This essay gives a situated introduction to body hacking, an underground surgical process that seeks to transform the body’s architecture, offering an ethnographic account of the affects that drive this corporeal intervention for performance artist Cheto Castellano, and later, for the author. A brief history of recent body modification movements is offered. Through these situated stories of corporeal transformation there is an exploration of Eva Hayward’s concept of transbecoming, exploring the perpetual change of the body in transition, particularly in relation (...) to posthumanistic transformations. The article closes with a speculative cyborg feminist body modification project titled 10,000 Generations Later, which explores how a subdermal archive of silicone implants stored under the author’s skin may assist her in a posthumanist transbecoming after the death of her companions species toy poodle Luk Kahlo, and perhaps even in a distant future. The author argues that this project becomes an apparatus of mestizaje between speculative cyborg feminism and significant otherness. (shrink)

Biomedical engineering technologies such as brain–machine interfaces and neuroprosthetics are advancements which assist human beings in varied ways. There are exciting yet speculative visions of how the neurosciences and bioengineering may influence human nature. However, these could be preparing a possible pathway towards an enhanced and even posthuman future. This article seeks to investigate several ethical themes and wider questions of enhancement, transhumanism and posthumanism. Four themes of interest are: autonomy, identity, futures, and community. Three larger questions can be asked: (...) will everyone be enhanced? Will we be “human” if we are not, one day, transhuman? Should we be enhanced or not? The article proceeds by concentrating on a widespread and sometimes controversial application: the cochlear implant, an auditory prosthesis implanted into Deaf patients. Cochlear implantation and its reception in both the deaf and hearing communities have a distinctive moral discourse, which can offer surprising insights. The paper begins with several points about the enhancement of human beings, transhumanism’s reach beyond the human, and posthuman aspirations. Next it focuses on cochlear implants on two sides. Firstly, a shorter consideration of what technologies may do to humans in a transhumanist world. Secondly, a deeper analysis of cochlear implantation’s unique socio-political movement, its ethical explanations and cultural experiences linked with pediatric cochlear implantation—and how those wary of being thrust towards posthumanism could marshal such ideas by analogy. As transhumanism approaches, the issues and questions merit continuing intense analysis. (shrink)

Implant ethics is defined here as the study of ethical aspects of the lasting introduction of technological devices into the human body. Whereas technological implants relieve us of some of the ethical problems connected with transplantation, other difficulties arise that are in need of careful analysis. A systematic approach to implant ethics is proposed. The major specific problems are identified as those concerning end of life issues (turning off devices), enhancement of human capabilities beyond normal levels, mental changes (...) and personal identity, and cultural effects. (shrink)

The use of cochlear implants in born-deaf infants addresses the issues of disability, proxy consent, and potential ethnocide of the Deaf culture. The ethical issues explored in this paper are: 1) the disability versus trait argument of deafness, 2) parents versus Deaf community in proxy consent, 3) justification for surgical intervention in a non-life threatening condition, and 4) justification for ethnocide. Decisions for non-competent individuals should be made to assure the child of an open future, with rights that need to (...) be protected now, so that the child can exercise them later as an adult. Cochlear implants provide the potential of an open future and are morally justified on that basis. (shrink)

Gilbert (2015) suggests that predictive and advisory brain implants threaten autonomy. He analyzes these threats in terms of one patient's “sense of autonomy,” reporting that the patient felt more...

In a world surrounded by smart objects from sensors to automated medical devices, the ubiquity of ‘smart’ seems matched only by its lack of clarity. In this article, we use our discussions with expert stakeholders working in areas of implantable medical devices such as cochlear implants, implantable cardiac defibrillators, deep brain stimulators and in vivo biosensors to interrogate the difference facets of smart in ‘implantable smart technologies’, considering also whether regulation needs to respond to the autonomy that such artefacts carry (...) within them. We discover that when smart technology is deconstructed it is a slippery and multi-layered concept. A device’s ability to sense and transmit data and automate medicine can be associated with the ‘sting’ of autonomy being disassociated from human control as well as affecting individual, group, and social environments. (shrink)

Deep brain stimulation (DBS) uses electrodes implanted in the brain to modulate dysregulated brain activity related to a variety of neurological and psychiatric conditions. A number of people who use DBS have reported changes that affect their sense of self. In the neuroethics literature, there has been significant debate over the exact nature of these changes. More recently, there have been suggestions that this debate is overblown and detracts from clinically-relevant ways of understanding these effects of DBS. In this paper, (...) we offer an alternative approach to understanding the effects of DBS on the self, drawing on John Sadler’s work on self-illness ambiguity. We argue that self-illness ambiguity is a complex concept, with at least three different aspects, and that each of the three aspects we identify also characterizes one kind of DBS-related change. Our analysis also suggests ways of helping patients to adjust to life as a DBS user. (shrink)

