debilitating diseases, premature deaths, or genetic disorders that cause profound disabilities. Many people are opposed to allowing germline therapy usually because of 3 arguments: 1) Violation of human dignity; 2) Unknown consequences, whether intended or unintended; and 3) Fear of enhancement therapy and liberal eugenics leading to “designer babies”. I outline these objections and respond at the end of each one.
 

A teacher sits with a pile of exams to grade. He has been looking at his phone for the past hour trying to muster the will to begin grading. He really wanted to finish early so that he could go to the park before nightfall. Wouldn’t it be nice to be able to take a pill that induces the required motivation?  A neglected domain for research into bioenhancement is what I call agential enhancement. For this paper, I focus narrowly on enhancing desires, a foundational motivational state with respect to agency. My treatment is not tied to any ethical theory; I do not discuss how to improve desires to make them align with morality. Instead, I discuss how to enhance desires qua desires – how to make desires better as the springs of action.  While I cannot provide a full catalogue of strategies for biotechnological methods for enhancing desires, I offer some intriguing possibilities, relating in particular to dopamine, its role in reinforcement learning, and its connection to desire. Current neuroscience suggests that dopamine is transmitted to the pre-frontal cortex when one’s actions produce an outcome better than expected. Thus, in the simplest cases the action tendency becomes more salient, and the agent is more likely to want to do it again in the future. It may be possible to pair a pill that increases dopamine transmission for healthy actions. Suppose the procrastinating teacher were to take a pill, wait an hour, and begin grading. Though he may continue to find grading unappealing, he might still get a strong motivation boost for the action tendency.
Alternatively, it might be possible to fight the onset of bad habits. Suppose that one could take a pill that, when ingested, would neutralize dopamine transmission for a short period. During that time, one could perform actions that one would not want to become a habit, and the action tendency will not be as likely to take hold. Possible applications might include addiction, social media use, or other activities that can stop people from achieving their goals.

In the paper, I discuss how desires are not always better when they are stronger. I compare four dimensions we might value when it comes to desires: generation, strength/weakness, harmony with other desires and values, and optionality (the ability to discontinue or at least resist the desire when one chooses). It is not yet clear how the biochemistry works with respect to these valued properties of desires, but I pursue some interesting lines of thought.  There is more to say here, including the limitations of pairing dopamine enhancement/neutralizing pills with action types. Such attempts at enhancement could be abused or lead to unintended consequences. But, surely there are limitations to current attempts of psychological interventions and words of encouragement or discouragement. It is worth exploring new avenues for enhancing agency.

 

I want to respond to the transhumanist view that transcending our mortal natural beings would be prudential and desirable. I take Homer’s Iliad as a resource for thinking about, and opposing, the transhumanist view. I will defend what I call the Homeric View, and argue that invulnerability, where it is conceivable at all, would make our lives go worse.
To be invulnerable as the gods, ageless and blissful – what could possibly be wrong with that?(**) My subject is whether or not our lives would go better if we were technologically enhanced humans or transhuman. If it were technologically possible, should we push towards bioengineered ‘perfection’? Should we make ourselves ‘more than human’? The debate raises the most enduring questions – about what it is to be human, about our relationship to nature, and about what kind of social world we want.
I will put together the ambition of transhumanism to be invulnerable with the Iliad, one of the oldest stories about gods and mortals, and about war and death. We are familiar, in the Iliad, with the importance of courage, virtue, and honour to human flourishing. But Homer also presents war as the occasion to reflect upon the significance of mortality and human vulnerability. The flourishing of an individual depends not only on courage in light of the inevitability of death in battle but also, more basically, on an understanding of human mortality. By exploring temporality, narrative, and the contrast between divine and mortal wounds in the Iliad, I will show how the Ancients speak to the present debate in bioethics.
I will focus on one basic idea, vulnerability, in the Iliad. I will suggest that it is close to the idea that we ourselves possess. Of course, neither pain nor death are desirable in themselves. Nevertheless, they contribute to ethical goods in virtue of their anticipation and the narratives provided in light of their existence. When Achilles eventually gives up his guise of invulnerability, he restores his particular individual nature and recovers his place in a social world. Achilles’s story suggests at least this: that vulnerability is not necessarily a bad thing, and not in the sense that vulnerability is a natural human experience, but in the first personal sense that it is a good thing for an individual. Homer leads us to see that vulnerability makes Achilles’s life go better.

