Article Text
Abstract
Many technology ethicists hold that the time has come to articulate neurorights: our normative claims vis-à-vis our brains and minds. One such claim is the right to mental integrity (‘MI’). I begin by considering some paradigmatic threats to MI (§1) and how the dominant autonomy-based conception (‘ABC’) of MI attempts to make sense of them (§2). I next consider the objection that the ABC is overbroad in its understanding of what threatens MI and suggest a friendly revision to the ABC that addresses the objection (§3). I then consider a second objection: that the ABC cannot make sense of the MI of the non-autonomous. This objection appears fatal even to the revised ABC (§4). On that basis, I develop an alternative conception on which MI is grounded in a plurality of simpler capacities, namely, those for affect, cognition, and volition. Each of these more basic capacities grounds a set of fundamental interests, and they are for that reason worthy of protection even when they do not rise to the level of complexity necessary for autonomy (§5). This yields a fully general theory of MI that accounts for its manifestations in both the autonomous and the non-autonomous.
- Ethics
- Human Rights
- Personal Autonomy
- Philosophy
- Consciousness
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Introduction
‘Nothing is at last sacred but the integrity of our own mind.’
Emerson [1, p. 62]
‘Brainjacking.’2 ‘Memory manipulation.’3 ‘Thought control.’4 ‘Crimes against minds.’5. Phrases that might sound like far-out science fiction now populate the pages of reputable academic journals. And not without reason. The twenty-first century has seen a steady proliferation of technologies for neuromodulation: targeted energetic intervention in the brain using electrical, magnetic, or other forms of stimulation. Deep brain stimulation is now used as an approved treatment for neurological disorders like Parkinson’s disease, essential tremor, and dystonia, as well as on an experimental basis for psychiatric disorders like obsessive-compulsive disorder, depression, anorexia nervosa, and schizophrenia.6 Similar implanted devices are used as an approved treatment for epilepsy.7 Other devices in development or human trials include brain-based visual prostheses for blindness.8 Some prominent technologists have also been vocal about aiming to use neuromodulation for non-therapeutic purposes like cognitive enhancement, communication, and entertainment.9–12 In her recent book The Battle for Your Brain, Nita Farahany has catalogued a number of contemporary efforts in these directions, as well as even more morally fraught ones such as use of neurotechnology for warfare.13
In response to all of this, many technology ethicists believe the time has come to articulate neurorights: our normative claims vis-à-vis our minds and brains.14–17 Examples include mental privacy (the right to control information about our minds), cognitive liberty (the right to do what we want with our minds), and mental integrity, our topic here. The idea of mental integrity (henceforth, ‘MI’) has already made a splash in international law, appearing in European Union human rights documents (specifically, the EU Charter of Fundamental Rights18 and the European Court of Human Rights’ Guide on Article 8 of the European Convention on Human Rights19) as well as the now superseded 1996 version of the Declaration of Helsinki20 and UNESCO’s Report on the Principle of Respect for Human Vulnerability and Personal Integrity.21 Perhaps even more notably, it also appears in a recently adopted amendment to the Chilean Constitution.22
Despite all of this legal interest, the concept of MI and a concomitant right to it have not been exhaustively theorised. The policy efforts described above have prompted philosophical discussions of MI, which have in turn generated momentum for further policy efforts. The dominant conception of MI that has emerged from the conversations thus far, however, has some serious drawbacks. After unpacking the dominant conception and considering its pitfalls, I develop an alternative account of MI. I focus in particular on MI as a moral notion rather than a legal one, attending primarily to conceptual questions rather than engaging with specific policy proposals.1
Neurorights and neurowrongs
The easiest way in to thinking about MI is to consider potential threats to it. We might term such threats neurowrongs. Bublitz and Merkel5 imagine some striking possibilities, such as retailers using Flash movies for subliminal priming of customers and psychiatrists covertly using transcranial magnetic stimulation (TMS) in order to increase patients’ truth-telling. Ienca and Andorno14 imagine even more extreme scenarios, such as unauthorised interference with brain-computer interface (BCI) devices (eg, limiting or controlling function of BCI-operated wheelchairs, artificial limbs, or visual prostheses; see also Ienca and Haselager23), selective boosting or erasure of memories by modulating synaptic connections (on which they cite, specifically, the work of Nabavi et al 24 on techniques for achieving these effects), and potential applications of TMS in warfare to enhance and/or suppress brain processes. They draw this latter application of TMS from a 2009 National Research Council report25 (pp. 84–85) (and see also recent reports of animal testing aiming to recapitulate symptoms of Havana syndrome in animals using pulsed radio frequency waves).26 While these scenarios are speculative, they illustrate the kinds of extreme possibilities that future advances in neuromodulation might occasion. In all of these cases, the victim’s mind is impinged upon in an objectionable way.
