to what extent can people be ordered to be enhanced with artificial limbs and muscles?

To what extent canpeople be ordered tobe enhanced withartificial limbs andmuscles?Damyan Todorov

Law & Technology

Tilburg University

March 2017

To what extent can people be ordered to be enhanced with artificial limbs and muscles?

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Preface and acknowledgements

The current thesis was written as a part of the LLM Law and Technology at Tilburg Universityand aims to focus on the interplay between human enhancement technologies and law.

I would like to thank my supervisors Ronald Leenes and Tom Chokrevski at Tilburg Universityfor their commitment and critical feedback.

Last but not least, I would like to thank my beloved family, my friends and all my colleaguesat Tilburg University for their amazing support and huge positive influence throughout thewhole year of my education at Tilburg University. Special thanks to my closest peers atTilburg University.

Recommended citation:

Todorov, D.O., “To what extent can people be ordered to be enhanced with artificial limbsand muscles?”,(2017)


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Table of ContentsChapter 1: Introduction.............................................................................................................. 4

Chapter 2: Artificial limbs and muscles in light of human enhancement technologies ............ 7

2.1 Introduction................................................................................................................. 7

2.2 Definition of human enhancement technologies........................................................ 8

2.3 Definition of artificial organs ..................................................................................... 10

2.4 Definition of artificial limbs ....................................................................................... 12

2.5 Definition of artificial muscles ................................................................................... 13

Chapter 3: Possible coercive enhancement of people by artificial limbs and muscles ........... 15

3.1 Introduction............................................................................................................... 15

3.2 Establishing a state of abundance of artificial limbs and muscle technologies ........ 16

3.3 Consequences of abundant availability of artificial limbs and muscles .................... 23

3.4 Coercion as a feasible undesirable consequence...................................................... 27

3.5 Examples of coercive enhancement across society .................................................. 28

3.6 People ordered by superior authority to be enhanced............................................. 31

Chapter 4: Limitations of ordered enhancement in the terms of law ..................................... 35

4.1 Introduction............................................................................................................... 35

4.2 The right to bodily integrity considerations .............................................................. 36

Chapter 5: Conclusion .............................................................................................................. 44

Bibliography.............................................................................................................................. 45


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Chapter 1: Introduction

Human enhancement is currently an expanding field of science that challenges ourperception of reality and human nature on a daily basis. Human enhancement technologiesvary tremendously and how they benefit humans depends on the nature of each particulartechnology. The significant rise and rapid advancement of human enhancementtechnologies nowadays, especially artificial organs, poses a new breed of questions andchallenges the ethics and morality of our society.

In the recent years the field of artificial limbs and muscles has shifted swiftly from thedomain of therapeutic devices to the emerging field of technologies that enhance thenatural human body capacity and capabilities. For example, prostheses are designated tohelp amputees to live better life and interact with the surrounding environment properly.The progress of this particular technology has reached a stage that amputees implanted withcutting-edge prostheses manage to outrun able-bodied runners. Another direction ofdevelopment of artificial limbs is the bionic devices. Their designation and specificationsallow possessors to enjoy better mobility and swiftness and even control them by thoughts.Along with improved specifications to assist amputees and other patients, scientists andresearchers have extended the utilization of these technologies to serve healthy individualsas well. Considering human body limitations, the advantages such technologies couldprovide to healthy adopters have been spotted by variety of scientists, biohackers, militaryand even major international corporations. The recognition of the advantages of advancedartificial limbs and muscle technologies for able-bodied possessors might trigger moreintensive research and further development of diverse models and designs. In general, theproduction of such devices has evolved these days based on less sophisticated productionprocess, 3D printing and lightweight construction materials. In light of these considerations,potential rise of diverse models available on the market seems technically plausible infuture. On the other hand, corporations and military strive for boosting the performance oftheir personnel. As some national authorities around the world have already analyzed thepossibility of enhancement of workers’ performance through human enhancementtechnologies, significantly increased levels of strength, endurance and mobility of humanbody might become a game changer in some industries. Boosting weight lifting capacity andmuscle capabilities of workers in labor-intensive jobs such as construction might contributeto companies outranking competitors and achieving market leading position. When it comesto military, development of superior soldiers might be achievable through the employmentof artificial limbs and muscles. The topic of HET in terms of military utilization has beenaround for a while and numerous experts and researchers have addressed their views andconcerns. The influence of biohackers and individuals devoted to augmenting their bodies,especially in light of Transhumanism, should not be neglected as a drive for acceleration ofthe research and development in this field as well. In other words, on the grounds of thewitnessed technical progress at the domain of artificial limbs and muscles and driven by the


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demands of major organizations as well as aspirations of individuals an expected expansionof the artificial limbs and muscle technologies market might not be a mere speculation.Taken all together, artificial limbs and muscle technologies at some time in future mightbecome advanced enough to be preferred and employed by many able-bodied possessors.Along with advantages offered and the requests of utilizations by corporations and army, thecombination between an increasing number of available and accessible devices and a risingacknowledgement of these technologies as adequate solutions of various ongoing problemsmight end up in overwhelming strive for employment of such technologies in many aspectsof human life. A state of abundant of artificial limbs and muscles might occur in future andthis thesis will investigate any indicators in these days such scenario to happen and reinforcethe foreseen possibility. The current thesis does not intend to predict the level of probabilityor a time frame a state of abundance of artificial limbs and muscles to be established.

Furthermore, the adoption and employment of these devices might challenge ethics,morality and law in various aspects. In that perspective the thesis will highlight a fewconsequences that are considered to affect individuals and society in multiple aspects. Oneof the undesirable effects is believed to be coercion. If corporations and military appreciateartificial limbs and muscle technologies as a means to achieve their objectives, the personnelmight be coerced to be implanted with such devices. Coercive enhancement is considered asone of the most plausible potential harms in terms of increasing employment of humanenhancement technologies. That notion is shared by scientists, scholars and ordinary peopleparticipating in surveys.1 Coercion is intensively discussed topic not only within academicworld but also in terms of military. In light of these considerations, questions are calling for athorough discussion based on the present legal framework. Can people be ordered bysuperior authority to be enhanced with artificial limbs and muscles? To what extent canworkers be ordered by their employers to be augmented with such devices? To what extentcan soldiers be ordered to be implanted with advanced military designed artificial limbs andmuscles?

In this thesis human enhancement technologies and particularly artificial limbs and muscleswill be explored and described briefly to make the reader familiar with the genesis of theresearch question. The second chapter will introduce definitions of human enhancementtechnologies and artificial organs as well as present the nature of artificial limbs and muscledevices. Next, in the third chapter, coercion as an undesirable effect will be outlined in theterms of possible significant rise of artificial limbs and muscles on the market. The concept ofcoercion will be described in general and in respect to human enhancement including formsof coercive enhancement. The legal implications of coercive enhancement in terms ofartificial limbs and muscle technologies will be considered in two aspects as well - thespecific domains of business companies and military. In light of these considerations, onlythe explicit coercive enhancement will be examined more precisely through its implications

1 Academy of Medical Sciences, the British Academy, the Royal Academy of Engineering and the Royal Society, Human Enhancement andthe Future of Work,2012, Available at https://www.acmedsci.ac.uk/viewFile/publicationDownloads/135228646747.pdf, p.44-45


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regarding the legal relationship between employer and employees and inside militaryorganization. These are specifically picked due to the limited nature of the thesis and withregard to possible employment of human body augmentation in business companies andmilitary. Given the preceding, the research question would be presented in legal perspectiveaiming to analyze whether coercive enhancement intercepts human rights and to whatextent. Among the list of recognized human rights at international and constitutional levels,the thesis will spotlight the right to bodily integrity and investigate to what extent coerciveenhancement interferes with it. The right to bodily integrity guarantees person’s corporalinviolability and so any forcible enhancement involving physical intrusion into human bodymight clash with this right. Chapter four will be devoted to analyzing and evaluating to whatdegree the coercive enhancement might interfere with the right to bodily integrity in theperspectives of military and employment in business companies. As the implantation ofartificial limbs and artificial muscles might include intrusion into human body to a severedegree this comprises an additional reason why the thesis focuses on the possibility forboom of coercive enhancement in future.


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Chapter 2: Artificial limbs and muscles in light ofhuman enhancement technologies

2.1 Introduction

In the current chapter a brief explanation of the nature of human enhancement and thetechnologies in its scope it will be provided. Furthermore, among all present known humanenhancement technologies this thesis will concentrate on artificial organs. The aim of thepresent chapter is to explain in short the essence of artificial organs and establish a basicunderstanding of their multiple applications. Next, this chapter will emphasize on twoparticular artificial organ technologies, namely the artificial limbs and muscles. Why artificialorgans are of importance and particularly the artificial limbs and muscles?

In the last decades, the field of human enhancement technologies is being developed at aphenomenal rate. Increasing number of emerging technologies is being presented to thepublic including human genetic engineering, neurotechnology, cognitive enhancement and3D bioprinting. These should be added to the list of existing human enhancementtechnologies such as PGD, plastic surgery, prostheses, doping, natural organ replacementsand artificial body organs. In order to comprehend the designation of each technology, anadequate piece of knowledge about the definition of human enhancement technologiesought to be provided to the reader. In such manner, the human enhancement technologiescould be delineated from any other technologies and then introduced their aspects ofemployment. Furthermore, after presenting the main characteristics of humanenhancement technologies, this chapter will aim attention at artificial organs as in the scopeof human enhancement technologies. Later on, the field of artificial organs will be exhibitedby their principal characteristics. Once the artificial organs are introduced and describedbriefly, definitions for artificial limbs and muscles will be reviewed as well. As the focus ofthe paper is the employment of artificial limbs and muscles, this chapter will explain to whatextent artificial limbs and muscles are in fact both artificial organs and human enhancementtechnologies in the same time. In that way, the chapter will connect the artificial limbs andmuscles with the broad field of human enhancement technologies. By introducing anddescribing the nature of human enhancement technologies and the employment of artificiallimbs and muscles, the next chapters will elaborate on the foreseen scenarios and probabledangers related to establishing a state of abundance of these technologies on the freemarket.


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2.2 Definition of human enhancement technologies

First and foremost, the term “human enhancement” includes a wide range of practices andfor that reason deserves a clarification. Obviously, one key element of the phrase is thehuman, the species Homo sapiens, as a natural person. However, the term “enhancement”raises variety of questions in different fields of study such as medicine, ethics, philosophyand law.

One definition describes human enhancement as “the application of technology toovercome physical or mental limitations of the body, resulting in the temporary orpermanent augmentation of a person’s abilities and features”.2 According to the Institute forEthics and Emerging Technologies, human enhancement should be understood as “anyattempt to temporarily or permanently overcome the current limitations of the human bodythrough natural or artificial means”.3 Despite the first cited definition looks narrower, thelatter comprises the same key elements. Furthermore, human enhancement is explained asa reference to the general application of the convergence of nanotechnology, Biotechnology,information technology and cognitive science (NBIC).4 Additionally, enhancements aredefined as “biomedical interventions that are used to improve human form or functioningbeyond what is necessary to restore or sustain health”5. Next, another definition ofenhancements is provided by Eric T. Juengst as “interventions designed to improve humanform or functioning beyond what is necessary to sustain, or restore, good health”.6 In thearticle “Coercion in Bioethics”, Jess Hasken refers to human enhancement in a very simplisticbut broad sense – “the ability to use technology to change our bodies and minds”.7 Althoughsome of the provided definitions above state that human enhancement encompassesrestoration of impaired human functions to previous or average levels, in the current thesisthe focus is put on the employment of human enhancement to “raise function to a levelconsidered to be beyond the norm for humans”.8 The aforementioned definitions give theimpression that human enhancement is an umbrella term. With regard to that, a workingdefinition of human enhancement would be - the ability to alter natural human mental andphysical capabilities through variety of means. Human enhancement technologies compriseone kind of means to achieve improvement of human body capacity and capabilities.

