Ethical issues in moral and social enhancement



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ETHICAL ISSUES IN MORAL AND SOCIAL ENHANCEMENT 
 
 
A thesis submitted to The University of Manchester for the degree of Doctor of 
Philosophy 
in the Faculty of Humanities and Social Sciences 
2015 
Anna Pacholczyk 
School of Law 
 



 
Contents 
ABSTRACT
 ........................................................................................................................... 5 
Declaration
 ............................................................................................................................. 6 
Introduction
 ............................................................................................................................ 8 
CHAPTER 1. What is moral enhancement
 .......................................................................... 15 
1.1.
 
Introduction
 .......................................................................................................... 15 
1.2.
 
Three senses of ‘moral’
 ........................................................................................ 15 
1.2.1.
 
Moral Enhancement as Enhancement that is Morally Desirable
 ................. 15 
1.2.2.
 
Moral Enhancement as a change in some aspect of morality that results in a 
morally better agent
 ..................................................................................................... 17 
1.2.3.
 
Moral Enhancement as a beneficial change in the sphere of morality
 ......... 18 
1.3.
 
Enhancement as improvement
 ............................................................................. 20 
1.3.1.
 
Treatment and enhancement
 ........................................................................ 20 
1.3.2.
 
Enhancement and benefit
 ............................................................................. 23 
1.3.3.
 
Moral dis-enhancement
 ................................................................................ 25 
1.4.
 
Ethical permissibility
 ........................................................................................... 28 
1.5.
 
Conclusions
 .......................................................................................................... 29 
CHAPTER 2. Hype or hope? Plausibility without techno-utopianism
 ................................ 31 
2.1. 
 
Introduction
 .......................................................................................................... 31 
2.2 
 
Reconsidering our goals
 ....................................................................................... 31 
2.3. 
 
Reconsidering our expectations
 ........................................................................... 33 
2.3.1.
 
Context-dependency and individual differences
 .......................................... 33 
2.3.2.
 
 Effectiveness
 ............................................................................................... 35 
2.4. 
 
A case study: oxytocin
 ......................................................................................... 37 
2.5. 
 
Conclusions
 .......................................................................................................... 42 
CHAPTER 3. The moral and the pro-social
 ........................................................................ 43 
3.1.
 
 Introduction
 ......................................................................................................... 43 
3.2.
 
Empathy’s charm
 ................................................................................................. 43 
3.3.
 
The limits of empathy
 .......................................................................................... 45 
3.4.
 
Moral and pro-social behaviour
 ........................................................................... 51 
3.4.1.
 
Is pro-social always good?
 ........................................................................... 51 
3.4.2.
 
Population perspective
 ................................................................................. 55 



3.4.3.
 
Moral modification instead of moral enhancement
 ..................................... 56 
3.5.
 
The importance of moral reasons
 ......................................................................... 59 
3.6.
 
Conclusions
 .......................................................................................................... 60 
CHAPTER 4. Moral disagreement
 ...................................................................................... 62 
4.1. 
 
Introduction
 .......................................................................................................... 62 
4.2. 
 
Moral disagreement and MB
................................................................................ 62 
4.3.
 
Fundamental moral disagreement
 ........................................................................ 64 
4.4.
 
Conclusions
 .......................................................................................................... 67 
CHAPTER 5: Medicalization
 .............................................................................................. 69 
5.1.
 
 Introduction
 ......................................................................................................... 69 
5.2. 
 
What is medicalization?
 ....................................................................................... 70 
5.2.1. 
 
Medicalization – early sociological approaches
 .......................................... 70 
5.2.2. 
 
New approaches to medicalization – biomedicalization
 .............................. 71 
5.2.3. 
 
Medicalization: a normative or non-normative concept?
 ............................. 73 
5.2.4. 
 
Efficacy and the sociological view of medicalization
 .................................. 74 
5.2.5.
 
 Medicalization and over-medicalization
 ..................................................... 75 
5.3. 
 
Ethical appraisal: arguments against medicalization
 ........................................... 76 
5.3.1. The ‘category mistake’ argument examined
 ...................................................... 76 
5.3.2. The’ proper goals of medicine’ and ‘the normal and usual traits’ objections
 .... 79 
5.3.3.
 
 Epistemic, pragmatic and moral justification of pain and harm
 ..................... 81 
5.3.4. The ‘full human life involves suffering’ argument
 ............................................ 84 
5.3.5. Living well requires that we let some problems be.
........................................... 89 
5.3.6. Social control: are we moulding ourselves to fit society instead of adapting the 
society to fit people’s needs?
 ....................................................................................... 91 
5.3.7. Exponential growth of costs and the undermining of non-medical coping 
arguments
 ..................................................................................................................... 95 
5.3.8. Is autonomy undermined by a shift in causal explanations?
 ............................ 100 
5.4. 
 
Ethical appraisal: the benefits of medicalization
 ............................................... 102 
5.5.
 
