 Thank you all for coming out in this blizzard. I hear that there are four inches of snow on the ground already. No, not so. Two, two so far. On behalf of the McLean Center for Clinical Medical Ethics and the Grossman Institute for Neuroscience, Quantitative Biology and Human Behavior, I'm delighted to welcome you to this lecture in our series on neuroethics. The lecture series, as you know, was organized by John Moncel, the Director of the Grossman Institute, Peggy Mason, Professor of Neurobiology, and Dan Salmezzi from the McLean Center. I am now delighted to introduce today's speaker, Professor Julian Savalescu. Professor Savalescu has held the hero chair in practical ethics at the University of Oxford since 2002. He holds degrees in medicine, neuroscience, and bioethics. Let me just tell you a little bit about Professor Savalescu. He's been a world leader in medical and practical ethics. His book, co-authored with Tony Hope and Judith Henrich, entitled Medical Ethics, The Core Curriculum, has become the standard textbook in the UK in medical ethics and is used at Oxford and Cambridge. Professor Savalescu has been prominent in end-of-life and research ethics, the ethics of the doctor-patient relationship, and has pioneered the field of enhancement. Together with Guy Kahane, he's established neuroethics in Europe, developing an empirical, philosophical approach to moral decision-making. Julian Savalescu has published 16 books, or has some of them under contract, has edited numerous volumes and articles and the like. For the past 10 years, through a series of publications, he's led the debate on the ethics of genetic selection and human enhancement. He introduced the principle of procreative beneficence in 2001, and there are now more than 350 citations to that article. He's currently co-authoring a book on procreative beneficence with Guy Kahane. He edits the Journal of Medical Ethics, which is the highest impact journal in the field, and is the founding editor of the Journal of Practical Ethics. I could go on, but I think we want to hear from Professor Savalescu. Today, Julian Savalescu's talk is entitled, Moral Enhancement. Please join me in welcoming Julian Savalescu. What's the cause of terrorism? Many people will say it's religious fundamentalism. But in each of these cases, the cause may be proximally carbon emissions or religious fundamentalism, but the ultimate cause is human choice and behaviour. This is the Fukushima nuclear disaster caused by a tsunami. But today we know what causes tsunamis and how to not place nuclear reactors in them at the level of potential protection. So even in the case of the Fukushima nuclear disaster, this was in part due to human choice. In healthcare, there's increasing attention to what are called sometimes lifestyle diseases, disorders or diseases that result from the choices that we make. Obesity is one of the most common examples, drug addiction and so on. These are diseases which at least in part result from human choice, the choice to eat or the choice to drink alcohol. What's fundamentally unique about this century is for the first time in human history, our fate will largely be in our own hands. Our health is one example and we have a large project looking at responsibility and healthcare and collective responsibility for infectious disease. Those are our two major research projects. But today I want to focus on other issues than health, so I'm sorry if this is going to disappoint you. But I think there are even bigger problems than obesity. The two characteristics of the modern world today are we have ever increasing technological power and we live in a globalised world. And these two features change the dynamic between the human being and their world. Richard Posner estimates that there's enough radioactive material in the former Soviet Union to produce 200,000 atomic bombs. So the power last century that a few single individuals had this century, thousands of people potentially can access that power. More problematic for the century, I believe, are biological weapons. On the top is a mouse with mouse pox. This disease was being used as a way of rendering mice infertile in Australia in the early 2000s. The mouse and scientists modified the human mouse pox with the aim of creating an infertility vaccine. Instead they produced a super lethal strain of mouse pox that killed all of the mice very quickly. Human smallpox very similar to mouse pox. The same change in the interleukin-1 gene in human smallpox could render smallpox not 30% lethal but 100% lethal. Now the world has over 7 billion people. 1% of the population are psychopaths. There are 70 million psychopaths in the world, not to mention non-psychopathic, fanatics and ideologues. And it only takes one person to decide to try to do this and the results would be catastrophic. So we eradicated smallpox through an enormous medical achievement of vaccination, but we could also reintroduce it and hundreds of thousands of people will have the power to do that. So not only is there the possibility through technology to create enormous point events of harm, there's also inbuilt obstacles to our solving the problems we've created for ourselves. Some of you will disagree with this, I'm sure, but the view I'm going to present anyway is that we are essentially still biologically and psychologically hunter-gatherers. We have the same psychology and dispositions that our ancestors had. That set of dispositions evolved to enable us to survive long enough and reproduce in the African savanna in small groups of 150. We carry with us that psychology into a world with biological and nuclear weapons that's globalised. And where we face global collective action problems. And it's because of this limited moral psychology that we fail to solve many of the world's problems. We have enough money to deal with global inequality, but only about seven countries have reached the very modest target of donating 0.7% of their GDP to foreign aid. The US, when I last looked, spent something like $3 trillion on the wars in Afghanistan and Iraq, and over the last 50 years has spent a total of $2 trillion in foreign aid, vastly different balance, versus retaliating to a harm versus aiding other people. Inequality is not reducing, it's increasing. The world's wealthiest fifth owns as much as the lowest 86% of the population. The poorest fifth only 1% of the world's wealth and productivity. These richest three individuals own as much as the poorest $600 million, and this is increasing. So 100 years ago, the difference between the richest per capita, the richest countries on a per capita basis was three to one. Between richest and poorest, it's now more than 100 to one. Problems like climate change are the result of global collective action. They're vastly different to the problems that we, as humans, face through most of our history. Climate change is an example of the tragedy of the commons. Through most of human history, we had small sets of resources within our groups that we had to manage. We managed them by trusting each other, by seeing the actions of others, by punishing free riders, and seeing that our actions had an effect. Climate change, on the other hand, is caused by huge states with millions of citizens who are anonymous, who don't trust each other. Their contributions make no difference. It's impossible to detect free riders and so on. Many of these features of global collective action problems make it very difficult for us as human animals to solve them. So while Stephen Pinker is correct that society is safer than ever before, homicide is reducing, the risk that we face are very large events that could even wipe out humanity increases as our technology increases and our world becomes more connected. Okay, so the contention of our book was that humans are unfit to meet this challenge, unfit in terms of it's not that they couldn't, and