2 John Steward, "Human Enhancement", Dartmouth Undergraduate Journal of Science, 2013 <http://dujs.dartmouth.edu/2013/11/human-enhancement/#.V0GbxVKVq9V>3 "Human Enhancement", Institute for Ethics and Emerging Technologies Official Website, 2016<http://ieet.org/index.php/tpwiki/human_enhancement>4 Ibid5 Juengst, Eric and Moseley, Daniel, "Human Enhancement", The Stanford Encyclopedia of Philosophy (Spring 2016 Edition), Edward N.Zalta (ed.), <https://plato.stanford.edu/archives/spr2016/entries/enhancement/>.6 Juengst, Eric. “What does Enhancement Mean?”, Enhancing Human Traits: Ethical and Social Implications, p.297 Hasken, Jess (2007) "Coercion in Bioethics," Macalester Journal of Philosophy: Vol. 16: Iss. 1, Article 3. Available at:http://digitalcommons.macalester.edu/philo/vol16/iss1/38 Academy of Medical Sciences, the British Academy, the Royal Academy of Engineering and the Royal Society, Human Enhancement andthe Future of Work,2012, Available at https://www.acmedsci.ac.uk/viewFile/publicationDownloads/135228646747.pdf, p.7


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Human enhancement technologies are defined as technological interventions to attempt torestore impaired human performance or extend it beyond normal function, thus overcomingthe limits of the human body.9 These include a wide range of technologies increasing humancognitive ability by improving mental capacity or alertness, ones increasing physical ability byimproving strength, sensory perception or speed and ones improving our ability to eradicatedisease and extend our lifespan. With regard to that, human enhancement technologies arealso characterized as “techniques that can be used not simply for treating illness anddisability, but also for enhancing human characteristics and capacities”.10 In his publicspeech about ethics and human enhancement over a decade ago, Carl Elliot introduces hisunderstanding of human enhancement technologies as “the idea of using medicine, orsurgery, or other kinds of medical technology not just to cure or control illnesses but ratherto enhance, or improve, human capacities and characteristics”.11 Taken all together, thecited definitions and descriptions can be summed up as broad range of technologies that areinitially developed to serve patients and later on are being upgraded to benefit in superiorfashion healthy humans as well. Such conclusion could be reinforced by the existence ofoutdated human enhancement technologies including ear trumpets, wooden legs andancient eyeglasses. However, human enhancement technologies are transforming in natureand specifications and due to the ongoing technological progress innovations in that field areemerging significantly. This means that present forms of the mentioned out of datetechnologies including hearing aids, contact lenses and bionic propulsion limb are providingtheir possessors almost natural capabilities. Nowadays, the development of humanenhancement technologies is focused on improvement of the existing technologies aiming tooffer superhuman and beyond natural body capacity and capabilities. On other side,revolutionary gadgets have been recently invented that are truly one of a kind includingGoogle glass, exoskeletons that are still augmenting biology with technology but it is hardlyto point a medical designation as a primary one. So, the description of human enhancementtechnologies should accommodate both types of technologies that enhance natural humancapacities. The underlying idea is that a technology that is engineered to interact with andaugment human anatomy resulting in enhancing natural body capacity and capabilitiesshould fall into the scope of human enhancement technologies.

Employment of human enhancement technologies by healthy people only makes sense incases when technologies benefit the receiver to a greater degree compared to his naturalcapacity and capabilities. For example, optical eyeglasses do fall into the extensivedescription of human enhancement technologies. However, it is unreasonable a person withproper eyesight to use optical eyeglasses. On the other hand, a person who desires a solidimprovement of his strength of his limbs might for replacement of these organs if there is asuitable technology on the market. In contrast to patients who enjoy human enhancement

9 Ibid, p.710 Ibid11 Carl Elliott, "What's Wrong With Enhancement Technologies?", CHIPS Public Lecture, University ofMinnesota, 1998 <http://www.ucl.ac.uk/~ucbtdag/bioethics/writings/Elliott.html>


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technologies with therapeutic purpose, soon humans might be to be transformed to acertain degree into an upgraded improved human organism, half-machines, half-humans.One reason for that would be that the augmented ones would be more productive, morefunctional and skillful. Enhancing normal human body capabilities and capacity mightbecome a powerful means of boosting the profit of business activities, way of conductingwars, etc. The scope of the thesis would be narrowed to human enhancement technologiesdisparate from therapeutic ones that enhance the human body capacity and capabilitiesthrough its transformation into a technological packed mechanism that could accommodatesuperhuman capabilities providing superior abilities to workers and soldiers.

Nowadays human enhancement technologies can be split into two main categories, namelycognitive enhancement and physical enhancement. First, emerging approaches to enhancehuman cognition include pharmacological cognitive enhancement, cognitive maintenanceand restoration, cognitive enhancement of healthy individuals as well as non-pharmacological cognitive enhancement.12 Second, physical enhancement was initiallydeveloped for restoration but in the last years its focus has been moving to extendingnatural body capabilities of healthy people. Under the term physical enhancement areincluded technologies in the scope of sensory enhancement, enhancement of mobility andlimb function, physiology and tissue engineering, cosmetic enhancement and performanceenhancement.13 In the scope of the current thesis fall only the technologies that benefithuman body in enhancement of mobility and limb function as part of the physicalenhancement technologies. They are intended to mimic the full functionality of naturalhuman limbs and muscles providing at least the same level of control, energy efficiency, andusability as the natural counterparts.

2.3 Definition of artificial organs

By definition, an organ is a specialized structure (e.g. kidney, heart, and limb) in an animal ora human made up of various cells and tissues that can perform some specialized function.Most parts of human body that perform specialized functions in fact can be classified asorgans. When these become defective and fail to perform properly, they might be replacedby an artificial organ or a prosthetic device. These devices are usually constructed of naturalor synthetic polymeric materials. In order to be employed and integrated into the humanbody they must exhibit good compatibility with blood and body tissues with they come intocontact. Additionally, the artificial device must closely duplicate the function of the natural

12 Academy of Medical Sciences, the British Academy, the Royal Academy of Engineering and the Royal Society, Human Enhancement andthe Future of Work, 2012, Available at https://www.acmedsci.ac.uk/viewFile/publicationDownloads/135228646747.pdf, p.1313 Ibid, p.23


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organ. In practice, these artificial devices are made of metals, ceramics, carbon, naturaltissues and synthetic polymers.14

Turning to the essence of artificial organs, a definition of the term “artificial organ” shouldbe introduced as well. So, a simple and clear definition of artificial organ is „a replacementfor natural organ in the body".15 The artificial organ is defined more thoroughly as a “man-made device that is implanted or integrated into a human — interfacing with living tissue —to replace a natural organ”16. A medical dictionary describes the term artificial organ as “anytissue, organ, limb, or highly complex biological structure that is partially or completelysynthetic in nature, and performs the tasks of the structure it is intended to replace”.17

Additional comprehensive artificial organ explanation is the following: “a human madedevice designed to replace, duplicate or augment, functionally or cosmetically a missing,diseased or otherwise incompetent part of the body, either temporarily or permanently andwhich requires a non-biologic material interface with the living tissue”.18 In other words, afew characteristics in the quoted definitions are in common including a man-madeconstruction identical to an exact natural human body organ, integration of the device intothe human body, interfacing with living tissue and performing tasks to replace the missing orfailing natural organ. In fact, the characteristics in common are the criteria to classify adevice as an artificial organ.

Conventionally, the artificial organs are divided in four groups: Bone/Joint replacements (e.g.hip, finger, knee), Skin/Soft Tissue Replacements (e.g. muscle, skin), Internal organs (e.g.heart, kidney, liver) and Sensory organs (e.g. eye, ear).19 Some artificial organs are designedto duplicate the function of natural ones (artificial knee, hip, heart) and other augmentingspecific functions (artificial pacemaker). Despite that usually the replaced function is relatedto life support, this is not always required. Other reasons of construction and implantation ofartificial organs include improving the patient’s mobility, ability to interact with the othersocial members and the quality of life. With regard to the provided division of artificialorgans some sound examples of artificial organ devices are the artificial hip, the varioustypes of prosthesis, the artificial kidney, the artificial heart, pacemakers, the cochlearimplants and bionic eyes. The listed devices fall into different categories of artificial organsbut they all fulfill in common the main characteristics of the artificial organ definitionsabove.

14 Gebelein, C.G. (1984). "Chapter 1: The Basics of Artificial Organs". In Gebelein, C.G. Polymeric Materials and Artificial Organs (PDF).Washington, DC: American Chemical Society. pp. 1.15 Ibid. pp. 2..16Catapano, G.; Verkerke, G.J. (2012). "Chapter 2: Artificial Organs". In Abu-Faraj, Z.O. Handbook of Research on Biomedical EngineeringEducation and Advanced Bioengineering Learning: Interdisciplinary Concepts - Volume 1. Hershey, PA: Medical Information ScienceReference. pp. 63.17 "Artificial Organ." Segen's Medical Dictionary. 2011. Farlex, Inc. 14 Jan. 2017 <http://medical-dictionary.thefreedictionary.com/Artificial+Organ>18 The Dawn of Biotechnology in Artificial Organs, GALLETTI, PIERRE M.; AEBISCHER, PATRICK; LYSAGHT, MICHAEL J.,http://journals.lww.com/asaiojournal/Citation/1995/01000/The_Dawn_of_Biotechnology_in_Artificial_Organs_.9.aspx19 Gebelein, C.G. (1984). "Chapter 1: The Basics of Artificial Organs". In Gebelein, C.G. Polymeric Materials and Artificial Organs (PDF).Washington, DC: American Chemical Society. pp. 1.


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Taken all together, the listed characteristics place artificial organs at the domain of humanenhancement technologies under the category of physical enhancement. The initial purposeof artificial organs is to restore to some extent impaired human performance and enhance it.The other aspect of the designation of human enhancement technologies, namely theextension and improvement of natural human body capabilities and capacity beyond thenorm, is also covered by the variety of the modern artificial organs such as artificial limbsand muscles. What is more, these devices do interact with human anatomy and that is howthey augment human body to a degree depending on the artificial limb implanted.

2.4 Definition of artificial limbs

Artificial limbs are artificially made devices that substitute or replace a natural limb of aperson. These mechanical devices are intended to restore a degree of normal function ofpeople missing a body part by replacing the natural limb. Devices that qualify for artificiallimbs are the limb prostheses. One medicine dictionary describes prosthesis as “an artificialsubstitute for a missing part, such as an eye, limb, or tooth, used for functional or cosmeticreasons, or both”20 The same medicine dictionary refers to artificial limb as “a replacementfor a missing limb” which is quite broad in sense. Limb prostheses are principally dividedbased on the part of the human body that is replaced into the following groups: below theknee (transtibial), above the knee (transfemoral), below the elbow (transradial) and abovethe elbow (transhumeral). Moreover, limb prostheses could be distinguished based on morecharacteristics including the construction material, design technology, functions anddesignation. The history of employment of prostheses proves that limb prostheses wereinitially used to restore the normal functionality of impaired human body limbs. It is not asecret that prostheses have been used since the Ancient times and there are manyprototypes found from that period of time.21 Still the prostheses are being employedprimarily to replace missing limbs lost through trauma, disease, or congenital conditions.However, due to the rapid development in the last decades, scientists come up with modelsof prostheses that actually exceed and outmatch the capabilities of natural limbs. In fact, theactual models of artificial limbs greatly vary and differ in construction materials, functions,capabilities and design. For example, the J-shaped, high-performance carbon compositeprostheses that Oscar Pistorius was equipped with, indeed, secured him “25% less energythan able-bodied runners to run at the same speed” and ”less vertical motion combined with30% less mechanical work for lifting the body” which was ruled as advantage over able-

20 Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. (2003). Retrieved January 14 2017from http://medical-dictionary.thefreedictionary.com/prosthesis21 Catapano, G.; Verkerke, G.J. (2012). "Chapter 2: Artificial Organs". In Abu-Faraj, Z.O. Handbook of Research on Biomedical EngineeringEducation and Advanced Bioengineering Learning: Interdisciplinary Concepts - Volume 1. Hershey, PA: Medical Information ScienceReference. pp. 68.


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bodied opponents by the International Association of Athletics Federations.22 This singleremarkable instance illustrates the ability of modern prostheses not only to restore orduplicate the function of a missing or failing natural limb but also to add superiority to thenatural body capacity of the device possessor.

However, not only prostheses are in the scope of artificial limbs technologies. The micro-processor limbs, known as "bionic legs", are also spotlighted by scientists and militaryexperts as a technology with proven benefits that military amputees could employ. Thesecutting-edge devices literally transform the lives of the technology possessors and offerthem “greater stability and mobility.”23 What is more, advanced models of bionic limbs arenot only designated to serve the military veterans. Many amputees around the world arereported to enjoy the advantages of such progressive devices and some even control themby mind.24

Under these circumstances, modern artificial limbs not only fall into the field of artificialorgans but they do qualify for human enhancement technologies. Compared to thedefinitions of human enhancement technologies mentioned above, the designation ofartificial limbs nowadays not only serves the amputees and patients but also could providesuperior specifications compared to natural human limbs in good condition.

