Emerging Therapeutic Enhancement Enabling Health Technologies and Their Discourses: What Is Discussed within the Health Domain?
Abstract
:1. Introduction
2. Experimental Section
2.1. Theoretical Framework
2.2. Data Sources
2.2.1. Brain Machine Interface (BMI)
2.2.2. Social Robotics
2.2.3. Neuroenhancement, Cognitive Enhancement, Human Enhancement
2.3. Coding
2.4. Limitation
3. Results and Discussion
3.1. Quantitative Data of the Themes Covered in Section 3
Discussion
Health care discourse relevant Terms | Human enhancement (n = 40 article = 100%) | Neuro- enhancement (n = 61 article = 100%) | Cognitive enhancement (n = 82 article = 100%) | Brain machine interface (n = 71 article = 100%) | Social robotics (n = 171 article = 100%) |
---|---|---|---|---|---|
Count (%) | Count (%) | Count (%) | Count (%) | Count (%) | |
Assessment | 40.0 | 42.6 | 58.5 | 33.8 | 29.8 |
Consumer | 20.0 | 16.4 | 8.5 | 12.7 | 4.7 |
Disab | 27.5 | 14.8 | 15.9 | 38.0 | 21.1 |
Ethics | 90.0 | 90.2 | 75.6 | 19.7 | 18.1 |
Evidence | 70.0 | 63.9 | 24.4 | 62.0 | 41.5 |
Evidence based | 0.0 | 11.5 | 3.7 | 2.8 | 0.0 |
Global | 27.5 | 78.7 | 24.4 | 25.4 | 2.9 |
Global Health | 2.5 | 3.3 | 1.2 | 0.0 | 0.0 |
Health | 87.5 | 90.2 | 87.8 | 64.8 | 48.5 |
Health care or Healthcare | 25.0 | 26.2 | 13.4 | 9.8 | 8.7 |
Healthcare ethics | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 |
Healthcare policy | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 |
Health consumer | 2.5 | 3.3 | 0.0 | 0.0 | 0.0 |
Health ethics | 5.0 | 0.0 | 2.4 | 0.0 | 2.3 |
Health policy | 5.0 | 0.0 | 2.4 | 0.0 | 14.6 |
Impairment | 17.5 | 29.5 | 23.2 | 32.4 | 10.5 |
Patient | 27.5 | 57.4 | 63.4 | 85.9 | 28.7 |
Policy | 67.5 | 88.5 | 47.6 | 11.3 | 21.6 |
Public Health | 2.5 | 14.8 | 15.9 | 2.8 | 0.0 |
Technology Assessment | 5 | 3.3 | 2.4 | 1.4 | 0.6 |
3.2. Qualitative Data: How Are Health Care and Some Linked Issues Discussed?
3.2.1. Neuroenhancement
3.2.1.1. Health Care
3.2.1.2. Disability
3.2.1.3. Health Care Policy and Ethics
3.2.2. Cognitive Enhancement
3.2.2.1. Health Care
3.2.2.2. Disability
3.2.2.3. Health Care Policy and Ethics
3.2.3. Human Enhancement
3.2.3.1. Health Care
3.2.3.2. Disability
3.2.3.3. Health Care Policy and Ethics
3.2.4. Brain Machine Interface (BMI)
3.2.4.1. Health Care
3.2.4.2. Disability
3.2.4.3. Health Care Policy and Ethics
- (a)
- “to ensure adequate safeguards, regulation and transparency to support a society of increasingly cognitively resourceful individuals, and also to moderate unrealistic expectations of infallibility”
- (b)
- discussed how public policy and regulations can:
- contribute to inequality by “driving up costs, limiting access and creating black markets”
- reduce inequality by “supporting broad development, competition, public understanding and perhaps subsidized access for disadvantaged groups”
- (c)
- discussed the obstacles to develop and use cognitive enhancements:
- licensing drugs and medical treatments: the system is geared toward dealing with traditional medicine for treatment, cure, prevention, diagnoses, or alleviation of disease. Medicine to enhance the human body is not within the framework. Access to enhancers then become dependent on individuals being able to find a physician “open-minded” enough to provide a prescription, therefore creating inequity because individuals with “higher social capital and good information” will get access, excluding others.