While pre-implantation genetic diagnosis is available and legal in Malaysia, there is an ongoing controversy debate about its use. There are few studies available on individuals’ attitudes toward PGD, particularly among those who have a genetic disease, or whose children have a genetic disease. To the best of our knowledge, this is, in fact, the first study of its kind in Malaysia. We conducted in-depth interviews, using semi-structured questionnaires, with seven selected potential PGD users regarding their knowledge, attitudes and decisions (...) relating to the use PGD. The criteria for selecting potential PGD users were that they or their children had a genetic disease, and they desired to have another child who would be free of genetic disease. All participants had heard of PGD and five of them were considering its use. The participants’ attitudes toward PGD were based on several different considerations that were influenced by various factors. These included: the benefit-risk balance of PGD, personal experiences of having a genetic disease, religious beliefs, personal values and cost. The study’s findings suggest that the selected Malaysian participants, as potential PGD users, were supportive but cautious regarding the use of PGD for medical purposes, particularly in relation to others whose experiences were similar. More broadly, the paper highlights the link between the participants’ personal experiences and their beliefs regarding the appropriateness, for others, of individual decision-making on PGD, which has not been revealed by previous studies. (shrink)

This paper uses the fictional case of the ‘Babel fish’ to explore and illustrate the issues involved in the controversy about the use of cochlear implants in prelinguistically deaf children. Analysis of this controversy suggests that the development of genetic tests for deafness poses a serious threat to the continued flourishing of Deaf culture. I argue that the relationships between Deaf and hearing cultures that are revealed and constructed in debates about genetic testing are themselves deserving of ethical evaluation. Making (...) good policy about genetic testing for deafness will require addressing questions in political philosophy and anthropology about the value of culture and also thinking hard about what sorts of experiences and achievements make a human life worthwhile. (shrink)

The development of predictive brain implant (PBI) technology that is able to forecast specific neuronal events and advise and/or automatically administer appropriate therapy for diseases of the brain raises a number of ethical issues. Provided that this technology satisfies basic safety and functionality conditions, one of the most pressing questions to address is its relation to the autonomy of patients. As Frederic Gilbert in his article asks, if autonomy implies a certain idea of freedom, or self-government, how can an (...) individual be considered to decide freely if the implanted device stands at the inception of the causal chain producing his decisions? He claims that PBIs threaten persons’ autonomy by diminishing their post-operative experience of self-control. In this commentary, I wish to discuss this claim. Contrary to Gilbert, I will suggest that PBIs do not pose a significant threat to patient’s autonomy, as self-control, but rather to his/her sense of authenticity. My claim is that the language of authenticity, already introduced in the recent bioethical literature, may offer a better way to voice some of the concerns with PBIs that Gilbert recognized. (shrink)

: Because I reject the notion that physical characteristics constitute cultural membership, I argue that, even if the claim were persuasive that deafness is a culture rather than a disability, there is no reason to fault hearing parents who choose cochlear implants for their deaf children.

Schools located in underpriviledged areas have to deal with different factors, like the dropout rate among students and teachers; the culture of action, the culture of oral and a «carpe diem» culture; the low literacy rates; the type of children's knowledges — sometimes different from those promoted at school — and the learning difficulties of pupils... In light of these factors, few states have decided to adopt measures to support pupils and teachers in these communities. In this sense, several studies (...) examine the potential role of philosophy for children (P4C), but none examines, in this kind of environment, the integration of P4C in the context of a teaching field experience program. Insofar several novice teachers start their career in these environments, it could be helpful to enrich our comprenhension on this subject. This paper presents results from an exploratory study on this issue, which led to raise questions about the bachelor of education program, at least in our university. (shrink)

As neural implants transition from engineering design and testing into human subjects research, careful consideration must be paid to the ethical elements in developing research protocols. Although these ethical aspects may be framed by the design choices of the engineering, a number of challenging choices arise. In spite of many ethical considerations for neural implant technologies being shared with generic research ethics questions, there are subsets needing special attention. Even in considerations requiring increased attention, substantial overlap can be found (...) with research ethics questions for general medical implants and for psychiatric pharmaceuticals. The special attention to specific ethical questions in neural implants exists because of the value placed on preserving cognition and control as well as our continued memory of significant past research abuses in neurosurgery. This paper focuses on three issues of particular saliency to neural implant testing: inclusion/exclusion of subjects with psychiatric conditions, consent withdrawal of research subjects, and enhancement as a goal. (shrink)