Gilbert et al 27 provide a final case that is especially instructive due to having actually occurred. They describe a patient suffering from severe chronic epilepsy whose seizure-detection implant was explanted against her wishes when the manufacturer (Neurovista) went out of business. The result was significant disruption to her autonomous agency, which had become ‘symbiotic’ with the device, as well as ‘a sense of confusion, disorientation, and anxiety as she navigates a new normal without the technology that had become an integral part of her cognitive and emotional processes’ (p. 785). Here the causal structure of the case is different: a beneficial intervention was removed, rather than a deleterious intervention being introduced. All the same, the case as described by Gilbert et al strikes me as quite a serious violation of MI.
To make good on that thought, however, we will need to clarify what exactly MI and the right to it are supposed to be. We can begin this task by considering the dominant autonomy-based conception of MI.
The ABCs of MI
According to most theorists, MI is principally about autonomy14 28–32 or something in the near vicinity, such as a self-determination,5 33 34 authentic choice,35 or self-ownership and personal sovereignty.36 This autonomy-based conception (ABC) admits of some variation that is worth unpacking.
Some theorists suggest that (1) MI is a person’s control or authority over her own mind and its associated brain processes, as against unwanted interference. Control is here understood as control over the contents of one’s own mind, such that the contravention of our autonomous preferences about these contents violates MI. Perhaps anticipating charges of overbreadth, other theorists further specify the form of control at issue. This variant of the ABC says instead that (2) MI is a person’s control over access to her mind and underlying neural processes, as against unwanted interference. Here, the autonomous preferences relevant to MI are restricted to those about the sources of influence, rather than the particular contents that they cause. It is contravention of our autonomous preferences about which sources will influence us (and how) that constitutes a violation of MI.
Other theorists, by contrast, think of MI as a state rather than a form of control. On this style of view, MI is just the absence of interference itself, such that: (3) MI is a person’s undisturbed state of not being mentally interfered with. Such views are still a variant of the ABC, however, for this reason: for these authors, what counts as interference is determined by an individual’s exercise (or lack thereof) of her autonomy. MI is the state of not having our autonomous preferences regarding our minds contravened. Which autonomous preferences count, of course, can be specified as either of the control variants (1) and (2) specify them.
In consequence, there is not much distance between control and state variants of the ABC. One camp identifies MI with the autonomous control whose non-violation consists in the undisturbed state that the other camp identifies with MI. Both camps agree that autonomy is central to MI and in analysing a corresponding right to MI as a negative right of non-interference. This right then either coincides with MI itself (on state conceptions of it) or safeguards the conditions of its exercise (on control conceptions). MI and the right to it are violated when our minds are interfered with contrary to our autonomous preferences. To make all of this clearer, we can examine some specific accounts of MI offered in the extant literature.
One influential account, Ienca and Andorno’s, emphasises the importance of protection against ‘unauthorised alteration’ of our mental life (14, p. 18), where the significance of the alteration being unauthorised is that this renders it contra-autonomous. Their more formal definition goes as follows:
For an action X, to qualify as a threat to mental integrity, it has to: (i) involve the direct access to and manipulation of neural signaling (ii) be unauthorized – i.e. must occur in absence of the informed consent of the signal generator, (iii) result in physical and/or psychological harm (Ibid.).
Condition (ii), in particular, makes clear the conceptual connection to autonomy. Because Ienca and Andorno’s definition is about what constitutes a threat to MI, it is ambiguous between the control and state variants of the ABC. It is most naturally interpreted as a state variant of the ABC, but could also be put in terms of control. Ienca and Andorno’s variant of the ABC is fairly stringent. It involves not only a lack of consent, but direct invention in neural processes and the presence of harm.
Subsequent accounts, however, have tended to broaden their conceptions of MI (and the right to it). Lavazza,31 for example, frames his own analysis against the backdrop of Ienca and Andorno’s. Lavazza loosens their (i) and drops (iii) altogether to arrive at the following definition:
Mental Integrity is the individual’s mastery of his mental states and his brain data so that, without his consent, no one can read, spread, or alter such states and data in order to condition the individual in any way (31, p. 4).
Here we have a clear instance of the control variant of the ABC, since MI is said to be an individual’s ‘mastery’ of her own mind and information about it.
