Neuro-enhancement at the Margins of Autonomy: In the Best Interest of Children and Elderly?

The prospects of neuro-enhancement have generated a large range of philosophical and ethical debates. The possibility of pediatric neuro-enhancement—using technology and pharmaceuticals to enhance children’s cognitive or emotive capacities—is particularly complicated for a number of reasons. One of the main reasons is that children (at least young children) are not autonomous and can therefore not possibly consent to any interventions. Nonetheless, parents can potentially make decisions to enhance the capacities of their children.

In this chapter I investigate ethical issues of pediatric neuro-enhancement and neuro-enhancement in elderly with diminishing autonomy. I argue that the similarities and differences between the philosophical and ethical questions that arise in the respective cases show how complicated neuro-enhancement in non-autonomous persons is. In particular, I look at three issues: (1) What kinds of autonomy are diminished or underdeveloped, and how does that affect the moral permissibility of neuro-enhancement? (2) What role does the concept of “an open future” play? (3) What does it mean to look out for “the best interest” of a child or a non-autonomous elderly person, and how does it translate to the permissibility of neuro-enhancement? I argue that the difference in how we conceptualize the non-autonomy of children and that of elderly affects the permissibility of neuro-enhancement. I conclude that, as long as we make sure that a person becomes autonomous enough to pursue her own autonomy as a condition and as an ideal, her best interests have been looked after in terms of autonomy.