The Ethics of Enhancement of Intellectual Abilities in Children

286 Pages·2016·1.56 MB·English

The Ethics of Enhancement of
Intellectual Abilities in Children:
A Risk of Creating ‘Superhuman’
Disabled?

A thesis submitted to The University of Manchester
for the degree of

PhD in Bioethics and Medical Jurisprudence

in the Faculty of Humanities

2016

Jenny Imke Krutzinna

School of Law
TABLE OF CONTENTS

ABSTRACT .......................................................................................................... 7
DECLARATION & COPYRIGHT STATEMENT ............................................. 8
DEDICATION ...................................................................................................... 9
ACKNOWLEDGEMENTS ................................................................................ 10
THE AUTHOR ................................................................................................... 11
TABLE OF STATUTES ..................................................................................... 13
TABLE OF CASES ............................................................................................ 14

CHAPTER 1: Introduction .................................................................................. 16

CHAPTER 2: Ethical and legal background ....................................................... 22
2.1 Introduction ............................................................................................... 22
2.2 Literature review ....................................................................................... 23
2.2.1 Enhancement ....................................................................................... 24
2.2.2 Disability ............................................................................................. 36
2.2.3 Intellectual abilities ............................................................................. 42
2.2.4 Welfare of children ............................................................................. 45
2.3 Gaps ........................................................................................................... 47
2.4 Research questions .................................................................................... 48

CHAPTER 3: Philosophical approach ................................................................ 52
3.1 Well-being ................................................................................................. 52
3.2 Empirical evidence .................................................................................... 59
3.3 Personal identity ........................................................................................ 60

CHAPTER 4: Legal approaches ......................................................................... 64
4.1 Treatment of embryos ............................................................................... 65
4.2 Welfare of the child ................................................................................... 67
4.3 Parental responsibility ............................................................................... 70
4.4 Disability ................................................................................................... 72

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CHAPTER 5: Outline of papers .......................................................................... 77
Article 1: Can a Welfarist Approach be Used to Justify a Moral Duty to
Cognitively Enhance Children? ....................................................................... 77
Article 2: Cognitively Enhanced Children: the Case for Special Needs and
Special Regulatory Attention .......................................................................... 78
Article 3: Beyond an Open Future: Cognitive Enhancement and the Welfare of
Children ........................................................................................................... 79
Article 4: Shaping Children: The Pursuit of Normalcy in Paediatric Cognitive
Neuroenhancement .......................................................................................... 80

CHAPTER 6: Can a Welfarist Approach be used to Justify a Moral Duty to
Cognitively Enhance Children? .......................................................................... 83
6.1 Background ............................................................................................... 83
6.2 P1: Well-being is the paramount consideration in moral decision-making
(welfarism) ...................................................................................................... 85
6.2.1 Theories of Well-Being ...................................................................... 89
6.3 P2: Cognition may positively affect well-being. 6.3.1 Cognition and well-
being ................................................................................................................ 90
6.3.2 Cognitive enhancement and well-being .............................................. 93
6.3.3 Potentiality .......................................................................................... 95
6.4 P3: Parents have a moral obligation to maximise their children’s well-being.
......................................................................................................................... 96
6.4.1 Quantification ..................................................................................... 96
6.4.2 Public argument .................................................................................. 98
6.4.3 Alternatives ......................................................................................... 99
6.5 C: Parents have a moral obligation to cognitively enhance their children.101
6.6 Conclusion ............................................................................................... 103

CHAPTER 7: Cognitively Enhanced Children: The Case for Special Needs and
Special Regulatory Attention ............................................................................ 106
7.1 Introduction ............................................................................................. 106
7.2 Definitions ............................................................................................... 111
7.3 Children with high learning potential (HLP) and cognitively enhanced
children (CE) ................................................................................................. 112
7.3.1 The social desirability of intelligence ............................................... 113
7.3.2 High learning potential ..................................................................... 114
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7.4 Discrimination: (special) education needs in England ............................ 116
7.4.1 ‘Significantly greater difficulty in learning’ ..................................... 122
7.4.2 ‘Disability preventing or hindering the making use of educational
facilities’ .................................................................................................... 123
7.4.3 Cognitively enhanced children ......................................................... 129
7.4.4 Taking stock ...................................................................................... 131
7.5 Welfare concerns: the link between health and education ...................... 132
7.5.1 HLP and CE children ........................................................................ 133
7.5.2 Healthy development ........................................................................ 134
7.5.3 Economic argument .......................................................................... 135
7.6 The role of the state and the question of responsibility ........................... 136
7.6.1 State responsibility ............................................................................ 138
7.6.2 Parental responsibility ...................................................................... 139
7.6.3 Inclusion............................................................................................ 142
7.7 Conclusion ............................................................................................... 146