2.5 Definition of artificial muscles

The human body naturally consists of numerous soft tissues such as muscles, connectivetissues and fatty tissues.25 Natural muscles provide the precise control of movement of partsof the human body. When it comes to soft tissue replacement devices, the artificial muscle isone significant piece of technology. In that light, artificial muscles attempt to emulate thecharacteristics of natural muscles and the motion of a particular human organ. Onedefinition of artificial muscle is “a generic term used for materials or devices that canreversibly contract, expand, or rotate within one component due to an external stimulus(such as voltage, current, pressure or temperature).”26 Additional try to define the artificialmuscle results in “any material, or device, whose shape can change in response to astimulus” which allows a broad range of devices to be labeled as artificial muscles.27 Similarlyto the natural muscle, any artificial muscle is characterized by “its ability to contract in

22 "'Blade Runner' Handed Olympic Ban", BBC SPORT, 2008 <http://news.bbc.co.uk/sport2/hi/olympics/athletics/7141302.stm> [accessed16 January 2017]23 "'Bionic Legs' For Military Amputees", BBC News, 2013 <http://www.bbc.com/news/uk-politics-21497473>24 "Brain-Controlled Bionic Legs Are Finally Here", Popular Science, 2015 <http://www.popsci.com/brain-controlled-bionic-legs-are-here-no-really>25 Gebelein, C.G. (1984). "Chapter 1: The Basics of Artificial Organs". In Gebelein, C.G. Polymeric Materials and Artificial Organs (PDF).Washington, DC: American Chemical Society. pp. 4.26 Mirvakili, Seyed M. (2013). Niobium Nanowire Yarns and Their Application as Artificial Muscle (M.A.Sc). University of British Columbia.27 Tondu B., What Is an Artificial Muscle? A Systemic Approach.. Actuators. 2015; 4(4):336-352.


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response to a chemical or physical stimulus” which describes any artificial muscle as “a kindof actuator generally defined by analogy with the skeletal muscle”.28Although thesereferences are quite technical, the artificial muscle technologies could actually fit into thescope of the artificial organs definitions. When the artificial muscle mechanism is integratedinto the human body and substitutes the functions of natural muscles it should be countedas an artificial organ. This conclusion is reinforced by inclusion of artificial muscles in thedivision of artificial organs introduced by Charles G. Gebelein.29 Research on artificialmuscles capable of mimicking human muscle response is advancing at a phenomenal paceand the new inventions would be probably utilized to interfere with medical devices thatneed to be implanted or attached to human body such as artificial-muscle-powered-prostheses, artificial diaphragm to help people breathe or just to replace or augment anymuscle in the body that is failing. A recent breakthrough in the research and development ofartificial muscles was introduced as “inexpensive high-strength polymer fibers used forfishing line and sewing thread can be easily transformed by twist insertion to provide fast,scalable, nonhysteretic, long-life tensile and torsional muscles”.30 These artificial musclesfrom fishing line and sewing thread have the abilities to “lift loads over 100 times heavierthan can human muscle of the same length and weight, and generate 5.3 kilowatts ofmechanical work per kilogram of muscle weight, similar to that produced by a jet engine”.31

By the integration of such ground-breaking artificial muscles into the human body, patientswith malfunctioning natural muscles would benefit and the proper functionality of theirbody would be restored to some extent. On top of that, integration of artificial muscle withthe cited specifications additionally enhances the body capacity and capabilities of healthypossessors of the technology as well. So, artificial muscles would account for humanenhancement technologies in certain cases. Namely, when they are integrated into humanbody and at the same time restore impaired human performance and/or extend it beyondthe natural limits of human body. With the progress of biotechnology scientists mightmanage to invent more advanced artificial limbs that not only attempt to emulate thecapabilities of natural muscles but also to provide their possessors superior musclecapabilities compared to non-augmented humans.

28 Ibid29 Gebelein, C.G. (1984). "Chapter 1: The Basics of Artificial Organs". In Gebelein, C.G. Polymeric Materials and Artificial Organs (PDF).Washington, DC: American Chemical Society. pp. 2.30 C. S. Haines and others, "Artificial Muscles from Fishing Line and Sewing Thread", American Association for the Advancement of Science,343 (2014), 868-872 <http://dx.doi.org/10.1126/science.1246906>.31 Ibid


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Chapter 3: Possible coercive enhancement of peopleby artificial limbs and muscles

3.1 Introduction

In the previous chapter this thesis introduced human enhancement and humanenhancement technologies through definitions and outlining the wide range of aspects theseindeed cover. In that context, artificial organs were spotlighted and explained briefly as asignificant part of the human enhancement technologies these days. Furthermore, in thefield of artificial organs artificial limbs and muscles were presented and described in shortaiming to establish a basic understanding regarding nature and applications of bothtechnologies. So, the preceding determines further elaboration in this chapter on theforeseen consequences a rapid development these technologies might bring to human life.

In this chapter one scenario related to proliferation of artificial organs and especiallyartificial limbs and muscle technologies would be exposed. The research and development inthe field of human enhancement suggests that in the near future an increasing number ofdevices that enhance people might be available on the market. Statistics and arguments inthis favour will be provided in the next paragraphs in order to reinforce a possibility of anexpected establishment of a state of abundance of artificial limbs and muscle technologies.Next, having such possible state of availability of devices on the market and the superiorbenefits they might provide to the possessors in future will have inevitable consequences forhumankind and the agenda of lawmakers. The thesis will make an attempt to outline theforeseeable consequences that are predictable at the moment based on the current level ofscientific knowledge and statistics. Human enhancement technologies are true disruptivephenomenon in the fields of medicine, ethics, law and technology. In that context, it isnatural that there will be both positive and negative effects of them. In light of that, socialcoercion is one feasible undesirable consequence that already bothers scientists andpolicymakers. This chapter will examine how relative and substantiated in fact this concern isand then some examples of expected coercive enhancement across society will be given. Thereason to focus on the coercion related to the distribution and accommodation of humanenhancement technologies as one crucial consequence will be also clarified and furnishedwith arguments later on. Finally, the chapter will narrow the scope of coercive enhancementthat might arise to the single aspect of people who are ordered by a superior authority to beenhanced. Doing so, the chapter will showcase and describe the foreseeable problemconnected with human enhancement technologies and coercion with the aim to furthercrystallize the legal implications of this feasible effects proliferation of artificial organs andespecially artificial limbs and muscles technologies.


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3.2 Establishing a state of abundance of artificial limbs and muscletechnologies

Any expectations for expanding the availability and accessibility of artificial limbs and muscletechnologies in future should be first considered in the perspective of expected rise ofdistribution and application of human enhancement technologies. In the current thesis theterm “abundance” should be apprehended as a diversity of devices available on the marketproviding variety of benefits to a broader scope of potential possessors. This thesis does notintend to predict when exactly a state of abundance might be established in the future. Itattempts to substantiate a possibility of such course of events some when in future and tospotlight the factors and indicators for such scenario. In that manner, the current thesispinpoints several examples of advanced devices in terms of artificial limbs and musclesoutlining their designation and advantages. Second, the thesis brings on the table numerousreports by variety of national authorities and adds these to business forecasts. Third,investigating the drives for possible trend of establishing an abundance of models also aimsto reinforce an expectation for establishing a state of abundance of artificial limbs andmuscle technologies. That is why, before all else the thesis will examine whether a moreconsiderable role of human enhancement technologies in human life is foreseeable.

The progress of converging technologies and human enhancement technologies is not amere speculation but an ongoing process that has been admitted by politicians, scientistsand researchers. The Technology Assessment on Converging Technologies Report, publishedby Policy Department Economic and Scientific Policy and commissioned by the EuropeanParliament, confirms converging technologies as the new challenge at the moment andexpresses belief that could contribute to tremendous changes in the way humans think andeven beating death.32 Additionally, the report elaborates on the expected exponentialprogress of cognitive technologies due to the computer capacity development. As drivingforces for an immense advancement are pointed out the defense and military needs toproduce smarter and stronger soldiers, the medical field concerning age slowing, curtailmentof death and life extension along with the aspirations of biotechnology enthusiasts andhackers.33 Later on, the report states that NBIC convergence is “already taking place in thelaboratories and research departments of contributing convergent disciplines” and policymakers have spotted the NBIC convergence trend.34 Next, the so-called American report onNBIC converging technologies, issued by the National Science Foundation (NSF) andDepartment of Commerce in 2002, concludes that “the new developments will berevolutionary and must be governed by respect for human welfare and dignity”.35 Although

32 European Technology Assessment Group, “Technology Assessment on Converging Technologies Report”, 2006,<http://www.europarl.europa.eu/thinktank/en/document.html?reference=IPOL-JOIN_ET(2006)375882> page i33 Ibid, page i-ii34 Ibid page iv35 Mihail C. Roco and William Sims Bainbridge , “Converging Technologies for Improving Human Performance NANOTECHNOLOGY,BIOTECHNOLOGY, INFORMATION TECHNOLOGY AND COGNITIVE SCIENCE”, 2003, Springer


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a bit outdated and not necessarily reflecting the views of the United States Government andEuropean Parliament, these comprehensive reports demonstrate that plot of rapiddevelopment and progress of converging technologies and human enhancementtechnologies is feasible and based on the current progress of information technologies,nanotechnology and medicine. On top of that, the fact that in 2003 the Health Council of theNetherlands also issued a report on Human enhancement, where it is confirmed that “duringthe next decade, new substances and methods for engineering healthy people will probablyemerge in a rapid tempo. They vary from cosmetic gene therapy and a new generation ofanxiety inhibitors and mood modulators, to psychotropic medication that boosts cognitiveabilities (concentration, memory) and a drug that would allow women to optimise theirsexual functioning. Billions are being invested in development” also reinforces theanticipated trend of proliferation of human enhancement technologies in the future.36

Indeed, more than a decade later the cited predictions seem not to have happened on suchmassive scale but in terms of methods for construction cheaper prostheses and artificialmuscles significant progress has been witnessed. This indicates for a greater probability ofthe outlined in the report course of events sooner to occur. The Human Enhancement andthe Future of Work Joint Report by the by the Academy of Medical Sciences, the BritishAcademy, the Royal Academy of Engineering and the Royal Society explores the implicationsof human enhancement technologies for the future of work which is obviously recognized asa pressing topic due to the admitted “widespread use of enhancements” and theanticipations that “demographic shifts will be accompanied by changes to the nature ofwork, and both of these transitions will influence the context in which enhancements mightbe used”.37 All mentioned reports reiterate that the widespread of human enhancementtechnologies has been happening for over a decade and indeed second that such trend ispredicted to last for a long time and grow in a considerable fashion. Although these reportsare not evidence certain probability that in future human enhancement technologies willtake over human life for sure they do indicate that the possibility should be consideredseriously.

One determinant for a possible proliferation of human enhancement technologies in futureis the proactive process of research and development happening across fields ofbiotechnology, engineering and computing in the last decades. As the population worldwideages and given the advancement in the other medical technologies over the past fewdecades, patients will come to expect the same improvements in the human enhancementfield as well. With regard to that, devices such as cochlear implants, artificial hip,pacemakers, artificial kidney, and bionic eyes have been serving millions of patients in thelast years so scientists and researchers are attempting to upgrade these technologiesconstantly. Scientists come up with improvements of existing well-known human

36 Health Council of the Netherlands. Human enhancement (Ethics and Health Monitoring Report 2003 no. 4). The Hague: Health Council ofthe Netherlands, page 537 Academy of Medical Sciences, the British Academy, the Royal Academy of Engineering and the Royal Society, Human Enhancement andthe Future of Work,2012, Available at https://www.acmedsci.ac.uk/viewFile/publicationDownloads/135228646747.pdf,, page 9


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enhancement technologies such as cosmetic enhancement, reproductive technologies andpharmaceutical means. At the same time, new breakthrough devices and technologies thatrevolutionize the performance of natural human body are invented. In that scope fallgroundbreaking achievements regarding the domains of physical performance enhancingdrugs, smart drugs, organ replacements, bionic limbs and implants, reproductivetechnologies, germline modification, sensory implants, deep brain simulation, nutrition,cosmetic enhancement, etc.

