Increasingly, technological and medical developments are providing people with ways to enhance themselves. Such developments include cognitive enhancement drugs (e.g Ritalin), devices (e.g transcranial direct current stimulation or tDCS, which stimulates the brain with electricity) and germline technologies (e.g) CRISPR).
The emergences of these technologies poses important legal and ethical questions about whether, and how, to regulate their use. This includes concerns about the workplace pressure to enhance, the risks of off-label drug use and the unregulated use of brain-stimulating devices to improve concentration.
A good example is modafinil, a drug used to treat narcolepsy. In non-narcoleptics, modafinil can combat fatigue-related decreases in cognitive capacity and it is increasingly used by students and professionals to maintain wakefulness. The US military is known to require its use by those undertaking long missions, and recently the Royal Society and others suggested that some high-responsibility professions such as surgeons and pilots might be obliged to enhance themselves.
My work has focused on exploring whether such an obligation could be established to support a claim of negligence. This resulted in two papers; the first, published in the Modern Law Review, rejected the idea that a medical practitioner could have a duty to take an enhancing drug.
The second, published in the Medical Law Review, argued that even if such a duty could be found, it would be nigh on impossible to establish a causal link between a failure to take a drug to combat fatigue and any harm a patient might experience due to a doctor's error. These papers were written as part of the Enhancing responsibility project, funded by the Dutch Research Council.
It became apparent that while there was considerable debate about the issues in the philosophy literature- and growing interest from lawyers- there had been relatively little attention paid in the media and not much informed debate within the community and amongst policy-makers. This is problematic given that in the near future the use of these technologies is likely to have a significant impact. Information currently available is either too academic, or largely hype and hyperbole. The matter is usually seen as somewhat esoteric or simply futuristic fantasy; this is short-sighted. Universities such as Duke are already developing policies to respond to the use of enhancing drugs by students. tDCS devices are being marketed to help gamers 'focus' (despite the risks) and at least one overseas government department has done a risk-benefit analysis on medical practitioners taking modafinil. There is a clear need for public debate and balanced information.
I began to explore ways to engage the public with the goal of promoting two-way sharing of information and views. I wanted to find a way to help people learn about human enhancement technologies and the issues they raise in a way that would enable them to develop their own points of view.
Currently, I am working on developing an informational website and series of interactive films to facilitate this. The website sets out what enhancement is and the ethical and legal issues it raises. Its centrepiece is an interactive animated film. The film, designed by Seed Animation, leads the viewer through a scenario in which a tired surgeon faces the choice of whether to take modafinil before undertaking a surgery. The viewer can choose what the surgeon does and then sees the possible consequences followed by some exploration of the issues and links to further information. The site will collect and report responses anonymously, forming a dataset to be used by me and Dr Nadira Faber, research Fellow at the Department of Experimental Psychology and Oxford Centre for Neuroethics. Further funding is being sought to produce more animations and other interactive elements for the site, as well as to create a series of live installation events around London that will enable direct interaction with the public.
The work is funded by three grants: an AHRC Follow-On Funding for Impact and Engagement Award, a University of Oxford Knowledge Exchange Seed Fund Award and a grant from the University to create an interactive presentation for the Oxfordshire Science Festival.