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On Neuroenhancement and Subjectivity Research Collection Journal Article Enhanced Cognition, Enhanced Self? On Neuroenhancement and Subjectivity Author(s): Ferretti, Agata; Ienca, Marcello Publication Date: 2018-12 Permanent Link: https://doi.org/10.3929/ethz-b-000303305 Originally published in: Journal of Cognitive Enhancement 2(4), http://doi.org/10.1007/s41465-018-0109-9 Rights / License: In Copyright - Non-Commercial Use Permitted This page was generated automatically upon download from the ETH Zurich Research Collection. For more information please consult the Terms of use. ETH Library Enhanced Cognition, Enhanced Self? On Neuroenhancement and Subjectivity Title: Enhanced Cognition, Enhanced Self? On Neuroenhancement and Subjectivity Authors: Ferretti, Agata1* and Ienca, Marcello1 1Health Ethics and Policy Lab, Department of Health Sciences and Technology, Swiss Federal Institute of Technology - ETH Zurich *Corresponding Author: Agata Ferretti +41 44 6324481 [email protected] Abstract: This paper investigates the implications of neuroenhancement from a first-person and phenomenological perspective that focuses on the role of the human brain and body as mediators of subjective experience. This analysis is conducted both on historical-philosophical and empirical grounds. At the historical-philosophical level, this article examines the frameworks of phenomenology and embodied cognition to explore how these theoretical approaches link the materiality of the body (including that of exogenous integrations such as implants) to the way in which subjects perceive themselves and experience reality. At the empirical level, the article attempts to corroborate this philosophical stance by critically assessing the emerging body of scientific evidence on the phenomenological effects of neuroenhancement technologies. Based on a narrative mini-review, this paper will argue that the quantitative enhancement of a cognitive or other physical function of the human body does not necessarily result in an equal qualitative improvement of a subject’s phenomenological experience. Indeed, a physical alteration designed to quantitatively augment a specific human capability may have ambivalent effects on how the subject experientially perceives that modification. This indeterminacy between the quantitative and qualitative dimension of neuroenhancement seems to challenge the thesis that any objectively measured improvement of a cognitive or other physical function of the human body directly corresponds to better personal and psychological well-being. Key Words: enhancement; neuroenhancement; subjective; first-person; embodied cognition; phenomenology; deep-brain stimulation Introduction The concept of “enhancement” has been largely debated in the philosophical and scientific literature (Bostrom and Sandberg 2009; Greely et al. 2008; Wolpe 2002). In spite of its widespread use, this concept still lacks a semantically clear and unanimously agreed definition. In the biomedical field, enhancement has been often described as any intervention that increases bodily functions over the threshold of “naturally normal” (Daniels 2000). This threshold is set upon a simple premise: it is logically possible to draw a distinctive line between therapy and enhancement. Interventions below that threshold should be categorized as treatment, those above it as enhancement. The consistency and epistemic value of the therapy- enhancement distinction have sparked controversy (Bostrom and Sandberg 2009; Karpin and Mykitiuk 2008), with some authors suggesting to discard this distinction and opt for a broader notion of enhancement encompassing both below-baseline and above-baseline improvement (Savulescu et al. 2011; Bostrom and Sandberg 2009; Harris and Chan 2008; Savulescu 2006). Defining what degree of improvement counts as enhancement is only one of many philosophical conundrums. Another problem is defining what kind of metric should be used to assess such improvement. In abstract terms, the concept of enhancement may be assessed using at least two metrics: (A) a measure of quantitative improvement in the execution of one or multiple functions according to standard cognitive, psychometric, and functional scales or (B) a qualitative general improvement of the subjective experience (Hoyer and Slaby 2014). The metric A is used in a variety of studies aimed at measuring enhancement effects on attention, motivation, memory, learning, and wakefulness in quantitative terms, using a variety of scales and tests (Battleday and Brem 2015). These include, for example, memory assessment scales such as the list acquisition scale or the immediate visual recognition scale (Williams 1991), the standardized mini-mental state scale examination (Molloy and Standish 1997), the paired- associates