So, while there is some intramural disagreement between ABC-theorists, they are unified by the idea that MI and the right to it are grounded in autonomy. More specifically, the ABC understands it primarily as a negative right of non-interference (a right against others affecting a person in certain ways, rather than a positive right to some good). It is fair, I think, to describe the ABC as an emerging consensus in the nascent literature on MI. But it faces difficulties that suggest something has gone awry. We can turn now to those difficulties, which will lead us to seek an alternative.
Revising the ABC
An important worry for the ABC is that it makes MI, and the concomitant right to it, far too broad. There are two distinct forms of overbreadth worth considering. First, there is overbreadth that results from understanding MI as threatened by both inputs and outputs. Our discussion so far has revolved around inputs: unacceptable interventions in a person’s mental life, causing it to be some way it should not be. But Blumenthal-Barby and Ubel37 think that the field also mistakenly counts a second very different phenomenon as threatening MI: outputs, the collection and transmission of information about a person’s mind and brain. Protecting both inputs and outputs under the rubric of a single right, Blumenthal-Barby and Ubel argue, leads to an implausibly broad and theoretically disunified conception of MI.
The charge is, I think, apt in the case of Lavazza’s31 account and others like it that understand MI as control over both one’s mind and information about it (or about underlying brain processes). Blumenthal-Barby and Ubel seem quite right that inputs and outputs are too dissimilar to be covered by a single right. Outputs chiefly concern mental privacy, which is distinguished from MI by most theorists of neurorights. This distinction is appropriate because a threat to integrity seems, conceptually, to involve a threat of deleterious alteration. But mental outputs can, at least in principle, be passively collected without at all disturbing the individual’s ongoing mental processes. While clearly worrisome, mere collection of information about the mind has a fundamentally different character than actively intervening in the mind. Theorists of MI, then, can reasonably respond to Blumenthal-Barby and Ubel’s worry by understanding inputs alone as fundamentally relevant to MI and holding that outputs require their own separate analysis in terms of concepts like mental privacy. This is compatible with recognising, of course, that outputs can make for more effective, individually tailored inputs. Outputs might make violations easier or more profound, but no amount of outputs alone violate MI (even if they do, plausibly, violate some other right).
A second, more serious form of overbreadth results from the fact that mental interference is ubiquitous.36 37 Ordinary life confronts us with a steady stream of mental inputs via sense-perception. Our minds are ‘interfered’ with by such commonplace occurrences as hearing a plane fly overhead, being confronted with street signs and traffic lights, and being engaged in conversation by other people. Anything that affects the content of our experience can be said on that basis to influence our minds, and any such influence on our minds is at least a potential influence on our behaviour as well. To say that MI is violated even by these sorts of unremarkable occurrences would be to trivialise it, and to make any supposed right to it terribly implausible. This brings out a serious inadequacy in the ABC. Any conception of MI must draw a distinction between mere mental influence and unacceptable mental interference, neurotechnological or otherwise. But this distinction has not been well articulated.
We can make progress on that score by going back to the beginning of MI discourse. The first to explicitly theorise about MI by that name was A. T. Welford.38 Welford’s concern is not neurotechnological interference in the mind, since neuromodulation research was during his time still in its infancy. Instead, we find his interest to be the then-novel conception of death as brain death. This conception of death, Welford thinks, implies a corresponding conception of life. And this conception of life he calls ‘mental integrity’. In explicating what he means, he offers a parallel between bodily and mental integrity. Both, Welford thinks, should be understood as forms of functional integrity. Here is how he puts it:
Death is normally conceived as having occurred when there is an irreversible cessation of bodily function, such that disintegration of the body will follow. Recently, especially in France, it has been argued that the individual as a whole is dead when his brain is dead—that is, when the seat of his personality and of the coordination of his thought and action which make him a human being has irreversibly ceased to function. Both these definitions are essentially in functional terms, so that we arrive at a concept of life as a state of functional integrity (38, p. 1136).
For Welford, an individual is a whole whose existence depends on the integrated function of its parts. For the body, integrated function is biological life, and its irreversible loss biological death. Something analogous is true of the mind. The life of a person, as distinct from a merely biological organism, is integrated function (‘coordination’) of various mental capacities (for Welford, thought, action, emotion, and memory). The death of a person is the irreversible loss of this coordination, and so of personality.
