Duquesne University Duquesne Scholarship Collection Electronic Theses and Dissertations Summer 8-8-2020 A Bioethical Paradigm for Enhanced, Post or Transhumans in Medicine and Biological Research Roderick Williams Follow this and additional works at: https://dsc.duq.edu/etd Part of the Bioethics and Medical Ethics Commons, and the Medical Humanities Commons Recommended Citation Williams, R. (2020). A Bioethical Paradigm for Enhanced, Post or Transhumans in Medicine and Biological Research (Doctoral dissertation, Duquesne University). Retrieved from https://dsc.duq.edu/etd/1923 This One-year Embargo is brought to you for free and open access by Duquesne Scholarship Collection. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Duquesne Scholarship Collection. A BIOETHICAL PARADIGM FOR ENHANCED, POST OR TRANSHUMANS IN MEDICINE AND BIOLOGICAL RESEARCH A Dissertation Submitted to the McAnulty College and Graduate School of Liberal Arts Duquesne University In partial fulfillment of the requirements for the degree of Doctor of Philosophy By Roderick K. Williams August 2020 Copyright by Roderick K. Williams 2020 A BIOETHICAL PARADIGM FOR ENHANCED, POST OR TRANSHUMANS IN MEDICINE AND BIOLOGICAL RESEARCH By Roderick K. Williams Approved May 07, 2020 ________________________ ________________________ Joris Gielen, PhD Gerard Magill, PhD Director, Center for Healthcare Ethics Vernon F. Gallagher Chair for Associate Professor Healthcare Ethics Integration of Science, Theology, (Dissertation Chair) Philosophy and Law Professor of Healthcare Ethics (Committee Member) ________________________ _____________________ Joris Gielen, PhD Peter Osuji, PhD Associate Professor Assistant Professor Center for Healthcare Ethics Healthcare Ethics (Committee Member) (Committee Member) Kristine Blair, PhD Dean, McAnulty College and Graduate School of Liberal Arts Professor and Dean of McAnulty College (Dean) iii ABSTRACT A BIOETHICAL PARADIGM FOR ENHANCED, POST OR TRANSHUMANS IN MEDICINE AND BIOLOGICAL RESEARCH By Roderick K. Williams August 2020 Dissertation supervised by Joris Gielen In this dissertation the question addressed is the ethical protocol that should be used when enhanced, post or transhumans present themselves as patients to hospitals, or as subjects for scientific research. With the advent of the birth of four children who were genetically engineered in China to be resistant to HIV, I contend that transhumans are already here, and the prevailing Western paradigm of principlism, while good, is not adequate to the task. I explore the basic religious argument that can be used against or in favor of what I call human-directed human evolution. I show how the fears of new kinds of persons are can be traced not just to myth, but also to the genre of science fiction. I start with Mary Shelley’s Frankenstein or The Modern Prometheus, through Star-Trek’s Borg Queen, and forward to BBC America’s “Orphan Black”. The argument for moral enhancement, a concept for which Julian Savulescu argues, is examined as is Nick Bostrom’s explication of superintelligence, and his joining Savulescu’s call for an enhancement of moral values. Several technologies currently in use for genetic testing, and that iv can be used for genetic engineering will be explained. These include preimplantation genetic diagnosis and mitochondrial replacement techniques (MRT), which are used to avoid birth defects in potential offspring. CRISPR-Cas9, TALENs, cloning and haploid stem cells are the technologies that not only can be used to develop specific treatment mechanisms, but they are the mechanisms that will allow humankind to engineer new kinds of persons, thus creating transhumans. From here I address the two prevailing sides of how to proceed: precaution where we move slowly trying to ascertain and prepare for any negative eventuality, and proaction where we move directly ahead after we have done all we can to prepare but opt to adjust along the way as the need arises. The ethical argument I make for the protocol that I think must be adopted does not just come from an examination of principlism. I also incorporate concepts from Buddhism, Confucianism, Islam, Hinduism and African philosophy. I posit that two other principles are needed: Particularity and Intrinsic Personhood. v TABLE OF CONTENTS Introduction 1 1.1 Ethical Responsibility 2 1.1.1 Autonomy 3 1.1.2 Consent 4 1.2 Human Enhancement 6 1.2.1 Bostrom’s Superintelligence 6 1.2.2 Savulescu on Moral Enhancement 8 1.3. Transhumanism 10 1.3.1 Precautionary Principle 11 1.3.2 Proactionary Imperative 13 1.4. Designing Progeny 15 1.4.1 PGD, mtDNA 15 1.4.2 Cloning, CRISPR-Cas9, Directed Evolution 17 1.5. The Case of Alassane Case 20 1.6 Narrative of Subsequent Chapters 22 Chapter 2. The Feminine and The Other: An Introduction to Transhumanism Through Science Fiction 39 Introduction 39 2.1 Frankenstein 42 2.1.1 His Monster as Criminal and His Role in IVF Debate 43 2.1.2 His Monster as Other, and Human Rights 46 2.2 The Borg Queen 48 2.2.1The Borg Queen: Other Goddesses in Otherworlds 48 2.3. Cloning (Using “Orphan Black”) 53 2.3.1 Orphan Black and The Patenting of People 54 2.3.2 What is the Definition of Human? 