it's not that there is some deterministic path towards destruction. It's just that it's very difficult for us, given our nature as human animals. So what is morality? What are moral dispositions? There are set of dispositions that facilitated cooperation in small groups. Just enabled us to survive long enough to reproduce. We had to compete for resources often with other groups and it was much easier to kill than it was to save lives. It was much easier to harm than it was to benefit. The characteristics of our psychological and moral dispositions is that we're biased towards the near future. We're biased towards small numbers. We care about our family and friends in our group. We can cooperate. Usually when we're watched at a time, people tend to free write and of course they tend to be distrustful of our group members and xenophobic. That's not to say that these things are unsolvable or purely biologically determined. It's that we have natural tendencies to be distrustful of our group members. Homicide was one of the largest causes of death of humans through most of human history. One of the biggest obstacles to dealing with the global problems that we have today is that we're partial to our family and friends. And indeed, cronyism and nepotism are always at play when there are limited resources because status is a limited resource. Powell and Buchanan and Russell Powell to philosophers have taken umbridge with our view of human nature and argue that cooperation can be quite extensive in times of luxury when there's no competition for resources and that we're too pessimistic about the possibility of human cooperation. What I think they miss is that the disposition to care about family and friends even in times of luxury is going to be there and indeed cronyism and nepotism will always be there because status is a limited resource. So even in times of relative economic fate these sorts of forces are at play. So our common morality is an expression of this psychology and the kind of world we lived in. We have very strong prescriptions against harming our own group and no morality has very strong provisions for aiding others. We believe that we're responsible for what we do but for not what we allow to happen. So in medicine this act submission distinction plays a very significant role. It divides active from passive euthanasia and within passive euthanasia it divides withdrawing treatment from withholding treatment. So with my colleague Dominic Wilkinson we've surveyed neonatal intensivists and other intensivists and it's common. Many believe that it's worse to withdraw treatment than it is to withhold. This is a feature that pervades medicine. I believe that act submission distinction has no serious moral justification. We can empathize with single individuals but not with large numbers so the more people involved in needing our help the less inclined we are to help. And there are other factors which make it difficult for us to solve these problems. So this is just a sketch of human moral limitation. I could have given you other examples and I'm sure you have your own. So I'm not surprised when these conventions around the climate, Paris, Kyoto and so on fail because there are huge psychological obstacles to dealing with that kind of problem just as there are huge psychological obstacles to dealing with obesity or addiction in the modern world. And our contention in the book is that in order to make progress we need to start not only by inventing policies from a romantic and unrealistic view of human behavior but by starting by understanding the human as an animal with certain strengths and limitations, certain abilities and disabilities and forming our policy around that. If there's time I'll talk a little bit about what we've been doing in terms of the tragedy of the commons and cooperation. But around 2008 I became interested in whether not only could we understand human moral behavior in the same way that psychologists had been understanding cognitive decision making around heuristics and choices but also whether we could directly intervene to modify it. So we began to explore the possibility that you could not only structure choice psychologically to engineer or encourage healthier or more moral choices so Nudge is a very familiar idea now that Casenstein has made popular creating an increase in the organ donor supply by making donation the default and people having to opt out. We've shown the same sort of things in Oxford apply to willingness to help and donate money to charities, that kind of structuring of situation but by also modifying human biology. So there's a lot of evidence that people are not as rational and free as they like to believe that they are and that their choices are largely determined by morally irrelevant factors and that those factors are sometimes physiological and sometimes amenable to physiological modification. So some of you will be familiar with the work of Jonathan Haight the psychologist I from Harvard I think he's now he's shown that the presence of a dirty desk or a bit of drink makes people more severe in their judgements. The presence of an eye makes people behave more honestly so if you place the picture of an eye above an honesty box in a coffee room people will be more prepared to put money into it. You get the same effect if you put three dots shaped like a face but if you reverse the dots it doesn't have an effect on honesty. I think this just shows how basic we are as animals we respond to these cues that seem to be largely morally irrelevant but that's how we are. Closing your eyes makes people behave more honestly and polarizes moral judgments. Laughter has the opposite effect and makes people more morally permissive and indifferent. It also makes people more willing to sacrifice one individual to save a larger number of others. Sleep deprivation also important for doctors working long hours and soldiers also affects people's moral behavior. In one study of US soldiers who didn't sleep for over 50 hours they found that they were more utilitarian more willing to sacrifice one for many decreased emotional intelligence and caffeine didn't affect this. Many of the features of our lives affect the moral choices that we make. In my favorite example of the importance of understanding ourselves as animals whose choices are partly influenced by our biology this study some of you may know this study from Israel of judges' willingness to offer probation and they looked over a large number of judges how willing judges were to offer probation and found that a very statistically significant result that the willingness dropped off significantly the further the case came from the time the last judge ate a meal. Now I'm not saying that we can tell from this whether they were too lenient soon after the meal or too severe as they approached the next meal you need some morals standard to evaluate that but what seems absolutely clear is the time at which your case comes after the time the judge last ate a meal is not a morally relevant consideration. Now exactly why this kind of physiological effect occurs why science may not be related to glucose. There's a kind of familiar set of constellation of features that in sort of folk psychology affect moral judgments halt, hunger, anger, loneliness and tiredness if you want to make better moral judgments avoid those and there may be some truth to that. A trader's morning testosterone levels will predict the day's profitability in a strong market testosterone reduces cognitive empathy in women reduces trust it's associated with rejection of unfair offers and reduced generosity but increases fair bargaining and what testosterone seems to do is make people more concerned with their social status rather than leading to aggression Now I'm not saying that testosterone is or isn't a moral enhancer what I'm saying is that features of our biology will