Unfortunately, Welford has little else to say about the specific capacities that underlie MI, or what it means for mental capacities to be functionally integrated. But this idea of MI as functional integration is also scattered throughout the more recent MI literature, often without explicit engagement with Welford. Bublitz33, for example, gets at something similar in considering the nature of integrity rights. ‘[W]hat is an integrity right?’ he asks. ‘Although there is no settled understanding, a right to the integrity of X seems to denote the preservation of the intactness, unity or identity of X. Alterations of these features then constitute interferences’ (§30.4.2). While Bublitz thinks that the best substantive conception of MI should be filled out in terms of self-determination, he recognises that the basic concept of MI itself has something to do with mental integration.
Similarly, Fuselli32 understands MI partly in terms of autonomy, but appeals as well to language like ‘mental balance’ (p. 419), ‘psychical borders’ (p. 424) and ‘the psychophysical unity of the subject’ (p. 426). He also relates MI specifically to integration:
[O]nly what is integral – what is not fragmented, not divided, not disjointed, not dispersed – can be properly called individual. Only what is not disjointed because of its individuality can have its own identity and autonomy in relating to itself and to somebody else or something else (p. 423).
Like Welford, Fuselli understands individuality as dependent on integration. Valera39 appeals to similar language (eg, ‘psychosomatic unity’). In dialogue with Fuselli, he also says, ‘Individuality needs integrity: a subject is an individual (from the Latin individuus, i.e., indivisible) only if its mental ecology is intact’39 (p. 102). Hildt40 likewise proposes an understanding of MI as ‘being mentally whole, unimpaired, or undivided’ (p. 91). Keeling and Burr35 propose an allostatic view of MI according to which it involves both an internal regulatory equilibrium and a similar equilibrium between the mind and the environment. And Fins’41 emphasis on positive as opposed to merely negative neurorights suggests a similar way of thinking about MI, one that anticipates some of the ideas of my own proposal.
These remarks all point in a common direction, towards a conception of MI as functional integration of the mind. Though all of these contemporary theorists retain autonomy-centric views of MI, they have rediscovered Welford’s thought that MI consists in something more fundamental that is a precondition of autonomy and other high-level features of a person. Valera39 sums the idea up nicely: MI is ‘the condition of possibility for other human dimensions, such as freedom, autonomy, and agency’ (p. 102).
This preconditional picture of MI suggests a way to revise the ABC to avoid overbreadth. Rather than understanding violations of MI in terms of the frustration of particular autonomous wishes about the contents of our minds, or in terms of particular instances of consent or its absence, we can shift to a different level of analysis.2 This revised ABC (‘ABC-R’) concerns itself exclusively with effects on our underlying general capacity to form and enact autonomous preferences and to consent. It is interference at this level, I propose, that threatens MI in particular. What is most distinctive about the kinds of cases we considered at the outset is that the victims’ standing abilities to evaluate, deliberate, choose, and act are themselves interfered with, such that their usual capacity for autonomy is (at least temporarily) diminished. The very autonomous self from which preferences and consent issue in the first place here comes under threat.
Zohny et al 42 independently arrive at a similar, but narrower, view. On their account, MI is violated by mental interventions that bypass rational control and cause alienated mental states. This is a helpful proposal, but one that seems to me to narrow the scope of MI too significantly. Bypassing a person’s rational control is one way of diminishing her autonomous agency, but not the only way. A second way is to engage her autonomous agency, but with inputs that will erode it over time. Here addiction may be an instructive example. A third way is overwhelming a person’s autonomous agency with inputs too complex to adequately navigate. Here an instructive (though not entirely uncontentious) example may be contemporary online consumers confronted with a dizzying array of choices, price points, reviews of varying reliability, and real-time targeted advertisements.
On the ABC-R, a right to MI is much more plausible, since it now appears to be a special case of a more general right safeguarding the basic conditions of our autonomy. Such an account also has the benefit of bringing theorising about MI into alignment with other areas of contemporary technology ethics. Similar thinking about autonomy has been deployed, for example, in arguments for the practice of digital minimalism.43–45
Accounting for the non-autonomous
We might think, then, that the ABC-R gives us a satisfactory theory of MI. Unfortunately, the ABC-R still faces a different kind of problem: making sense of the MI of the non-autonomous. In the case of bodily rights, we properly draw a distinction between bodily autonomy and bodily integrity, where the latter is something like ‘the right to have one’s own body whole and intact’46 (see also Herring and Wall’s analysis).47 This right is appropriately accorded even to those who lack autonomy, such as children and those with profound intellectual disabilities. These individuals, too, have a right to the preservation of their bodily wholeness and intactness even in the absence of an autonomous preference to that effect. These individuals’ rights vis-à-vis their bodies will need to be grounded, then, in something other than autonomy. In like fashion, these non-autonomous individuals plausibly have rights against certain forms of mental violation, too. We would presumably not tolerate arbitrary interference with their mental processes despite their lacking any autonomous preference against such interference. But such rights cannot, of course, be autonomy rights. MI must then be grounded in something more general and fundamental than autonomy—something that is accompanied by or involves autonomy in the autonomous, but is present also in the non-autonomous.3
To get a handle on what that might be, consider again the preconditional idea of the last section. A view of that kind need not appeal to a single, highly sophisticated capacity (autonomy) in articulating the normative significance of MI. We can instead understand MI in terms of a plurality of simpler capacities, ones that can be combined in sophisticated ways to yield higher-order capacities such as autonomous agency. But the capacities need not rise to that high level in order to be worthy of protection. They are worthy of protection in themselves, including as they manifest in the non-autonomous. Or so I will now suggest.