* The research for this paper started with a question I often pose to myself when I begin a philosophical investigation: ‘What would Bernard Williams think?’ Here I drew inspiration from Williams’s essay ‘The Makropulos Case: reflections on the tedium of immortality’ in Problems of the Self, CUP, 1973, and ‘Persons, Character, and Morality’ in Moral Luck, CUP, 1981.
** I am indebted to Leon R. Kass’s paper ‘Ageless Bodies, Happy Souls: Biotechnology and the Pursuit of Perfection’ in The New Atlantis, Spring 2003: 9-28, and also his book Life, Liberty, and the Defense of Dignity, 2002, Encounter Books, San Francisco, especially Chapter 9 ‘L’Chaim and Its Limits: Why Not Immortality?’
 

With the beginning of the Digital Revolution people developed a complete dependence on the Internet that is accompanied by a deep mistrust. In order to understand and explain this ambiguous feeling of need and mistrust, I will borrow from anthropology the concept of Mana. Indeed, if we consider the term Mana as Codrington taught us – namely as an indeterminate “force” that greatly increases who gets it but that, at the same time, is extremely dangerous to manage – we can easily imagine that the Internet has become the Mana of contemporary society. Despite the way that extending the term Mana to contemporary society could sound misleading, the research of Hubert and Mauss proves that the concept of Mana reveals a general and universal predisposition of human beings. Following their research, Levi-Strauss shows that Mana can be used either as a noun, an adjective, or a verb but it is the product of a universal and permanent thought. For this reason, Levi-Strauss identified the Mana as a floating signifier, namely a word that doesn’t point to any actual object or meaning but that transmits a general structure of thought. What better term than floating signifier can be used to approach the extremely variable and particularly fast virtual universe that characterizes the Internet and its relation with human beings? As I want to argue, the Internet is not simply considered evil, otherwise it would be condemned and persecuted. On the contrary, the Internet has become the essential “force” for the life of almost everyone in the world and people cannot avoid – and do not want to stop – making use of it. What I want to show is that this conscious use is paid with an unconscious fear that, as anthropology shows, accompanies all societies that handle the strange empowerment of the Mana. Furthermore, using a floating signifier like Mana helps to dismantle the easy opinion that the Internet is just an object between our hands. It is a mistake to reduce the Internet to a simple object because it leads to the belief that our relationship with the Internet is utilitarian and remains limited to itself. Indeed, in the form of a personal computer, smartphone or tablet – which are different forms of the same thing – the Internet is not simply our typewriter, book, dictionary, camera, map, clock, calculator, post office, shop, bank, radio, television, etc., it is also the virtual place within which we express and experience our feelings. Social, dating and pornographic websites are just some examples of a general universalization of virtual reality which incorporates the “real” world of discussion, friendship, fun, sex, and love. Believing that there is an ontological distinction between the real and the virtual since the subject cannot physically follow its virtual extension does not consider the fact that the virtual is already part of our reality since it is the medium of all kinds of relationships and, in the end, prevents a rigorous critique of the use of the internet itself.
 

The Dangerous Olive of Evidence: Ethical Tension between Technological Advancement and Social Determinants of Health in Diabetic Management
by Michael Munoz et al.
Read complete paper (PDF)