CHAPTER 8: Beyond an Open Future: Cognitive Enhancement and the Welfare
of Children ........................................................................................................ 150
8.1 Introduction ............................................................................................. 150
8.2 The right to an open future ...................................................................... 152
8.3 Choice ...................................................................................................... 155
8.4 The right to an open future: Case studies ................................................ 156
8.4.1 Case study 1 – Pre-conception CE: Genetic selection ...................... 157
8.4.2 Case study 2 – Pharmacological CE ................................................. 159
8.4.3 Case study 3 – Post-conception CE .................................................. 162
8.5 Case analysis ........................................................................................... 164
8.6 The Importance of Ends .......................................................................... 164
8.7 Conclusion ............................................................................................... 169

CHAPTER 9: Shaping Children: The Pursuit of Normalcy in Paediatric
Cognitive Neuroenhancement ........................................................................... 172
9.1 Introduction ............................................................................................. 172
9.2 The idea of normalcy ............................................................................... 175
9.3 Why ends matter ...................................................................................... 177
9.4 Motives and reasons ................................................................................ 178
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9.5 Challenges of psychiatric disorders ......................................................... 180
9.5.1 Models of disability .......................................................................... 180
9.5.2 Autism spectrum disorder (ASD) ..................................................... 182
9.6 Key ethical issues arising from cognitive neuroenhancement ................ 185
9.6.1 Autonomy ......................................................................................... 186
9.6.2 Designing children ............................................................................ 187
9.6.2 Private and public interests ............................................................... 189
9.7 Conclusion ............................................................................................... 191

CHAPTER 10: Conclusion ............................................................................... 194
10.1 Introduction ........................................................................................ 194
10.2 Key findings ....................................................................................... 197
10.2.1 It is crucial to determine the actual benefit of cognitive enhancement
................................................................................................................... 197
10.2.2 Morally permissible cognitive enhancement entails enhanced
responsibilities ........................................................................................... 201
10.2.3 Ends matter greatly in discussing the ethics of cognitive enhancement
................................................................................................................... 205
10.2.4 Researching cognitive enhancement remains important ................ 211
10.3 The risk of creating ‘superhuman’ disabled children ......................... 214
10.4 Where next? ........................................................................................ 217
10.4.1 Regulating cognitive enhancement ................................................. 218
10.4.2 Enhanced cognitive disability ......................................................... 221
10.4.3 Allocating resources for enhancement ............................................ 224
10.5 Concluding remarks ........................................................................... 227

BIBLIOGRAPHY ............................................................................................. 231
APPENDIX ....................................................................................................... 248
Published papers ............................................................................................ 248

Word Count (Main Text including Footnotes): 65,196
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PRELIMINARIES
ABSTRACT

Name of University: The University of Manchester
Candidate Name: Jenny Imke Krutzinna
Degree Title: PhD in Bioethics and Medical Jurisprudence
Thesis Title: The Ethics of Enhancement of Intellectual Abilities in
Children: A Risk of Creating ‘Superhuman’ Disabled?
Date of Submission: 14 December 2016