The simpler capacities I propose are the capacities for (1) affect, (2) cognition, and (3) volition. These are present not only in autonomous adults, but also in children and adults with profound intellectual disabilities, as well as a wide variety of non-human animals. Even in rudimentary form, these capacities are deserving of protection because each is the basis of certain fundamental interests. The value of MI is that it is the precondition of possessing these interests. On my account, the right to MI is a right against diminishment of these interest-grounding mental powers.
Integrity and interests
By an individual’s interests, I mean the fundamental respects in which her life has first-personal significance. We have interests insofar as our lives matters from the inside, in ways dependent upon and only fully graspable through our own perspective (see also Willaschek,48 who arrives at a similar conception of value via a rather different route). Such interests come, it seems to me, in three basic varieties: (1) affective interests deriving from our nature as feeling subjects, (2) epistemic interests deriving from our nature as inquiring subjects, and (3) agential interests deriving from our nature as willing subjects.
Denizens of the philosophical literature on welfare will recognise these as the three kinds of capacities picked out by values-based theories of welfare.49–53 Contra such theories, I believe it is instead most plausible to identify our welfare solely with interests of the first kind, such that epistemic and volitional interests are personal but non-welfare interests. The account of MI on offer, though, does not stand or fall with that claim. If the claim is incorrect, and welfare does turn out to be the joint product of affective, epistemic, and volitional elements, a welfare-based account of MI would instead be plausible. Even then, however, it would still make good sense to distinguish the three kinds of interests, despite bringing them under the common heading of welfare. With that in mind, we can now consider these three kinds in detail.
Affective interests
Our capacity for affect is our ability to experience certain feelings: those whose experiential character involves positive or negative polarity (valence). Examples include pleasure, joy, amazement, tranquillity, pain, sadness, suffering, anxiety, anger, and disgust. Some of these states can be free-floating (pleasure, pain, tranquillity, sadness, anxiety), that is, not about anything in particular. Others are (at least sometimes) about some particular thing (amazement, suffering, anxiety, anger, disgust, and perhaps all of the other examples, too). I would also hasten to include here affective desire 54 55 and other felt pro-attitudes (valuing, loving), as well as their negative opposites. Felt pro-attitudes also plausibly form an affective core of various interpersonal caring relationships, such as friendship, romantic love, and parenting.56 57
To confirm that our capacity for affective experience in this sense does indeed give life a great deal of first-personal significance, we need only imagine its absence. Consider, for instance, the prospect of a ‘radical pheno-ectomy’ which would remove all affective experience from a person’s life while leaving the rest of their experience intact. This is a variant of Siewert’s58 thought experiment (p. 320) and similar to a case given by Crisp59 (p. 122). It seems clear that this would constitute a massive impoverishment, and an impoverishment from the individual’s own perspective. It would be the loss of a whole modality of their experiential engagement with the world, with others, and with themselves.
We might, of course, want a deeper theoretical explanation of the significance of affective interests. While that is beyond our scope here, it is worth mentioning one kind of explanation to illustrate how the story might go. As I alluded to above, a tidy explanation of the significance of our affective interests is that they coincide with our welfare, the states of affairs consisting in things going well or poorly for us in the sense of benefiting or harming us. Our affective interests and our welfare, you might think, are in fact one and the same thing.56
You need not, of course, accept this illustrative explanation in order to accept the general claim that we have affective interests that give first-personal significance to our lives. It is only this more general claim that the proposed theory of MI requires, and that claim, I suspect, will be widely shared.
