What Does it Mean to be Human? Life, Death, Personhood and the Transhumanist Movement by D. John Doyle Submitted in fulfillment of the requirements for the degree of Doctor Philosophiae FACULTY OF HUMANITIES UNIVERSITY OF PRETORIA PRETORIA January 19, 2017 Supervisor: Professor Benda Hofmeyr Co-supervisor: Professor Alex Antonites © University of Pretoria © University of Pretoria SUMMARY Title: What Does it Mean to be Human? Life, Death, Personhood and the Transhumanist Movement Author: D. John Doyle Supervisor: Professor Benda Hofmeyr Co-supervisor: Professor Alex Antonites Degree: Doctor of Philosophy (D Phil) Department: Philosophy Faculty: Humanities ii © University of Pretoria ABSTRACT This dissertation addresses various aspects of the question “What does it mean to be human?”, approaching the issue from biological, philosophical and ethical perspectives. The discussion focuses primarily on the philosophical and ethical implications of the transhumanist movement, an intellectual community seeking to favorably transform the human organism via the safe deployment of interventions such as genetic engineering and pharmacologic enhancement. Following a review of bioethical principles, the dissertation begins by examining the notion of “personhood” in philosophical, historical and biological contexts. Next, the possibility that developments in neuropharmacology might ultimately lead to an artificial paradise free of the negative aspects of the human condition (but without the often destructive effects of today’s mood altering drugs) is considered. A philosophical difficulty related to the existentialist notion of “authenticity” in such a “mood optimized” synthetic existence is identified. iii © University of Pretoria This discussion is followed by a rather technical exposition on the occasional difficulties of establishing when a person is alive or dead, particularly in the setting of “brain death”. A number of philosophical flaws with the notion of brain death as it is used currently are presented. The discussion then considers some of the philosophical issues raised by the possibility of human cryonic suspension. A distinction is made between the information preserved in a person's brain and the substrate used to hold that information. Implications for personhood are also discussed, as well as a number of related ethical issues. Finally, objections raised by “bioconservative” critics of transhumanism are critically examined and found to be for the most part unconvincing, frequently relying on emotion and intuition rather than on evidence, logic and reason. iv © University of Pretoria VITAE D. John Doyle is an anesthesiologist at Cleveland Clinic, in Cleveland, Ohio, where he holds the rank of Professor. He is now seconded to Cleveland Clinic Abu Dhabi, where he is the Chief of the Department of General Anesthesia. Dr. Doyle received the MD, PhD and FRCPC qualifications at the University of Toronto in Toronto, Canada in 1982, 1986 and 1986 respectively. Although he has numerous scholarly publications in the fields of medicine and anesthesiology, in recent years he has developed his long-standing interest in philosophy by branching into occasional research and academic writing in the fields of ethics and bioethics. v © University of Pretoria ACKNOWLEDGEMENTS I am particularly grateful for helpful discussions and advice from Professor Benda Hofmeyr and Professor Alex Antonites, my doctoral dissertation advisors at the University of Pretoria. I am also indebted for helpful insights from Dr. Martin Harvey and Dr. Allyson L. Robichaud of the Department of Philosophy, Cleveland State University, Cleveland, Ohio, USA, as well as from Dr. James Hughes of Trinity College, Hartford, Connecticut, USA. Finally, I am grateful to my wife Jo-Anne and my son Jonathan for being supportive of my never-ending academic pursuits. vi © University of Pretoria FOREWORD It has been a pleasure and a challenge undertaking this project. One special challenge faced in the writing of this dissertation was that it necessarily addressed two very different audiences: philosopher/ethicists on the one hand and clinician/scientists on the other. With respect to the first audience, I have done my best to avoid unnecessary technical jargon, although I readily admit that this is at times simply unavoidable. With the second audience in mind, I have done two things. First I have included an unusually comprehensive review of bioethics in Chapter 2. Second, in the citations section I have also included the PubMed PMID codes and related information for as many referenced papers as possible in order to facilitate the retrieval of these articles by interested parties. vii © University of Pretoria I have been fortunate that I have been able to publish a great deal of the material contained herein in the journal Ethics in Biology, Engineering and Medicine, as indicated in the list below. Doyle DJ. An Introduction to Bioethics and Ethical Theory. Ethics in Biology, Engineering and Medicine. 