affect morally relevant outcomes another example some of you may be on selective serotonin reuptake inhibitors such as Prozac these drugs raise serotonin in the brain which has been associated with increased cooperation fairer distribution of resources increased aversion to harming others so an unwillingness to sacrifice one to save five and so on so many people are morally modified by the psychoactive substances they take for the treatment of depression and other disorders Psytocin another well explored neurohormone released by sex touching but also by the oral contraceptive pill and glucocorticoids for the treatment of asthma essentially makes you more bonded to your own group makes you more trusting of in-group members more trustworthy but has the opposite effect to our group members makes you less willing to cooperate and trust our group members in Oxford our own student Sylvia Turbeck showed that propranolol the beta blocker used to treat anxiety and blood pressure reduces implicit racism on the IAT implicit association test so of course we use enhancers the second largest export in the world is caffeine but you've seen the widespread use of performance enhancing drugs in sport and increasingly drugs like ProVigil by college students and university students Ritalin, Adderall and so on wide range of cognitive enhancers in many cases the drugs that will be developed to much more effectively improve memory will also improve memory in normal human beings you're familiar with Walter Michelle's famous marshmallow experiments on four-year-old children children able to withstand the temptation of a marshmallow for some short period of time when rewarded later with two marshmallows those who were able to exercise impulse control ten years later more friends, more motivation to succeed more highly correlated with university entrance and SAT scores than IQ and we have drugs now that improve impulse control Ritalin is one example this is also an example of partly a moral enhancement I'll come back to this later because it also reduces impulsive aggression love most highly coded biological biologically coded behaviour three phases in all mammals last attraction attachment you're not that different from chimpanzees in your romantic relationships you've got great sort of poetry and art and talk about it a lot more oxytocin used to promote pair bonding and attachment in dysfunctional couples and associated with counselling an example of a crude love drug could we do something more significant than this? well, we've done it with dogs breeding of dogs is a great genetic experiment over 10,000 years some are placid, some are vicious, some are smart some are stupid, some are hardworking some are lazy, that's all genetic and what took us 10,000 years in the dog can take us one year today using genetic engineering it's a fluorescent rabbit created by transferring a gene from a jellyfish into a rabbit it's also been done with monkeys on the right is a human embryo that's fluorescing created by transferring a gene from a jellyfish into a human embryo which was destroyed afterwards this is again proven principle that you can successfully phenotypically modify advanced life forms my favourite example I'm not sure if it'll come up on this is this mouse but it may not be on the we've had to change the loading here we go so scientists are trying to understand muscular dystrophies genetically engineered a mouse called super mouse by modifying part of its sugar cycle that's not going to show anyway, they modified part of its sugar cycle and this mouse a normal mouse running at 20 metres a minute will run for 200 metres looking for food before it's exhausted super mouse, 6 kilometres it is able to reproduce the equivalent of a human woman reproducing at the age of 80 it has 10% of the body fat it's significantly different to a normal mouse by a simple change in the glucose cycle it shows you the power of small modifications to massively change phenotype performance enhancement is alive and well in sport 6 out of 8 runners in the solar Olympics were subsequently found to be doping not just Ben Johnson these are the people who have run under 9.8 seconds ever there's only one Usain Bolt who has not been implicated in doping why are they not implicated in doping and the reason is that humans vary and this is a very important slide for the purposes of both sport cognition and moral behaviour humans are not all equal the feature of evolution is that there is natural human variation so where you lie on this curve will determine how well you're likely to do in an endurance event if you're born with a hematocrit of 41 you're going to do a lot worse if someone is born with a hematocrit of 50 and so what's happening in doping in sport the reason why one there was a recent reanalysis of the London Olympic data one third of medals suspicious blood samples were independently analysed in my view two thirds of athletes are doping but the figures go from one third to two thirds could be high why aren't they being detected because they're moving within this normal range if you find somebody with a hematocrit of 49 how are you going to tell whether they started at 43 or they were naturally at 49 you have to get some sort of historical example some sort of history that's what the biological passport is around but if you're constantly taking my photos you're not going to pick that up so what they're doing is moving within this normal range with normal substances this could be the curve for testosterone it could be the growth hormone it could be the curve for blood cells it doesn't matter what they're using are natural substances and moving within the normal range is it dangerous? it's not dangerous at all, it's a normal range that's why they're not dropping dead all the time if they push themselves out here they wouldn't be dying of strokes or they'd have acromegaly I asked the chief scientist for the Sydney Olympics can you pick up growth hormone he said no so this is this is why human performance enhancement is so difficult to pick up in sport they're moving within a normal range that prefers significant advantages without any health significant health costs now if this was moral behaviour and you move people within the normal range so every substance in our body varies from individual to individual and across individuals at time and that has an effect it could be the curve for serotonin it could be the curve for oxytocin it could be the curve for anything and the enhancement project is really a very simple project it's just we could do better than nature nature has no design and that natural variation has implications ok so the US military realised this with IQ even in the second world war they didn't take normal people with an IQ of less higher than 93 this area another fundamental problem with medicine is people think there is a deep distinction between disease and health if you have an IQ less than 70 you've got an intellectual disability an intellectual disorder and you're in fact you won't be executed if you commit a capital crime Theresa Lewis years ago in Virginia convicted of a capital crime her council appealed sadly for her IQ was 72 so she was executed now what's the difference between an IQ of 72 and 69 functionally what's the moral relevance of that difference so where you lie on this curve I mean it's useful for deciding how to allocate funding for various rough and ready social purposes but there is no magic about two standard deviations below the mean we could have defined disease as one standard deviation below the mean in which case there'd be around 15% of people who have an intellectual disorder so what matters is not where you lie on this curve what the implications of being on this curve are for various valued outcomes in particular in this case well-being in the moral case in terms of moral behaviour we can genetically select embryos in a