- Introduction to the Special Section:Feminist Approaches to Neurotechnologies
Bioethics has already had a rich interaction with the relatively new field of neurotechnology. Scholars have wondered whether neurotechnological interventions, such as deep brain stimulation, are threats to personal identity (Baylis 2013), lead to alienation or create dilemmas between authenticity and autonomy (Kraemer 2013a; 2013b), impact autonomy (Mackenzie and Walker 2015), detract from agency (Goddard 2017), or lead to self-estrangement (Gilbert et al. 2017). Many of these ethical investigations are concerned not with the targeted health benefits of neurotechnology but with whether and how they fit into users' lives in more personal and profound ways.
In some ways, this focus on general bioethical issues related to the self (including authenticity, autonomy, identity, and agency, among others) is unsurprising given that neurotechnologies target brain-based disorders, and many people in Euro-American contexts believe that the brain is the locus of selfhood. Thus, targeting the brain means targeting the self. Peter Kramer (1997) was one of the first to point out how brain-based therapies might impact selfhood with his pioneering study of patients' experiences with the selective-serotonin reuptake inhibitor Prozac. Like Prozac, neurotechnologies, such as deep brain stimulation (DBS, which has been the focus of bioethical inquiries), target brain-based disorders, such as depression, obsessive compulsive disorder, and anorexia nervosa, although their main use has been for movement disorders such as Parkinson's Disease. Thus, this bioethical interest in the self is to be expected, given neurotechnology's target.
Further, we would argue that studies linking patient experiences with neurotechnologies and ethical questions about the risks and benefits related to selfhood properly belong in feminist bioethics in a number of ways. First, the move to take users' experiences with their devices seriously is relatively recent and reflects the broader concern with ensuring that medical and technological innovation do not proceed "top down" based on researchers' understandings [End Page 89] of what people need but incorporate user perspectives on their own priorities. This concern is a form of ethical enfranchisement and is a core tenet of feminist efforts to empower individuals to have a say in decisions that affect their lives. Second, the interest in the self reflects broader feminist theoretical interest in how autonomy can be bolstered or knocked down by supportive or oppressive relationships and environments. Rather than a stalwart individual impenetrable by outside influence, our sense of self and ability to self-govern are fundamentally interrelated with others and with our environments, as feminist theory has emphasized. Third, and finally, the connection between DBS use for bodily disorders, such as Parkinson's disease, and mental illnesses, such as depression, highlights the fluid interconnection between body and mind that underscores feminist attention to embodiment. A DBS system is a foreign body surgically implanted in a patient's brain and as such is a physical presence with profound simultaneous effects on the patient's body and mind. These three features of ethical concerns with neurotechnologies reinforce that feminist theorizing is well placed to address ethical issues that arise from these interventions.
In the following paragraphs, we describe the contributions of our two target articles and the respective commentaries on them, before offering some thoughts on the future trajectory of research into the intersection of DBS research and feminist bioethics.
The two target articles and four commentaries that comprise this special section devoted to "Feminist Approaches to Neurotechnologies" highlight the ways in which attention to relationality and socialization (whether oppressive or supportive) can improve our thinking and moral reasoning in respect to the development and implementation of neural devices. Rather than focusing on the interests and experience of the individual narrowly defined, these authors situate neural device users in complex social and relational networks that enable and support (or obstruct and diminish) their authenticity, agency, and autonomy. As Anna Gotlib notes, "Abstracting the self with procedural requirements of self-control toward one's will can both ignore the deeply social aspects of who we are and exclude a vast number of human beings who already take their sense of themselves to be deeply embedded in the intersecting moral geographies of their lives...