This article describes how sexbots: sentient, self-aware, feeling artificial moral agents created soon as customised potential sexual/intimate partners provoke crucial questions for technoethics. Coeckelbergh's model of human/robotic relations as co-evolving to their mutual benefit through mutual vulnerability is applied to sexbots. As sexbots have a sustainable claim to moral standing, benefits and vulnerabilities inherent in human/sexbots relations must be identified and addressed for both parties. Humans' and sexbots' vulnerabilities are explored, drawing on the philosophy and social science of dehumanisation and inclusion/exclusion. This article argues humans as creators owe a duty of care to sentient beings they create. Responsible innovation practices involving stakeholders debating ethicolegal conundrums pertaining to human duties to sexbots, and sexbots' putative interests, rights and responsibilities are essential. These validate the legal recognition of sexbots, the protection of their interests through regulatory oversight and ethical limitations on customisation which must be put in place.

This article describes how sexbots: sentient, self-aware, feeling artificial moral agents created soon as customised potential sexual/intimate partners provoke crucial questions for technoethics. Coeckelbergh's model of human/robotic relations as co-evolving to their mutual benefit through mutual vulnerability is applied to sexbots. As sexbots have a sustainable claim to moral standing, benefits and vulnerabilities inherent in human/sexbots relations must be identified and addressed for both parties. Humans' and sexbots' vulnerabilities are explored, drawing on the philosophy and social science of dehumanisation and inclusion/exclusion. This article argues humans as creators owe a duty of care to sentient beings they create. Responsible innovation practices involving stakeholders debating ethicolegal conundrums pertaining to human duties to sexbots, and sexbots' putative interests, rights and responsibilities are essential. These validate the legal recognition of sexbots, the protection of their interests through regulatory oversight and ethical limitations on customisation which must be put in place.

Sex robot scholarship typically focuses on customizable simulacra, lacking sentience and self-awareness but able to simulate and stimulate human affection. This paper argues that future humans will want more: sex robots customized to possess sentience and self-awareness [henceforth, sexbots], capable of mutuality in sexual and intimate relationships. Adopting a transdisciplinary critical methodology focused on the legal, ethical and design implications of sexbots, it assesses implications of sexbots’ non-mammalian subjectivity, balancing designed-in autonomy and control, decision-making capacity and consent, sexual preferences and desire, legal and moral status, vulnerability and contrasts between mammalian and non-mammalian moral decision-making. It explores theoretical, ethical, and pragmatic aspects of the tensions involved in creating sentient beings for utilitarian purposes, concluding that sexbots, customized manufactured humanlike entities with the capacity for thought and suffering, have a consequent claim to be considered moral and legal persons, and may become the first conscious robots. Customizing sexbots thus exemplifies many profound ethical, legal and design issues. The contradictions inherent in their inconsistent ethical and legal status as both manufactured things and sentient, self-aware entities who are customized to be our intimate partners augments existing human/animal scholars’ call for a new theoretical framework which supersedes current person/thing dichotomies governing human responsibilities to other sentient beings. The paper concludes that the ethical limits and legal implications of customizable humanlike robots must be addressed urgently, proposing a duty on humans as creators to safeguard the interests and minimize the suffering of created sentient beings before technological advances pre-empt this possibility.

Patients offered experimental or novel treatments for serious conditions are often considered vulnerable, desperate for a possible cure, and hence unable to weigh risks/benefits (Mathews et al. 201...

Decisions on whether, on what basis, and when human and nonhuman entities should be accorded moral salience cannot be value-neutral or objective, rendering finding consensual justifications challen...

