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Published in: Health Care Analysis 4/2017

Open Access 01-12-2017 | Original Article

Could Moral Enhancement Interventions be Medically Indicated?

Author: Sarah Carter

Published in: Health Care Analysis | Issue 4/2017

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Abstract

This paper explores the position that moral enhancement interventions could be medically indicated (and so considered therapeutic) in cases where they provide a remedy for a lack of empathy, when such a deficit is considered pathological. In order to argue this claim, the question as to whether a deficit of empathy could be considered to be pathological is examined, taking into account the difficulty of defining illness and disorder generally, and especially in the case of mental health. Following this, Psychopathy and a fictionalised mental disorder (Moral Deficiency Disorder) are explored with a view to consider moral enhancement techniques as possible treatments for both conditions. At this juncture, having asserted and defended the position that moral enhancement interventions could, under certain circumstances, be considered medically indicated, this paper then goes on to briefly explore some of the consequences of this assertion. First, it is acknowledged that this broadening of diagnostic criteria in light of new interventions could fall foul of claims of medicalisation. It is then briefly noted that considering moral enhancement technologies to be akin to therapies in certain circumstances could lead to ethical and legal consequences and questions, such as those regarding regulation, access, and even consent.
Footnotes
1
To clarify: I will be using the terms ‘enhancement’ and ‘therapy’/’treatment’ as shorthand for bioenhancement, biotherapy, and bio-treatment.
 
2
I will use the terms treatment and therapy interchangeably in this context.
 
3
It is not the purpose of this paper to dwell on these issues; however it is important to acknowledge the consequences of considering moral enhancement interventions as therapeutic (within certain contexts).
 
4
Understanding empathy in this extended sense is not without its critics, in particular Coplan [12]; however this extended account of empathy is widely used in the literature in any case (as Coplan acknowledges).
 
5
As I shall argue in the sections to follow.
 
6
Further, there could also be concerns regarding a loss of identity; I do not have the space to discuss this issue here, however I have explored this in some detail previously [8].
 
7
Of course this is not to say that people without a deficit of empathy never find themselves in such situations, however it is reasonable to assume that aggressive people, and those who participate in criminal acts, are more likely to encounter such consequences with much more frequency than less aggressive people who do not.
 
8
This in turn could raise the question of what we could consider to be a disease; I shall consider this in a short while.
 
9
It is prudent to note that one could argue that even Boorse’s account involves some normative judgement, as departure from species typical functioning is considered undesirable; however, this is beside the point for our purposes. (I am grateful to the anonymous reviewer for bringing this to my attention).
 
10
This assertion is explored in more detail in the section on psychopathy.
 
11
This is noted as well by Simon Baron-Cohen [3, pp. 107–110].
 
12
Although, interestingly, the psychopaths did seem to consider both social conventions and moral rules to be authority-independent; that is that even if a figure of authority were to permit that action, it would still in actuality be wrong to perform it—although Blair seemed to dismiss this as the psychopathic inmates hoping to show that they had reformed and “learned the rules” rather than an actual assertion of belief.
 
13
I will concede that this assertion does seem to contradict the findings of Blair noted above. Unfortunately I do not have the space to explore this issue further, but I would still be inclined to argue that diagnosing children with MDD would most likely be an inexact science due to the nature of childhood development more generally.
 
14
I am grateful to the anonymous reviewer for bringing this point to my attention.
 
15
If we were to find a genetic marker which indicated a lack or deficit of empathy, then this could go a long way to assisting us in diagnosing MDD in both children and adults; however it is beyond the scope of this paper to explore this idea (and its related ethical concerns) in sufficient depth.
 
16
This issue is explored in some detail in [24].
 
17
As noted in the section on defining moral enhancement and empathy.
 
18
I explore this briefly in [8].
 
19
Although it is doubtful this was considered as such when it was in common usage.
 
20
This issue was explored in a report by BBC News in 2008 [21].
 
21
As was my intention in this paper.
 
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Metadata
Title
Could Moral Enhancement Interventions be Medically Indicated?
Author
Sarah Carter
Publication date
01-12-2017
Publisher
Springer US
Published in
Health Care Analysis / Issue 4/2017
Print ISSN: 1065-3058
Electronic ISSN: 1573-3394
DOI
https://doi.org/10.1007/s10728-016-0320-8

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