The Cognitive Science of Religion (CSR) holds that religion emerges from human cognition and its intuitions. Hence, it describes religion as a ‘natural’ belief in ‘supernatural agents’. Traditional theology also maintained that there is an ‘innate’ or ‘implanted’ knowledge of God or gods. It will be argued that CSR and theology can be related, yet not in a straightforward manner. After sketching out in what sense CSR calls religion ‘natural’ and how it describes ‘supernatural agents’, this article explores some examples (...) of the traditional theological doctrine of an ‘implanted’ knowledge of God. It shows that the reliability of such an ‘implanted’ knowledge of God was disputed among theologians and, even if it was affirmed, had an ambiguous position in theology. This also applies to CSR if it is to be related to the traditional theological doctrine. There are illuminating convergences between CSR and theology but also considerable divergences. Both, however, prove significant for theology. (shrink)

Objective : Pre-implantation genetic diagnosis (PGD) has been utilized by assisted reproductive technology (ART) to genetically screen embryos before placement in the uterus. However, many objections have been raised against the genetic screening of embryos, giving the practice an uncertain ethical, legal, and social status. Our aim was, therefore, to survey the possible presence and compliance to any legislation for PGD in the existing 60 in vitro fertilization (IVF) centres in the Gulf Cooperative Council (GCC) countries as well as the (...) availability of such a technological service. Methods : The study was performed in the department of biochemistry at King Faisal University between the periods Mar 2006 to Nov 2007. A questionnaire, in the form of a table, was sent to responsible persons of all 60 IVF centres and health authorities in the GCC countries. The collected data about the regulations and guidelines for the PGD program was analyzed using SPSS software package version 12.0 and the level of significance was set at P Results: 18 respondents, 16 IVF centres and 2 health authorities (26.87% of total) participated in the survey. The PGD techniques, mainly FISH analyses, were practiced in three centres in Saudi Arabia and one centre in the UAE. The major provider of PGD was King Faisal Specialist Hospital and Research Centre in Riyadh where more than 300 PGD tests had been performed. Whilst some regulations and guidelines have been introduced to IVF centres in all GCC countries, their implementations were left to the discretion of the treating centre. Conclusions : PGD services in the GCC countries were under-utilized due to the high cost of tests, the sophisticated technology involved and the poor returns of the investment. As a result of some deficiencies in the legislations which regulated PGD, the medical teams involved often faced difficulties on what rights to exercise in various PGD cases. (shrink)

The access to human pre‐implantation embryos that is afforded by procedures now developed for the treatment of infertility presents the possibility of very early prenatal diagnosis, before implantation in the uterus, of certain genetic diseases. Only the normal embryos would be replaced in the mother for initiation of implantation and pregnancy. Early experiments on a mouse model for Lesch‐Nyhan syndrome (HPRT‐deficiency) show that pre‐implantation diagnosis of genetic disease is feasible.

I introduce the implantation argument, a new argument for the existence of God. Spatiotemporal extensions believed to exist outside of the mind, composing an external physical reality, cannot be composed of either atomlessness, or of Democritean atoms, and therefore the inner experience of an external reality containing spatiotemporal extensions believed to exist outside of the mind does not represent the external reality, the mind is a mere cinematic-like mindscreen, implanted into the mind by a creator-God. It will be shown that (...) only a creator-God can be the implanting creator of the mindscreen simulation, and other simulation theories, such as Bostrom’s famous account, that do not involve a creator-God as the mindscreen simulation creator, involve a reification fallacy. (shrink)

I distinguish and assess three separate arguments utilized by the opponents of cochlear implants: that treating deafness as a medical condition is inappropriate since it is not a disability; that so treating it sends a message to the Deaf that they are of lesser worth; and that the use of such implants would signal the end of Deaf culture. I give some qualified support to the first and second claim, but find that the principal weight of the argument must be (...) borne by the third argument: that use of the cochlear implants is impermissible because Deaf culture is intrinsically valuable. I show that this claim is, in practice, incompatible with the claim that deafness is not a disability: that the significant disadvantages suffered by the hearing impaired can only be corrected by measures that would end Deaf culture. Since the potential recipients of cochlear implants are, in the main, the prelingually deaf children of hearing parents, the burden of banning the implants would be borne by people who are not members of Deaf culture, and who owe that culture nothing over and above what we all owe cultures in general. I conclude that we cannot ask the parents of these children to sacrifice the interests of their children for the sake of Deaf culture. (shrink)