more radical way and we can genetically modify humans as we have done with animals Chris Bark has 9 gene editing is a currently discussed method of very accurately modifying embryos okay so you might think oh this is science fiction this guy's Savile SQ is completely crazy what they do over there in England is completely disconnected from reality I want to just give you two examples of moral enhancers that are being used one is the use of Ritalin for reduction of violence in attention deficit disorder and the use of anti-libidinal agents to reduce sex driving in pedophiles so Ritalin in one Swedish study in the New England Journal of Medicine if you put convicted criminals violent criminals who have attention deficit disorder on Ritalin you reduce violent reoffensive men by 32% that's massive if I had some social program that promised to reduce violence by 32% people were falling over themselves to implement it but are they falling over themselves to now I'll ask whether we should be putting criminals on Ritalin or whether we should offer them the option that I think is an interesting question in the US you're one of the places in the world that uses chemical castration I think is one of the substances used and this reduces sex drive and in some cases it's mandatory and in other cases it's optional now how should you think about that what are the ethics of giving people drugs in this case not to increase their hormonal function but to reduce it so how should we think about these things quickly some just a few ethical points what time should I finish ethics is about reasons it's not about it's like physics reasons have a direction and they have a strength now the strength sometimes people say ethics is relative it's relative to culture it's relative to people's desires it's relative to the group it's called moral relativism I don't think moral relativism is anything to do with ethics if you believe moral relativism you think that well what the Nazis did was write in their terms according to their code of ethics they were behaving very ethically what they really mean or what I mean anyway when I say ethics is relative is I mean it's relative to context so how strong this vector is depends on the context how much freedom people should have is relative to the context a great example if there were a Zika epidemic so even the Pope has modified his pronouncements around contraception in light of the Zika problem in South America it's alright to use contraceptions and condoms to prevent in that case it's an example of even the Catholic Church is not absolutist about reasons against contraception relative to the circumstance so you don't encourage termination of pregnancy or genetic testing in pregnancy there's a principle of non-directive counseling if you had a Zika epidemic in the US with hundreds of thousands of pregnancies affected with microcephaly you would change your approach to reproductive counseling the incentives that you offer or even maybe the requirements that you have because you would balance public health against freedom okay so what are these so you use this sort of reasoning in everyday life you weigh the vectors to come to an overall decision about what to do okay so what are the vectors one vector is well-being now utilitarians it's the only reason okay now health is not the only aspect of well-being and I won't labour this but in my view what makes people's lives go well is not just happiness it's not just desire satisfaction there are objective elements that make our lives go well most psychological approaches and evaluations of quality of life use these purely subjective measures and this yields paradoxical answers to questions like how bad is paraplegia paraplegics once they've adapted are not a lot less happy than people who aren't paraplegics and they are often satisfied with their lives to a similar degree on subjective measures their quality of life is not that bad and that's a feature of human adaptation and for that reason we also need to evaluate the impact of disorders like paraplegia on objective measures okay the other and this is particularly important to all of neuroethics so one of the issues with neuroethics is how are we going to use these neuro technologies to improve people's lives I think you're going to need some objective measures so to give you one example of a more clinical paper because some of you are probably losing interest at this point I'm working on a paper on deep brain stimulation for chronic pain with tipper disease and colleagues with neurosurgeons so they face this dilemma you've got these people who nothing works for their pain absolutely excruciating they often end up committing suicide deep brain stimulation can be very effective at relieving pain downside is it can cause epilepsy and fitting so and in fact because of the risk of epilepsy this pressure to stop the program now how do you evaluate first of all whether such a program is in the person's overall interests I think that's a very interesting question and here I think you need some kind of objective measure of the impact of the pain and also of the epilepsy one of the other interesting ways that medicine typically deals with these dilemmas is when the risk benefit profile when the risks and benefits are complicated let the patient decide for themselves problem is when it comes to the brain and things like deep brain stimulation you often change the patient so you change executive function so there's some evidence that in some of these sorts of cases you introduce apathy so when the person does that I prefer to have the deep brain stimulation is that really what they want is that really their choice is that authentically themselves I'm going to come back to that freedom is a very important issue in life and in neuroethics one of the objections to modifying people directly using the knowledge of biology or deep brain stimulation for non-medical purposes moral bio enhancement my colleague John Harris said we'll make the freedom to do immoral things impossible rather than simply making the doing of them wrong giving us moral legal potential reasons to pay it removes the freedom to choose what you're doing which is fundamental to being a human being what John Harris has in mind are the notorious surgery experiments of the 1950s and 60s and also the aversion therapy of last century that was used to treat moral deviancy or alleged moral deviancy like homosexuality this was even considered in the penal system became the subject of a clockwork orange the film by Stanley Kubrick the Ludovico technique and indeed Michael Sandel the Harvard moral philosopher has said to imagine that our moral capacities could be deepened in the pill would cause unimaginable damage to everything we understand about human moral character so once you undermine the human capacity to choose for yourself you're failing to respect people as human beings now let's ask the question then does modifying people's moral dispositions necessarily undermine their freedom this is the story of Ulysses in the Sirens Ulysses famous Greek hero wanted to hear the song of the sirens a very beautiful song that was supposedly the most melodious beautiful song any human had ever heard the problem was you were irresistibly drawn towards the sirens as you heard their song and their island was surrounded by rocks and you were killed on the rocks and you could tell of how beautiful the song was and Ulysses wanted to live to tell the tale so what he did was he told his men we're going to sail by the island I'm going to put beeswax in your ears and you're going to tie me to the mast and when I ask you to release me you mustn't release me actually to constrain your freedom so I'll give you an example of deep freedom cleaning your teeth twice a day but here you've decided and you've set a rule for yourself and you stick to it so what matters is what our values are and