Military Neuroenhancement and Risk Assessment - Neurotechnology in National Security and Defense - page 243

risk for one's own side may be morally legitimate and even morally required. These
facts considerably complicate the ethics of risk assessment for military human
neuroenhancement.
In the absence of precise probabilities, can we say anything useful about how to
determine whether or not particular neuroenhancements pose an acceptable risk or
not? Perhaps some further conceptual clarification will help.
a ccepTable -r isk if acTOr
To begin, the major issues in determining “acceptable risk” include, but are not
limited to, the following five factors (Lin et al. 2008).
Consent/Voluntariness
Is the risk voluntarily endured, or not? For instance, secondhand smoke is usually
considered more objectionable than firsthand, because the passive smoker did not
consent to the risk, even if the objective risk is smaller. Will those who are at risk
from military human enhancements reasonably give consent? When, if ever, would it
be appropriate to engage in enhancement without consent of those affected?
Morality ordinarily requires the possibility of consent: to be autonomous is, at mini-
mum, to have the capacity to either give or withhold consent to some action. But warf-
ighters often have no choice about substantial parts of their roles and duties; once an
individual has volunteered for service, military ethics accepts that many choices open to
civilians are no longer options to military personnel. But which choices exactly—that
is, under what circumstances could a human enhancement be required for warfighters?
Informed Consent
Another possible problem is the uncertainty or unpredictability arising from
enhancements: Will they actually work as promised? Even if they do, will the
enhancements have unintended consequences or side effects? This leads to a second
aspect of consent, familiar from the bioethics literature.
The worry here begins with the usual requirement in civilian bioethics to inform
patients of the details about his or her diagnosis, prognosis, alternative treatment
options, and side effects of each alternative, before treatment is morally permitted.
For enhancement ethics, this is already problematic: a “diagnosis” is commonly
understood as a physician's theory of what ails a patient, but nothing ails the soldier
undergoing enhancement; enhancement is typically understood to stand in contrast
to therapy (Allhoff et al. 2010). Instead, the “diagnosis” refers to whatever ability
the enhancement is intended to improve or optimize—possibly regardless of its
effect on the rest of the warfighter's life. The “prognosis” then refers to the expected
future with respect to that ability given the enhancement, versus the expected future
without it; only if alternative enhancement treatments are offered would further
alternatives be relevant to discuss. And if the enhancements are given prior to the
completion of clinical trials, the side effects may be merely speculative, or even
completely unknown. Are warfighters entitled to all of this information before they
consent to enhancement, if their consent is indeed required?