Nicolás Serrano, PhD.
The first NEBA Seminar focusing on neuroethical conceptions of personal identity and the impact of emerging neurotechnologies was held between August and October 2023. In a context of rapid advances in neurosciences, the dizzying development of neurotechnologies for diverse uses (including clinical applications and uses in the military, education, and entertainment, among others) forces us to think about how such developments impact (if at all) our understanding of who and what we are, that is, how we understand our personal identity and whether and how our identity could be modified (or not) by the new neurotechnologies. The theoretical tools needed to address these issues must rely on interdisciplinary collaboration. This aspect, typical of neuroethical research, was reflected in the background of those attending the Seminar who came from areas as diverse as philosophy, neurology, law, and education, among others. In what follows, I present a brief assessment of the results, sharing two of the many reflections that emerged throughout the Seminar.
One of the first topics covered was the question "What does the debate about personal identity in neuroethics consist of?" When approaching the specialized bibliography on the subject, it is difficult to avoid the suspicion that a certain rhetorical ambiguity may be detrimental to a correct understanding of the conceptual plane in which the various positions are handled. It seems that the question of personal identity can be understood in at least two ways. In the first, which I will call metaphysical, the question consists in giving a characterization of the ontological nature of personhood. A metaphysical theory of personal identity should give a precise characterization of what are the essential properties of personhood as well as clear identity criteria for each of the particulars (i.e. persons) that fall under such a universal. Ideally, a good metaphysical theory of personal identity should offer well-founded and satisfactory answers to the kinds of real and/or imaginary scenarios that are often used to strain our pre-theoretical intuitions about identity. For example: can an evil genius make two people change their bodies and still remain, respectively, the same person? Is someone who has lost all memory, all character traits, and all psychological traits she once possessed still the same person? how many people inhabit the body of a patient with dissociative identity disorder?
From a second perspective, which I will call epistemic, the relevant issue is not so much a metaphysical one, but a psychological and/or pragmatic specification of personal identity. Epistemic theories do not seek to unveil the nature of personhood, but to clarify the way in which we tend to understand and use the notion of personhood. Instead of asking "What are persons?", the leading question is usually "What do we mean by personhood?." For example, the narrative tradition of authors such as Baylis (2011, 2013), Schechtman (2010), Mackenzie & Walker (2015), and Goering (2017), among others, often appeals to intersubjective criteria of acceptance and negotiation to determine which "narratives" succeed in constituting personhood identities. Crucially, the consensual nature of such criteria can (and often does) lead to scenarios where the subject's "preferred narrative" does not turn out to be accepted by his or her environment, preventing it from becoming his or her identity narrative. The case of the insane man convinced that he is Napoleon is a common example, although what those attending the Seminar found more interesting was to apply these ideas to issues such as alienation and discrimination and to consider the potential of these reflections for thinking about contemporary societal phenomena.
As the previous paragraph makes evident, the use of eminently metaphysical notions (such as those of "constitution" and "identity") can lead to the aforementioned confusion between conceptual levels of analysis. This makes it necessary to explicitly draw the distinction between metaphysical and epistemic perspectives on personal identity. For example, is personal identity metaphysically constituted by a narrative, or do we understand our identities in the light of narratives dialectically negotiated with our contexts? Well, one of the first points of agreement of the Seminar was that, while the distinction seems to be blurred and even confused in some contemporary texts, it had been implicitly recognized in the origins of the discussion (see Schechtman 1990). We consider that narrative conceptions of personal identity are best understood as epistemic conceptions rather than as a characterization of the metaphysical nature of personhood. This implies that such positions face the arduous task of striking a fragile balance between a descriptive and a revisionist task. A descriptive task that respects our pre-theoretical intuitions and a revisionist task to develop our theoretical understanding beyond such intuitions seems key in order to apply such notions to novel cases in a consistent way. In this line, the effects that emerging neurotechnologies such as deep brain stimulation (DBS) devices may have on our self-understanding, sense of agency, and personal narrative present interesting challenges to the descriptive/revisionist balance of narrative conceptions. The appeal to relational elements, linked to the active role of context (both institutional, cultural, and interpersonal) in the constitution of identity narratives, offers novel and interesting tools to address typical cases in the emerging literature.
The second reflection pertains to one of the goals of the Seminar: to show that the usefulness of those theoretical tools goes beyond the hypothetical and/or conceptual analysis of certain cases in academic contexts. The aforementioned interdisciplinary nature of the participants led some of them to apply the results of their readings and reflections to their daily professional practice. In particular, the narrativist suggestions of Schechtman (2010) and Baylis (2013) on how to address the side effects of DBS impacted H.P., a neurologist who (among other things) works with Parkinson's patients. As part of his daily practice, H.P. must face the complex task of informing potential DBS recipients about the risk-benefit profile of the treatment, as well as accompanying the patient's development if she agrees to receive such an intervention. Having H.P. in the Seminar gave a much-needed air of reality to the debates, illuminating the specific details and commonalities of the problems we addressed with the typical (and often detrimental) distance of conceptual analysis. But, conversely, H.P. also pointed out how such analyses had allowed him to understand and approach the usual problems of his clinical practice from a new perspective. If I may admit it, the session in which H.P. began by pointing out how he had "already applied" the recommendations of Baylis and Schechtman during a consultation was one of my greatest satisfactions during the Seminar.
The interdisciplinary synergy between theoretical analysis and concrete practice in different areas is one of the most powerful features of neuroethics. It is my hope that the Seminar on Personal Identity and Neurotechnologies has managed to successfully convey this commitment. And that, in doing so, it has managed to exemplify NEBA's commitment to research in (and dissemination of) the contributions that this area has to offer the community.
References:
Baylis, Françoise. (2011). The self in situ: A relational account of personal identity. Being Relational: Reflections on Relational Theory and Health Law. 109-131.
Baylis Françoise (2013). "I Am Who I Am": On the Perceived Threats to Personal Identity from Deep Brain Stimulation. Neuroethics. 2013;6(3):513-526.
Mackenzie, Catriona & Walker, Mary (2015). Neurotechnologies, personal identity and the ethics of authenticity. In Springer Handbook of Neuroethics. Dordrecht: Springer. pp. 373-92.
Schechtman, Marya (1990). Personhood and personal identity. Journal of Philosophy 87 (2):71-92.
Schechtman, Marya (2011). The narrative self. En Shaun Gallagher (ed.), The Oxford Handbook of the Self. Oxford University Press.
Goering, Sara & Klein, Eran & Dougherty, Darin & Widge, Alik. (2017). Staying in the Loop: Relational Agency and Identity in Next-Generation DBS for Psychiatry. AJOB Neuroscience. 8. 59-70.