learning test (Talpos et al. 2014), reaction time tests (Randall et al. 2005), and many others (Repantis 2013; Battleday and Brem 2015). In contrast, metric B is used more commonly among studies that employ qualitative methods such as interviews, self-reports and open- question surveys (Vargo and Petróczi 2016; Gilbert et al. 2017; Maier et al. 2013; Franke et al. 2012). Most basic scientific research on enhancement as applied to human physical (aka physical enhancement) and cognitive abilities (aka cognitive enhancement) has primarily focused on the quantitative metric A. For example, researchers have adopted functional and cognitive scales for the evaluation of neuroelectric and environmental enhancers (Riemersma- Van Der Lek et al. 2008; Flöel 2014). This privileged role of quantitative assessments is recognizable also in the literature on the ethics of enhancement, where the moral permissibility of enhancing interventions has often been discussed based on quantifiable parameters like efficacy, safety, risk, and benefit—either in the short or long term (Urban and Gao 2017; Repantis 2013; Garasic and Lavazza 2016; de Sio et al. 2014; Brukamp 2013). In contrast, little attention has been devoted to the qualitative metric, especially with regard to the effects of (cognitive and physical) enhancement on subjective experience (Vargo and Petróczi 2016; Mehlman 2004). Of the few studies attempting to investigate the metric B, most attention has been devoted to ethical and normative challenges raised by enhancement for subjectively relevant notions such as authenticity, alienation, autonomy, and psychological continuity (DeGrazia 2000; Schelle et al. 2014; Kraemer 2011; Bolt 2007; Klaming and Haselager 2013). One issue that remains underexplored, however, is how physical and cognitive enhancement, in particular, enhancement generated by neuroscience-based tools that alter directly or indirectly the functioning of the human nervous system, i.e., neuroenhancement (Farah et al. 2014), may affect a subject’s phenomenological experience. This narrative mini-review will attempt to navigate this twilight zone of research by examining both the philosophical roots of phenomenology and the emerging empirical evidence on the phenomenological effects of neuroenhancement technologies—especially neurostimulation. Based on this examination, it will attempt to discuss the mutual relationship between the quantitative and the qualitative metric of enhancement and discuss whether enhancement according to one metric will thereby imply a corresponding enhancement according to the other metric. The role of the body in mediating subjective experience: philosophical roots Phenomenology is the study of structures of consciousness as experienced from the first-person point of view. These structures include perception, memory, imagination, thought, emotion, desires, embodied action, physical awareness, and social interactions (as linguistic activity). In other words, phenomenology studies conscious experiences as experienced from the first personal, subjective perspective and explores the meanings of things through the personal experience of the world (Smith 2018). Phenomenological approaches to the study of cognition have been often linked to the notion of embodiment, i.e., the role of the body in shaping cognitive processing (Gallagher and Zahavi 2007; Zahavi 2002). The reason for this stems from the fact that, from a phenomenological perspective, humans are seen to perceive, understand, and interact with the world as embodied subjects (Husserl 1950). The body as described by Husserl, the philosopher who established the school of phenomenology, is neither internal to consciousness nor external to the subject in the environment; it is neither subject nor object, rather it is “a thing ‘inserted’ between the rest of the material world and the ‘subjective’ sphere” (Husserl 1950). In this way, the body becomes the instrument that orientates humans through their experience of the world. It is worth noting that, in Husserl’s analysis, the body is not understood as the objective and material body (Körper) but rather as the subjective body (Leib) that constantly and actively interacts with the world (Walsh 2017). Wherever there is a body, there is a personal interaction with the world. This interaction is considered unique, as unique is also the mind of the subject, as well as the time and context of its interaction with the environment. This notion of the body as Leib can be dated back to Friedrich Nietzsche’s Thus Spoke Zarathustra, where it was used to highlight the poietic function of the body in shaping subjective experience. In a section called “The Despisers of the Body”, Zarathustra argues: “Ego” sayest thou, and art proud of that word. But the greater
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