A critical ethics of care must address the role of the rhetoric of care in the subjectivation of neoliberal citizens. This chapter focuses on security and care in relation to affective structures underpinning the regulation of biotechnologies, in particular synthetic biology. It argues that both self-betterment and insurance are framed as rational risk-prevention strategies properly undertaken by homo prudens and both incorporate fantasies and affective yearnings central to a critical ethics of care. P. Rabinow defines equipment as 'a set of truth claims, affects and ethical orientations, designed and combined in a practice'. The chapter describes a critical ethics of care should make a valuable contribution to this new equipment. It focuses on the plethora of ethical questions it illuminates over the biopolitics of which forms of life should be prioritized, how issues of access to resources are to be managed and the use of the rhetoric of care and security to do so.

M was diagnosed as being in a persistent vegetative state (PVS) after suffering brain damage at 43. Eight years later, after a rediagnosis of a minimally conscious state (MCS), she demonstrated cap...

Many nations’ fairy tales and fables recount the sad fate of geese who lay golden eggs, only to be killed by greedy owners whose impatience guarantees impoverished futures. Fecal microbiota transplantation (FMT) represents such a “hope technology,” based upon the exchange of fecal samples repurposed to represent golden eggs. Advanced ‘omics technologies measuring microbial communities’ biological properties promise to revolutionize taxonomies and treatments, including FMT, in human health. Yet greed and gullibility endanger FMT’s clinical promise. Today, “wellness” and “happiness” are commodities (Cederstrom and Spicer 2015), food is medicine, and feeling good constitutes virtue (Davies 2016a). Widespread self-help bodily practices aimed at shaping one’s mind and body to resemble self-appointed social-media-established “wellness” gurus with a gift for hype (BBC 2017) render FMT uniquely open to do-it-yourself (DIY) selftreatments lacking proof of efficacy. Ma and colleagues’ (2017) excellent overview of ethical issues surrounding FMT calls for appropriate, effective regulation. This outcome demands an appreciation of what legal oversight is practicable, given existing difficulties in regulating not only FMT but also exchanges involving comparable body parts. Readily accessed and exchanged bodily products such as sperm, urine, feces, hair, breast milk, nail clippings, perspiration, and tears raise unique regulatory difficulties. Unlike internal body parts with clinical and exchange value (organs, blood, bone marrow, tissue), they may be obtained without intrusive removal procedures, stored, and informally exchanged beneath the radar of legal regulation and clinical practice. While all human body parts may be subject to criminal law prohibitions of the theft of another’s genetic material in order to ascertain their DNA (as in England, Australia, and many U.S. states), these have proven to be practically unenforceable. In terms of medicolegal oversight of readily accessed and exchanged bodily products, while transactions involving material for commodities (hair, urine), or exchanges of commercially valueless items (nail clippings, perspiration, tears), pose no untoward ethical or legal problems, the clinical and social implications of exchanges involving sperm, breast milk, and feces render this area crucially important. Nonetheless, as they are readily accessed and exchanged informally, expectations of close regulatory control are unrealistic. Furthermore, public health regulation of FMT is likely to be hampered by today’s affective economy. Post-truth, the “relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than are appeals to emotion and personal belief,” was

Hubner and White's (2016) thought-provoking scenario rests on a unified conception of psychopathy, a reliance upon subjective suffering and individual medical benefit as grounds to justify ethical ...