Another substantial factor for an expectation of a state of abundance of humanenhancement technologies is the military research and development in that field. As far asmilitary human enhancement projects are concerned, it ought to be highlighted theimmanent commitment of researchers to construct cutting-edge military technologies andtheir efforts to augment natural human capabilities. In his article “Emerging MilitaryTechnologies: Balancing Medical Ethics and National Security”, Efthimios Parasidis describesthe twenty-first century as “the age of the biomedical military”.38 His conclusion is based ona statement of the U.S. Department of Defense (DoD) that “one of its primary goals is toexploit the life sciences to create soldiers with superior physical, physiological, and cognitiveabilities”.39 The article references to projects that include: “(1) developing drugs that canreduce fear, increase aggressiveness, or keep individuals awake and alert for up to sevendays straight; (2) genetically engineering the human immune system so that it is able torecognize and adapt to any pathogen; (3) creating implantable electrodes that permithuman-to-human and human-to-computer communication via thought alone; and (4)establishing human-to-computer interfaces that are able to detect a person’s neurologicalstate and release neurochemicals that can combat fatigue, enhance mood, suppress orimprove memory, or facilitate learning’’.40 So far, there are numerous HET being developedto advance the performance of soldiers and enhance their battle abilities. For example, theexoskeleton suits, artificial blood, artificial muscles and joints being developed and tested atthe moment are anticipated to be put into practice soon.41 42 The US Defense AdvancedResearch Projects Agency (DARPA) is devoted to support the US army with breakthroughtechnologies for national security. Some among the human enhancement technologiesdeveloped by DARPA could be evaluated not only as tries to design a futuristic super-soldier.Instead, the mentioned military projects and inventions might revolutionize the ordinaryhuman being. It should be no surprise if in the future most of the human enhancementtechnologies prototypes designed for military purposes actually become available on themarket. For example, the exoskeleton suit could be used by both disabled veterans and

38 Efthimios Parasidis, Emerging Military Technologies: Balancing Medical Ethics and National Security, 47 Case W. Res. J. Int'l L. 167 (2015)Available at: http://scholarlycommons.law.case.edu/jil/vol47/iss1/13, p.16839 Ibid40 Ibid41 "DARPA Tests Battery-Powered Exoskeletons On Real Soldiers", IEEE Spectrum, 2015 <http://spectrum.ieee.org/video/robotics/military-robots/darpa-tests-batterypowered-exoskeletons-on-real-soldiers>42 "First Batch Of DARPA's Synthetic Blood Delivered To FDA, Could Be On Battlefields Soon", Popular Science, 2010<http://www.popsci.com/technology/article/2010-07/darpas-synthetic-blood-flows-lab-fda-could-be-battlefields-soon>


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soldiers on duty. Today exoskeleton technology is developed to help soldiers to carry heavyloads in the battlefield with less effort. To summarize, the conscious intention to bringmilitary forces on a higher level through means of human enhancement technologies mightinduce more active research and development in that field resulting in high-techtechnologies that could benefit soldiers as well as civilians eventually.

The latest achievements at the human enhancement technologies domain inspireenthusiasts to augment themselves and experiment with their bodies. So, the third drive forsubstantiation of a possibility of establishment of a state of abundance of humanenhancement technologies should be the aspirations and overwhelming enthusiasm of agrowing number of people to augment their healthy bodies as well as stakeholders toenhance their employees’ work performance. Many supporters of Transhumanism arewilling to augment their bodies and enhance their natural capabilities.43 The same applies tobiohackers who are devoted into cutting-edge technology and eager to experiment withtheir own body. Especially scientists and wealthy enthusiasts are trying to facilitate differentprototypes of futuristic artificial organs in their bodies.44 45 What is more, global companiesare also looking into the development of human enhancement technologies and theiradvantages. Not only individuals or groupings of enthusiasts sharing technical passion areattached to the idea of accommodating human enhancement technologies but also majorcorporations are implementing them into the work process. The exoskeleton technologythat was mentioned regarding its military application turns out to be lucrative formultinational corporations as well. This technology is primarily designed for patients withmobility disorders to allow them to walk.46 Some companies such as Panasonic and Hyundaiyet plan to employ exoskeleton technology on a regular basis to serve their factoryworkers.47 48 Among the most useful specifications of the device is the ability to detect theperfect moment automatically when worker is about to lift something heavy and reduce thestress. Besides, Panasonic introduced the Ninja exoskeleton suit prototype that mimics thenatural human movement and assists the possessor while walking or running.49

The particular example of exoskeleton technology is quite remarkable because outlines howa single human enhancement technology could be accommodated by various types of usersand benefit them – patients, soldiers and healthy people.

43 "Transhumanist Values", NICK BOSTROM <http://www.nickbostrom.com/ethics/values.html>44 Frank Swain, "The People With ‘Animal Powers’", Bbc.com, 2014 <http://www.bbc.com/future/story/20140407-the-people-with-animal-powers> [accessed 22 May 2016].45 "Can We Biologically Extend The Range Of Human Vision Into The Near Infrared?", Experiment - Moving Science Forward, 2014<https://experiment.com/projects/can-we-biologically-extend-the-range-of-human-vision-into-the-near-infrared> [accessed 22 May 2016].46 "Exoskeletons: My Friend With A Robot Skeleton", BBC Future, 2014 <http://www.bbc.com/future/story/20140912-my-friend-and-his-robot-legs>47 Danielle Muoio, "Hyundai Created Its Own 'Iron Man' Exoskeleton Suit", Tech Insider, 2016 <http://www.techinsider.io/hyundai-creates-iron-man-exoskeleton-photos-2016-5>48 Danielle Muoio, "These Robotic Suits Will Give Workers Superhuman Strength", Tech Insider, 2016<http://www.techinsider.io/panasonic-robotic-suits-provides-extra-strength-2016-3>49 Ibid


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In brief, the dynamic progress in the field of human enhancement technologies that istriggered by the calling problems and challenges of medicine, the ongoing government-sponsored programs and projects aimed to raise superior human soldiers and the aspirationsof biotechnology enthusiasts and companies to accommodate wide range of humanenhancement technologies for personal purposes frame a sheer grounds for a prediction fora proliferation of human enhancement technologies in future. Each of the describeddirections of the human enhancement technologies research and development servesdifferent objectives. Nevertheless, all these in total substantiate a possibility that a state ofgreat amount and supply of human enhancement technologies is plausible to be expectedsooner or later. In that context, falling into the scope of human enhancement technologiesartificial limbs and muscle devices should be also investigated whether an increase of theiravailability and accessibility could be expected.

With regard to all abovementioned, it is true that any trends in terms of humanenhancement technologies are not a solid argument that the same would apply forsubstantiation of a possible scenario of growth of artificial limbs and muscles on the market.An analogy regarding the lack of relation between an increasing number of cars sold and theamount of electric vehicles that will be sold in future is to some extent valid. However,investigating the development of cars and the advance of their specifications as well as theevolution of consumers’ needs and desires could prove one possible scenario of risingproduction of electric vehicles in future. The same applies to self-driving vehicles that justtwenty years ago were seen only on the science-fiction movies and were not discussedamong scholars or legislators. In that context, the next paragraphs elaborate on recognizingthe determinants and indicating factors for outlining a probability of establishing a state ofabundance of artificial limbs and muscle technologies in future.

When it comes to artificial limbs, the possibility of abundant technologies gives theimpression of plausible one not that far in the future. Although at the moment the cost ofquality models of prostheses is usually unaffordable for many patients around the world, atrend of new technologies and materials contributing greatly to tremendous cost-reductionof the prostheses devices has been happening in recent years. Today, the ubiquity of 3Dprinters and innovations in prosthetic design, manufacturing and distribution, offer apracticable solution for the large number of people living with limb loss globally. Thistechnology is being improved at a phenomenal rate and nowadays an increasing number ofpatients could benefit from variety of 3D-printed prostheses.50 During the last five yearsmany successful stories of disabled patients, worldwide equipped with inexpensive 3Dprinted prostheses, were introduced to the public.51 Open-source initiatives allow everyoneto customize a 3D model of a prosthetic hand and then to print it on own 3D printer.52

50 Ventola, C. Lee. “Medical Applications for 3D Printing: Current and Projected Uses.” Pharmacy and Therapeutics 39.10 (2014): 704–711.Print. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189697/>51 "3D Printed Prosthetics", Enabling The Future <http://enablingthefuture.org/tag/3d-printed-prosthetics/>52 Enable Community Foundation, 2017 <http://www.enablecommunityfoundation.org/>


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Other complementing technologies such as 3D scanning and body modeling technologiesenable 3D scan their own limbs and have prosthetics modeled after them eventually.53 Therising compatibility of 3D printers with new materials like lightweight titanium would providemore durable and strong 3D printed prostheses. Despite its flourishing popularity andendorsement among patients, scientists and business, 3D printing is not the only technologythat might significantly add to abundance of artificial limbs devices in future. Theimplementation of special biomaterials such as pre-impregnated carbon fibers, polyurethaneand PE foams attempt to answer the demanding of prostheses providing patients withcomfort, biocompatibility, high performance and versatility.The military research and development of artificial limbs for the needs of disabled veteransand soldiers on active duty reinforce the trend of improvement of the artificial limbstechnologies. With regard to DARPA priority to maintain and enhance greatly the abilities ofthe warfighters, it has already developed, to a certain point, advanced prostheses (featuringmind-controlled limbs).54 Some quadriplegic volunteers had their brain surface implantedwith small array “to pick up these neural signals for motor control, and then to use those tocontrol these new, very sophisticated, robotic, prosthetic arms”.55 DARPA introduced a newprosthetic technology that provides the patient with an almost natural sense of touch. Infact, a young man who has been paralyzed for more than a decade has become able to “feelphysical sensations through a prosthetic hand directly connected to his brain, and evenidentify which mechanical finger is being gently touched”.56 Seems that there is an ampleroom for improvement, supported by the proven benefits of the technology and increasingdemand by patients, might guarantee constant progress and bright future for thesemechanical devices.

It is no secret that production of artificial limbs is a multimillion-dollar industry that cares forits clients and aims to expand its range of customers. In that context, market analysistsaround the world issue global projections for the artificial limbs and joints market. Accordingto the “Artificial Limbs and Joints Market Size, Application Analysis, Regional Outlook,Competitive Strategies and Forecasts, 2014 to 2020” report “increasing geriatric populationand growing obese population are amongst key factors attributing to the growth of theartificial joints market”.57 The conclusion of this report is that “on the basis of technology themarket is segmented into digital and manual limbs. Digital limbs are expected to grow at alucrative rate over the forecast period owing to advantages associated with it”.58 Anothercomprehensive market report, entitled “Orthopedic Prosthetics Market - Global Industry

53 Body Labs, 2017 <https://www.bodylabs.com/>54 "DARPA's New Biotech Division Wants to Create a Transhuman Future", 2045 Initiative Official Website, 2014<http://2045.com/news/32738.html> [accessed 22 May 2016].55 Ibid56 "Neurotechnology Provides Near-Natural Sense of Touch", DARPA Official Website, 2015 <http://www.darpa.mil/news-events/2015-09-11> [accessed 22 May 2016].57 "Artificial Limbs And Joints Market Size, Application Analysis, Regional Outlook, Competitive Strategies And Forecasts, 2014 To 2020",Grand View Research <http://www.grandviewresearch.com/industry-analysis/artificial-limbs-and-joints-market> [accessed 29 January2017].58 ibid


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Analysis, Size, Share, Growth, Trends and Forecast 2015 - 2023”, informs that “the increasingnumber of old age population and growing trauma cases all over the world are creating thehigh rise in demand for orthopedic prosthetic products” meaning that “these factsrepresents the massive demand for the orthopedic prosthetic products globally and theincreasing trend of the requirement in coming future. The technological advancements inorthopedic prostheses in terms of better fixation, wear-resistant material and cement lessdesign along with this suitable reimbursement circumstances and increasing number oftrained healthcare professionals are driving the growth of the market”.59 Next market reportpoints at market growth drives being the “aging global population, rising diagnoses ofdegenerative joint diseases and a patients’ willingness to pursue a more active lifestyle”.60

Why the mentioned market reports substantiate a possibility of establishing a state ofabundance of artificial limbs could be answered as follows: reports in question mark somedistinct market drives that are believed to push the research and development of advancedartificial limbs devices forward and the predicted demand for different types of artificiallimbs might result in variety of models.