in many cases we need to constrain ourselves because of our human limitations the psychological heuristics and biases our biological dispositions the biological environment the social environment etc all of these need to actually control so this is an example where ethics makes a fundamental difference to practice if you choose to take Ritalin because you believe it's best for you or you choose to take an anti-libidinal agent because you think it's wrong to abuse children and you subsequently change your behaviour that's not an assault on your freedom that's making you more free that's enabling you to realise the rules that you've set yourself so one way to avoid many of the problems of controversial interventions is to enable people to make their own decisions according to their values so even something like racism and biological modification if propranolol did have these effects on racial bias and somebody chose to take it because they were concerned about their racial bias of course they're not the right way to deal with racism that's not the solution to racism but it's not going to reduce their freedom it's going to increase okay so what would reduce people's freedom well some of the fellows will talk about this other paper that I wrote subsequently if you were able to control people's mind directly they became subject to your will so imagine that you could put a chip that detected your intentions and as soon as the intention to murder an innocent person was arrested and it could gather information for the environment it would just change the intention so to you it seems as if you changed your mind and that's the only thing it did the only thing it did was to change people's intention to kill innocent people would that undermine people's freedom yeah it would undermine their freedom that would undermine their freedom Paris and Sandela are right but does that mean we shouldn't employ it no I mean freedom is only one value and the freedom to harm other people is something that can be constrained and we're not entirely free we're incarcerated when we kill other people so again you have to balance the reasons you have to balance the benefits of this one restriction of freedom against the costs and in my view it's an open question that's what I mean by context sensitive we can't answer the question should we ever change people's their consent I don't know general not but it will depend on the particular case I mean again psychopathy is an example where it may be that if we could change people's mental states in that kind of case there would be an argument for it okay I want to finish so in the case of aggression, attention deficit disorder and adult violence should riddle and be compulsory well one easy answer is it should be offered and then it's simply a pre-commitment contract in my view it should be compulsory why do I say that? because it's better for society it reduces impulsive aggression but it's also better for the individual because it enables essentially to delay gratification to have longer term life plans to have wider range of options so this would be something that would be good and good for society and ethical no brainer the only thing against it if you apply it compulsorily is that it doesn't respect people's freedom okay I want to leave some time for questions so I'm not going to go through all these other wonderful vectors there are many reasons that affect any kind of decision I want to deal with one objection which I'm sure all of you have said this is all very interesting but what are you going to enhance what's morality we can't agree on that I mean some people are religious fundamentalists some people are libertarians you know what Donald Trump thinks is moral enhancement will be different to what Hillary Clinton thinks so this is just a ludicrous project well the first point to note is that it's not particular to moral bio enhancement it's actually a problem for organising society at all and deciding what kind of moral education to give children or how we bring up our children and the second thing there are some things that we agree I started with examples like releasing biological weapons you know killing innocent people, those are low hanging fruit we agree that that's not that doesn't matter how relativistic you are those sorts of things are outcomes we'd like to reduce and I think the challenge for ethics for what we're doing is to try to understand what could be a common morality that we can all agree to but here's one part of what I think is a common morality duty of easy rescue now you might part company with me here but I think that it's a part of the meaning of moral that there's an element of other regardingness that is it's different from prudence or self-interest where you promote your own interests it requires some level of sacrifice of your interests for another how much for circumstances moral theories differ small sacrifice though for others so what's an example of that duty of easy rescue small cost you are performing in action large benefit to others we ought to do that child drowning in a pond all you have to do is get your shoes wet morally you ought to rescue the child doesn't matter what your other moral commitments are okay that sounds pretty simple but in fact you can do this the simplest rescue you could ever do which is zero cost is donating organs after death they're completely useless to you they save seven lives donating blood that's even more inconvenient than donating your organs after death so if we have a moral obligation to do anything we have an obligation to give our organs after death and if our religion says that we shouldn't then our religion is telling us to do something immoral and so we should have opt out systems for organ donation and many of you will be familiar with this field of what's called empirical philosophy where Josh Green set off this field of studying people's behaviour and scanning their brains as they made different moral decisions using the so called trolley problem you push one person off a bridge to save five others what's going on in the brain is it shows nothing of great moral interest it just shows that when you have to make a counter-intuitive judgement areas associated with rationality light up and when you're making an intuitive judgement areas associated with emotion light up that's not very surprising you're nothing to do with whether you're a utilitarian or a non consequentialist what we're trying to do is not work out what makes people push people off the bridge to save five others it's what will affect their decision to perform easy rescues what makes somebody decide to do that and what are the obstacles to do psychologically but also what are the physiological influences so just several projects we're doing in Oxford just to bring this a bit back so we have one project that shows that when people are uncertain about the outcome of their actions that affect somebody else they act more selfishly when they're uncertain about the impact on the person that is how badly that person will be affected they behave more altruistically in fact Molly Crocker one of my colleagues showed that people will accept more pain for themselves to avoid inflicting pain on others very interesting finding another study shows that when people's actions are public they behave more altruistically than when they're private the biggest determinant of people's willingness to give is not the level of their own income it's not their religion it's not their age it's whether they belong to a small or large community and we think it's the reputational effects so all of these kinds of effects not only should we harness to improve health but we should harness to make society better now what is the better society to discuss I think a better society would be one where people don't die of organ failure now maybe I'm wrong about that maybe it's a crazy belief but