Epistemic interests
We can move on now to our capacity for cognition and the epistemic interests it grounds. The term ‘epistemic interests’ figures in contemporary work in the philosophy of science,60 61 but such work does not, as far as I am aware, understand it as a first-personal form of significance that grounds individual interests. I employ it here to express the idea that we have a second set of interests in our capacity as inquirers attempting to make sense of the world and our place in it, often in concert with others. This can be motivated by pointing to epistemic goods like knowledge and intellectual virtue,62 conscious understanding,63–67 and credibility.68 69 In addition to their instrumental value, such goods also seem worth possessing for their own sake. We can imagine a life rich in the fulfilment of our affective interests but comparatively impoverished in these epistemic respects, and such a life seems to be missing something deeply important. The thought that we have distinctively epistemic interests is also bolstered by recent work on epistemic injustice68 and epistemic rights,70 which catalogue the various ways we can be set back in our capacity as epistemic subjects.
We might, naturally, hope for a deeper explanation of the significance of epistemic interests—an account of what makes them important. As with our affective interests, providing an exhaustive explanation of that kind would take us too far afield. But one tentative suggestion is to appeal to life’s meaning. Recent theories of what it is to live a meaningful life have appealed to sense-making and intelligibility, and so understood meaning as a fundamentally epistemic phenomenon.71–73 We might leverage these kinds of accounts to provide a more robust story about the nature of epistemic interests. The picture will be something like this: the more and more complicated sense-making in which one engages, the more meaningful one’s life. But a life need not have an abundance of meaning in order to be at all meaningful. The above account suggests that any life containing epistemic activity thereby contains some non-zero amount of meaning. Unlike welfare, meaning seems to lack a negative opposite. Individual cognitive episodes can be relatively unintelligible, and so lack much meaning, but they cannot be anti-intelligible (though cf. Nyholm).74 We might understand the category of epistemic activity as quite broad indeed, including not only paradigmatically ‘intellectual’ cognitive states like thought, belief, and rational reflection, but also sense-perception, memory, and imagination. The result is an expansive understanding of epistemic interests that covers the mental lives not only of the autonomous, but of most or even all conscious beings.
This is again only illustrative of the kind of explanation one might give of the category of epistemic interests. I take it that the category itself will have broad appeal as a form of first-personal significance worth protecting even to those who favour a different explanation of why this is so.
Agential interests
To complete the picture, consider now a third set of interests: our agential interests. The capacity associated with these interests is that of volition, the ability to intend or will and act accordingly. In its more sophisticated exercises, of course, volition also involves deliberation, planning, retrospective reflection, and the like. Such exercises include cognitive and perhaps also affective elements. To determine whether volition as such has first-personal significance, we will need to abstract away from these additional elements as best we can.
Our agential interests, so understood, are the form of significance to which Mill75 may be referring in On Liberty when he remarks that ‘If a person possesses any tolerable amount of common sense and experience, his own mode of laying out his existence is the best, not because it is the best in itself, but because it is his own mode’ (p. 64). A person’s own active role in shaping her life contributes to its value, the thought goes, regardless of its particular character and over and above the other forms of first-personal significance it might also possess.
This form of significance is also, I think, what is at issue in Sartre’s dilemma between going off to fight in a (just) war or remaining to care for one’s ailing mother76 (pp. 30–34). Here traditional moral reflection (which subsumes, let us suppose, the reasons given by one’s own affective and epistemic interests) underdetermines the choice due to uncertainty and the apparent incommensurability of different sorts of reasons. All that is left, on Sartre’s telling, is to make an existential choice, a choice about who to be and what sort of life to live. If that sort of choice has independent significance, it would seem to reside in the value of willing as such.
The plausibility of this as a distinct form of first-personal significance is further motivated by the following scenario imagined by Griffin.77 Suppose I am given the choice to go on living my life as I currently do, structuring it at least partly on the basis of my own efforts and choices, or instead placing care over my life in the hands of a benevolent dictator who will (it turns out) do a better job of running the show than I myself will. Our reluctance to accept such a deal suggests that there is non-derivative value in something like self-authorship: the value of my life’s being, to some significant extent, my own doing (and see also Siewert66 on the value of self-expression).
Given our background purposes, it is worth also considering an example of agential interests in a non-autonomous individual. A toddler learning to grasp objects or take their first steps may not, at least at the start, get much out of this where their affective or epistemic interests are concerned. They might merely step into and explore (in a literal way) their developing agential capacities, simply willing to do something and doing it. Pure volition of this kind, one might think, counts for something just on its own, and perhaps makes sense of the value of phenomena like unstructured play.