Turning to the field of artificial muscle technologies, predictions for the artificial limbsmarket still apply to some extent. In fact, cutting-edge artificial limbs require advancedartificial muscle technologies. In other words, the dynamic investigation into new designs ofartificial limbs might provoke proactive development of artificial muscles as well. Next drivefor improvement of artificial muscle technologies is the field of robotics where the primaryapplications include humanoids and powered exoskeletons. One crucial part of human bodyis muscles that let people move and walk. Despite intensive research and development ofartificial muscles for the purposes of robotics these might still not be advanced as biologicalmuscles but eventually a breakthrough in this field will benefit the replacement of biologicalhuman muscles with enhanced artificial ones.61 The artificial muscles, for either robotics orhuman medical applications, need to be flexible and strong enough to replicate their naturalcounterparts. Such breakthrough invention was already introduced as “inexpensive high-strength polymer fibers used for fishing line and sewing thread can be easily transformed bytwist insertion to provide fast, scalable, nonhysteretic, long-life tensile and torsionalmuscles”.62 Strong and flexible artificial muscles, constructed of light-weight and affordablematerials that are suitable to be implanted into human body, are a goal of scientists andresearchers around the world.63 Once inexpensive materials are adopted and used on a large

59 "Orthopedic Prosthetics Market - Global Industry Analysis, Size, Share, Growth, Trends And Forecast 2015 - 2023", Transparency MarketResearch <http://www.transparencymarketresearch.com/orthopedic-prosthetics-market.html> [accessed 29 January 2017].60 "New Report Offers Global Projections For Orthopedic Prosthetic And Orthotic Markets", Healio Orthotics/Prosthetics, 2011<http://www.healio.com/orthotics-prosthetics/industry-news/news/print/o-and-p-news/%7Bc2d04446-465a-4c7d-944b-21fd57603547%7D/new-report-offers-global-projections-for-orthopedic-prosthetic-and-orthotic-markets> [accessed 29 January 2017].61 "The Freaky Artificial Muscles On This Human Skeleton Are The Future Of Robotics", GIZMODO, 2016 <http://gizmodo.com/the-freaky-artificial-muscles-on-this-human-skeleton-ar-1783445499> [accessed 29 January 2017].62 C. S. Haines and others, "Artificial Muscles from Fishing Line and Sewing Thread", American Association for the Advancement of Science,343 (2014), 868-872 <http://dx.doi.org/10.1126/science.1246906>.63 Leah Burrows, “Artificial muscle for soft robotics: low voltage, high hopes”, Harvard, 2016<https://www.seas.harvard.edu/news/2016/07/artificial-muscle-for-soft-robotics-low-voltage-high-hopes >


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scale for the construction of artificial muscles the possibility of increased amount of modelsmight not seem unimaginable.

3.3 Consequences of abundant availability of artificial limbs and muscles

Based on the introduced statistics, facts and market conditions one forecast is that a state ofabundance of artificial limbs and muscle technologies is plausible and the market of suchdevices might expand greatly sooner or later. Under these circumstances, diverseconsequences might be expected as aftermath of the increased accessibility and diversity ofmodels. As human enhancement relates to enhancement of individuals and theirperformance in society, the phenomenon of abundant artificial limb and muscletechnologies should be examined in the perspective of society as well. In that context, theeffects of the consequences of abundant availability of artificial limbs and muscles might beon two main levels: towards individuals and towards society. Next evaluation of the effectswould be based on whether the technologies in question provide benefits or risks. Likealmost every piece of technology these days there are not merely positive or negativeeffects upon adoption. So, existence of a great amount of artificial limbs and muscletechnologies would probably result in contrasting effects.

When it comes to the consequences of a possible proliferation of artificial limbs and muscletechnologies, the list of positives hints at a few. The first and foremost expectation is thecost of artificial limbs and muscles to decrease due to the greater supply of suchtechnologies. The indirect consequence of that availability would be the increasing numberof customers that would be able to obtain a device in the scope of artificial limbs andmuscles. Based on such accessibility the positives for individuals would vary significantly.Both aspects of utilization of artificial limbs and muscles, namely for restoration of bodilyfunctions and enhancement of capabilities of healthy people, are tightly connected with theprimary designation of artificial limbs and muscle technologies. Soldiers will employ artificiallimbs and muscles that improve their performance during warfare, professions that requireimmense bodily strength and endurance will be supplemented by the extraordinarycapabilities artificial limbs and muscle technologies, sportsmen will be augmented toenhance their sports records and probably establish tournaments for augmented only. Theremight be collateral positive consequences in other fields such as robotics, space travelling byastronauts, etc. Additionally, unexpected benefits might be witnessed as well. The secondconsequence that might result from a proliferation of artificial limbs and muscletechnologies is the supply of a wide range advanced models on the market. In such a casethe main benefits for individuals will be related to the opportunity to obtain cutting-edgehuman enhancement technology on a competitive price that satisfies their specific needsand preferences. In other words, the segmentation of the market that might occur willbenefit the customers with specific requirements and preferences. Under these


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circumstances, a broader employment of artificial limbs and muscle technologies might beprojected. To conclude, the two main consequences that are foreseen based on establishinga state of abundance of artificial limbs and muscle devices might deliver considerableadvantages to a broader scope of technology adopters. Correspondingly, an expandingdegree of individual enhancement will influence society and trigger social implications.

As far as social benefits are concerned, any projected growing trend of enhancement byindividuals with artificial limbs and muscles might carry out some social implications.Improved individual performance of workers might increase the productivity of communitiesand even further promote the GDP of countries. By augmenting their bodies healthyindividuals might contribute to greater public achievements in the terms of economics,sports, demography, science, space travelling because they will accommodate extraordinarybody capacity and capabilities.

The damaging social effects in the fields of ethics, morality and fairness that are usuallypredicted related to human enhancement to some extent also apply in the particular termsof artificial limbs and muscles. Reducing costs and greater supply of various models mighttrigger problems with respect to inequality, undesirable cultural change, undesiredsubstitution of the human spirit, dramatic change in the conduct of war and socialcoercion.64 All mentioned could be examined on both individual and social levels as theseexpected issues comprise undesirable effects of the direct consequences in case of abundantmarket of artificial limbs and muscle technologies.

In the context of human enhancement technologies undesirable cultural change is anotherexpected negative effect worth to be elaborated on. Elements of undesirable cultural changecould comprise normalisation, medicalisation and alteration of our perception ofhumanity.65

Enhancement with artificial limbs and muscles at some point in future might have an effectof standardization. That would be the case if augmentation is found on the need to complywith a specific dominant norm meaning reinforcement of the validity of that norm. Thesocial pluriformity could be at stake if the normalisation norm is defined by the dominanceof enhancement and the opponents of self-augmentation are put under social pressure dueto refusing to keep up with the new social norm. In this case the normalisation in questionwould express another form of stereotypes and prejudices with the possibility to result inextreme forms such as discrimination and eventually apartheid.66 In the broad scope ofexisting human enhancement technologies a striking example is the evolving understandingof beauty based on the progress of cosmetic enhancement through plastic surgeries,pharmaceutical means and other interventions. In the last years, the social norms in the

64 Health Council of the Netherlands. Human enhancement (Ethics and Health Monitoring Report 2003 no. 4). The Hague: Health Council ofthe Netherlands, page 1365 Ibid, p.1466 Ibid, p.14-15


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terms of beauty and aesthetic appearance have changed significantly due to theproliferation of cosmetic enhancements and the development in this field resulting inabundance of affordable technologies such as Botox, etc. In such a context, the reportedtrend of electing limb prostheses as means of self-expression for patients with upper-limbloss is an identical mirror trend.67 However, with regard to artificial limbs and muscles it isnot only about the aesthetic norms through society but also the functional advantages theycould offer. When it comes to human enhancement as a practice of improving human bodycapacity and capabilities beyond the natural degrees, the dominant norm could become theenhancement of natural human body. In terms of artificial limbs and muscles, that wouldmean more people attempting to obtain and utilize these technologies with aspirations tocomply with the dominant social norm set by the increasing number of augmented humans.In the beginning, an abundance of artificial limb and muscle technologies might primarilyserve amputees and patients. In time, in accordance with the development of thetechnologies and benefits they offer, more people might strive to augment themselves toimprove their natural limbs and muscles capabilities. At this time, the trend might beongoing and when an exponential growth of employment of artificial limb and musclesflourishes the dominant norm might be established. In respect to a state of abundant modelson the artificial limbs and muscles market this dominant norm might transform into astandard that could disrupt the social perception of human nature. Such scenario paves theway for social coercion.

Any abundance of artificial limbs and muscles that are easily obtainable and accessible mightin fact end up in medicalization. That means extreme accommodation of augmentation inways offering solutions to problems that are usually handled in non-medical ways. 68 In otherwords, medicalization might become the first option for resolving simple issues even inmundane and trivial cases. Although probably legitimate in the perspective of an individualcase, the social impact might be harmful and undesirable. The risk in relation to themedicalization phenomenon might contribute to diminishing of natural human feelings andemotions regarding adopting the easy enhancement solutions. This is one aspect of thereplacement of authentic human nature that human enhancement technologies aresuspected of. Physical substitution of natural limbs and muscles might evolve into aneffortless way to bypass trivial issues or obstacles that in the past were solved by consistencyand tremendous efforts. For example, young athletics, not willing to improve their sportachievements through exhausting and intensive trainings and exercises taking years,preferring implantation of cutting-edge artificial limbs or muscles securing themconsiderable advance or at least equal capabilities as the leading athletes. On social level,the trend of medicalization might be adopted and encouraged for the sake of promotingprosperity of nations and communities. For instance, companies might stimulate with special

67 Chris Lake, CPO, LPO, FAAOP; and Mary Lake, "Society Spotlight The Healing Effects Of Self-Expression For The Prosthetic Patient", 2011<http://www.oandp.com/articles/2011-12_02.asp> [accessed 29 January 2017].68 Health Council of the Netherlands. Human enhancement (Ethics and Health Monitoring Report 2003 no. 4). The Hague: Health Council ofthe Netherlands, page 14


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bonuses or lucrative contract clauses their employees to augment their bodies to be moreproductive. The problem with such course of events could be explained again with possiblesocial coercion in terms of abuse of medical interventions and bodily intrusions.

Furthermore, it is believed that enhancement alternates the perception of humans forhumans. This is considered to be true especially if an understanding ofoverinstrumentalisation of the human body is adopted, reinforcing the idea that itsappearance and functionality is more important than mentality and human spirit.69 In light ofartificial limbs and muscles, the mechanical perception of human body is fully suitable inrespect to that natural limbs are the instruments of the human body to interact with thesurrounding environment and move within it. With regard to that, the augmentation ofhuman body with artificial limbs and muscles indeed transforms the human into a superiorinstrument to achieve objectives that are unthinkable or barely achievable through naturalhuman body capacity and capabilities. That would make it quite lucrative to look at humanbody as a piece of hardware that can be upgraded to boost its performance for betterproductivity. To put it more simply, the risk of overinstrumentalisation effect based onabundance of artificial limb and muscle technologies on the market lays on the basis ofintended metamorphosis of the natural human body into an advanced posthumanmechanism. How is that possible? First, in the terms of military, soldiers are contemplated asthe means to achieve the target. The human units on the battlefield are instruments to winthe battle. In light of these considerations, the military developments of artificial limbs andmuscles might turn soldiers into almost robots and replacing body parts with various devicesclashes with the law of war as the Geneva Conventions prescribe. Such plot perfectly coversthe foreseen undesirable scenario of neglecting human values in comparison to meremechanical functionality and utilization for achieving greater goals. Workers are also at staketo be apprehended even more like half-machines, half-humans, rather than human personsin connection with the employment of advanced artificial limbs and muscles that enhancetheir work abilities. In other words, at some time overinstrumentalisation of human bodymight be developed as a prevalent tendency having its roots in the ongoing strive for profitsmaximization. A tendency in that matter would bother the fields of morality and ethics interms of the human spirituality.

The tendencies of normalization, medicalization and overinstrumentalisation are closelyconnected with another predicted undesirable effect that might be witnessed within a stateof wide range of artificial limb and muscle models. In fact, these trends might triggercoercion across society related to the adoption of human enhancement technologies.

69 Ibid


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3.4 Coercion as a feasible undesirable consequence

Given the preceding, coercion across society seems like a feasible outcome based on risingnormalisation, medicalization and overinstrumentalisation of human body in terms ofenhancement with artificial limbs and muscles. In this context, the coercion might bedefined as a collateral effect based on the increasing number of acknowledged advantagesartificial limbs and muscle technologies offer and their growing accessibility. But what ismeant by coercion? How does coercion relate to the social understanding and utilization ofartificial limbs and muscles?

Coercion is a quite philosophical term like truth, good, fairness, equality and so might bevery slippery to attempt to define it. What is more, some scholars believe it has a divisivenature and in that context Martin Gunderson described coercion like „a necessary evil".70

A long time ago, notorious philosophers such as Kant, Lock and Hobbes have establishedtree criteria for coercion, namely the following: if a relationship between two people exists;if the coercer acts coercive towards the corcee; if the coercee takes action in response of thecoerceer's act. The second mentioned criterion is the aspect that is considered as evil one.71

An explanation of that is because „coercion is typically thought to carry with it severalimportant implications, including that it diminishes the targeted agent's freedom andresponsibility, and that it is a (pro tanto) wrong and/or violation of right.72 When it comes tothe field of bioethics, the Bioconservatives and Transhumanists argue on the definition ofcoercion but both groups see it as evil based on different reasoning.

