Exactly when does a human being actually come into existence?

February 18, 2020

Pär SegerdahlThe one who prepares the food may announce, “The food is ready now!” when the food is ready. However, when exactly is the food actually ready? When the kitchen timer rings? The potatoes are cooked then. Or when the saucepan is removed from the stove? The cooking ends then. Or when the saucepan is emptied of water? The potatoes are separated from the cooking medium then. Or when the potatoes are carried to the table? The food will be available to the guests around the table then. However, is the food actually available for eating before it is on the plate? Should not each guest say, “The food is ready now,” when the food is on the plate? However, if the food is too hot, is it actually ready? Should not someone around the table say when you no longer burn your tongue, “The food is ready now”?

Yes, exactly when is the food actually ready? You probably notice that the question is treacherous. The very asking, “exactly when, actually?” systematically makes every answer wrong, or not exactly right. The question is based on rejecting the answer. It is based on suggesting another, smarter way to answer. Which is not accepted because an even smarter way to answer is suggested. And so on. Questions that systematically reject the answer are not any questions. They can appear to be profound because no ordinary human answer is accepted. They can appear to be at a high intellectual level, because the questioner seems to demand nothing less than the exact and actual truth. Such extremely curious questions are usually called metaphysical.

However, we hardly experience the question about exactly when the food actually is ready as important and deep. We see the trick. The question is like a stubborn teenager who just discovered how to quibble. However, sometimes these verbally treacherous questions can appear on the agenda and be perceived as important to answer. In bioethics, the question about the beginning of a human being has become such a question. Exactly when does a human being actually come into existence?

Why is this question asked in bioethics? The reason is, of course, that there are ethical and legal limits to what medical researchers are permitted to do with human beings. The question of what counts as a human being then acquires significance. When does a fertilized egg become a human? Immediately? After a number of days? The question will determine what researchers are permitted to do with human embryos. Can they harvest stem cells from embryos and destroy them? There is disagreement about this.

When people disagree, they want to convince each other by debating. The issue of the beginning of a human being has been debated for decades. The problem is that the question is just as treacherous as the question about exactly when the food actually is ready. In addition, the apparent depth and inquisitiveness of the question serves as intellectual allurement. We seem to be able to determine exactly who is actually right. The Holy Grail of all debates!

The crucial moment never comes. The Holy Grail is constantly proving to be an illusion, since the question systematically rejects every answer by proposing an even smarter answer, just like the question about food. The question of the beginning of a human being has now reached such levels of cleverness that it cannot be rendered in ordinary human words. Philosophers earn their living as intellectual advocates who give debating clients strategic advice on metaphysical loopholes that will allow them to avoid the opponent’s latest clever argument. Listen to such metaphysical advice to debaters who want to argue that a human being comes into existence exactly at conception and not a day later:

”Given the twinning argument, the conceptionist then faces a choice between perdurantist conceptionism and exdurantist conceptionism, and we argue that, apart from commitments beyond the metaphysics of embryology, they should prefer the latter over the former.”

Do you feel like reading more? If so, read the article and judge for yourself the depth and seriousness of the question. Personally, I wish for more mature ways to deal with bioethical conflicts than through metaphysical advice to stubborn debaters.

Pär Segerdahl

Efird, D, Holland, S. Stages of life: A new metaphysics of conceptionism. Bioethics. 2019; 33: 529– 535. https://doi.org/10.1111/bioe.12556

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Neuroethics as foundational

January 28, 2020

Pär SegerdahlAs neuroscience expands, the need for ethical reflection also expands. A new field has emerged, neuroethics, which celebrated its 15th anniversary last year. This was noted in the journal AJOB Neuroscience through an article about the area’s current and future challenges.

In one of the published comments, three researchers from the Human Brain Project and CRB emphasize the importance of basic conceptual analysis in neuroethics. The new field of neuroethics is more than just a kind of ethical mediator between neuroscience and society. Neuroethics can and should contribute to the conceptual self-understanding of neuroscience, according to Arleen Salles, Kathinka Evers and Michele Farisco. Without such self-understanding, the ethical challenges become unclear, sometimes even imaginary.