We should recognise, of course, that it is difficult to fully untangle our judgements about the value of willing from residual affective and epistemic interests that may be present (or imagined to be) in such examples. This difficulty leaves room for scepticism that agential interests really are a third, distinctive form of interest. Even if they are not, however, there is still a clear place for them in a theory of MI. Volition need not ground its own distinctive form of significance to be deeply relevant to MI. Our volitional capacities allow us to enact and promote our affective and epistemic interests, structuring our choices and lives in light of them. This goes for the non-autonomous, too, even if their volitional capacities take forms less complex than those of the autonomous. So even if we doubt that volition has intrinsic first-personal significance, we can still confidently accord it massive instrumental first-personal significance.
Putting it all together
This completes the substance of my proposal for an alternative to the ABC. For conscious but non-autonomous beings, (at least some of) the following will still be true. They have affective states, both free-floating and with particular objects. They have cognitive states, perceiving (and perhaps to some degree reflecting upon) the world around them such that it to some degree makes sense or is intelligible to them. And their experienced exercise of their own volitional powers contributes to the course and character of their lives. They are, in short, individuals with their own particular sensibilities, even if they are not autonomous individuals. Their individuality, too, is on my proposal worthy of the form of protection that MI involves.
One might at this stage wonder how this proliferation of values is supposed to help. Are not our affective, epistemic, and agential interests influenced by all manner of ordinary interactions? It would, indeed, quickly lead to absurdity to treat any setbacks to these interests as violations of MI. That is not the proposal. Instead, the proposal is structurally analogous to the ABC-R from earlier: MI is violated when the capacities underlying fundamental interests are bypassed, eroded, overwhelmed, or otherwise undermined. Threats to MI are threats to the mental preconditions of these forms of first-personal significance. Mere negative impacts on our affective, epistemic, and volitional interests that do not diminish underlying capacities will of course under many circumstances be rights violations of other kinds, but not violations of a right to MI.
To make the theory more concrete, we can relate it to some contemporary examples of interaction with digital technologies. The unpleasantness of reading an upsetting post online mildly sets back my affective interests. It does not, however, threaten my MI, since my underlying general affective capacities are unaffected. But engaging with a sufficient amount of such content over a sufficient amount of time (perhaps algorithmically targeting my specific affective sensibilities), such that my very emotional stability is diminished, would undermine my MI. Similarly, the presence of online misinformation that prevents my understanding something, and so makes the world a little less intelligible to me, does not violate my MI. But pervasive misinformation that throws me into epistemic chaos, unable to accurately make sense of the world or my place in it, does. Likewise, being distracted by my smartphone on some isolated occasion is likely to leave my underlying volitional capacities unaffected, and so MI is not threatened. But if this happens with such sufficient frequency that my powers of attention or self-control are themselves eroded, then it is. And if we now imagine the same examples with a different subject—rather than me, a 10-year-old child engaged in the same kinds of activities, say—we will see that the same verdicts hold for the non-autonomous as well, with the added urgency that their developing capacities may be more easily impinged upon than mine.
An important objection
One might still worry that my own conception of MI is subject to a worry of overinclusiveness of the kind discussed earlier.4 Consider, for example, a woman who comes across a video on the internet that depicts the awful conditions of a factory farming operation. Suppose that her resulting anger and frustration temporarily interfere with her ability to think clearly. Could this really count as an unacceptable violation of MI? Presumably not. Similarly, consider a man sentenced to three months in jail after being found guilty of joyriding a stolen vehicle. Suppose that fear of going to jail overwhelms him, rendering him incapable of deciding whether or not to appeal the decision. Could this really count as an unacceptable violation of MI? Again, presumably not. In order to be plausible, my conception of MI must be able to accommodate such verdicts.
It can do so by being responsive to one or both of the following features of the cases. One issue raised by the examples is that of the threshold for undermining a capacity. Just what degree of setback to a capacity’s exercise is needed for it count as having been undermined? Different degrees of strictness are possible here. One might set the bar quite high, viewing a capacity as undermined only when its usual exercise is extensively impaired or prevented altogether. That would definitively rule out these examples, but might also rule out the sorts of cases I sought to include above. Still, a theorist of MI otherwise friendly to my conception might adopt this strategy. And it may be that a plausible threshold can be identified that rules out factory farming videos and fear of jail as undermining MI, whilst ruling in the cases of digital interaction to which I earlier gestured.