Who should decide whether anything short of full recovery post traumatic brain injury (TBI) constitutes a life not worth living and authorize withholding/withdrawing of life-prolonging treatment? Patients exercising precedent autonomy by imposing the wishes, values, and preferences of their competent preinjury self on their incompetent postinjury self via advance directive (AD)/surrogate decision maker? Clinicians? Family? The incompetent postinjury self? Most intensive care unit (ICU) brain-injured patients die after clinical decisions withholding/withdrawing life-prolonging treatment, but prognostic models are insufficiently accurate as sole justification for treatment limitation, patients may lack capacity to communicate treatment preferences, surrogate decision makers may not represent preferences accurately, and at the acute stage predicting patients’ ability to adapt to life with significant disability is challenging (Geurts et al. 2014). Documented ADs/surrogate decision makers refusing life-prolonging treatment exacerbate difficulties. Assessing decision-making capacity (DMC) post TBI is fraught: Evaluating the impact of neurological damage is complex, patients’ views on their prospective quality of life (QOL) may take time to stabilize, and ADs’/surrogate decision-makers’ refusals of treatment are often open to question (Mackenzie and Watts 2011). Clinical practice reflects these challenges. In a recent survey of trauma clinicians, 65.8% reported they rely on families to make end-of-life decisions, though 80.7% feel that families are rarely or only sometimes in appropriate emotional states to do so. Also, 59.6% rely on ADs most or all of the time, but only 61.1% regard them as useful and only 56.3% feel that families’ decisions are in keeping with ADs most or all of the time (Martin et al. 2014). Legally mandated precedent autonomy, TBI sequelae, and rehabilitation ethics are a poor fit. ADs and surrogate decision making are legal mechanisms to refuse specified life-prolonging treatments for future incompetent selves. In end-of-life situations involving terminal illnesses/neurodegenerative conditions where health trajectories involve irrevocable decline, they enable avoidance of dying processes regarded as worse than death and overburdening families. However, post TBI, clinical context renders precedent autonomy mechanisms ethically questionable. Rehabilitative possibilities underpin upward trajectories toward degrees of recovery. Even severe injuries falling short of brain death need time to resolve into stable or predictable outcomes. Clinicians, patients, and families making end-of-life decisions in ICUs immediately post TBI are placed under time constraints incompatible with rehabilitation ethics, which incorporate time to consider evolving prognoses and treatment alternatives. Changing values and perceptions of the self post TBI challenge the assumption of continuity underpinning precedent autonomy. Values of the postinjury self usually change from those of the preinjury self in a mechanism known as response shift, as the importance of different domains of life alters through recalibration, reprioritization, and reconceptualization. Life satisfaction, as measured by self-reported QOL measures, plummets initially, then usually returns to previous levels, remaining stable or improving even where there is severe physical incapacitation: In a large long-term study of locked-in-syndrome patients, most had stable or improved QOL and none wished for euthanasia (Rousseau et al. 2015). Adverse implications for cognitive faculties and emotional integration post TBI complicate matters (Mackenzie 2013). Sudden loss of a coherent, satisfying, and complete sense of self post TBI destabilizes subjective QOL assessments. Positive post-TBI changes in self-identity depend upon “selfreflective meaning-making, giving a purpose in life, providing motivation and goals for future behavior” (Thomas, Levack, and Taylor 2014, 1033). Narratives of continuity with the preinjury self are not a given, but must be constructed gradually as part of rehabilitation. We engage in QOL recalibration, reprioritization, and reconceptualization and self-reflective meaning-making throughout life, contemplating personal and familial impacts of mental and physical decline. Yet ICU treatment decisions take place in a context of abrupt, not gradual, change. Temporal constraints curtail opportunities for self-reflective meaning-making as part of the recovery process. After emergency treatment, where DMC is adjudged absent, prognoses

Debate over sentient, self-aware artificially intelligent [AI] entities focuses on controlling them to protect human interests, while pre-sentient sexbots like Roxxxy, mechanical sex-dolls lacking self-awareness, are condemned as degrading human/human sexual intimacy. I argue that humans owe sentient, self-aware sexbots an ethical duty as creators of sentient beings to protect them from harm and suffering. This means we must avoid the seductive danger inherent in deliberately customising them as inferior, controllable beings vulnerable to exploitation. Many consequent uncertainties over sexbots' moral and legal standing remain to be resolved. Given the pace of technological developments, we need to debate these crucial issues now, before events overtake us.

Debate on conceptions of futility over whether those diagnosed with psychiatric conditions should be regarded as competent, able to refuse lifesaving treatment, needs to be reframed. In many jurisd...