Foundational conceptual analysis can sound stiff. However, if I understand the authors, it is just the opposite. Conceptual analysis is needed to make concepts agile, when habitual thinking made them stiff. One example is the habitual thinking that facts about the brain can be connected with moral concepts, so that, for example, brain research can explain to us what it “really” means to be morally responsible for our actions. Such habitual thinking about the role of the brain in human life may suggest purely imaginary ethical concerns about the expansion of neuroscience.

Another example the authors give is the external perspective on consciousness in neuroscience. Neuroscience does not approach consciousness from a first-person perspective, but from a third-person perspective. Neuroscience may need to be reminded of this and similar conceptual limitations, to better understand the models that one develops of the brain and human consciousness, and the conclusions that can be drawn from the models.

Conceptual neuroethics is needed to free concepts from intellectual deadlocks arising with the expansion of neuroscience. Thus, neuroethics can contribute to deepening the self-understanding of neuroscience as a science with both theoretical and practical dimensions. At least that is how I understand the spirit of the authors’ comment in AJOB Neuroscience.

Pär Segerdahl

Emerging Issues Task Force, International Neuroethics Society (2019) Neuroethics at 15: The Current and Future Environment for Neuroethics, AJOB Neuroscience, 10:3, 104-110, DOI: 10.1080/21507740.2019.1632958

Arleen Salles, Kathinka Evers & Michele Farisco (2019) The Need for a Conceptual Expansion of Neuroethics, AJOB Neuroscience, 10:3, 126-128, DOI: 10.1080/21507740.2019.1632972

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Communicating thought provoking research in our common language

December 11, 2019

Pär SegerdahlAfter having been the editor of the Ethics Blog for eight years, I would like to describe the research communication that usually occurs on this blog.

The Ethics Blog wants to avoid the popular scientific style that sometimes occurs in the media, which reports research results on the form, “We have traditionally believed that…, but a recent scientific study shows that…” This is partly because the Ethics Blog is run by a research center in ethics, CRB. Although ethics may involve empirical studies (for example, interviews and surveys), it is not least a matter of thinking. If you, as an ethicist, want to develop new recommendations on informed consent, you must think clearly and thoroughly. However, no matter how rigorously you think, you can never say, “We have traditionally believed that it is ethically important to inform patients about…, but recent philosophical thoughts show that we should avoid doing that.”

Thinking does not provide the authority that empirical research gives. As an ethicist or a philosopher, I cannot report my conclusions as if they were research results. Nor can I invoke “recent thoughts” as evidence. Thoughts give no evidence. Ethicists therefore present their entire thinking on different issues to the critical gaze of readers. They present their conclusions as open suggestions to the reader: “Here is how I honestly think about this issue, can you see it that way too?”

The Ethics Blog therefore avoids merely disseminating research results. Of course, it informs about new findings, but it emphasizes their thought provoking aspects. It chooses to reflect on what is worth thinking about in the research. This allows research communication to work more on equal terms with the reader, since the author and the reader meet in thinking about aspects that make both wonder. Moreover, since each post tries to stand on its own, without invoking intellectual authority (“the ethicists’ most recent thoughts show that…”), the reader can easily question the blogger’s attempts to think independently.

In short: By communicating research in a philosophical spirit, science can meet people on more equal terms than when they are informed about “recent scientific findings.” By focusing on the thought provoking aspects of the research, research communication can avoid a patronizing attitude to the reader. At least that is the ambition of the Ethics Blog.

Another aspect of the research communication at CRB, also beyond the Ethics Blog, is that we want to use our ordinary language as far as possible. Achieving a simple style of writing, however, is not easy! Why are we making this effort, which is almost doomed to fail when it comes to communicating academic research? Why do Anna Holm, Josepine Fernow and I try to communicate research without using strange words?

Of course, we have reflected on our use of language. Not only do we want to reach many different groups: the public, patients and their relatives, healthcare staff, policy makers, researchers, geneticists and more. We also want these groups to understand each other a little better. Our common language accommodates more human agreement than we usually believe.

Moreover, ethics research often highlights the difficulties that different groups have in understanding each other. It can be about patients’ difficulties in understanding genetic risk information, or about geneticists’ difficulties in understanding how patients think about genetic risk. It may be about cancer patients’ difficulties in understanding what it means to participate in clinical trials, or about cancer researchers’ difficulties in understanding how patients think.

