Anticipating bioethical issues in enhancement prosthetics

About This Grant

Abstract Rapid improvements in prosthetic technology present opportunities for human enhancement never seen before. How should we prepare for the eventual availability of better-than-human limbs? This project seeks to rigorously examine the bioethics of the design, development, and implementation of enhancement prosthetics. In particular, it asks how we should think about a future in which some people may find advanced bionic limbs so appealing— in function and form—that they would choose to undergo elective amputation to allow their use. Our first aim involves conducting a comprehensive ethical analysis of the appropriateness of elective amputation for enhancement prosthetics and the design of enhancement prosthetics that may, whether intended or not, be used for this purpose. This will include a comparative ethical analysis of hypothetical case studies, exploring the implications of enhancements to both function and form. The ethical analysis performed will rely heavily on Principlism, a predominant approach to applied ethics that holds that four prima facie moral principles—respect for autonomy, beneficence, non-maleficence, and justice—lie at the core of moral reasoning in medical care. From this ethical analysis we will offer guidelines for ethical conduct by designers and innovators with respect to designing for enhancement versus restoration, consumer appeal through aesthetics and fashion, and responsible media interaction. We will also offer preliminary ethical conclusions that can be used to guide professional, regulatory and policy responses, as well as identify further areas of study. The second aim is to use semi-structured interviews with amputees, prosthetists, surgeons, and biomedical engineers/prosthetic designers to elicit their perspectives on elective amputation and enhancement prostheses. We aim to discover bioethical, psychological, social, or other considerations relating to this topic that we have not anticipated, thus enriching our development and final analysis of the hypothetical case studies described above. These interview results will provide the groundwork for further, more rigorous data collection in future studies on the knowledge and perspectives of diverse populations relating to enhanced prosthetics. By accomplishing these aims, our research will contribute significantly to the evidence base guiding the future design and use of enhancement prosthetics and elective amputation. Our cross-disciplinary team, with its extensive experience and diverse academic backgrounds, is uniquely positioned to address these emerging challenges. This project's significance lies in its ability to offer values-based ethical analyses, aiming to maximize the benefits of prosthetic advancements, with attention to concerns of autonomy and justice, while minimizing potential harms.