Conclusions
 ...................................................................................................... 105 
CHAPTER 6: Narrative identity
 ........................................................................................ 107 
6.1.
 
Introduction
 ............................................................................................................ 107 
6.2.
 
Schechtman’s objection to the use of direct brain modulation
 .............................. 109 
6.2.1.
 
Schechtman’s account of narrative identity
 ................................................... 109 
6.2.2.
 
Schechtman’s objection to biomedical modification
 ..................................... 110 
6.2.3.
 
Arguments against Schechtman’s objection
 .................................................. 113 



6.2.4.
 
Empathic access: another challenge?
 ............................................................. 115 
6.2.5.
 
Conclusions
 .................................................................................................... 118 
6.3.
 
Can Ricoeur’s view of narrative identity ground an ethical objection to MB?
 ...... 119 
6.3.1.
 
Ricoeur’s view of narrative identity
 ............................................................... 119 
6.3.2.
 
Deficient and dissolving narratives
 ................................................................ 121 
6.3.3.
 
Narrative disorganisation
 ............................................................................... 122 
6.3.4.
 
Deficit in integration between multiple self- or other-representations as an 
example of a narrative not fulfilling the homophony criterion
 ...................................... 123 
6.3.5.
 
Against Ricoeur’s homophony criterion
 ........................................................ 125 
6.3.6.
 
How many voices are too many?
 ................................................................... 126 
6.3.7.
 
Conclusions
 .................................................................................................... 127 
6.4.
 
Arguments against the strong ethical narrative view and the strong psychological 
narrative view
 .................................................................................................................... 128 
6.5.
 
Conclusions
 ............................................................................................................ 131 
CHAPTER 7. Freedom, autonomy and the God Machine
 ................................................. 133 
7.1.
 
Introduction
 ........................................................................................................ 133 
7.2.
 
Introducing the God Machine
 ............................................................................ 135 
7.3.
 
Moral praise and blame
 ...................................................................................... 137 
7.3.1.
 
Black vs. the God Machine
 ........................................................................ 137 
7.3.2.
 
The making of moral luck
 .......................................................................... 141 
7.4.
 
Free will and free action
 .................................................................................... 145 
7.4.1.
 
Introduction
 ................................................................................................ 145 
7.4.2.
 
Frankfurt on free will and free action
 ........................................................ 145 
7.4.3.
 
Frankfurt’s own free will and the God Machine
 ........................................ 147 
7.4.4. Conclusions
 ...................................................................................................... 149 
7.5. Free thought and will of one’s own
 ........................................................................ 150 
7.5.1. Introduction
 ...................................................................................................... 150 
7.5.2. Separating thought from action and the appropriate engagement with reasons
 ................................................................................................................................... 151 
7.5.3. Separating thought from action and overdetermination
 ................................... 156 
7.5.4. What is a good state of mind worth?
 ................................................................ 158 
7.5.6. Conclusions
 ...................................................................................................... 161 
7.6. Freedom and domination
 ........................................................................................ 162 
7.6.1. Introduction
 ...................................................................................................... 162 
7.6.2. The God Machine impersonated
 ...................................................................... 163 



7.6.3. Arbitrary and unchecked power
 ....................................................................... 165 
7.6.4. Ghost in the God Machine: Who is dominating?
 ............................................. 167 
7.6.5. Conclusions
 ...................................................................................................... 175 
7.7. Why is the God Machine an undesirable way of making a better society?
 ............ 175 
7.7.1. Introduction
 ...................................................................................................... 175 
7.7.2. The harm principle
 ........................................................................................... 176 
7.7.3. The inner citadel
 .............................................................................................. 179 
7.8. Why the God Machine is a poor analogy for real-world MB
 ................................. 182 
7.9. Conclusions
 ............................................................................................................. 186 
CHAPTER 8. Beyond the God Machine
 ........................................................................... 188 
8.1. Introduction
 ............................................................................................................. 188 
8.2. Are ‘compulsions for the good’ beyond moral review?
.......................................... 191 
8.2.1. Introduction
 ...................................................................................................... 191 
8.2.2. Online and offline moral review vs online and offline moral control
 .............. 191 
8.2.3. Biomedical emotion modulation and moral review
 ......................................... 197 
8.2.4. Conclusions
 ...................................................................................................... 203 
8.3. Moral control
 .......................................................................................................... 205 
8.3.1. Introduction
 ...................................................................................................... 205 
8.3.2. Aristotle’s akrasia, enkrateia and virtue
 ........................................................... 206 
8.3.3. Is inverse akrasia any good?
 ............................................................................ 208 
8.3.4. Deliberation to action
 ....................................................................................... 212 
8.3.5. Is enhancing individual moral agency self-indulgent?
..................................... 218 
8.3.6. Why enkrateia will not suffice
 ......................................................................... 220 
8.3.7. Conclusions
 ...................................................................................................... 226 
Conclusions
 ........................................................................................................................ 229 
References
 .......................................................................................................................... 235 

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