56 2.4. Ethical Considerations Posed by the Subjects 57 2.4.1 Personhood 58 vi 2.4.2 Critical Race Ethics as a Template for Otherness 60 2.5. Fuller and Lipinska: The Proactionary Manifesto 63 Conclusion 66 Chapter 3: The Ethical Justification of Transhumanism 68 Introduction 68 3.1 Introduction to the History of Transhumanism 69 3.1.114th through 19th Century 69 3.1.2 20th Century 71 3.2 The Philosophical Basis for Transhumanism in Fuller and Lipinska’s Proactionary Imperative 74 3.2.1 Proaction and Precaution: The Basic Concepts 74 3.2.2 The Proactionary Imperative Considered in Light of Indebtedness and the Commonweal 76 3.3 Genetics Technology 78 3.3.1 CRISPR Cas-9 78 3.3.2 TALENS 80 3.3.3 Cloning with Emphasis on the 2013 Breakthrough 80 3.3.4 Haploid Stem Cells 82 3.4 Ethical Arguments for Caution (the precautionary principle) 83 3.4.1 Question 1: Is Humankind the Epitome of Creation 84 3.4.2 Question 2: Are we playing God? 87 3.5 Discovering What Is: An Experimental City 90 Conclusion 93 Chapter 4: Superintelligence and Moral Enhancement: Bostrom And Savulecsu and the Development of an Ethical Basis for Natural and Posthuman Interaction 95 Introduction 95 4.1. Superintelligence (Bostrom) 96 4.1.1 AI to Superintelligence Defined and Explained 97 4.1.2 Whole Brain Emulation, Biological Cognition, Brain-Computer Interface 99 vii 4.1.3 Cognitive Superpowers 102 4.2. Bostrom Interrogated 103 4.2.1 Becoming Posthuman:An Alternative Superintelligence in the Individual 104 4.2.2 Enhancements: Benefits and Tradeoffs 105 4.3. Savulescu: The Need for Moral Enhancement 108 4.3.1Common-Sense Morality, Ego and Biases Toward Our Own 108 4.3.2 The Liberal Democracy and Rights 112 4.3.3 Ultimate Harm and Destruction of The Commons 114 4.3.4 Why Moral Enhancement is Necessary, Applying the Moral Enhancement to Interaction with Post-Humans 118 Conclusion 120 Chapter 5: The Ethics of Genomics Regarding the Possibility of Designing Babies Introduction 122 5.1 Preimplantation Genetic Diagnosis 123 5.1.1 PGD: The Science and Technology 123 5.1.2 Ethical Issues and PGD 126 5.2 Mitochondrial (mtDNA) Disease and Replacement Therapies 128 5.2.1 The Charlie Gard Case 128 5.2.2 Mitochondrial Disease (mtDNA) and Mitochondrial Replacement Techniques (MRT) 129 5.2.3 Ethical Considerations of Mitochondrial Replacement Techniques 131 5.3 Intentional Genetic Modification and CRISPR Technology 133 5.3.1 After PGD and MRT, CRISPR-Cas9 133 5.3.2 CRISPR-Cas9 Experimentation 135 5.4. Cloning 138 5.4.1 Cloning: History and Process 138 5.4.2Transgenic Experimentation and Development 140 5.5 Human Directed Human Evolution (Transhumanism) 142 5.5.1 An Overarching Scenario 143 viii 5.5.2 Transhumanism Definition and Discussion 144 5.5.3 Is China Moving Forward? 145 Conclusion 146 Chapter 6: An Ethical Analysis of Beneficence and Non-maleficence to Guide Emerging Medical Technology 148 Introduction 148 6.1. Non-maleficence and Beneficence: Principlism Concepts, UNESCO’s UDBHR 149 6.1.1 Nonmaleficence 150 6.1.2 Beneficence 152 6.1.3 Benefit and Harm: Article 4 of UNESCO’s UDBHR 152 6.2. Immunological Medicine, Genomic-Based Medicine and Reproductive Technology an Overview with Examples 154 6.2.1 Immunological Medicine 154 6.2.2 Genetics-Based Medicine 157 6.2.3 Reproductive Technology 159 6.3. A Discussion of the Precautionary Principle 161 6.4. Non-Western Ethical Concepts Related to Beneficence and Nonmaleficence 165 6.4.1 Ahimsa as applied to the unborn: assessing their value (Hindu/Buddhist) 165 6.4.2 The concept of Ren: Confucian Virtue Ethics Applied to Reproductive Technology 167 6.4.3 Ubuntu: Reproductive technology as a benefit to the community 170 Conclusion 175 Chapter 7: An Ethical Analysis of Justice to Avoid Exploitation of and Discrimination Against Vulnerable Populations 177 Introduction 177 7.1 Vulnerability 179 7.1.1 Definition and Dimensions 179 7.1.2 Respect for Vulnerability…: Article 8 UNESCO’s UDBHR 183 7.2. Principlism: Concept of Justice and Vulnerability 187 ix 7.2.1An Explication of Justice 188 7.2.2 Justice for the Vulnerable: Its Application to Posthumans 191 7.3. Justice and Civil Rights 195 7.3.1 Envy and The Question of Exploitation 195 7.3.2 Ensuring Justice with Health Care Policy 197 Conclusion 200 Chapter 8: The Principle of Particularity 202 Introduction 202 8.1.