If ethics identifies our human difficulties in understanding each other as important ethical problems, then research communication will have a particular responsibility for clarifying things. Otherwise, research communication risks creating more communication difficulties, in addition to those identified by ethics! Ethics itself would become a communication problem. We therefore want to write as clearly and simply as we can, to reach the groups that according to the ethicists often fail to reach each other.

We hope that our communication on thought provoking aspects of ethics research stimulates readers to think for themselves about ethical issues. Everyone can wonder. Non-understanding is actually a source of wisdom, if we dare to admit it.

Pär Segerdahl

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Ethical issues when gene editing approaches humanity

December 2, 2019

Pär SegerdahlGene editing technology, which already is used to develop genetically modified organisms (GMOs), could in the future also be used clinically in humans. One such application could be genetic modification of human embryos, editing genes that would otherwise cause disease.

Of course, the scenario of ​​clinical uses of genetic modification in humans arouses deep concern and heated debate. In addition to questions about efficacy and safety for the people who would be directly affected by the treatments, huge issues are raised about the fate of humanity. When gene editing is performed on germ cells, the changes are passed on to future generations.

What is often overlooked in the debate are ethical questions about the research that would have to precede such clinical applications. In order to develop genetic techniques that are effective and safe for humans, much research is required. One must, for example, test the techniques on human embryos. However, since genetic editing is best done at the time of fertilization (if done on the embryo, not all cells are always modified), a large number of donated gametes are probably required, where the eggs are fertilized in the laboratory to create genetically modified embryos.

Emilia Niemiec and Heidi Carmen Howard, both at CRB, draw attention to these more immediate ethical concerns. They point out that already the research, which precedes clinical applications, must be carefully considered and debated. It raises its own ethical issues.

In a letter to Nature, they highlight the large number of donated eggs that such research is likely to need. Egg donation involves stress and risks for women. Furthermore, the financial compensation they are offered can function as undue incentive for economically disadvantaged women.

Emilia Niemiec and Heidi Carmen Howard write that women who decide on egg donation should be given the opportunity to understand the ethical issues, so that they can make an informed decision and participate in the debate about gene editing. I think they have a good point when they emphasize that many ethical issues are raised already by the research work that would precede clinical applications.

A question I ask myself is how we can communicate with each other about deeply worrying future scenarios. How do we distinguish between image and reality when the anxiety starts a whole chain reaction of frightening images, which seem verified by the anxiety they trigger? How do we cool down this psychological reactivity without quenching the critical mind?

In short, how do we think and talk wisely about urgent future issues?

Pär Segerdahl

Niemiec, E. and Carmen Howard, H. 2019. Include egg donors in CRISPR gene-editing debate. Nature 575: 51

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An extended concept of consciousness and an ethics of the whole brain

November 4, 2019

Pär SegerdahlWhen we visit a newly operated patient, we probably wonder: Has she regained consciousness? The question is important to us. If the answer is yes then she is among us, we can socialize. If the answer is negative then she is absent, it is not possible to socialize. We can only wait and hope that she returns to us.

Michele Farisco at CRB proposes in a new dissertation a more extensive concept of consciousness. According to this concept, we are conscious without interruption, basically, as long as the brain lives. This sounds controversial. It appears insensitive to the enormous importance it has for us in everyday life whether someone is conscious or not.

Maybe I should explain right away that it is not about changing our usual ways of speaking of consciousness. Rather, Michele Farisco suggests a new neuroscientific concept of consciousness. Science sometimes needs to use familiar words in unfamiliar ways. For example, biology cannot speak of humans and animals as an opposition, as we usually do. For biology, the human is one of the animals. Just as biology extends the concept of an animal to us humans, Michele Farisco extends the concept of consciousness to the entire living brain.

Why can an extended concept of consciousness be reasonable in neuroscience? A simple answer is that the brain continues to be active, even when in the ordinary sense we lose consciousness and the ability to socialize. The brain continues to interact with the signals from the body and from the environment. Neural processes that keep us alive continue, albeit in modified forms. The seemingly lifeless body in the hospital bed is a poor picture of the unconscious brain. It may be very active. In fact, some types of brain processes are extra prominent at rest, when the brain does not respond to external stimuli.