In a world surrounded by smart objects from sensors to automated medical devices, the ubiquity of ‘smart’ seems matched only by its lack of clarity. In this article, we use our discussions with expert stakeholders working in areas of implantable medical devices such as cochlear implants, implantable cardiac defibrillators, deep brain stimulators and in vivo biosensors to interrogate the difference facets of smart in ‘implantable smart technologies’, considering also whether regulation needs to respond to the autonomy that such artefacts carry (...) within them. We discover that when smart technology is deconstructed it is a slippery and multi-layered concept. A device’s ability to sense and transmit data and automate medicine can be associated with the ‘sting’ of autonomy being disassociated from human control as well as affecting individual, group, and social environments. (shrink)

The nuclear engineer emerged as a new form of recognised technical professional between 1940 and the early 1960s as nuclear fission, the chain reaction and their applications were explored. The institutionalization of nuclear engineering—channelled into new national laboratories and corporate design offices during the decade after the war, and hurried into academic venues thereafter—proved unusually dependent on government definition and support. This paper contrasts the distinct histories of the new discipline in the USA and UK (and, more briefly, Canada). In (...) the segregated and influential environments of institutional laboratories and factories, historical actors such as physicist Walter Zinn in the USA and industrial chemist Christopher Hinton in the UK proved influential in shaping the roles and perceptions of nuclear specialists. More broadly, I argue that the State-managed implantation of the new subject within further and higher education curricula was shaped strongly by distinct political and economic contexts in which secrecy, postwar prestige and differing industrial cultures were decisive factors. (shrink)

We have long used mechanical devices to compensate for physical disability. Soon, however, it may be possible to augment mental capacity—to add memory or upgrade processing power. We should ponder the enormous moral implications of the machine‐assisted mind now, before it is accomplished.

In congenitally or prelingually deaf childrencochlear implantation is open to seriousethical challenge. The ethical dimension ofthis technology is closely related to both asocial standard of quality of life and to theuncertainty of the overall results of cochlearimplantation. Uncertainty with regards theacquisition of oral communicative skills.However, in the western world, available datasuggest that deafness is associated with thelowest educational level and the lowest familyincome. Notwithstanding the existence of aDeaf-World, deafness should be considered as ahandicap. Therefore, society should provide themeans for the (...) fulfilment of a deaf child'sspecific needs.For the time being there is no definitiveanswer with regard the best way to rehabilitatea particular deaf child. Therefore,communitarian values may be acceptable. If thedeaf child parents' decide not to implant,their decision should be respected. Guardiansare entitled to determine which standard ofbest interest to use in a specificcircumstance. They are the proper judges ofwhat (re)habilitation process is best for theirdeaf child. However, most deaf children areborn to two hearing parents. Probably, theywill not be acculturated in the Deaf-World. Itfollows that cochlear implantation is awelcomed (re)habilitation technology.If auditory (re)habilitation will in the futureprovide the necessary communicative skills, inparticular oral language acquisition, customs,values and attitudes of the hearing worldshould be regarded as necessary to accomplish adeaf child's right to an open future. Ifcochlear implantation technology will provideall deaf children with the capacity to developacceptable oral communicative skills –whatever the hearing status of the family andthe cultural environment – then auditory(re)habilitation will be an ethical imperative. (shrink)

This essay argues that the reigning medical and scientific understanding of the endocrine system, which insists on its fundamental biological plasticity, was historically constructed through a dual child–animal metaphor. The work accomplished by such organic metaphors, as Donna Haraway terms them, returns us to the endocrine laboratories and clinics in which they were built in Europe and the United States in the first half of the twentieth century. The child and animal metaphors implanted the concept of plasticity into the human (...) body to the effect of bringing sexed and gendered life under the jurisdiction of science and medicine, where it could not only be normalized in a sense long appreciated by transgender studies but also cultivated towards the ostensible “improvement” and “perfection” of the human. This is also, then, a history of the eugenic heritage of modern endocrinology, which has been largely ignored in recent discussions of plasticity and the body’s materiality. To interrogate the role of foundational organic metaphors in endocrinology is to open up plasticity not only to its historical context but also to radical contestation, making the contemporary assumptions of transgender medicine untimely, particularly the medicalization of the transgender child. (shrink)

Implantable brain–computer interface technology is an expanding area of engineering research now moving into clinical application. Ensuring meaningful informed consent in implantable BCI research is an ethical imperative. The emerging and rapidly evolving nature of implantable BCI research makes identification of risks, a critical component of informed consent, a challenge. In this paper, 6 core risk domains relevant to implantable BCI research are identified—short and long term safety, cognitive and communicative impairment, inappropriate expectations, involuntariness, affective impairment, and privacy and security. (...) Work in deep brain stimulation provides a useful starting point for understanding this core set of risks in implantable BCI. Three further risk domains—risks pertaining to identity, agency, and stigma—are identified. These risks are not typically part of formalized consent processes. It is important as informed consent practices are further developed for implantable BCI research that attention be paid not just to disclosing core research risks but exploring the meaning of BCI research with potential participants. (shrink)

