Military Neuroenhancement and Risk Assessment - Neurotechnology in National Security and Defense - page 240

A LOOK BEYOND TRADITIONAL BIOETHICS
To better explain the role of an RBA here, much of bioethics commonly uses some
version of Principlism, from the Nuremberg Code (1948) through Beauchamp
and Childress' influential textbook (1977), to the official Belmont Report (1979).
Typical statements of Principlism assert that medical professionals must uphold
nonmaleficence, beneficence, autonomy, justice, and other relevant principles in
their work, while following sometimes-complicated recipes to resolve conflicts
among those principles in difficult cases. This complexity partly exists because
new cases—especially involving novel technologies—challenge common inter-
pretations of how to apply the principles, as well as the usefulness or even the
validity of the principles themselves.
In particular, standard applications of these principles are often rooted in certain
presuppositions about the limitations and features of the human brain and mind, and
these presuppositions are upended by the emerging human enhancement technolo-
gies. For example, to force prisoners of war to stay awake for 48 consecutive hours
would seem to be unethical and illegal: for normal humans with normal brains, such
actions are torturous. But it may not be objectionable to employ a drug that safely
enables a soldier to stay awake and alert for that duration, for example, for stand-
ing guard or in actual combat. Moreover, where the traditional focus of bioethics is
on the welfare of the individual, in a military setting, the welfare of the individual
legitimately may be subordinated to the interests of the unit, the mission, or the state;
and so, we need something else to reconcile any discrepancies between the two.
In the following, we propose that a risk-assessment approach can serve as a useful
instrument in the larger ethical toolbox.
THE RISK-ASSESSMENT MODEL
Bioethical dilemmas, then, are exacerbated when core principles come into conflict,
or when exact consequences or circumstances of application are uncertain. Under
these conditions, it is reasonable to turn to an RBA, sometimes understood as a form
of cost-benefit analysis, as a way to assess the permissibility of possible actions. The
Belmont Report (1979) had such concerns listed as desiderata under the principle of
beneficence (and nonmaleficence):
Assessment of Risks and Beneits
1. The nature and scope of risks and benefits.
2. The systematic assessment of risks and benefits.
But the vagueness of these terms is a recurrent problem in bioethics. While more
rigorous RBA is widely used in policy making, such as evaluating the impact of
engineering projects, it may be an unfamiliar territory for bioethicists and thus worth
explicating here.
“Risk” is an unavoidable concept in the ethics and policy of military neuroen-
hancement, yet the term is often used much too loosely. Without a clear under-
standing of the range, quality, quantity, diversity, or other aspects of the risks at