Uehiro Oxford Institute

In this talk, Professor Tony Coady examines the contrast between reason and emotion and argues that much of the separation of reason and emotion that underpins the debate is misguided. In the debate about the pros and cons of human enhancement, proponents of enhancement often accuse their opponents (so-called “conservatives”) of substituting emotion for reason. In this, they are relying upon an age-old dichotomy between reason and emotion that has a long popular and philosophical history. Plato’s picture of Reason as the charioteer controlling the turbulent horses of the passions has had a significant influence (though its popular version ignores Plato’s reservations.) Cognitive psychologists and neuro-scientists have recently joined the fray and sought to examine the role of reason on the one hand and emotion on the other in moral outlooks and decisions. This paper will examine the contrast between reason and emotion and, while noting many ambiguities in both concepts, will argue that much of the separation of reason and emotion that underpins the debate is misguided.

In this St Cross Special Ethics Seminar, Jeremy Howick defends Grünbaum’s work on placebos. He outlines a need to re-examine policies on ethics of placebos, and revise our estimations of their effects in both clinical practice and trials. There is currently no widely accepted definition of ‘placebos’. Yet debates about the ethics of placebo use (in routine practice or clinical trials) and the magnitude (if any!) of ‘placebo’ effects continue to rage. Even if not formally required, a definition of the ‘placebo’ concept could inform these debates. Grünbaum’s 1981/1986 characterization of the ‘placebo’ has been cited as the best attempt thus far, but has not been widely accepted. Here we argue that criticisms of Grünbaum’s scheme are either exaggerated, unfounded or based on misunderstandings. We propose that, with three modifications, Grünbaum’s scheme can be defended. Grünbaum argues that all interventions can be classified by a therapeutic theory into ‘incidental’ and ‘characteristic’ features. ‘Placebos’, then, are treatments whose characteristic features do not have effects on the target disorder. To Grünbaum whether a treatment counts as a placebo or not is relative to a target disorder, and a therapeutic theory. We modify Grünbaum’s scheme in the following way. First, we add ‘harmful intervention’ and ‘nocebo’ categories; second, we insist that what counts as a ‘placebo’ (or nonplacebo) be relativized to patients; and third, we issue a clarification about the overall classification of an intervention. We argue that our modified version of Grünbaum’s scheme resists published criticisms. Our work warrants a re-examination of current policies of the ethics of placebos in both clinical practice and clinical trials, and a revised empirical estimation of ‘placebo’ effects, both in the context of clinical trials and clinical practice.

Tom Walker discusses autonomy and informed consent to medical treatment There are two features of consenting to medical treatment that have been little explored in the extensive literature on this topic. The first is that the requirement to obtain consent is conditional in the following sense – we only need to obtain consent for those things that are both wrong if done without consent, and that we want or have reason to do. The second is that whilst many patients in their interactions with doctors are initially uninformed, this does not always prevent them from choosing to have, or not to have, possible treatments. In this paper I explore the implications of these two features for the idea that doctors ought to provide information to patients about the treatments they propose. I will argue that these features create a serious problem for the widely held idea that it would be wrong, because it would fail to respect his autonomy, to give a competent patient medical treatment without his valid consent (where this refers to a voluntary and informed agreement to have the treatment). As such the requirement to respect autonomy will not give any reason for doctors to provide information in these cases; in fact on at least some accounts of autonomy the obligation to respect autonomy would give them a reason not to provide that information. The paper then goes on to consider some ways in which the obligation to provide information about potential treatments could be supported.

If networking is considered to be either cultivating non-merit-based favouritism or demonstrating one’s merit in advance of formal selection processes, then I argue that it is an attempt to gain illegitimate advantage over competitors and is thus immoral. Networking is taken to be a perfectly innocuous part of business and career-advancement. I argue that, where the aim is to increase one’s prospects of prevailing in a formal competitive process for a job or university placement, networking is an attempt to gain illegitimate advantage. This is true no matter which of the two standard characterisations we accept. If networking is about building personal relationships, as some claim, then it involves cultivating non-merit-based favouritism. To that extent it shares one of the wrong-making features of bribery. On the other hand if networking is about demonstrating one’s merit in advance of formal selection processes, it shares one of the wrong-making features of earwigging in legal advocacy. One way or the other, the networker denies (or tries to deny) rival candidates something to which they are presumptively entitled. Either he denies their right not to be disadvantaged for reasons other than lack of relative merit, or he denies their right not to be disadvantaged by private ex parte communications that take place outside of formal selection processes.

I argue that the value of love in friendship illuminates issues about parental love and examine whether allowing same-sex couples access to adoption has any bearing on the moral status of prohibitions on same-sex couples using assisted reproduction. An emotional liberty rationale for broad access to IVF and other forms of assisted reproduction focuses on how narrow restrictions on such access prevent prospective parents from developing forms of parental love which are distinctively valuable (apart from prospective parents’ motives for reproducing). This rationale supports a general principle that it is pro tanto wrong to deliberately place obstacles in the way of opportunities to develop such forms of parental love – as when states prohibit same-sex couples from accessing IVF (or, for that matter, from accessing adoption). These normative claims do not require that such forms of parental love are very common in parent-child relationships. But how broadly are such distinctively valuable forms of parental love plausibly thought to extend, such that it is clear what would count as an obstacle to the development of this love? Answering this question is also important for addressing issues about whether the value of one sort of parental love can plausibly be substituted for another, as some have suggested in debates about IVF access.