Sometimes the term “coercion” is used in quite broad sense to describe social pressures orthe manipulative effects of advertising, one's upbringing, or the structuring of society moregenerally. In other cases it is treated as a general concept that encompasses a variety ofexamples of interpersonal infringement on one's rights.73 In the 20th century, philosophersand legal theorists ended up with a more explicit definition of “coercion” and the way itrelates to other ideas. Their view on coercion connected it tightly with “the use of force orviolence, as well as to threats of the same”.74 In his essay “Coercion” Robert Nozickestablished a framework for understanding coercion. Nozick's invention differs from thetraditional idea of coercion as it associates coercion “only with proposals and excludes directuses of force or violence as the same time it insists that coercion takes place only when thecoercee acquiesces to it; and it makes coercion explicitly dependent on the coercee's choiceto take or not take a specific action A, and mandates that a judgment about coercion must

70 Hasken, Jess (2007) "Coercion in Bioethics," Macalester Journal of Philosophy: Vol. 16: Iss. 1, Article 3.Available at: http://digitalcommons.macalester.edu/philo/vol16/iss1/3, p.1671 Scott Anderson, “Coercion.” The Stanford Encyclopedia of Philosophy. 2006. Metaphysics Research Lab,CSLI, Stanford University. 30 November 2006. <http://plato.stanford.edu/entries/coercion/>72 Ibid73 Ibid74 Ibid


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refer to facts about the coercee's psychology, such as her assessment of the consequencesA-ing in light of the coercer's proposal”.75 In order to identify acts of coercion, AlanWertheimer introduces „two-pronged test for whether or not a proposal constitutes acoercive threat".76 The first test actually consist of the outcome whether there is anindication by the coercer if his proposal is refused will the coercee be put in worse positionthan ought to be in. Because Wertheimer believes that “only threats coerce, but not allthreats do” he poses a second requirement. It states that the „choice forced upon thecoercee be such that the latter has no reasonable choice but consent".77

3.5 Examples of coercive enhancement across society

In his article “Regulating Human Biological Enhancements: Questionable Justifications andInternational Complications” Henry T. Greely divide the coercive enhancement into threecategories, namely frank, parental and implicit, based on the current development and stateof human enhancement technologies. 78

Frank coercion could be described as direct or explicit coercion. That particular form ofcoercive enhancement is considered to be the most despotic in the sense of the relationshipbetween coercer and coercee. Frank coercive enhancement could comprise practices such asmandatory training sessions or physical training for employees in comparison to any coerciveintentional physical intrusions into the human body or other non-invasive enhancementpractices that enhance the coercee. As in very specific and isolated cases mandatorytreatment and invasion of human's body is legally prescribed, generally competent adultshave the almost absolute right to refuse medical treatment. In light of these considerations,frank coercion usually needs to be regulated appropriately because of its intrusive nature.79

In light of Alan Wertheimer’s understanding of coercion, the explicit coercive enhancementinvolves a wrongful threat towards the coercee from the coercer when coercee’s denial willmost probably end up in worse off based on a subordinate connection between both. Inother words, this could be explained as the most severe form of coercion as to greatestextent forces the coercee to succumb. The legal implications of such scenario concernhuman dignity, the right of bodily integrity, the right to autonomy and equality.

Second recognized form of coercive enhancement could be defined as “parental” and relatesto the coercion of children by their parents. This coercion is illustrated by the obligations of

75 Ibid76 Hasken, Jess (2007) "Coercion in Bioethics," Macalester Journal of Philosophy: Vol. 16: Iss. 1, Article 3.Available at: <http://digitalcommons.macalester.edu/philo/vol16/iss1/3>77 Ibid78 Greely, Henry T --- "Regulating Human Biological Enhancements: Questionable Justifications and International Complications" [2005]UTSLawRw 4; (2005) 7 University of Technology Sydney Law Review 87 available at<http://www.austlii.edu.au/au/journals/UTSLawRw/2005/4.html#fn30>79 Ibid


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parents to allow their children receive certain enhancement such as education andvaccinations. The extensive topic of coercion of children could be narrowed down to thecoercive acts against minors by their parents and guardians. As the law prescribes theobligation that parents are responsible for the conducts of their minor children at the sametime parents are granted the right to prevent their children from misconducting throughcoercive practices. Law leaves room for parental discretion in the terms of coercivemeasures but also sometimes prescribes mandatory ones. As mentioned, in most countriesaround the world the first stage of education is obligatory and parents are obliged to sendtheir children to school. That case comprises a mandatory human enhancement practicethat is less intrusive in terms of the freedom and autonomy of children. On the other hand,the second mentioned example, namely mandatory vaccinations, demonstrates a legalobligation for coercive enhancement of children that has to be executed by the parents. Aschildren are receivers of the enhancement eventually this form of coercive enhancementcould not be defined neither as merely direct, nor merely implicit. The legal prescription thatrequires parents to coerce their children by certain enhancements for the sake of their ownand social health and well-being is very specific and unique due to the participants in thislegal mechanism for coercive enhancement. In the same way, an abundance of advancedand inexpensive artificial limbs and muscles on the market in the future might drive to theadoption of identical legal obligations for parents. For instance, due to the proven benefitsof limb prostheses for the individual and society in addition to their inexpensive cost acountry might adopt legislation obliging parents to enhance their children suffering fromcongenital limb defects with an artificial limb provided by the national healthcare system.Such coercive enhancement resembles the case with vaccinations due to the believed healthbenefits for the individual and the prevention of infectious diseases. However, there aremany other differences either in the terms of law, or in terms of social benefits justificationbetween the example provided and vaccinations. One crucial difference is the fact that somemandatory vaccinations are aimed to help prevent the spread of these diseases to others.

Third, implicit coercion could be also described as indirect or collateral. When individualsbenefit from human enhancement technologies to an extent that they significantly outrankothers in some fashion, then the enhanced ones implicitly put coercive pressure on others toemploy human enhancement technologies just to stay competitive or to avoid becomingworse off compared to their initial condition.80 Aging television presenters that havecosmetic enhancements to look youthful in order to compete with the young risingpresenters are a striking example of implicit coercion. This form of coercion is also called„coercion of voluntary enhancements" further explained with the instance of the increasinguse of steroids and other performance enhancing drugs in sports when other athletes areenhancing themselves as well.81 In other words, despite their unwillingness to take a

80 DAN W. BROCK, “Enhancements of Human Function: Some Distinctions for Policymakers”, in Parens, ed. Enhancing Human Traits, pp.60-6181 I. G. Cohen, What (if anything) is Wrong With Human Enhancement? What (if anything) is Right with It?, 49 Tulsa L. Rev. 645 (2014).Available at: <http://digitalcommons.law.utulsa.edu/tlr/vol49/iss3/4>


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performance-enhancing drug, some athletes might feel compelled to do so just to staycompetitive. From a societal perspective, enhancements might have coercive effects onpeople who are not willing to augment themselves, especially in cases that fall into thescope of the medicalisation and normalisation effects already discussed. A real example ofthe medicalization and normalisation effects in the terms of the implicit coerciveenhancement is the case with the New York Times in 2006. Six letters were addressed withregard to the issue of using drugs to alter the behavior of kids.82 One letter actuallyillustrates most profoundly the undesirable situation writing the following “Anecdotalevidence about the high percentage of children treated with Ritalin and other prescriptiondrugs suggest that we may be overmedicating” meaning that many of the treated childrenwere given drugs based on no medical reason or illness. 83 To put it more simply, the morechildren are enhanced by drugs, the standard for the expected results changes and thereforemore parents might attempt to keep up within the framework of social norms byovermedicating their children. In fact, such conformity is reflected in the Transhumansconcept for human enhancement - coercing individuals to „ pursue an artificial standardrather than a natural one".84 So, this kind of coercion in the terms of human enhancementtechnologies could be describes as “conformity enhancement”. The core of such coerciveenhancement comprises the inevitable clash between the reward that the enhancedindividuals are awarded or the goal they accomplish thanks to the enhancement incomparison to others, non-enhanced people, struggling to compete with the augmentedones and feeling self-driven and socially pressured to take identical measures to remaincompetitive.85 Although in some situations the implicit coercion benefits society and themajority of its members, the right to autonomy and self-determination as well as humandignity and freedom might be at stake. With regard to artificial limbs and muscles, the citedexamples and theories might be elaborated on. A sheer employment of artificial limb andmuscle technologies due to availability of diverse advanced models on the market mighttrigger fierce competition between workers, soldiers, sportsmen to have themselvesaugmented in order to improve their abilities and so significantly increase their productivity,capabilities and achievements. First, workers that are not explicitly coerced to enhance bytheir employer or supervisor might be implicitly put under pressure by some their colleaguesalready equipped with artificial limbs or muscles. Employment of moderate bionic arms orlegs in future might secure tremendous advantage to those workers who are involved inlabor-intensive jobs. When it comes to military, the same scenario might apply either amongcolleagues in the army, either between enemy armies when soldiers are not explicitlycoerced. Turning to sportsmen, athletics are the ones expected in the future to strive toremain competitive with other augmented with artificial limbs or muscles eventually. The

82 Blau, Jessamyn. “Using Drugs to Alter Kids’ Behavior” New York Times. November 27, 2006 Section A. p.24.83 Hasken, Jess (2007) "Coercion in Bioethics," Macalester Journal of Philosophy: Vol. 16: Iss. 1, Article 3.Available at: http://digitalcommons.macalester.edu/philo/vol16/iss1/3 p.2084 Hasken, Jess (2007) "Coercion in Bioethics," Macalester Journal of Philosophy: Vol. 16: Iss. 1, Article 3.Available at: http://digitalcommons.macalester.edu/philo/vol16/iss1/3 p.2085 I. G. Cohen, What (if anything) is Wrong With Human Enhancement? What (if anything) is Right with It?, 49 Tulsa L. Rev. 645 (2014).Available at: http://digitalcommons.law.utulsa.edu/tlr/vol49/iss3/4 p.20


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notorious case with Oscar Pistorius and his cutting-edge limb prostheses hints theadvantages that advanced models of artificial limbs could contribute to their users.

3.6 People ordered by superior authority to be enhanced

As the thesis already discussed the explicit form of coercive enhancement in general, thenext paragraphs will elaborate on examples of expected coercive enhancement ordered bysuperior authority. In general, by superior authority the thesis intends a higher levelauthority in terms of an organisation. In hierarchical organisations everyone is subordinateto someone else within the organization except the ones on the top of the pyramid. In thatcontext, higher levels of the hierarchical structure are superior authorities compared toothers subordinate to them. So, even if hierarchical structures resemble in their layout ofpyramids and the different levels existing, the hierarchical organisation within an entitymight differ significantly. The distinction could be found in the nature of relationshipsbetween levels, the liability for insubordination and the ability to resign from theorganisation swiftly. In the light of these considerations, two particular types of entitiesillustrate considerable differences with regard to the enumerated characteristics, namelybusinesses and military.

This particular form of coercion in the terms of human enhancement turns out to beexpected and discussed not only at academic level but also survey respondents and militaryexperts. Participants in the joint workshop hosted by the Academy of Medical Sciences, theBritish Academy, the Royal Academy of Engineering and the Royal Society outlined “howpressure might also be felt from employers, both implicitly and explicitly” as a potentialsocial harm regarding the infiltration of human enhancement technologies.86 Due to theglobalization and global economic trends, businesses and stakeholders are driven these daysto foster competitiveness and pursue maximizing productivity based on implementation ofnew technologies; employers are in position to require the employees to utilize varioushuman enhancement technologies. Meanwhile, military experts and scholars alert thatsoldier enhancement, through biological and technological augmentation of humancapabilities is a foreseen trend and so would pose numerous ethical challenges. Therationale of biological enhancement of soldiers would be the extension of physicalendurance and improved resilience to injuries and tortures.

In this paragraph only the explicit cases of coercive enhancement will be considered as theimplicit coercive enhancement was already discussed. As the scope of the research questionprimarily covers the coercive enhancement by artificial limbs or muscles, the followingpossible scenarios will be examined based on specific reasoning. In fact, nowadays

86 Academy of Medical Sciences, the British Academy, the Royal Academy of Engineering and the Royal Society, Human Enhancement andthe Future of Work,2012, Available at https://www.acmedsci.ac.uk/viewFile/publicationDownloads/135228646747.pdf p.45


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employers and businesses do impose requirements to their employees to enhance withrespect to their job. Varying from enhancement practices such as trainings to more intrusivepractices including providing medicaments or supplements improving employees’ focus andawareness, these still do not clash to a great extent with freedom, human dignity, right tobodily integrity and autonomy. A proliferation of artificial limbs and muscles might lead tocoercion exercised by employers towards employees on a whole new level. Implantation ofartificial limbs and muscles involve intrusive physical interventions into the human bodyincluding surgical procedures.