This article ethnographically considers the experiences of Australian young people who were born deaf and who hear and listen through cochlear implants to explore the intersection between the sensory body, lived experience and technology. The article draws on phenomenology to examine how experiences of deafness are productive in analysing articulations of embodiment and the meanings embedded in a body that is valued as both deaf and hearing. Leaving aside binary conceptions of deaf versus hearing, and understandings of the cochlear (...) class='Hi'>implant as a remedy for sensory deficits, we instead make a case for nuanced understandings of the device and embodied experiences through technology. This analysis identifies how a cochlear implanted body navigates connections to the world and to others in turning on and off engagement. We contend that the device has an intrinsic value for recipients through enabling their access to hearing while not removing their experiences of deafness. (shrink)

Pre-Implantation Genetic Diagnosis represents the first fusion of genomics and assisted reproduction and the first reproductive technology that allows prospective parents to screen and select the genetic characteristics of their potential offspring. However, for some, the idea that we can intervene in the mechanisms of human existence at such a fundamental level can be, at a minimum, worrying and, at most, repugnant. Religious doctrines particularly are likely to collide with the rapidly advancing capability for science to make such interventions. This (...) paper focuses on opinions and arguments of selected religious scholars regarding ethical issues pertaining to PGD. In-depth interviews were conducted with religious scholars from three different religious organizations in the Klang Valley, Malaysia. Findings showed that Christian scholars are very sceptical of the long-term use of PGD because of its possible effect on the value of humanity and the parent-children relationship. This differs from Islamic scholars, who view PGD as God-given knowledge in medical science to further help humans understand medical genetics. For Buddhist scholars, PGD is considered to be new medical technology that can be used to save lives, avoid suffering, and bring happiness to those who need it. Our results suggest that it is important to include the opinions and views of religious scholars when it comes to new medical technologies such as PGD, as their opinions will have a significant impact on people from various faiths, particularly in a multi-religious country like Malaysia where society places high value on marital relationships and on the traditional concepts of family. (shrink)

Those who advocate a “historicist” outlook on moral responsibility often hold that people who unwillingly acquire corrupt dispositions are not blameworthy for the wrong actions that issue from these dispositions; this contention is frequently supported by thought experiments involving instances of forced psychological manipulation that seem to call responsibility into question. I argue against this historicist perspective and in favor of the conclusion that the process by which a person acquires values and dispositions is largely irrelevant to moral responsibility. While (...) the thought experiments introduced by historicists raise perplexing questions about personal identity and involve clear instances of moral wrongs done to the manipulated subjects, neither of these considerations bear on the question of moral responsibility. Rather, questions about moral responsibility in manipulation cases should be answered, I argue, by considering whether a manipulated agent is capable of expressing through her actions the objectionable attitudes that make blame appropriate in normal cases of wrongdoing. (shrink)

The use of cochlear implants, especially for prelingually deafened children, has aroused heated debate. Members and proponents of Deaf culture vigorously oppose implants both as a seriously invasive treatment of dubious efficacy and as a threat to Deaf culture. Some find these arguments persuasive; others do not. And in this context arise questions about the extent to which individuals with disabilities may decline treatments to ameliorate disabling conditions. When they do so, to what extent may they call upon society to (...) provide supportive services and accommodations? (shrink)

: This paper examines ethical issues related to medical practices with children and adults who are members of a linguistic and cultural minority known as the DEAF-WORLD. Members of that culture characteristically have hearing parents and are treated by hearing professionals whose values, particularly concerning language, speech, and hearing, are typically quite different from their own. That disparity has long fueled a debate on several ethical issues, most recently the merits of cochlear implant surgery for DEAF children. We explore (...) whether that surgery would be ethical if implants could deliver close to normal hearing for most implanted children, thereby diminishing the ranks of the DEAF-WORLD. The ethical implications of eugenic practices with the DEAF are explored, as are ethical quandaries in parental surrogacy for DEAF children, and their parallels in transracial adoption. (shrink)

