Emerging Therapeutic Enhancement Enabling Health Technologies and Their Discourses: What Is Discussed within the Health Domain?

Abstract

So far, the very meaning of health and therefore, treatment and rehabilitation is benchmarked to the normal or species-typical body. We expect certain abilities in members of a species; we expect humans to walk but not to fly, but a bird we expect to fly. However, increasingly therapeutic interventions have the potential to give recipients beyond species-typical body related abilities (therapeutic enhancements, TE). We believe that the perfect storm of TE, the shift in ability expectations toward beyond species-typical body abilities, and the increasing desire of health consumers to shape the health system will increasingly influence various aspects of health care practice, policy, and scholarship. We employed qualitative and quantitative methods to investigate among others how human enhancement, neuro/cognitive enhancement, brain machine interfaces, and social robot discourses cover (a) healthcare, healthcare policy, and healthcare ethics, (b) disability and (c) health consumers and how visible various assessment fields are within Neuro/Cogno/Human enhancement and within the BMI and social robotics discourse. We found that health care, as such, is little discussed, as are health care policy and ethics; that the term consumers (but not health consumers) is used; that technology, impact and needs assessment is absent; and that the imagery of disabled people is primarily a medical one. We submit that now, at this early stage, is the time to gain a good understanding of what drives the push for the enhancement agenda and enhancement-enabling devices, and the dynamics around acceptance and diffusion of therapeutic enhancements.

Ethical aspects of brain computer interfaces: a scoping review

“…This raises questions as to what the end result of BCI should be. The definition of “treatment” tends to be benchmarked to the species-typical body [ 42 ], and the principle of beneficence suggests that doctors have an obligation to restore health to ‘normal’ levels [ 22 ]. However, there is also the perspective of “tyranny of the normal” [ 43 ], as described elsewhere by Anita Silvers.…”

“…Some scholars assert that, as BCIs are being engineered, those most likely to be affected by the technology, including potential end users [ 8 , 50 ] and the general public [ 7 ], should have input into the design process. Wolbring et al (2013) worry that most BCI literature treats disability as a medical issue rather than a socio-cultural one, suggesting that some perspectives of persons with disability have not been considered [ 42 ]. Many examples of BCI technology are currently still in the clinical research stage, so some justice concerns overlap with research ethics.…”

Ethical Considerations in Paralympic Sport: When Are Elective Treatments Allowable to Improve Sports Performance?

“…Nevertheless, it seems reasonable to say that case 1 (botulinum toxin injection) and 2 (Achilles tendon lengthening surgery) are prima facie cases of therapeutic intervention that may have enhancement effects. Our case here does not refer to therapeutic enhancements beyond the species typical range [10] but represents an enhancement to the individual concerned beyond what his or her previous normal function might have been [11]. By contrast, case 4 focuses on the ethical permissibility or desirability of nontherapeutic enhancement, whereas case 3, the most challenging of all, entails nontherapeutic harm to enable athletic participation in disability sports.…”

Sustainable Consumption of Healthcare: Linking Sustainable Consumption with Sustainable Healthcare and Health Consumer Discourses

“…These enhancements change the very framework of various health discourses [55]. However, so far these new classes of health technologies are not discussed within the framework of health consumerism, despite that they are expected to even change who defines oneself as a health consumer [56]. We posit these body linked health technologies that add new, beyond the normal, abilities to the body as well as the many other health technologies that allow for self-diagnostic and self-care, will add a new form of impact to the goal of sustainable healthcare.…”