My own impulse, however, is to focus primarily on a second feature of the cases: they involve treatment that is not wrong in the circumstances described, but that would be wrong if inflicted for no good reason. It would be wrong, to some degree, to post horrific videos online solely to cause distress to unsuspecting people who happen upon them. (This need not imply that it should be unlawful to do so, but merely that the poster commits at least a mild moral wrong in spreading them.) But it is not wrong to do so in the pursuit of justice in non-ideal circumstances. Similarly, it would be very wrong indeed to inflict fear of jail on an innocent person. But it is not wrong (or a least, much more defensible) in the case of someone guilty of the offence—acknowledging, of course, that there are significant questions about whether incarceration is a just punishment for crimes of the kind under discussion. For a rich exploration of the intersection of neurorights with issues of criminal justice, see Ryberg78 (ch. 3).
What these examples reveal, then, is that violations of MI are wrong other things being equal, but not unconditionally. What is unconditionally wrong is to violate MI for no good reason. This makes the scope of a right to MI highly dependent on what counts as a good reason for violating MI. That issue rests in turn on a variety of considerations in general moral theory that cannot be readily settled here. A complete theory of MI must offer an account of what counts as a good reason for violating it. I rest content here with having outlined a general conception of MI whose precise contours are well worth further exploration.
Conclusion
I have identified a common basis for the MI of both the autonomous and the non-autonomous. The shape and strength of a right to MI, however, may vary significantly between the two groups. As Mill stresses, an autonomous person is generally better positioned than anyone else to safeguard and promote her own interests.75 An autonomous person best knows, or is at least in a highly favourable position to best know, the details of her first-personal interests. The interests being first-personal, and so a matter of self-knowledge, implies this in all but unusual cases. We might say that that an autonomously reflective person has inside information of a very strong sort. Her status as an autonomous agent means that she is also in a position to act on that information, and to act from a proximity different in kind than that of anyone else—so in addition to inside information, she has the inside track on doing something with that information. The autonomous are therefore properly afforded wide-ranging discretion where their own MI is concerned. The non-autonomous, by contrast, will often be owed benevolent intervention rather than discretion.
There is obviously a great deal more to say about the nature and structure of the right to MI. I have here been assuming, for simplicity’s sake, a Millian account of rights according to which their moral function is the protection of important interests. Arriving at a fuller picture of the right to MI will require critical consideration of this and other models of rights and their moral function(s). While that analysis must await a future occasion, the value-theoretic considerations adduced here are a necessary preparation for the task. They are also, at least to my mind, of independent significance. I hope here to have shown why, regardless of the precise theoretical contours of a right to it, MI is so well worth cultivating and protecting—a conclusion with important implications for how to structure our individual lives in addition to its moral and political salience.
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Acknowledgments
For their helpful comments on various iterations of these ideas, I thank Sean Aas, Jenny Blumenthal-Barby, Anna Giustina, Anthony Kelley, Zak Kopeikin, Uriah Kriegel, Miles Meline, Gabriel Lázaro-Muñoz, Dan Pallies, George Sher, Charles Siewert, Rafael Yuste, and audiences at the Centro de Investigaciones Filosóficas, the Harvard Center for Bioethics, the 2022 meeting of the Neuroethics Affinity Group of the American Society for Bioethics and Humanities, the 2023 Rocky Mountain Ethics Congress, the Well-Being Working Group, East Carolina University, the University of Texas at Arlington, Louisiana State University, and Massachusetts General Hospital.
References
Footnotes
Contributors All contributions are by PZ, the sole author, except where others have been thanked for their comments and suggestions.
Funding Research reported in this publication was supported by the National Institute of Neurological Disorders and Stroke (NINDS) of the National Institutes of Health (NIH) as part of the NIH BRAIN Initiative under Award Number F32MH127776, administered by the National Institute of Mental Health (NIMH). The content is solely the responsibility of the author and does not necessarily represent the official views of the NIH, BRAIN Initiative, NINDS, NIMH, or Harvard Medical School.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
↵It is my hope that this conceptual work will inform such proposals, and I view it as preparatory for a more detailed analysis of their merits in future work. I thank an anonymous reviewer for emphasising the importance of this kind of engagement.
↵This is in no way intended to diminish the general normative significance of consent. Rather, the point is that a consent-based theory of MI would require already possessing an antecedent account of which sorts of mental interventions require consent and which do not. I thank Sean Aas for making this point clear to me.
↵An anonymous reviewer suggests that a general obligation of non-harm can explain the MI of the non-autonomous. This strikes me as fundamentally correct and in keeping with my proposal. MI is not, on my telling, a sui generis moral category independent of notions of harm and benefit. Rather, I understand MI as a unifying concept that captures the different kinds of fundamental interests involved in being the possessor of a mind, and the ways in which these interests can be set back.
↵I thank an anonymous reviewer for raising this point and supplying the accompanying examples.