Humans show a bias to favour information related to themselves over information related to other people. How does this effect arise? Are self biases a stable trait of the individual? Do these biases change fundamental perceptual processes? I will review recent work from my laboratory showing that self-biases modulate basic perceptual processes; they are stable for an individual and are difficult to control; they reflect rapid tuning of brain circuits to enhance the saliency of self-related items. I discuss the implications of this work for understanding whether perceptual processes are informationally encapsulated, and whether perception changes as a function of social context.

Antidepressants are commonplace yet there is much debate about their clinical efficacy. Are they merely placebos or do they have a clinical effect on the way our brains work? In this presentation, Professor Cowen investigates the evidence. Antidepressant drugs are commonly prescribed for clinical depression but have a rather dubious public reception. Professor Ian Reid has commented that, 'antidepressants are regularly caricatured in the media as an addictive emotional anaesthetic, peddled by thoughtless general practitioners as a matter of convenience, and taken by credulous dupes who seek "a pill for every ill".' (BMJ 2013; 346: f190). There is also a perception that antidepressants, in fact, work only through placebo mechanisms and have no specific activity to relieve depression. In this presentation I will look at the evidence for the effectiveness of antidepressants and the kind of clinical situation where their use seems justified. I will also describe a new 'cognitive' theory of antidepressant action which suggests that antidepressants work through a specific effect on how the brain evaluates emotional information.

We explore some possible interactions between enhancement technology and punishment, reflect on ethical issues that arise as a result, and consider what our justice system must do in order to ensure that it keeps pace with developments in technology. Criminal justice systems currently employ a limited range of penal sanctions to punish offenders. The type and nature of the sanctions employed are, in large part, determined by the penal aims a particular system is designed to pursue. However, they are also shaped by beliefs about what people are typically like, and by the resources available to develop and deploy punishments. Technology - particularly human enhancement technology - could change both of these latter influences. It could facilitate more effective punishments, support existing punishments, undermine certain punishments, make certain punishments more severe than was originally intended, and alter the resources available for punishments and the constraints on types of punishment.

The talk discusses the balance between cyber security measures and individual rights - any fair and reasonable society should implement the former successfully while respecting and furthering the latter. Defeating online insecurity is like defeating a Hydra with many heads: from e-commerce and online banking scams to malware, from hacking to cyberwar, it requires Herculean efforts to slay the Hydra. However, fighting and preventing attacks on security may easily cause serious ethical problems, since security measures can also undermine individual liberties such as privacy, freedom of speech and expression. This is because such measures often rest on the collection, storage, access, or elaboration of individuals' personal information. Clearly, any democratic government, fair society and responsible organisation need to identify a balance between online security and individual rights, in order to implement the former successfully while respecting and furthering the latter. The talk discusses a criterion for such a balance to be ethically sound. It is claimed that cyber security measures and individual rights are not necessarily antithetical and that they should be both considered fundamental aspects of individual's well-being in the information age.

If doping were done in a healthy and fair way, would it be OK? If so, all wrongs would lie in doping abuses involving health risks, deceit and unfairness. I argue that perhaps the doping sinner best exemplifies human dignity and existential authenticity. If doping would be done in a sufficiently healthy, candid, autonomous, wise and fair way, would doping be OK? If so, all wrongs would lie in doping abuses, namely when done with too much health risks, deceit, coercion, fecklessness and unfairness. I will briefly advocate this important point - already made by many others - only to proceed to the further argument that under certain circumstances, perhaps nobody can exemplify human(ist) dignity and existential(ist) authenticity better than that modern witch, the doping sinner.

From a humanist-existentialist self-understanding, which I take to be the most plausible outlook on life, moral character and authenticity demand that one does not imagine one's biological constitution to be a responsibility-relieving excuse or a purpose-providing exhortation - no matter how psychologically gratifying that would be. Instead, our god- and nature-forsaken human condition should be acknowledged and if possible, testified of in practice. What better way to do so than to supplant some fundamental part of one's natural blueprint with an artefact of one's own volition, enabling oneself to realize an existence that is originally and authentically one's own? Affirming Leon Kass' dictum that "an untroubled soul in a troubling world is a shrunken human being", I concur that we must not manipulate our self-understanding so as to blind ourselves from discomforting but true aspects of the human predicament, for instance via a helping of Aldous Huxley's wellbeing-inducing drug Soma. However, in a second irony an analogy can be made between Soma and the more traditional opiate of religion. One could argue that by fabulating some (crypto-)creationist or teleological self-understanding and thinking one lives meaningfully by following the cues of one's biology, in a sense one dopes oneself into a inauthentic and morally unwarranted state of existential comfort. In a third and final irony, I again wholeheartedly affirm the widespread anti-enhancement worry that for all the health, ability, beauty and welfare that the human enhancement enterprise may bring, we will be enhancing ourselves into a state of increasingly acute existential perplexity. Indeed, as the determinants that shape and drive our existence become increasingly up for grabs, the plausibility of a prefabricated meaning to our existence crumbles, and our self-understanding becomes increasingly circular. I argue therefore that Bill McKibben is right in fearing that "should we ever escape our limits and become 'everything' we will become - nothing." However, I take this experience of existential vacuity to be at the heart of the human tragedy. I conclude that we must above all not see ourselves as creatures of Nature, God or Fortune who live meaningfully by executing their directives. Sharing the core values and concerns of Kass and McKibben, my conclusion is the polar opposite to theirs. We ought to openly affirm our god- and nature-forsaken condition and, ideally, wilfully estrange ourselves from our default biology to testify of our (unfortunate but true) condemnation to be free. To a significant extent, it would make us a Homo Ludens come full circle: living a life of our own devise, in bodies of our own devise.