those are the sorts of questions that we should be asking what sort of society do we want and how can we understand our own limitations as a barrier to achieving that and what measure should we employ now I'm not saying that biological bio enhancement is the major or even a part of the solution as a human as an animal and modifying our biology may be a part of a comprehensive solution in conjunction with social, political, legal and reform thank you somebody must disagree so many things to disagree with just to break the ice one thing that you didn't touch on I have so many questions but I think I'll touch on the one that you didn't touch on and that is that often gets raised in discussions of moral enhancement assuming that it is a good or that certain kinds of it are good who gets it what did you discuss so access to anything is a sort of big issue when it doesn't just apply to moral enhancement applies to healthcare, education, technology now who gets it you know this has lots of different answers in my view if it's important it should be offered to everyone so if it's really beneficial like education it's offered and it's compulsory where it's involves a trade-off between individual self-interest and social interest in general individuals decide for that unless there's some pressing societal emergency as in the Zika epidemic case so who gets it I think it will depend on exactly what it's like for what it's worth this is what I think the most likely trajectory for moral enhancement is one of the technologies I didn't talk about was trans-cranial direct current stimulation electrical stimulation enhances learning now if that continues to show effects what it may well be that our children are utilizing this to learn numeracy better to learn foreign languages better but also to let's say learn empathy or response to other people's emotions and it will initially start off with maybe with people with Asperger's or autism but it will progress and that would be a part of a general education system what the risks and benefits are but it could be rolled out to everyone without any consent it could be that we offer it to specific individuals it could be that we let people buy it on the market why would I want to be a more moral person a lot of morality in my view perhaps most of it is social signalling it's signalling that you're a good person people always object and people that's against human dignity and that's a way of just saying I'm a good person there are great social benefits to being a moral person and of course free writing sometimes benefits you but there may be moral reasons to there may be personal reasons to also want to be a more moral person thanks for a really interesting talk so you brought up religion a little bit in sort of the negative sense that it really spoke against the morality of the issue and I think historically I think religion was looked upon as a way of at least enhancing some morality so how do you see the biologic morality enhancement in the context of sort of religious because right now I mean the examples fundamentalism one could look at is sort of a very negative sort of moral enhancement in terms of group you know fighting for a group against the other and it has something also to do with your initial talking about whether you're a member of a group or not and your relationship with that so I'd like to hear your thoughts about that well religion was a very effective way of regulating human moral behaviour and it was very important and it's an expression of of these general moral codes of don't kill don't steal the good Samaritan is a sort of an early example of duty of easy rescue do unto others as you would have him do unto you is an example of the principle of universalisability that Kant and Hare and others have had so there's a lot that's in religion that is just good very important sets of moral rules that were were enforced in various ways but of which being the promise of eternal life which was helpful to ensuring conformity so how would that feature you know I think the challenge in the long term for religions is to take those aspects that are important a kind of future universal morality and so for example the golden rule it's a very good thing encouraging people to be able to think in that way and if there were you know modifications of the sort of physiological environment that enhanced people's ability to sort of apply the golden rule would be a good thing of course religion also has other aspects that potentially could be enhanced and I think would lead to moral regression and would be extremely dangerous so that's a danger not just of religion but of any kind of application of changing people's behavior so like any powerful technology can be abused or used for good and I think that I mean I don't think a lot about religion you know I spoke at my mother's church and they sort of like me I mean I think their challenge is really to connect in the right way with the next generation and to take what's good and biology may have a role in that I mean it sounds crazy when you say biology but you know just sleeping modifies your neurophysiological state so how much you should sleep when Derek Parford said to me if you want to make a decision sleep on it for a night it's like suggesting a kind of form of bio enhancement like those early decisions by the judges yeah well maybe they were right first decisions of the morning really interesting talk and I think I agree with you on a lot of what you're saying the one thing I guess to kind of play a little bit devil's advocate is that you know we benefit from species diversity and I'm wondering do you ever worry about you know with I mean obviously we don't want social pastings like that but are you worried that if we make the distribution so narrow we're going to be missing out on things that may be somewhat counterintuitive that are important to society so if we're making people more uniform could there be some negatives to that yeah look that's a good question and there's sort of many many things to say so diversity was very beneficial to our species as a way of withstanding infectious and sort of other insults so you had you know why so how would we have survived HIV historically a small group of people would have had some kind of genetic resistance lots of people would have died off they would have repopulated the species is that how we deal with HIV today we're waiting for the sort of the genetically privileged to repopulate the species we develop prevention and treatment and in fact you know that just sort of genetic diversity the sort of genome is degrading as we sort of keep people alive in worse and worse situations so I don't think the role that genetic diversity has had historically applies to the same degree but more importantly you raise this with psychopaths 1% of the population is psychopaths is that diversity good you have the capacity to ask yourself is this kind of diversity a good thing for the sort of society or the sort of life that we want people to have and in my view in many cases it won't be but notice that as I said there's a huge status quo bias that operates in ethics people say oh the diversity is good so should we have more of it so have we got enough diversity so maybe we should be looking at increasing diversity of diversity is a good thing or maybe just certain kinds of diversity so I think that you need to have a set of values that you're aiming at and then you need to understand how different scenarios contribute to those values so I don't think just diversity per se is a benefit so I'm writing a paper on species diversity we could repopulate the planet with lots of species we could introduce woolly mammoths we could introduce and so people when they say we should protect diversity what they mean is the diversity that we have today why is that the right kind of diversity so just I agree with you that in