When it comes to the potential implications for the future of work in relation to proliferationof artificial limbs and muscles, specific occupations and industries are more pliable to beinfluenced to a greater extent. For example, construction and manufacturing workers aretwo specific groups at stake. Their labor requires solid limb and muscle capabilities that arebeing exhausted within the process of work during the years. At the same time, thedemanding nature of these occupations implies amputations as a severe workplace hazard.The two aspects of the cited professions determine distinctive scenarios that might beexpected in the future in case artificial limbs and muscle technologies become abundant.

Scenario one, a construction company orders some of their employees to be augmentedwith artificial muscles that will benefit the receivers with exceptional muscle capabilitiessuch as lifting heavier loads. As a result, the company will be able to benefit from this groupof augmented construction workers in the long term along with a team for expressconstruction securing the company better market positions. The legal relationship betweenthe company and the workers is based on the employment contract. So, the “augmentedcrew” will be established only based on the contractual relationship between employee andemployer aiming to bring competitiveness of the company and contribute to its futurebusiness prosperity.Scenario two, a major manufacturing company points out as reasons for their coerciveenhancement policy the enormous economic losses suffered due to the increasing numbersof worker amputees along with the risk for the health of the workers due to the hazardousnature of the manufacture. The company proposes the workers at stake to be implantedwith artificial limbs that prevent them within the process and improve their mobility,precision and diminish the risk of workplace hazard. The essence of the proposal explicitlyimposes the dilemma on the employee either to agree the enhancement because it willimprove career prospects and prevent his health, or to refuse and be worse off. Bothscenarios share common characteristics but actually differ in crucial elements. Indeed, inboth plots employees are ordered to be augmented with artificial limbs and muscles. On theother hand, the orders for coercive enhancement differ in their fashion as the first isabsolutely explicit in comparison to the other one not that explicit. Another strikingdifference between both scenarios is the purpose of the coercion and the goal aimed in theterms of the ethics, morality and law. With respect to the research question, the mentionedexamples illustrate how flexible the meaning of explicit coercion could be, especially in


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terms of human enhancement. As inherently competitive activity, companies fight toachieve a particular goal or to execute a business plan successfully at an organizational level.In that manner, the pressure reflects on the employees at an individual level as they are themeans to achieve the goals of the company.

As previously discussed in the paper, military needs are a major drive for the research anddevelopment of artificial organs and especially artificial limbs including advanced prosthesesand bionic limbs. Since some believe that 21th century is the “age of the biomedicalmilitary”, cutting-edge models of artificial limb and muscle technologies are highly expectedto be progressively employed among warfighters.87 In light of the considerations related tocommanded enhancement by artificial limbs and muscles, soldiers might be ordered by theircommanders to be implanted with such artificial organ technologies to improve their battleperformance. For example, in cases of soldiers taken prisoners as preventing from torturessuch as denailing and toes scission soldiers might be ordered to be augmented with artificiallimbs beforehand. As at the moment Dexedrine and Provigil, two drugs approved to treatnarcolepsy and other disorders, are used as stimulants to keep US soldiers awake duringcombat missions. In the same manner is quite possible that soldiers might be physicallyaugmented to run faster, walk further, move swifter and climb higher. The research ofadvanced exoskeletons and artificial limbs for veteran amputees paves the way of cutting-edge military designs of artificial limb technologies that upgrade the body of soldierssignificantly. In that context, to resist tortures, to provide exceptional battle performanceincluding extra endurance, stamina, awareness, and precision alongside minimizing physicalsuffering, warfighters might be ordered to be turned out into partly machines, partlyhumans. This scenario, including the coercive enhancement of soldiers, is dissimilar to thecoercive enhancement of workers in several aspects. The employment relationship is acontractual legal link between two equal parties that enjoy reciprocal rights andobligations.88 On the other hand, military is structured based on the “chain of command”concept described as the “the succession of commanding officers from a superior to asubordinate through which command is exercised.”89 To put it more simply, it comprises anorganizational structure where orders are passed from a higher-ranked soldier to lower-ranked personnel down the chain of command. While the employee could refuse to obeyorders or instructions of the employer at his discretion and resign, military members whodisobey the lawful orders of their superiors risk serious consequences including criminalliability for any military member who “willfully disobeys a lawful command of his superiorcommissioned officer”.90 However, it is a grey area to what extent commanding warfightersto be enhanced through physical intrusions into a soldier’s body is a lawful command.

87 Efthimios Parasidis, Emerging Military Technologies: Balancing Medical Ethics and National Security, 47 Case W. Res. J. Int'l L. 167 (2015)Available at: http://scholarlycommons.law.case.edu/jil/vol47/iss1/13 , p.16888 "Employment Relationship", International Labour Organization (ILO) <http://ilo.ch/ifpdial/areas-of-work/labour-law/WCMS_CON_TXT_IFPDIAL_EMPREL_EN/lang--en/index.htm> [accessed 29 January 2017].89 US Department of Defence Dictionary of Military and Associated Term, available at http://www.dtic.mil/doctrine/dod_dictionary/, p.3390 UNIFORM CODE OF MILITARY JUSTICE, X. Punitive Articles 877 77, article 90, < https://www.law.cornell.edu/uscode/text/10/subtitle-A/part-II/chapter-47>


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Compared to the legal status of an employee, the legal status of soldiers is tremendouslydebatable and quite slippery topic.


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Chapter 4: Limitations of ordered enhancement in theterms of law

4.1 Introduction

So far the thesis described the nature of human enhancement, artificial organs andparticularly artificial limbs and muscles. Furthermore, an expectation for establishing a stateof abundance of artificial limb and muscle technologies was outlined. The consequences ofsuch scenario were presented and narrowed down to the coercive enhancement as afeasible undesirable effect of proliferation of artificial limbs and muscles on the market.Extending the accessibility and the scope of benefits provided to a wider range of technologypossessors, artificial limbs and muscles might be projected to be employed by variety oforganizations supporting their progress and achievement of aimed goals.

This chapter will elaborate on the legal aspect of the expected coercive enhancement byartificial limbs and muscles. In the previous chapter some rationales of utilization of artificialorgan technologies by industries and for military needs were discussed. Due to theincreasing number of benefits and advantages that advanced models of artificial limbs andmuscles might contribute to the performance and interaction with the surroundingenvironment of the possessors of these devices, the paper already considered anexponential future growth of employment of the technologies in question. Under thesecircumstances, the consequences of abundant artificial limbs and muscle technologies mighthave different implications. Coercion is one of the most common shared considerations andan undesirable effect that might flourish gradually. Frank coercion or explicit coercion mightbe witnessed in hierarchical organisations where superior authorities order enhancement oftheir subordinates. In particular, augmentation with artificial limbs and musclespredominantly requires physical intrusions into human’s body. Such coercive enhancementinterferes with ethics, morality and law and touches upon the topics of human freedom,bodily integrity, autonomy, human dignity, etc. In the current chapter how orderedenhancement with artificial limbs and muscles interferes with the right to bodily integritywill be examined as well as to what extent superior authorities can order their subordinatesto enhance.


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4.2 The right to bodily integrity considerations

Before examining whether coercive enhancement might interfere the right to bodilyintegrity, an attempt to outline the essence of this right is necessary.

The right to bodily integrity is not definitely mentioned in the Universal Declaration ofHuman Rights as a fundamental human right.91 However, this right is explicitly embodied inseveral national constitutions including the Dutch Constitution (Grondwet), the GermanConstitution (Grundgesetz), the Constitution of Canada.92 Additionally, Article 3 of the EUCharter of Fundamental Rights secures the right to bodily integrity as a part of integrity ofthe person.93 The EU Charter of Fundamental Rights is considered as a very modern legalframework in terms of bioethics including prohibition of eugenic practices, making thehuman body and its parts as such a source of financial gain and reproductive cloning ofhuman beings.94 With regard to European Convention of Human rights, the right to bodilyintegrity is not specifically recognized but in ECtHR case law it has been interpreted to bepart of the right to respect for private and family life (Article 8 of ECHR).95 The Courtreiterated in connection with a forcible gynaecological examination that “a person's bodyconcerns the most intimate aspect of private life. Thus, a compulsory medical intervention,even if it is of minor importance, constitutes an interference with this right (Article 8)”.96Interms of common law, the US Supreme Court has held that “there is a right to be free fromunjustified intrusions on personal integrity, suggesting that such a right is protected by thedue process clause of the Fourteenth Amendment”.97 This includes a variety of contexts suchas unsolicited medical procedures, corporal punishment in schools, the decision to foregomedical treatment, etc.98 With regard to that, in common law “the progression of bodilyintegrity in the courts confirms that the US Supreme Court recognizes and protects peoplefrom governmental invasions on personal security. The US Supreme Court ruled that theright to bodily integrity encompasses unwanted surgery, compulsory pregnancies andmandated contraception methods”.99 According to Article 11 of the Dutch Constitution„Everyone shall have the right to inviolability of his body, without prejudice to restrictionslaid down by or pursuant to Act of Parliament".100 In the context of the Dutch Constitution

91 "Universal Declaration Of Human Rights", United Nations Official Website <http://www.un.org/en/universal-declaration-human-rights/>[accessed 29 January 2017].92 M. N. Gasson et al. (eds.), Human ICT Implants: Technical, Legal and Ethical Considerations, Information Technology and Law Series 23,p.8593 "CHARTER OF FUNDAMENTAL RIGHTS OF THE EUROPEAN UNION", Official Journal of The European Union <http://eur-lex.europa.eu/legal-content/EN/TXT/HTML/?uri=CELEX:12012P/TXT&from=EN> [accessed 29 January 2017]. Article 394 Ibid95 YF v Turkey (No 24209/94, 22/07/03), European Court of Human Rights, para 3396 Ibid97 Weiler, Stephanie (1998) "Bodily Integrity: A Substantive Due Process Right to Be Free from Rape by Public Officials," California WesternLaw Review: Vol. 34: No. 2, Article 19, p.596 Available at: <http://scholarlycommons.law.cwsl.edu/cwlr/vol34/iss2/19>98 Ibid99 Ibid, p.601100 M. N. Gasson et al. (eds.), Human ICT Implants: Technical, Legal and Ethical Considerations, Information Technology and Law Series 23, ,p.85


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article, “the right to bodily integrity explicitly covers the right to prevent others from anindividuals harming their body (defensive right) as well as the right for an individual to dowhatever they wanted with their body (right of self-determination). The government had aduty to make the positive right possible to be executed. There is a duty of care to ensurethat a climate arises in which the constitutional right to inviolability of the human bodyindeed comes to expression. In general a violation of the right is not tolerated by the Dutchcourts unless the violation is justified by a right of another individual that should prevail inthe particular case. The right is therefore not an absolute right.”101 Another definitionprovided for the right to bodily integrity describes it as “a right to do with one's bodywhatever one wants (a right to self-determination) and it implies the right to prevent one'sbody from being harmed by others.”102 Considering these concepts for the right to bodilyintegrity it should be analyzed how coercive enhancement interferes with this right.

Coercive enhancement poses a variety of questions due to the nature of intrusion involves inall three of its forms abovementioned. Human enhancement in terms of artificial limbs andmuscles inevitably comprises physical intrusions into the human body including theimplantation of the technology into person's body and further interaction with living tissues.In the context of common law, such intrusions are not under suspicion if a genuinelyvoluntary decision is taken.103 Coercive enhancement covers the two aspects of humanenhancement, namely treatment and enhancement of natural human capacity andcapabilities. In light of these considerations, competent adults have an “almost right” torefuse medical treatment except in cases with concerns that infectious diseases that mightendanger others.104 When it comes to coercive enhancement in the terms of augmentationof healthy persons, the question to what extent they could be ordered to be enhanced withartificial organs flourishes.105

This chapter will employ the examples provided in the previous one related to businessesordering their employees to be enhanced and military ordering soldiers to be augmentedwith artificial limbs and muscles. The purpose is to analyze more precisely to what extentpeople can be ordered by their superiors to be enhanced with artificial organs withinbusiness companies and military.