As the demand for prosthetic limbs with reliable and multi-functional control increases, recent advances in myoelectric pattern recognition and implanted sensors have proven considerably advantageous. Additionally, sensory feedback from the prosthesis can be achieved via stimulation of the residual nerves, enabling closed-loop control over the prosthesis. However, this stimulation can cause interfering artifacts in the electromyographic (EMG) signals which deteriorate the reliability and function of the prosthesis. Here, we implement two real-time stimulation artifact removal algorithms, Template Subtraction (TS) and ε-Normalized (...) Least Mean Squares (ε-NLMS), and investigate their performance in offline and real-time myoelectric pattern recognition in two transhumeral amputees implanted with nerve cuff and EMG electrodes. We show that both algorithms are capable of significantly improving signal-to-noise ratio (SNR) and offline pattern recognition accuracy of artifact-corrupted EMG signals. Furthermore, both algorithms improved real-time decoding of motor intention during active neurostimulation. Although these outcomes are dependent on the user-specific sensor locations and neurostimulation settings, they nonetheless represent progress toward bi-directional neuromusculoskeletal prostheses capable of multifunction control and simultaneous sensory feedback. (shrink)

This article provides an ethnographic account of pediatric cochlear implantation, revealing an important shift in the definition of deafness from a sensory loss to a neurological processing problem. In clinical and long-term therapeutic practices involved in pediatric implantation, the cochlear implant is recast as a device that merely provides access to the brain. The “real” treatment emerges as long-term therapeutic endeavors focused on neurological training. This redefinition then ushers in an ensuing responsibility to “train the brain,” subsequently displacing failure (...) from the device onto the individual’s ability to train his or her brain. New caregiving techniques that accompany implantation are understood through neuropolitics, showing how parents are encouraged to engage in neuro-self-governance, and how the concept of neuroplasticity is used to cultural ends. (shrink)

In this article, I describe how gender bias can affect the design, testing, clinical trials, regulatory approval, and clinical use of implantable devices. I argue that bad outcomes experienced by women patients are a cumulative consequence of small biases and inattention at various points of the design, testing, and regulatory process. However, specific instances of inattention and bias can be difficult to identify, and risks are difficult to predict. This means that even if systematic gender bias in implant design (...) is an ethical issue, it is one with no clearly blameworthy player. From a practical perspective, there is no single obvious point at which to intervene. Philosophers working in other areas have explored structurally similar moral problems—sometimes referred to as “moral aggregation problems”—such as the type of environmental harm caused by small actions of many players. I describe key features of these type of problems and strategies to address them. I then draw on these to suggest an approach to gender bias in medical implant design and use. (shrink)

"Cet essai de bioéthique propose de penser l'Homme et son avenir à travers une innovation technologique extraordinaire : les implants cérébraux. Utilisés déjà dans des contextes de maladies, leur développement actuel laisse espérer pouvoir contrôler bientôt des dispositifs robotiques en connectant le cerveau à des ordinateurs équipés d'intelligences artificielles. Si les premiers résultats sont très encourageants, ces interfaces cerveau-machines posent néanmoins un questionnement éthique majeur. Que devient l'Homme si son cerveau fonctionne avec un dispositif électronique "intelligent" implanté? Pourrait-on percer les (...) secrets de ses pensées? Pourrait-on augmenter son intelligence ou sa mémoire? Afin d'appréhender ces trois questions, cet essai commence par penser l'Homme et son rapport aux technologies : la vulnérabilité humaine n'appelle-t-elle pas le recours aux techniques et technologies pour habiter le monde? Pour aider certaines personnes en situation de handicap, n'a-t-on pas besoin parfois de dépasser techniquement les limites de la nature humaine? Mais peut-on pour autant tout se permettre, même pour compenser un handicap? Comment accompagner les chercheurs dans leur propre questionnement? Ne serait-ce qu'une question de bon et de mauvais usage des techniques et technologies? C'est cette aventure philosophique et bioéthique que propose cet essai.". (shrink)

Studies have shown that children vary in the trajectories of their language development after cochlear implant (CI) activation. The aim of the present study is to assess the preverbal and lexical development of a group of 20 Italian-speaking children observed longitudinally before CI activation and at three, 6 and 12 months after CI surgery (mean age at the first session: 17.5 months; SD: 8.3; and range: 10–35). The group of children with CIs (G-CI) was compared with two groups of (...) normally-hearing (NH) children, one age-matched (G-NHA; mean age at the first session: 17.4 months; SD: 8.0; and range: 10–34) and one language-matched (G-NHL;n= 20; mean age at the first session: 11.2 months; SD: 0.4; and range: 11–12). The spontaneous interactions between children and their mothers during free-play were transcribed. Preverbal babbling production and first words were considered for each child. Data analysis showed significant differences in babbling and word production between groups, with a lower production of words in children with CIs compared to the G-NHA group and a higher production of babbling compared to the G-NHL children. Word production 1 year after activation was significantly lower for the children with CIs than for language-matched children only when maternal education was controlled for. Furthermore, latent class growth analysis showed that children with CIs belonged mainly to classes that exhibited a low level of initial production but also progressive increases over time. Babbling production had a statistically significant effect on lexical growth but not on class membership, and only for groups showing slower and constant increases. Results highlight the importance of preverbal vocal patterns for later lexical development and may support families and speech therapists in the early identification of risk and protective factors for language delay in children with CIs. (shrink)