principle diversity can be a good thing it can also be a bad thing and it just depends on what kind of diversity for what situation another example just I mean I think this is quite important that you know this is another moral principle moral responsibility you know you're responsible for what you can foresee and what you can avoid in my view and that includes what you do and what you fail to do now if you choose not to do anything and you could have you're responsible for that outcome now I'll tell you something that's happening in the US empathy is reducing large meta-analysis all the psychological studies involving empathy empathy has consistently been reducing especially since the year 2000 that's the curve we know that now is that a good thing or a bad thing well some people might say it's a good thing you know we want less empathetic people so they make more rational decisions and they're not so partial to their family about others I don't know whether it's a good thing or a bad thing but what I do think is we should ask that question and say should we arrest this decline should we accelerate or should we just let it happen but people think that somehow the sort of natural curve has some kind of added value in it Thanks for your talk really interesting one of the things I thought was especially interesting was the data on propranolol and racism do you think that that can sort of be extrapolated to other kinds of prejudice like sexism and issues of religion and things I'm proud I don't know enough about that that sort of area I don't know I mean look you know again I mean I've talked to all this but I really think it's verging on which doctor I mean I really like studying the psychology and this sort of area but even take the Walter Michelle study which I you know often cite about the importance of impulse control someone told me recently if you look at the kids who eat the marshmallow straight away some of them some of them have come from extremely deprived abusive unreliable environments where they just don't trust that there will be two marshmallows in the future so it's rational for them to take the marshmallow now because they don't have an experience so even the kind of validity of that or you know one of my colleagues criticised the IAT by saying look you built in these racist assumptions and then you find the people are racist you know I think what I really want to say is I think these are important questions to address scientifically and ethically I think what we need is science and ethics and we need good science but we also need ethics so what would one thing that does modify sexism is blindness blindness so when they auditioned for the Vienna Philharmonic Orchestra when they had blinded auditions a lot more women were given places than men so you know and this is a sort of simple thing and again another thing for racism if you want to I don't really know you were talking about one of the goals of this is to kind of lift people past our nomadic phase and looking into improving society as a whole how where you're introducing it into a society that's already divided into democrats and republicans and this and that how would you go about getting past the objection of saying you know there will be people who are moral enhancers then not and then that's it just becomes one further division of society saying these are going to be people who will agree with you and use it and then there are people who don't and you know how do you kind of move it past that objection yeah another one is Dr. Siegler mentioned this sort of work on procreated beneficence one striking finding from twin studies is the correlation from twin studies of genetics and religiosity and one of the objections I always get is well if you allow this procreated beneficence won't highly religious people select embryos that are more likely to be religious and atheists select ones that are less likely to be religious and all you'll get is a kind of polarization and so you know won't democrats choose one kind of quality and republicans a different kind of quality and all we'll get is that inbuilt into people's biology rather than just I think that is a problem and I think you would need to look at the collective effects of a program that would result in polarization because one of the goals that you want is an integrated society and that's why I think you're going to have to set goals I mean it applies to education as well I mean we have these religious schools in the UK in my view I think it shouldn't be the case of religiously indoctrinated children in school that's polarizing society so this sort of polarization is an issue not just for bio enhancement it's much more profound than bio enhancement will be how you bring up your child and what sort of person because that brainwashing is just as effective as deep brain stimulation and you know I'm not saying that brainwashing is a curler but people sometimes think oh these problems that you're describing they're unique they have polarization and choice of values and privilege and how we redistribute that are pressing problems regardless of this project but it is a problem so continuing with this question do you think that we should change the way that we assess people which are modified so should we have different laws or different school exams for people that have better cognitive skills or their morality because they were modified because that's going to create another division and you're going to have people which is supposed to be smarter because of that and then how we assess them and how we assess people without this modification because we have to assume that not all people are going to have this additional thing to do not all of them are going to be changed right? so again it depends on ethics so when I just passed I mentioned the person but I was just in another place and one of my colleagues said that he said a common dilemma he'd moved to a certain city because of the school and the school had a very high Jewish population very high academic standards it was a state school and he wanted his kid to have a good education so he moved to the school just as he moved some of you may know where this is they decided there was also a very bad school with very poor academic outcomes close by that was predominantly African American and they were going to rezone the schools so that they were mixed so that everyone was in the single zone and they would either go to the good school or the bad school and he said and he's a very progressive reasonable person he said I know that from the point of view of equality it would be better if the schools were mixed but I want my kid to go to the current good school so if your priority if the value that's most important is social justice and equality you should mix the schools you should mix the cognitively enhanced should mix races you should mix empirically that might be the thing that most promotes a value of tolerance and justice and so on empirically that's an empirical question if it were that might be in conflict with what you want to buy as a privilege for your child now what do I think the right answer to that conflict between self-interest and morality is that's one of the great questions of ethics how much should we give up for the sake how demanding can morality be and so it depends on the answer to that so I don't have a simple answer if you live into an economic model people will just buy privilege they'll buy a better school they'll buy a group that is morally enhanced that's cognitively enhanced and they will create a kind of ghetto a kind of advanced ghetto now maybe some people think that's a good thing speciation of different branches of humanity some will be a certain way others will be different eventually will be different species I don't have an answer he's had his hand up I've got the mic I guess so they can get it later thanks I'll join