The role and expectation of social justice in clinical practice and ethics are both complex and controversial. In the context of medicine, social justice is the equality in access, quality and cost to all. Behaviors and social determinants of health (SDoH) and socioeconomic disparities accounts for more than 60% in the outcome of a disease. The social policy, professionalism, and system-based practice of physicians fall short of the Social Determinants of Health (SDoH) and disparities in health through socioeconomic status (SES).The health effects of education, income and occupation are mysterious but are also powerful components of SES and SDoH. Education in Social Justice requires self-reflection, advocacy and collaboration in patient care via community assessment. There is a global burden and inequality in the care of complex and chronic diseases like DM. Social Justice in the management of Diabetes Miletus (DM) requires the knowledge, skills and attitude for the effects of SDoH, the role of advocacy, community need assessments and development of DM care. The environmental/community infrastructure like transportation, economic stability, food security, education, access to care and social and cultural community support play a collective major role in the long- term outcome of DM in communities.
The “Dangerous Olive of evidence” metaphor suggests that we often do not fully grasp the big picture when it comes to the causes and potential solutions to complex problems like the global epidemic of DM. The theory identifies that only a very small proportion of interventions has shown actual evidence of effectiveness, making this concept the core of the olive. Meanwhile, the flesh of the olive consists of studies and data that have not been fully understood yet. In DM, that consists of technological advancements and vast complex contents and outcomes. There have been many mixed outcomes on many technological advances in diagnosing, glucose monitoring, insulin delivery as well as managing and monitoring DM using data management, decision analysis, and connected care with artificial intelligence (AI). As technology continues to progress and become more incorporated into healthcare, many of these technological advances in diabetic management require patient engagement, physical and social infrastructure and access to quality care. One must look at the Dangerous Olive metaphor and ethical tension between social justice, inequality in care, and technological advances. The technological advance can pose an increased risk of a digital divide and health inequality in the management of complex chronic disease like DM. We will debate and analyze the ethical tension and “dangerous olive” in growth of technology in DM management with its relationship with SDoH, SES and social justice in regards to population health.
 

The advance of technology that affords prospective parents the ability to predict the traits of potential offspring raises difficult issues in the ethics of procreative decision-making, among the most difficult of which is the non-identity problem. There are acts which, on the one hand, are a necessary condition for the existence of some individual and, on the other, cause that same individual to have a life which, though worth living, is seriously deficient in one or more respects. The non-identity problem concerns how one is to account for the apparent wrongness of such acts. Many solutions to the problem from a variety of different perspectives have been proposed, such as Kantian, contractualist, and rights-based solutions. Somewhat surprisingly, however, natural law theorists have had precious little to say about the problem. In this paper, I aim to make up for this lack (albeit to a limited degree) by giving a sketch of a possible natural law solution to the non-identity problem. I adopt as my framework the classical version of natural law theory grounded in an Aristotelian-Thomistic (A-T) metaphysics. I contrast my approach with the impersonal solution proposed in James Delaney's article "The Nonidentity Problem and Bioethics: A Natural Law Perspective." Delaney contends that states of affairs can be impersonally ranked from an A-T value-theoretic perspective. From that basis, intuitively correct answers can be given to certain problematic non-identity cases. I argue that value impersonalism is in tension with natural law theory as classically understood, because it treats a certain difference of moral kind—the difference between acts that are intrinsically wrong and those that are merely circumstantially wrong—as a difference of degree. On the alternative account that I have in mind, the wrong in certain non-identity cases is to be understood in terms of an act's being contrary to the natural end associated with the procreative role.

 

Eugenics has been the subject of several dystopian science-fiction novels and movies, from Brave New World to Gattaca and more recently Star Trek. They mostly depict a bleak future of humanity in which genetic determinism is taken to its extreme. Genetic engineering has been getting a bad reputation for valid but arguably, mostly historical reasons. Scientific progress has reached a point, however, where a serious engagement with the moral issues at stake has become unavoidable. In this paper, I critically examine the claim from Mehlman & Botkin (1998) that human enhancement will inevitably accentuate existing inequality in a free market and analyze whether prohibition is the optimal public policy for this objection as various sorts of egalitarians might, therefore, advise (Lamont and Favor, 2014). Of course, various moral theories will evaluate this claim, which I shall call the inequality-objection, differently. Yet, for the purposes of the present paper, I shall only consider whether the inequality-objection is a problem to the at least historically, dominant moral framework in policy-making, i.e. utilitarianism. The question then becomes, whether enhancement poses a threat to agents’ well-being or not. In what follows I argue that the inequality-objection has several problems.

My criticism is structured as follows: In Section 2 I will attempt to bring the inequality-objection into formal argument structure and clarify terms that are unclear. In Section 3.1 I attack the claim that cognitive enhancements lead to inequality. In Section 3.2 I analyze how inequalities in access to enhancements could decrease well-being and if it is the case that the benefits from human enhancements do not actually outweigh the costs, which is what utilitarians should be concerned with. In Section 3.3 I argue that even if the inequality-objection is right in that inequality and a decrease in well-being is unavoidable, prohibition is unlikely to be the best possible policy-response in order to maximize well-being. Lastly, in Section 4 I will summarize my attacks on the argument and conclude that the inequality-objection does not sufficiently support the conclusion that human enhancement should be prohibited by policy-makers.