Health-related psychedelic research should focus on helping us flourish, not just remedying ill-health or addiction. We don't know enough about how psychedelics could enhance human flourishing. Factors promoting health-through-flourishing include finding meaning in life, spiritual practices, comfortable levels of social bonds, emotionally/physically satisfying sex in a long-term monogamous relationship and control over one's daily life. Psychedelic research could find more. Neuroscience anchors psychedelic research into disease and disorder, e.g. addiction, PSTD, migraine, anxiety, pain etc. Neurophenomenological psychedelics research could illuminate relationships between health, ASC/NOSCs and cognitive liberty to promote human flourishing. If we accept the self as an epiphenomenon of subsystems within the brain, we 'know' 'unconsciously', but are not aware of, many things which affect our lives profoundly. These include control over identifying, remembering and forgetting our states of mind and how to move between them. A prerequisite for integrated investigations into ASC/NOSCs is the establishment of a taxonomic knowledge base which lists, categorises and characterises ASC/NOSCs to enable us to choose specific states of mind and move securely among them. Or, in other words, to enable us to exercise our cognitive liberty safely. I believe that human health and flourishing would be enhanced were we able to direct our states of being by consciously choosing them. Given the promise of mindfulness techniques to enhance our health, happiness and spiritual growth, constructing both personal and generic classifications of salient ASC/NOSCs makes sense. Laws need to change. The neuroscience of pleasure, love, spirituality, decision-making, pattern recognition and location of meaning should inform health-enhancing psychedelic research while promoting flourishing through cognitive liberty. As part of cognitive liberty, our end-of-life choices should include how we die. In other words, our idea of the good death should include access to psychedelics. Dying high is increasingly likely to become a popular choice as baby boomers age and place their economic clout behind the reform of end-of-life laws as well as drug laws. Achieving such crucial legal changes depends partly on the ability to produce research to anchor evidence based law and policy. Research into psychedelics, ASC/NOSCs and the neurobiology of the dying process is essential.

Recent English cases have set a very low threshold for the capacity to consent to sexual activity, and the Court of Appeal in IM v LM (2014) has held that "the ability to use and weigh information is unlikely to loom large in the evaluation of consent to sexual relations." Such cases significantly affect the legal status of such activities involving persons diagnosed with a learning disability (LD), an autistic spectrum disorder (ASD) or other neurodiverse (ND) conditions. A principal focus on two cases in particular-IM v LM (2014) and A Local Authority v TZ (no 2) (2014)-supports the argument that the current test needs reframing from a relationship-centred perspective, in order to reflect an evidence-based model of sexual decision-making. Relevant training for persons diagnosed as LD, ASD, or ND is essential in order to promote socio-sexual competence. This is critical for resolving existing tensions between (1) sexual rights guaranteed in international agreements; (2) criminal law provisions and local authorities' obligations to protect the vulnerable; and (3) sexual health concerns.

Much sex is neither intimate nor loving but is accompanied by coercion and/or commodification in the billion dollar sex industry. Some suggest that sexbots replace sex workers. I consider ethicolegal issues arising over how far human rights and laws protecting sex workers and other citizens should apply to sexbots. Without legal protections, the sex industry would undoubtedly produce sexbots for morally unacceptable sexual practices, like pedophilia.

Much sex is neither intimate nor loving but is accompanied by coercion and/or commodification in the billion dollar sex industry. Some suggest that sexbots replace sex workers. I consider ethicolegal issues arising over how far human rights and laws protecting sex workers and other citizens should apply to sexbots. Without legal protections, the sex industry would undoubtedly produce sexbots for morally unacceptable sexual practices, like pedophilia. Sexbots thus test boundaries of acceptable sexual practice. Sexbots could be manufactured who gained pleasure from pain, or who wanted to be tortured or killed, or to manifest qualities which specialist websites show have fetishistic appeal, including children and nonhumans. My contribution to HCI research is this critical analysis of how far sexbots' cognitive, emotional and physical abilities and their autonomous choices and decision-making might permissibly be restricted and what legal protections they should be afforded. I argue that a code of ethical design and agreement on their ethicolegal status are urgently needed.