Atualmente, biotecnologias são empregadas na forma de protocolos a fim de sincronizar o crescimento folicular e a ovulação, bem como permitir que vacas atuem como receptoras de embriões visando melhorar o potencial genético do rebanho. O objetivo desse estudo foi avaliar o efeito da utilização de implantes intravaginais de progesterona de 1º, 2º e 3º uso no protocolo de transferência de embriões em tempo fixo (TETF) sobre a taxa de prenhez em receptoras girolandas. O experimento ocorreu em uma fazenda localizada (...) no município de São Sebastião do Maranhão (MG). Foram utilizadas 74 vacas submetidas aos seguintes protocolos: No dia 0 (D0) administrou-se 2 ml de 17β-Estradiol e progesterona e foi colocado o implante intravaginal de progesterona. Estes implantes foram colocados de forma aleatória, sendo de 1° uso (grupo 1; n=15), 2° (grupo 2; n=24) ou 3° (grupo 3; n=35).No D8, os implantes foram retirados e administrou-se 2 ml PGF2α; 1,5 ml de eCG e 1 ml de 17β-Estradiol e progesterona. A inovulação dos embriões in vitroo correu no D (16) para todas as vacas que apresentaram um corpo lúteo. As variáveis qualitativas (prenhe ou não prenhe) foram comparadas em tabelas de contingência e analisadas pelo teste de qui-quadrado a 5% de probabilidade. Neste estudo não houve diferença estatística entre os grupos protocolados em relação ao aproveitamento como receptoras: 1º uso (53,3%), 2º (79,2%) e 3º (68,65). Ademais, observou-se uma taxa de prenhez entre os grupos de 37,5% para o 1º uso, 42,1% para o 2º e 33,3% para o 3º (P>0,05). Dentre as vantagens ao reaproveitamento dos implantes multiusos destaca-se a redução dos custos dos protocolos hormonais, já que a progesterona é o hormônio mais oneroso, desta forma, a maximização do uso reduz o valor final do protocolo sem prejuízos a taxa de prenhez. (shrink)

Regenerative Medicine promises to develop treatments to regrow healthy tissues and cure the physical body. One of the emerging developments within this field is regenerative implants, such as jawbone or heart valve implants, that can be broken down by the body and are gradually replaced with living tissue. Yet challenges for embodiment are to be expected, given that the implants are designed to integrate deeply into the tissue of the living body, so that implant and body become one. In (...) this paper, we explore how regenerative implants may affect the embodied experience of implant recipients. To this end, we take a phenomenological approach. First, we explore what insights the existing phenomenological and empirical literature on embodiment offers regarding the experience of illness and of living with regular (non-regenerative) implants and organ transplants. Second, we apply these insights to better understand how future implant recipients might experience living with regenerative implants. Third, we conclude that concepts and considerations from the existing phenomenological literature do not sufficiently address what it might be like to live with an implantable technology that, over time, becomes one with the living body. We argue that the interwovenness and intimate relationship of people living with regenerative implants should be understood in terms of ‘entanglement’. Entanglement allows us to explore the complexities of human-technology relations, acknowledging the inseparability of humans and implantable technologies. Our theoretical foundations regarding the role of embodiment may be tested empirically once more people will be living with regenerative implants. (shrink)

The paper focuses on processes of normalization through which dis/ability is simultaneously produced in specific collectives, networks, and socio-technological systems that enable the construction of such demarcations. Our point of departure is the cochlear implant, a neuroprosthetic device intended to replace and/or augment the function of the damaged inner ear. Unlike hearing aids, which amplify sounds, the CI does the work of damaged hair cells in the inner ear by providing sound signals to the brain. We examine the processes (...) of the CI’s genesis as well as its specific uses by and interrelations to the different and divergent actors that the CI assembles. We argue that the technological device and the implicated normalization process mobilize complex effects in varying socio-technical arrangements. The CI is conceived as a “boundary object” [89] or a “quasi-object” [49, 83], i.e., a metastabilized medium of translation that coordinates social, cultural, and technological action. Although intended to transform non-hearing or hard of hearing people into competent and “normal” hearing subjects, the CI system reproduces the asymmetrical structures of the disability discourse [14] through its function of “developing and maintaining coherence between intersecting social worlds” [89, 393]. Additionally, it initiates controversial discourses that have resulted in new forms of biosocial collectivities ranging from cochlear implantees with normal human hearing to human configurations who have passed through human enhancement. Our approach is thus situated at the intersection of disability and media studies and tackles the particular conditions technological media configurations impose upon the production of dis/ability. (shrink)