others and thank you for a very stimulating lecture it seemed to me at one point if I followed you correctly you were suggesting that your sort of theory of ethics is that the right decision is the one that sort of promotes both well-being and freedom and recognizing that they clash I was wondering if you can tell us a little bit about how we would go about deciding how to balance those whether it's for moral enhancement or any other decision do you have a few of you how to balance those this is like my kind of one line for it I mean I like Tom Beecham and James Childress's work on the four principles a lot of people don't like it but I think they're actually onto something I think there's three principles and basically most things boil down to balancing these three things there's freedom or autonomy there's well-being or beneficence and then there's the public interest or justice okay and as a general rule we ought to give people maximum freedom so we ought the first point people should be free to make their own choices so in general freedom is prior that said we can restrict freedom for the public interest or for justice reasons or for preventing direct harm to others so if there are these significant social reasons to override freedom then we can restrict it so I don't think we have an app I'm not a libertarian I'm a libertarian consequentialist so I think you need to give people maximum freedom but there are legitimate grounds for reducing that so I don't think for what it's worth I think that organ transplantation should be compulsory organ donation I don't think it should be an opt-out system just take the organs as you do when you perform an autopsy so we take organs and dissect people for the sake of understanding the cause of death but we don't do it to save a life which is more important understanding why that person died or trying to stop another person dying but that's a very fringe view but I would be quite inclined to restrict liberty in that case so then there's well-being so well-being should be used to inform policy inform people set up maybe heuristics and biases things that influence people's behaviour but in general so for example just to give you I have this principle that says we ought to select the best child so we have a moral obligation to select the best child you've got two embryos one's healthy you've got a genetic disorder I think not only should people be free they ought to select the healthy child you've got one embryo with normal levels of impulse control one with low normal levels of impulse control all other things equal you ought to select the one with the normal level of impulse control because they're expected to have a better life you've got one hearing embryo and one deaf embryo morally you ought to select that embryo that's the right thing to do that is deafness will be a disadvantage not in all worlds but in this world it is likely to be a disadvantage should people be free to deliberately create a deaf embryo and have a deaf child like yeah they ought to be free to do that why? they're not harming the child I think they're doing the wrong thing and maybe they're doing something that imposes an additional cost on society but they ought to have that freedom so I think that in general we ought to be for example in the pedophile case it would I would be persuaded by how effective these substances are if they were highly effective really and they had few significant side effects I think the case for making the compulsory would be strong if they weren't that effective and had significant side effects I think it ought to be offered perhaps in return for some shortened sensing and it ought to be the individual's own decision to answer that final question thank you I think I'm pretty much on board the enhancement train I really like what you had to say one question I have is the question of unintended consequences and less so the catastrophic science fiction scenario where you put an enhancer in the water most of us die and the rest becomes zombies but with the a subtle example so maybe you figure out a way to marginally lower levels of aggression aggression marginally lower levels of aggression and perhaps marginally increase caring for those outside of the in group to expand the circle a bit and on the face of it that might sound great if everyone were a little less aggressive and a little had a little bit of a broader view is it a concern for you perhaps there are unforeseen consequences down the road that part of human advance part of where we got to today was not in spite of aggression and in group preference but actually because of those it's hard to see it but those were beneficial and if we reduce them there may be subtle unforeseen consequences this is the best version of the playing guide objection that these are complex systems it's very difficult to predict the long term effects of these consequences we tend to mess up complex systems and so in general I agree I wouldn't take this stuff I've got colleagues that take medathinal all the time I don't know what the sort of long term consequences unintended effects of doing that are I wouldn't take this sort of stuff myself so I'm sympathetic with that for you but women are less aggressive than men and they're also more cooperative so if you're saying that we were going to make men slightly more like women would that be a bad thing or a good thing well I get it is a question that's amenable to prediction and to evidence and to studying and I genuinely don't know the answer to that I think the playing guide objection is that you ought to not jump in when you don't know what you're doing you should do some research but at some point when you want to cross a river and you've done everything you can to work out how deep it is, how fast it's flowing whether there's piranhas in there or not and you've done what you can you've got to decide am I going to jump or am I going to stay here and you know there might be a case for making and if I said to you and this is another sort of fascinating thing people have a bias towards the natural and we're doing psychological research on this as well if I said to you there's that you're giving your child fish oil every day will make your child more caring and less aggressive, a lot of people would give it to their boys but if I say now I'm going to genetically engineer your child to be slightly less aggressive and more caring you can't do that and the only difference between genetic engineering and a dietary intervention is the risks and benefits now of course it's more risky at the moment but in principle there's nothing that would say we shouldn't and again people have through social pressures and legal pressures and various environmental reasons become less aggressive now we don't see that as a step backwards it's holding us back now we're just too soft and again if you were correct maybe we should have a bit more aggression and this I'll finish with this, this is why I think it's important and I'm sorry I haven't given you a great systematic overview of the science because it would take days or weeks but sometimes I get this objection, look psychopaths are valuable you want diversity even psychopaths can provide a benefit to a community psychopathy was probably of evolutionary value in a community that was warring with each other and engaged in physical violence and so on and they say no look there are CEOs of companies who are psychopaths if you look at the again it's my understanding of the data if you look at the the role of psychopathy in business it's true a lot of them are psychopaths but they generally destroy a company and they generally don't make for a long term successful business so it's true they can rise up but it's not true that they are necessarily good for even the company so but you could study that thank you, thank you so much well I hope it wasn't too disconnected from you