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Self-Identity and the Evaluation of Medical Technology Philip Brey University of Twente Full professor in philosophy of technology Director of the 3TU.Centre.

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Presentation on theme: "Self-Identity and the Evaluation of Medical Technology Philip Brey University of Twente Full professor in philosophy of technology Director of the 3TU.Centre."— Presentation transcript:

1 Self-Identity and the Evaluation of Medical Technology Philip Brey University of Twente Full professor in philosophy of technology Director of the 3TU.Centre for Ethics and Technology www.ethicsandtechnology.eu

2 Overview 1.Introduction 2.Ethics and stages of technology development 3.The problem of uncertainty and technology forecasting 4.Three existing approaches 5.Anticipatory Technology Ethics 6.Conclusion 2 1. Self-Identity and Agentive Identity 2. Agentive Identity and Technology 3. Agentive Identity and Medical Technology 4. Self-Identity and the Quality of Medical Technology Medical Technology Structure of the Talk

3 1. Self-Identity and Agentive Identity 3

4 Two types of personal identity Self-Identity (self-concept) The way we reflectively understand ourselves Third-person identity The attributions we make to others I will focus only on self-identity

5 Two Dimensions of the Self-Concept -Existential self: conception of oneself as an experiencing and acting subject separate from the environment -Categorical self: conception of oneself as object (appearance, traits, roles, etc.)

6 Dimensions of the Categorical Self -Bodily identity -Character traits (personality) -Ability -> Agentive Identity -Personal history -Social identity (social roles and relationships)

7 Ability and Agentive Identity Abilities are properties of individuals that define what they are capable of doing or enduring They include physical, mental and social abilities Agentive (self-) identity is the understanding of oneself as an agent with specific abilities and inabilities

8 2. Agentive Identity and Technology 8

9 Technology as extension of human ability Technology extends human abilities (Gehlen, McLuhan, Rothenberg) It does so by building on, enhancing, replacing, improving or restoring abilities of the unaided body and mind As a result, it changes our agentive self-identity

10 Extended agency With technology, we become extended agents: beings who can cut wood, melt iron, fly, move 120 km/h, calculate the 1000000th digit of Pi But none of these are permanent, inalienable abilities: they depend on the availability of technological artifacts So do these abilities become part of our agentive self-concept?

11 The layered agentive self-concept Our agentive self-concept has multiple layers: -The unaided self: abilities of the unaided body and mind -The permanently extended self: abilities that include use of artifacts to which there is permanent access -The temporarily extended self: abilities that include use of temporarily available artifacts

12 Internalized vs. External Technology Agentive identification depends on degree of Internalization Internalized technology: Technology that is surgically inserted or permanently attached to the body This technology may become part of the unaided self- concept Bodily attached technology: Technology that is attached to the body (e.g., glasses, artificial leg) Tool technology: unattached technology operated manually as a tool or instrument Stand-alone technology: technology that operates largely autonomously (machines, devices)

13 Degree of Embodiment Agentive identification with artifacts also depends on their degree of embodiment Embodiment is the incorporation of artifacts into the body schema, by which they become part of one’s agency rather than objects on which agency is exercised. E.g., glasses, hammer are used to engage the environment, are not normally engaged themselves. Cf. remotely controlled robot through haptic device

14 3. Agentive Identity and 3. Agentive Identity and Medical Technology Medical Technology 14

15 Types of medical technologies as extensions 1. Therapeutic medical technologies that extend agency (medical devices and pharmaceuticals). They do so by restoring bodily or mental ability and health. They can be internal or external, and temporary, periodical or permanent.

16 Internal, permanent or periodical: pacemaker, deep brain implant External, permanent or periodical: portable infusion pump, nonportable hemodyaliser Internal and external, temporary: antibiotic treatment, orthotic devices Consequences for agentive self-identity: Restoration of “normal” agency depends on the extent that the technology is either temporary or internal and/or nonintrusive

17 2. Prosthetic Technologies These are technological replacements of body parts which (partially or completely) restore function. They become part of the body schema, and can be internal or attached to the body. Examples: artifical heart, artificial limb, skin graft, artificial pancreas, cochlear implant

18 Consequences for agentive self-identity: Restoration of “normal” agentive self-identity may occur to the extent that the prosthesis is internal, embodied, non-intrusive, and yields similar functionality.

19 3. Assistive Technologies These are external, non-invasive technologies that assist peope with disability by replacing biological function or aiding impaired biological function. Examples: wheelchairs, glasses, accessible computing, speech generators, drinking aids, cognitive orthotics

20 Consequences for agentive identity: Partial or complete restoration of “normal” abilities. However, not a full restoration of normal agentive self-identity. They are external and may not be fully embodied. They often only aide with specific tasks, not general functionality of an organ.

21 4.Enhancement Technologies They augment normal abilities or introduce new ones through prosthetic, pharmocological or genetic means Examples: superhuman bionic limbs, eye or ear, nootropic drugs, designer babies, implanted artificial memory with superior abilities

22 Consequences for agentive identity: Abilities of the “unaided” self are enhanced. Self-concept of superior agency May however be impaired if enhancements have side-effects, are partially external or are not properly embodied

23 4. Self-Identity and the Quality of Medical Technology

24 Good Medical Technology Good medical technologies for restoring or extending human ability should positively affect self-identity, especially agentive, bodily and social By doing so, they enhance self-esteem and well- being But when is self-identity positively affected ?

25 Positive Impact on Agentive Identity -Ability: Can I do A (where A is an action)? -Reliability: Can I consistently and reliably do A? -Convenience: Can I do A without extraordinary effort, time, risk, or inconvenience to myself and my surroundings? -Autonomy: Can I do A -Without external aides (drugs, devices) -Without help from others -Without special environmental features (e.g., wheelchair ramps)

26 Positive Impact on Bodily Identity -Appearance: Do I maintain normal bodily appearance when I use the technogy (for some or all of the time). If not, how intrusive and unaesthetic is the technology? -Body Schema: Can the technology be embodied into the body schema? To what extent? -Humanness: To what extent am I still human? Have I become part machine?

27 Positive Impact on Social Identity -Normalcy: Can I do A as well as others, in the same way and with similar appearance? -Dependency: Does the technology make me socially dependent on others? To what extent? -Social ability: Can I engage in the same social roles, relationships and practices as others?

28 Recommendations -In developing and selecting medical technologies for human ability, their effects on agentive, bodily and social identity should be considered. -Ten criteria were discussed for evaluating medical technologies for these effects -Special consideration is needed for human enhancement technologies, for possible undesirable effects on self-identity and the self- identity of unenhanced others.

29 Thank you !


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