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Cognitive Enhancement as Transformative Experience: The Challenge of Wrapping One’s Mind Around Enhanced Cognition via Neurostimulation

Published online by Cambridge University Press:  23 February 2024

Paul A. Tubig  and
Eran Klein Open the ORCID record for Eran Klein [Opens in a new window]
Paul A. Tubig*
Affiliation:
Department of Philosophy & Religious Studies, Georgia Southern University, Statesboro, GA, USA
Eran Klein
Affiliation:
Department of Neurology, Oregon Health and Science University, Portland, OR, USA Portland Veterans Administration Health Care System, Portland, OR, USA Department of Philosophy and Center for Neurotechnology, University of Washington, Seattle, WA, USA
*
Corresponding author: Paul A. Tubig; Email: ptubig@georgiasouthern.edu
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Abstract

In this paper, the authors explore the question of whether cognitive enhancement via direct neurostimulation, such as through deep brain stimulation, could be reasonably characterized as a form of transformative experience. This question is inspired by a qualitative study being conducted with people at risk of developing dementia and in intimate relationships with people living with dementia (PLWD). They apply L.A. Paul’s work on transformative experience to the question of cognitive enhancement and explore potential limitations on the kind of claims that can legitimately be made about individual well-being and flourishing, as well as limit the kind of empirical work—including the authors’ own—that can hope to enlighten ethical discourse. In this paper, the authors advance the following theses: (1) it is sometimes reasonable to characterize cognitive enhancement as a transformative experience; (2) the testimonies of people intimately acquainted with dementia may still be relevant to evaluating cognitive enhancement even though cognitive enhancement may be a transformative experience; and (3) qualitative studies may still be useful in the ethical analysis of cognitive enhancement, but special attention may need to be given to how these are conducted and what kind of insights can be drawn from them.

Keywords

cognitive enhancementdeep brain stimulation (DBS)dementiatransformative experience
Type
Research Article
Information
Cambridge Quarterly of Healthcare Ethics , First View , pp. 1 - 16
Copyright
© The Author(s), 2024. Published by Cambridge University Press

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References

Notes

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10. It is possible that this hypothesis may generalize to non-technological forms of cognitive enhancement as well, but here we hope to at least make the narrower point plausible.

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22. LA Paul limits transformative experiences to the types of experiences that are both epistemically and personally transformative. Although epistemic transformation does not always lead to personal transformation and personal transformation may still occur without having an epistemically transformative experience, transformative experience is meant to pick out the sort of experiences that are both epistemically and personally transformative, see note 23, Paul 2014, at 16–17.

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36. Some of this information included: (1) how the devices might work, (2) the risks of brain surgery, (3) what cognitive abilities are being enhanced (memory, language, executive function, etc.), and (4) possible ways that cognitive abilities, or changes in them, might alter daily functioning (e.g., driving, shopping, paying bills, engaging in conversation).

37. We have found that these struggles imaging how hypothetical devices might be used for cognitive enhancement are present not only when individuals are specifically asked about cognitive enhancement devices, as in the current study, but also when individuals contemplate how devices intended for cognitive therapy also might be used for cognitive enhancement (see [reviewed for review]). The participant quotes included here reflect both.

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40. One participant in the study referenced the movie Flowers for Algernon and the possible alienation from others that might come from becoming cognitively enhanced. Also, there have been testimonies from people whose relationships with others have changed as a result of psychological changes stemming from their use of DBS. Agid, Y, Schupbach, M, Gargiulo, M, Mallet, L, Houeto, JL, Behar, C, Maltête, D, Mesnage, V, Welter, ML. Neurosurgery in Parkinson’s disease: The doctor is happy, the patient less so? Journal of Neural Transmission Supplementum 2006;70:409 Google Scholar.

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43. It is worth noting that dementia can also be reasonably understood as a transformative experience. Does this mean that people living in close proximity to dementia are foreclosed from any understanding of what it is like to live with dementia? This claim seems to be unreasonably strong. There is something to be said about certain adjacent experiences and how traveling with others as they go through a transformative experience grants people access to some “insider” knowledge. Think of a childless friend or relative living with and helping raise a child of new parents, someone intimately connected in the day-to-day lives of the parents and child before and after birth. Is it really true that this person is no better positioned than a stranger to understand the transformative experience of becoming a parent? This seems wrong. Surely there is experiential overlap in some kinds of transformative experiences that is relevant to understanding those experiences, perhaps even undergoing the relevant perceptual changes. For this reason, we do not think that Paul is quite right that all transformative experiences are epistemically opaque, and an adequate decision theoretic account of transformative experiences must be sensitive to adjacent experiences as conferring some epistemic access to transformative experiences. Unfortunately, this cannot be adequately addressed in this paper and will be expanded in an upcoming paper.