With pre-implantation genetic diagnosis (PGD), genetic testing and selective transfer of embryos is possible. In the future, germ-line gene therapy (GLGT) applied to embryos before implantation, in order to introduce missing genes or replace mutant ones, may be possible. The objective of this dissertation is to analyse moral aspects of these technologies, as described by eighteen British, Italian and Swedish gynaecologists and geneticists. The objective is systematised into three parts: research interviews and qualitative analysis, philosophical analysis, and elaboration of a (...) framework that supports the combination of analytic methods. PGD was described as positive since it enabled some couples at risk for a genetic disease to have a child without the disease. PGD was described as in different senses ‘better’ than methods for prenatal diagnosis and selective termination of pregnancy. It was also described as positive since it provided couples at risk with one more option, even if it did not result in the birth of a healthy child. However, interviewees were concerned about the difficulty of defining and evaluating genetic disease. They were also concerned about patients’ choices, and about exaggerated use or misuse. Whereas PGD gave rise to ambivalence in terms of how to understand, describe and evaluate it, GLGT was often described as unrealistic or undesirable. The results of the qualitative analysis are used in a philosophical analysis of the concepts of choice, autonomous choice, ambivalence, trust and ambivalence in trust relations. A set of distinct characteristics of each concept are elaborated. The results of the philosophical analysis are used in the discussion of the results of the qualitative analysis. The study shows that the technologies imply both ‘new’ ways to perform ‘old’ medical practices and ‘new’ practices. Old moral questions are reformulated. New moral questions are added. Against the background of this, the concept of genetic identity is discussed. Key words: empirical ethics, pre-implantation genetic diagnosis, germ-line gene therapy, qualitative research, philosophical analysis, medical progress, genetic disease, choice, autonomous choice, ambivalence, trust, genetic identity. (shrink)

A number of late Stoic sources describe either ethical concepts or a supposed universal belief in gods as being innate in the human animal. Though Chrysippus himself is known to have spoken of "implanted preconceptions" (ἔμφυτοι προλήψεις) of good and bad, scholars have typically argued that the notion of innate concepts of any kind would have been entirely incompatible with his theory of knowledge. Both Epictetus' notion of innate concepts of good and bad and the references to an innate belief (...) in gods by other philosophers of the Roman era are thus generally held to be later developments, probably owing to a Platonist-Stoic syncretism. Review of the evidence, however, shows that Chrysippus, like Epictetus, held ethical concepts to represent a special category of conception in that their formation was guaranteed by oikeiôsis. Unlike other concepts, that is, these represent a formal conceptualization of an innate tendency to distinguish between things fitting for one's constitution and things not fitting that all animals, according to the Stoics, bring to their empirical experiences. While the notion that human belief in gods is similarly innate does seem to have been a later development, it too was explained with reference to oikeiôsis rather than resulting from a simple "syncretism.". (shrink)

Implantable cardioverter defibrillators (ICDs) reduce mortality in selected patients at risk for life-threatening heart arrhythmias, and their use is increasingly common. However, these devices also confer risk for delivery of unexpected painful shocks during the dying process, thus reducing the quality of palliative care at the end of life. This scenario can be avoided by ICD deactivation in appropriate circumstances but patients will remain unaware of this option if not informed about it. It is not known how often end-of-life implications (...) are discussed with patients prior to ICD implantation, when focus is primarily on the short-term potential complications of the device placement procedure itself. We conducted a retrospective chart review to determine how often end-of-life implications were discussed with patients as part of the informed consent process. We evaluated consent forms and related other chart documentation for 91 patients (ranging from age 60 to 89 years) undergoing first-time ICD placement at a mid-western academic medical center from 2006-2008. Only one chart documented any discussion of end-of-life implications, in a case where the issue was raised by a patient who noted that quality of life was their main focus. Consent was provided by a health care surrogate in only four of the 91 cases. In conclusion, patients giving consent for ICD implantation may be uninformed about the device's potential future impact on end-of-life care, the dying process, and the option for device deactivation. Truly informed consent requires that both short- and long-term potential implications be reviewed with patients. (shrink)