Additional factors support an extended neuroscientific concept of consciousness. One is that even when we are conscious in the usual sense, many brain processes happen unconsciously. These processes often do the same work that conscious processes do, or support conscious processes, or are shaped by conscious processes. When we look neuroscientifically at the brain, our black and white opposition between conscious and unconscious becomes difficult to discern. It may be more reasonable to speak of continuities, of levels of the same consciousness, which always is inherent in the living brain.

In short, neuroscience may gain from not adopting our ordinary concept of consciousness, which makes such an opposition between conscious and unconscious. The difference that is absolute when we visit a newly operated patient – is she conscious or not? – is not as black and white when we study the brain.

Does Michele Farisco propose that neuroscience should make no difference whatsoever between what we commonly call conscious and unconscious, between being present and absent? No, of course not. Neuroscience must continue to explore that difference. However, we can understand the difference as a modification of the same basic consciousness, of the same basic brain activity. Neuroscience needs to study differences without falling victim to a black and white opposition. Much like biology needs to study differences between humans and other animals, even when it extends the concept of an animal to the human.

The point, then, is that neuroscience needs to be open to both difference and continuity. Michele Farisco proposes a neuroscientific distinction between aware and unaware consciousness. It captures both aspects, the difference and the continuity.

Michele Farisco’s extended concept of consciousness also has ethical consequences. It can motivate an ethics of the whole brain, not just of the conscious brain, in the usual sense. The question is no longer, merely, whether the patient is conscious or not. The question is at what level the patient is conscious. We may need to consider ethically even unconscious brains and brain processes, in the ordinary sense. For example, by talking calmly near the patient, even though she does not seem to hear, or by playing music that the patient usually appreciates.

Perhaps we should not settle for waiting and hoping that the patient will return to us. The brain is already here. At several levels, this brain may continue to socialize, even though the patient does not seem to respond.

If you want to know more about Michele Farisco’s extended concept of consciousness and his ethics of the whole brain, read the dissertation that he recently defended. You can also read about new technological opportunities to communicate with patients suffering from severe disorders of consciousness, and about new opportunities to diagnose such disorders.

Pär Segerdahl

Farisco, Michele. 2019. Brain, consciousness and disorders of consciousness at the intersection of neuroscience and philosophy. (Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1597.) Uppsala: Acta Universitatis Upsaliensis.

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Honest questions examining our intellectual sinfulness

October 21, 2019

Pär SegerdahlWhy should we hold our philosophical tradition in high esteem? Why should we admire Socrates and other great thinkers? Because they strengthened reason? Because they taught humanity to set emotions aside and instead purify facts and logic?

If that were true, we should admire the philosophers for armoring humanity. For turning us into clever neurotics without contact with our emotional life.

I believe the greatness of these philosophers is more simple, humble and human. They were embarrassingly aware of their own intellectual sinfulness. They had the courage to confess their sins and to examine them closely. They had the courage to know themselves.

That sincere humility, I believe, marks true thinkers from all parts of the world. Just as Socrates, in the middle of a discourse, could hear an inner voice stop him from speaking with intellectual authority on some topic, Lao Tzu saw it as a disease to speak as if we knew what we do not know.

These genuine thinkers hardly spoke with intellectual certainty. At least not in their most creative moments. They probably felt ashamed of the cocksure voice that marks many of our intellectual discussions about prestigious topics. They probably spoke tentatively and reasoned hesitantly.

We are all fallible. Philosophy is, at heart, intense awareness of this human fact. How does such awareness manifest in a thinker? Usually through questions that openly confess that, I know that I do not know. A philosophical inquiry is a long series of confessions. It is a series of sincere questions exposing a deep-rooted will to control intellectually the essence of various matters. The questions become clearer as we come to see more distinctly how this will to power operates in us. When we see how our desire to dictate intellectually what must be true, blinds us to what is true.

Do you and I, as academics, dare to admit our intellectual sinfulness? Do we dare to confess that we do not know? Do we have the courage to speak tentatively and to reason hesitantly?

I believe that we would do a great service to ourselves and to humanity if we more often dared to speak openly in such a voice. However, we are facing a difficulty of the will. For there is an expectation that researchers should master facts and logic. Surely, we are not paid to be ignorant and irrational. Therefore, must we not rather disseminate our knowledge and our expertise?