Human enhancement continues to be hotly debated by both ‘professionals’ and
academics, and increasingly also by the general public. This is no surprise, given that
the idea of making human beings better – individually and collectively – has existed
for centuries. Parents appear to be especially receptive to new ways of improving the
qualities of their offspring – first and foremost their cognitive abilities – in the hope
of giving them the best life possible. At the same time, children as not-yet
autonomous persons are vulnerable to the decisions made on their behalf. This
dynamic has led to a long-running philosophical debate about the moral
permissibility of paediatric enhancement. Unfortunately, this debate has somewhat
stalled at the point of disagreement on general permissibility, with both sides
strongly relying on the notion of well-being to support their respective positions.
Rapid progress in the sciences, including the development of the new CRISPR-Cas9
technique, holds much promise for effective cognitive enhancement in children, and
this makes proper ethical assessment an urgent matter.
Arguing that enhancement is here to stay and that prohibition is not a feasible option
in a globalised world, I suggest that the debate should instead focus on what
cognitive enhancement in children is likely to mean for the welfare of children.
Addressing the question of whether enhancement of intellectual abilities in children
is likely to lead to the creation of ‘superhuman’ disabled children – that is, children
with superior or even yet-unseen cognitive capacities but a disability in some other
sense (medical, social or both) – I draw on evidence from various fields, including
education, law, disability studies and sociology, to demonstrate that the positive
effect of cognitive ability on individual well-being is frequently overestimated and
can thus not serve as a moral justification for cognitive enhancement. Furthermore,
the current legal environment with regard to children with higher intellectual abilities
gives cause for concern about the well-being of future cognitively enhanced children
and urges us to address prevailing shortcomings in educational provision before
deliberately engaging in the creation of more cognitive potential. Suggesting that any
moral judgment about cognitive enhancement should focus strongly on the ends
pursued, I argue that the welfare of children is endangered not so much by the new
possibilities and methods of enhancement as by the failure to fully appreciate
children’s need for the provision of appropriate opportunities to match their
individual abilities.
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DECLARATION & COPYRIGHT STATEMENT

Declaration

No portion of the work referred to in the thesis has been submitted in support of an
application for another degree or qualification of this or any other university or other
institute of learning.

Copyright

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owns certain copyright or related rights in it (the “Copyright”) and she has given The
University of Manchester certain rights to use such Copyright, including for
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described in this thesis, may not be owned by the author and may be owned by third
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Thesis restriction declarations, deposited in the University Library, The University
Library’s regulations (see http://www.library.manchester.ac.uk/about/regulations/)
and in The University’s policy on Presentation of Theses.

Jenny Imke Krutzinna December 2016
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DEDICATION

“Why should you live in a world without feeling its weight?”
― Karl Ove Knausgård

(To Lukas)

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ACKNOWLEDGEMENTS

There are so many people to whom I owe gratitude for both their encouragement to
pursue this PhD in the first place and for the support along the way to completion of
this thesis.
First of all, I would like to express my deepest gratitude to my supervisors, Ruth
Chadwick and Margot Brazier. I realise how extremely fortunate I have been in
having such experienced, competent and caring supervisors. Ruth and Margot, our
meetings have been one of the most enjoyable parts of this PhD and will certainly be
missed. I have found great role models in both of you – thank you for having made
this thesis possible!
The unique nature of the Bioethics and Medical Jurisprudence PhD programme has
made this thesis an invaluable experience in every way. I am grateful to Rebecca
Bennett and Alexandra Mullock for their commitment to the programme, their
continuous help and support, and for always fostering a friendly and stimulating
environment. I also owe a huge thank you to the Law PGR office, especially Jackie
Boardman, for patiently answering my many questions. I have greatly benefited from
being part of a supportive and friendly cohort, and for this I owe my gratitude to my
fellow students. A special thank you go to Sarah Carter, David Lawrence, David
Gibson, Sacha Waxman, Louise Bouic, Patrick Sullivan, Paul Skowron, César
Palacios, Sarah Chan, Nicola Williams, Beverly Clough, Laura Pritchard-Jones and
all the other past and present members of CSEP and iSEI that I have had the pleasure
to engage with. David Lawrence and Sarah Carter deserve a special mention for
keeping me company during many evenings in Manchester which would otherwise
have been very lonely; as does Becki Bennett for providing a home away from home
on more than one occasion. Thank you for your friendship!
There are numerous other people that have helped me with the completion of this
thesis in one way or another. These include Neville Harris, who kindly took the time
to discuss my ideas about the special educational needs of the gifted; my friend
Thomas Heichele, who encouraged me to join him in the ranks of “philosophers”;
Liora Lazarus, who helped me overcome my fears about returning to academia and
encouraged me to pursue my dream; Sarah Barter for so many little things during
difficult times; Saskia Nagel and the participants of the interdisciplinary research
week in Osnabrück for giving me the opportunity to learn so much with and from
them; and numerous other fabulous people.
Finally, I want to thank my family for their continuous love and support, especially
during the tougher times in the last few years. I am eternally grateful for everything
you have done for me, without ever expecting anything in return. Thank you!
And last but definitely not least, Lukas, to whom I owe the greatest debt of gratitude
of all. Thank you for being my companion, for supporting me in all my quests, for
never doubting me and for sharing my dreams! You are truly amazing.
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