- change in patient-physician relationship—patients are becoming more informed and involved in their health, being aware of treatments and options for their condition (information accessed from Internet services). Suggests the need for regulatory change to inform individuals from risks, ensuring they understand the risks before undergoing enhancement procedures.
- establish baseline level of acceptable risk;
- develop enhancement licenses to ensure informed consent is received and enables better monitoring; barrier for individuals with low cognitive capacity;
- there is a need for more public funding research to reflect potential personal and social benefits of cognitive enhancements;
- cultural challenge of de-stigmatizing enhancers; perception is that taking medicine is a “regrettable activity” and the use of non-therapeutic medicine raises suspicion and possible misuse;
- testing of cognitive enhancements need to take place in natural environments rather than in labs;
- would access to enhancements be regarded as a human right? Banning enhancements would result in black market sales, limiting social benefits;
- legalizing enhancements would result in affordable and safe enhancements.
- ethics issues often cover policy issues that also effect health policy issues. Of the 1,058 articles covering brain machines 1.9% (n = 21) of articles covered ethics issues. The following ethical issues with health policy implications around BMI are raised in the literature: there is currently no legislation put in place to “safeguard the informed consent of the patients before a BMI is used in therapy” resulting in issues around the protection of patient privacy [128];
- concerns are raised with regards informed consent from minors and incompetent individuals—who should be making the decision to provide or not provide consent for TE? [127];
- the need for protocols with implementing BMI application for humans “in terms of acceptable risk to subject” [127];
- research reliability comes into question with small effect size. This runs unforeseen risks upon exposure to the greater population [127];
- risk of human dependency on “outside technology, infrastructure, or drugs” which could result in experiences of withdrawal or impairments [127];
- ethical and quality of life issues around BMI research and application [129].
3.2.5. Social Robotics
3.2.5.1. Health Care
3.2.5.2. Disability
3.2.5.3. Health Care Policy and Ethics
3.2.6. Discussion
- (1)
- to keep one’s local and global competitive advantage;
- (2)
- to live securely;
- (3)
- to maintain one’s quality of life and one’s consumer life-style.
3.3. What Does the Health Consumer Discourse Cover?
3.3.1. Neuroenhancement
3.3.2. Cognitive Enhancement
3.3.3. Human Enhancement
3.3.4. Brain Machine Interface (BMI)
3.3.5. Social Robotics
3.3.6. Discussion
3.4. Who Does Make the Assessment?
3.4.1. Neuroenhancement
3.4.2. Cognitive Enhancement
3.4.3. Human Enhancement
3.4.4. Brain Machine Interface
3.4.5. Social Robotics
3.4.6. Discussion
4. Conclusions
Acknowledgments
Conflict of Interest
References
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Wolbring, G.; Diep, L.; Yumakulov, S.; Ball, N.; Leopatra, V.; Yergens, D. Emerging Therapeutic Enhancement Enabling Health Technologies and Their Discourses: What Is Discussed within the Health Domain? Healthcare 2013, 1, 20-52. https://doi.org/10.3390/healthcare1010020
Wolbring G, Diep L, Yumakulov S, Ball N, Leopatra V, Yergens D. Emerging Therapeutic Enhancement Enabling Health Technologies and Their Discourses: What Is Discussed within the Health Domain? Healthcare. 2013; 1(1):20-52. https://doi.org/10.3390/healthcare1010020
Chicago/Turabian StyleWolbring, Gregor, Lucy Diep, Sophya Yumakulov, Natalie Ball, Verlyn Leopatra, and Dean Yergens. 2013. "Emerging Therapeutic Enhancement Enabling Health Technologies and Their Discourses: What Is Discussed within the Health Domain?" Healthcare 1, no. 1: 20-52. https://doi.org/10.3390/healthcare1010020