2010; 1:19-41. (Based on Chapter 2). Doyle DJ. What Does It Mean to Be Human? Humanness, Personhood and the Transhumanist Movement. Ethics in Biology, Engineering and Medicine. 2010; 1:107-131. (Based on Chapter 3). Doyle DJ. Pharmacologic Emancipation from the Human Condition: Laudable Goal or Dangerous Pipe Dream? Ethics in Biology, Engineering and Medicine. 2010; 1:199-214. (Based on Chapter 4).\ Doyle DJ. The Thorny but Pervasive Problem of Permissible Deaths. Ethics in Biology, Engineering and Medicine. 2010; 1:259-265. (An expansion of Section 2.21) viii © University of Pretoria Doyle DJ. Should Logic Trump Intuition in Bioethical Discourse? Contrasting Peter Singer and Leon Kass. Ethics in Biology, Engineering and Medicine. 2011; 2:1-9. (Based in part on Chapter 2.) Doyle DJ. Life, Death and Brain Death: A Critical Examination. Ethics in Biology, Engineering and Medicine. 2011; 2:11-31. (Based on Chapter 5.) Doyle DJ. Cryonic Life Extension: Scientific Possibility or Stupid Pipe Dream. Ethics in Biology, Engineering and Medicine.2012; 3:9-28 (Based on Chapter 6.) Doyle DJ. Robots, Androids, and Cyborgs in Warfare: Ethical and Philosophical Issues. Ethics in Biology, Engineering and Medicine.2014; 1:13-23 (Based in part on Chapter 3.) ix © University of Pretoria TABLE OF CONTENTS Summary Abstract Vitae Acknowledgements Foreword List of Figures List of Tables Chapter 1 Introduction 1.1 What Does it Mean to be Human? 1.2 Insights from Science Fiction 1.3 Transhumanism 1.4 Artificial Life 1.5 Cosmetic Neurology 1.6 Personhood Theory 1.7 Death x © University of Pretoria 1.8 Cryonics 1.9 Critique of Transhumanism Chapter 2 Biomedical Ethics 2.1 Introduction 2.1 Overview of Ethics and Bioethics 2.3 Hippocratic Origins of Bioethics 2.4 Lapses in Medical Ethics I: The Origins of Formal Bioethics 2.5 Lapses in Medical Ethics II: The Tuskegee Syphilis Study 2.6 Lapses in Medical Ethics III: Japanese Wartime Medical Atrocities 2.7 Ethical Theory 2.8 Kantian Ethics 2.9 Principlism 2.10 Ethical Conflicts in Principlism: Autonomy as "First Principle Among Equals" 2.11 Peter Singer 2.12 A Transplantation Example xi © University of Pretoria 2.13 Critique of Utilitarianism 2.14 John Rawls 2.15 Virtue Ethics 2.16 Characteristics of a Good Moral Theory 2.17 Bernard Williams 2.18 Reason vs. Moral Intuition 2.19 Sanctity of Human Life 2.20 Further Concerns about Singer 2.21 Logic in Philosophical Discourse 2.22 An Axiomatic Approach 2.23 Consent 2.24 Medical Futility 2.25 Doctrine of Double Effect 2.26 Therapeutic Privilege 2.27 The Permissible Death Problem 2.29 Legal Perspectives 2.29 Conclusion xii © University of Pretoria Chapter 3 Humans, Transhumans and Humanoids 3.1 Introduction 3.2 Moral Standing 3.3 Personhood 3.4 Nonhuman Personhood 3.5 Classical Eugenics 3.6 Liberal Eugenics 3.7 Introducing Transhumanism 3.8 Nick Bostrom 3.9 Julian Savulescu 3.10 John Harris 3.11 Charles Tandy 3.12 Enhancing Human Performance for Spaceflight 3.13 Animal / Human Hybrids and Other Strange Creatures 3.14 Putting Human Genes into Animals 3.15 Language Genes 3.16 Human / Animal Chimeras xiii © University of Pretoria 3.17 Inserting New Genes in Existing Humans 3.18 Human / Computer Hybrids and Neuroprostheses 3.19 Robots, Androids and Artificial Persons 3.20 Consciousness, Artificial Beings and the Turing Test 3.21 Artificial Beings and Moral Standing 3.22 Moral Robots and Robot Ethics 3.23 Conclusion Chapter 4 Pharmacologic Enhancement: Possibilities and Perils 4.1 Introduction 4.2 Might Pharmacological Interventions Improve the Human Condition? Scenario One: Movement Enhancement Scenario Two: Creativity Enhancement Scenario Three: Performance Enhancement in Emergencies 4.3 Some Pharmacophilosophical Questions 4.4 Imagining a World Without Negative Emotions 4.5 Brain Enhancement via Electrical Brain Stimulation xiv © University of Pretoria 4.6 But Should We Partake? 4.7 What Does it Mean to be an “Authentic” Human Being? 4.8 Back to Religion Chapter 5 Life, Death, and Brain Death 5.1 Introduction 5.2 What is Life? 5.3 The Traditional Concept of Death 5.4 Brain Death 5.5 Early Brain Death Criteria 5.6 Ancillary Tests for Confirming Brain Death 5.7 Death of the Entire Brain as a Requirement for Brain Death 5.8 Ignoring the “Death of the Entire Brain” Rule in Declaring Brain Death 5.9 Some Brain Stem Nuclei are not Tested when Testing for Brain Stem Death 5.10 The Problem of Spontaneous Movements Despite Brain Death 5.11 The Problem of Waxing and Waning of Neuronal Function xv © University of Pretoria 5.12 Limitations Inherent in all Medical Testing 5.13 Ambiguity in the Definition of Brain Death 5.14 Further Difficulties in the Declaration of Brain Death 5.15 The Problem of Indistinct Boundaries: Death as a Process 5.16 Peter Singer and Brain Death 5.17 The Diagnosis of Brain Death Compared to a Murder Trial 5.18 Neomorts 5.19 Non-heart-beating Organ Donors 5.20 Nanotechnology and the Death of Death Chapter 6 Cryonic Life Extension: Scientific Possibility or Stupid Pipe Dream? 6.1 Introduction 6.2 What is Cryonics? 6.3 Is Cryonics Possible in Principle? 6.4 Vitrification 6.5 Substrate Preservation vs.