Of course! However, without awareness of our intellectual sinfulness, which could stop Socrates in the middle of a sentence, we run the risk of contributing to the disease that he treated in himself. We display not only what we happen to know, but also a shiny facade that gives the impression that we control the truth about important matters.

In short, we run the risk of behaving like intellectual Pharisees, exhibiting an always well-polished surface. Below that surface, we wither away, together with the society to which we want to contribute. We lose touch with what truly is alive in us. It succumbs under the pressure of our general doctrines about what must be true. Intellectualism is a devastating form of fact denialism. In its craving for generality, it denies what is closest to us.

Do not armor yourself with rationalism as if truth could be controlled. Instead, do what the greatest thinkers in the history of all of humanity did. Open yourself to what you do not know and explore it in earnest.

You are vaster than your imagined knowledge. Know yourself!

Pär Segerdahl

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Who belongs to us?

October 2, 2019

Pär SegerdahlBioethics has a problem with human beings, the philosopher Roland Kipke writes. It must ask who belongs to our moral community. Who has rights? Who has human dignity? Who has the moral status usually attributed to healthy adult humans? Who has the right to life?

The question is: Who belongs to us? Are human embryos included in the community? Newborns? Those with advanced dementia? Intelligent animals?

A common response to the question is to propose a philosophical criterion. Two positions dominate in bioethics. One includes all biological human beings, thereby embryos, newborns and those with advanced dementia. Everyone who belongs to the species Homo sapiens belongs to the moral community.

The second position holds that species membership is irrelevant. Instead, the focus is on mental capacities that one holds characterize a “person.” For example, rationality and self-awareness. This excludes embryos, newborns and those with advanced dementia from the community. However, a rational chimpanzee may enter. All persons belong to the moral community, regardless of species affiliation.

Kipke shows how both criteria compel us to answer the question “Who belongs to us?” in ways that contradict most people’s moral intuitions. We might accept this if the positions could be justified by strong arguments, he says. However, such arguments are missing.

What should a poor philosophical gatekeeper do then? Who should be admitted into the community? Who should be kept out?

The solution to the gatekeeper’s dilemma, Kipke suggests, is our ordinary concept of the human. When we talk about “humans,” we usually do not use the scientific concept of a biological species. Our everyday concept of a human already has moral dimensions, he points out. We cannot see a human being without seeing a living person belonging to our community. According to this third position, all humans belong to the moral community.

The only problem is that the gatekeeper needs a criterion to distinguish the human members of the community. It is true that we have everyday uses of the word “human.” It is also true that we normally have no difficulties in distinguishing a human being. However, do these uses really contain a criterion suitable for more philosophical gatekeeper tasks? They do, according to Kipke. He holds that there is a characteristic “living human gestalt or the form of the body,” especially the face, which easily allows recognition of a human being, even when she is seriously injured and deformed.

The “living human form” would thus be the criterion. This form makes us equals in the moral community.

Kipke’s article is philosophically exciting and his criticism of the two dominant positions is revealing. Personally, I nevertheless find the still dominant preoccupation with the question “Who belongs to us?” somewhat terrifying, and perhaps even inhuman. Bioethics treats human concerns about, for example, genetics and stem cell research. Admittedly, people often express their concerns in the form of boundary issues. People who worry about the destruction of embryos in stem cell research, for example, can talk about the embryo as a human individual or as a potential person. However, addressing their worries by suggesting that our common language contains a criterion that has the authority to separate the members of the moral community will probably not still the minds of such worried and perhaps even angry humans. They need a lot more attention. Perhaps it turns out that the intellectual boundary issue concealed the living source of their concerns and made it impossible to treat the problem at its source.

I believe we need a bioethics that responds to moral concerns more humanly and communicatively than only as philosophical boundary issues. Could we not use our ordinary language to think together about the issues that worry us? To refer to an ordinary concept of the human as an arbiter that supposedly dictates the answers to bioethical boundary issues seems characteristic of a smaller community: one that is professionally preoccupied with philosophical boundary issues.

Is that not placing bioethics before life? Is it not putting the cart before the horse?

Pär Segerdahl

Kipke R. Being human: Why and in what sense it is morally relevant. Bioethics. 2019;00:1–11. https://doi.org/10.1111/bioe.12656

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