In the first example, when companies order employees to be augmented with models ofartificial limb and muscle technologies, either for the sake of the company’s prosperity, orprotect workers from workplace hazards, the coerced employees’ right to bodily integritymight be at stake. Why is that? As explained with regard to the definition of the right to

101 Ibid102 Mark N. Gasson, Human ICT Implants: From Restorative Application to Human Enhancement, Human ICT Implants: Technical, Legal andEthical Considerations, p.24103 Greely, Henry T --- "Regulating Human Biological Enhancements: Questionable Justifications and International Complications" [2005]UTSLawRw 4; (2005) 7 University of Technology Sydney Law Review 87104 Ibid105 Greely, Henry T --- "Regulating Human Biological Enhancements: Questionable Justifications and International Complications" [2005]UTSLawRw 4; (2005) 7 University of Technology Sydney Law Review 87


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bodily integrity adopted by the Dutch Constitution, this right is “meant to provide aprotection of the human body, thus to prevent others from infringing the body” and appliesto “horizontal relationships” including relations between citizens as well as between citizensand government.106 With regard to the explicit form of coercion when superior authorityorders enhancement of workers, the degree of conducted coercion should be considered inthe perspective of the employment relationship. The nature of the relationship betweenemployee and employer is horizontal as both comprise contractual parties in the terms ofcivil law. The right to bodily integrity allows the worker, ordered to be enhanced withartificial limbs and muscles, to refuse at any time without hesitation. With regard to thetechnical aspects of the nature of artificial limb and muscle technologies, their utilizationrequires physical intrusions into person’s body to implant the artificial limb or muscles. Inlight of these considerations, the right to bodily integrity preserves and secures the ability ofthe coercee to deny the order by the employer.

When it comes to the example with the construction company willing to augment workers toboost its prosperity, there are a handful of legal obstacles to be considered. First, the right tobodily integrity guarantees that the coercee enjoys legal protection of his bodily integrityfrom any unwanted treatments or interventions. Implanting an artificial muscle into thehuman body implies access to that. In the context of explicit coercion, the defensive natureof the right to bodily integrity withholds others from accessing human body.107 The right tobodily integrity withstands accessing human body and in that manner protects the bodilyinviolability of the coercee from any coercive enhancement. The defensive nature of theright to bodily integrity prevents the coercee from the coercive enhancement aspirations ofthe coercer. Second, in common law and in the EU case law the exercise of the right tobodily integrity can be limited to some extent only to strike a balance between the rights andfreedoms of others or if the public interest is at stake.108 109 110 With regard to ECtHR caselaw, the Court reiterated that a medical intervention against the will of the person “willviolate Article 8 of the Convention unless it is “in accordance with the law”, pursues one ofthe legitimate aims and set out in the second paragraph of that Article, and can beconsidered “necessary in a democratic society” in pursuit of that aim”.111 Having to do withthe current example, neither there are fundamental human rights endangered, neithergeneral interest should be taken into consideration in the scenario in question. Under thesecircumstances, any coercive enhancement act that the construction company might conducttowards its workers with respect to ordered implantation of artificial muscles is legally

106 M. N. Gasson et al. (eds.), Human ICT Implants: Technical, Legal and Ethical Considerations, Information Technology and Law Series 23, ,p.85107 Ibid, p.95108 Greely, Henry T --- "Regulating Human Biological Enhancements: Questionable Justifications and International Complications" [2005]UTSLawRw 4; (2005) 7 University of Technology Sydney Law Review 87109 Weiler, Stephanie (1998) "Bodily Integrity: A Substantive Due Process Right to Be Free from Rape by Public Officials," California WesternLaw Review: Vol. 34: No. 2, Article 19, p.600-601110 CJEU, Joined cases C-92/09 and C-93/09, Volker and Markus Schecke GbR and Hartmut Eifert v. Land Hessen, 9 November 2010, para.50111 YF v Turkey (No 24209/94, 22/07/03), European Court of Human Rights, para 35,36


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inadmissible and interferes with the right to bodily integrity. Indeed, enhancement thatincludes any physical intrusions into worker’s body ordered in explicit manner is not onlylegally inadmissible but also clashes ethics and morality.

Turning to the second instance, namely manufacturing company ordering workers to beaugmented with artificial limbs to diminish the risk from workplace hazard and to reducecompany healthcare expenditures, the right to bodily integrity still applies and protects thecoercee from unwanted enhancement. In this situation, the right to bodily integrity shouldbe considered along with the potential benefit for the individual’s health and safety though.Preservation of human health in this case is probably at stake as health and well-being of theworkers is endangered by the hypothetical hazardous work environment. As a general rule,workers are obliged to follow special safety rules and to use personal protective equipmentto minimize exposure to workplace hazards. Protective equipment might include clothing,tools, gear or advanced wearable technologies that do not involve physical intrusion into thehuman body or biochemical interventions at any degree. Nevertheless, in this hypotheticalsituation the manufacturing company requires enhancement with artificial limbs to beconducted towards some employees as a safety measure.

The rationale of the company states allegedly preservation of human life and protection ofworker’s health. Due to the hypothetical nature of the instance it might be examined in twoaspects. First, if individual’s health is endangered by the nature of the manufacturing andthere is a potential risk for other non-augmented workers’ health the case with mandatoryvaccinations is applicable. What might be in common might be a specific hypotheticalinfectious disease that the non-enhancement with artificial limbs might trigger and spreadmassively within the manufacturing employees. The legal implication of such scenario wouldintercept the right to bodily integrity as well as the protection of the rights and freedoms ofothers. Although the right to bodily integrity withstands any undesired intrusions andinterventions into person’s body, as in the terms of common law it is reiterated that “themajor exception concerns infectious epidemic diseases where one person’s lack oftreatment may endanger many others”.112 In addition, one of the landmark cases of USSupreme Court addressed mandatory vaccinations in regard to smallpox, ruled that thepolice power of a state absolutely included reasonable regulations established by legislatureto protect public health and safety and justified such regulations as they fall within the manyrestraints to which every person is necessarily subjected “for the welfare of thecommunity”.113 With regard to EU law and ECHR, the ECtHR concludes that a medicalintervention against the will of the person “will violate Article 8 of the Convention unless it is“in accordance with the law”, pursues one of the legitimate aims and set out in the secondparagraph of that Article, and can be considered “necessary in a democratic society” inpursuit of that aim”. So, in terms of the right to bodily integrity the ordered enhancement

112 Greely, Henry T --- "Regulating Human Biological Enhancements: Questionable Justifications and International Complications" [2005]UTSLawRw 4; (2005) 7 University of Technology Sydney Law Review 87113 Jacobson v. Massachusetts. 197 U.S. 11(1905). LSU Law Center, para 25-27


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with artificial limbs in this case might be admissible only for the protection of the rights andfreedoms of others and in accordance with the law. On the other hand, protection only ofthe health and well-being of an individual falls again at the domain of the established caselaw and the concept of the right to bodily integrity prohibiting inviolate intrusion intoperson’s body. In the light of the US Supreme Court rulings that “a competent person hasthe right to refuse life-saving nutrition and hydration.”, “[n]o right is held more sacred, or ismore carefully guarded by the common law, than the right of every individual to thepossession and control of his own person, free from all restraint or interference of others,unless by clear and unquestionable authority of law” and the reiterated protection ofwomen against forced Cesarean sections by the right to bodily integrity reinforce conclusionthat in this situation the right to bodily integrity outweighs the mandated enhancement dueto alleged risk for the employee’s health.114 115 In other words, even if there is a real andconsiderable risk of workplace hazard an exception from the right to bodily integrity is notjustified and admissible and therefore coercive enhancement is prohibited in somejurisdictions.

With regard to the military example in the previous chapter, soldiers ordered by superiorauthority to be enhanced with artificial limbs and muscles, poses again legal, ethical andmoral questions rather in another perspective. Could soldiers be ordered to be enhancedwith artificial limbs and muscles? Can a warfighter refuse enhancement based on ethicalgrounds? Are there limits to who should be enhanced?116 These questions merely touch thelarge list of uncertainties and considerations that flourish in the context of military humanenhancement. However, the scope of the current research questions is narrowed down toenhancement including physical intrusions into the human body that indeed interfereseverely with the right to bodily integrity. In comparison to the companies’ organizationalsystem and employment relationship between employer and employees, the military chainof command system differs in many aspects. As it was already discussed, the subordinatemilitary personnel are obliged to obey any lawful order of its superior authorities.Otherwise, military insubordination, if the offense is committed in time of war, is punishedby death.117 According to Article 90 of UCMJ, if the offense is committed at any other time,by such punishment, other than death, as a court-martial may direct. The striking distinctionbetween the punishment for willful disobedience of lawful command of his superiorcommissioned officer in time of war and at any other time outlines two aspects of theapplicability of the right to bodily integrity in the terms of military context. First, inpeacetime the ordered enhancement with artificial limbs and muscles should fall into thefield of application of the right to bodily integrity at its full degree. In other words, theordered soldiers enjoy the same constitutional rights and freedoms as civil citizens. Second,

114 Weiler, Stephanie (1998) "Bodily Integrity: A Substantive Due Process Right to Be Free from Rape by Public Officials," California WesternLaw Review: Vol. 34: No. 2, Article 19. Available at: http://scholarlycommons.law.cwsl.edu/cwlr/vol34/iss2/19, p.600,603115 Union Pac. Ry. Co. v. Botsford, 141 U.S. 250, 251, 11 S. Ct. 1000, 1001 (1891)116 Col. Dave Shunk, Ethics and the Enhanced Soldier of the Near Future, MILITARY REVIEW January-Feruary 93 ENHANCED SOLDIER, p.95117 UNIFORM CODE OF MILITARY JUSTICE, X. Punitive Articles 877 77, article 90, < https://www.law.cornell.edu/uscode/text/10/subtitle-A/part-II/chapter-47>


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in wartime human rights are being neglected for the sake of public interest and achievementof military objectives. Does that mean that the right to bodily integrity might be outweighedby prevailing military objectives during wartime?

The progress in the field of military human enhancement technologies in the recent years istremendous especially devices developed and introduced by DARPA and the US Departmentof Defense. Moreover, special programs such as Force Health Protection Concept ofOperations (CONOPS), DARPA's Warrior Web project, etc. are devoted to implementation ofthe human enhancement technologies into the US military and improving the performanceof its service members. That is why the next lines will analyze the emerging militarytechnologies in terms of US law. Distinction is set between the practice of medicine andmedical research with respect to US military law. With regard to medicine, the USDepartment of Defense (DoD) can mandate service members „to be administered treatmentof an FDA-approved medical product that the DoD determines is in the best interest of anindividual service member or a military mission".118 An example in that context is thesmallpox vaccine mandate promulgated in 2002 to US troops. DoD went further and adoptedthe smallpox vaccine as requirement of service, pursuant to military law. Consequently,service members who refused the vaccine are reported to be subjects to court-martial andsevere punitive measures.119 So, from the perspective of the assumed best interest of anindividual service member or a military mission coercive biochemical interventions arejustified and allowed in the terms of US military law.

On the other hand, with regard to military medical research, several federal regulations andDoD guidelines were adopted providing various safeguards for army personnel who isinvolved into biomedical research conducted or sponsored by the military to prevent fromcoercion. Despite of the safeguards laid down in the US legislation on federal and militarylevel, a number of laws in fact negate some of the protections including informed consentwaiver, clinical trial setting bypass, etc. 120 Furthermore, in light of the Uniform Code ofMilitary Justice, applicable to all service members in US military, existing regulations inrespect to a medical treatment deemed by officials to be necessary for the good of thearmed forces do not limit medical-related orders to products approved by the FDA and evento non-FDA-approved. There were even service members prosecuted for their refusal ofadministration of non-FDA-approved medical products for the use intended by the DoD inthe past.121 The brief look into the U.S. military law regulations and legal framework, carryout some deductions partly related to the right to bodily integrity. First, even in the contextof American court decisions upholding mandatory treatment that are believed to “generallyold and may be questioned in light of the growth of civil rights over the past century”, at the

118 Efthimios Parasidis, Emerging Military Technologies: Balancing Medical Ethics and National Security, 47 Case W. Res. J. Int'l L. 167(2015) Available at: http://scholarlycommons.law.case.edu/jil/vol47/iss1/13, p.169119 Ibid120 Ibid, p.169-173121 Ibid, p.177


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domain of military law the exceptions swallow the rule.122 The right to bodily integrityimposes prohibition to everyone who wants to intrude without permission into otherhuman’s body but seems in the terms of military it is plausible to bypass the restrictions ofthis right aiming to achieve military objectives. That could be a slippery road as mandatoryvaccinations and mandated involvement into military medical research programs might pavethe way to experimental implantation with cutting-edge artificial limbs or artificial musclesinto warfighter’s bodies ordered by governmental bodies. Since majority of the mandatoryvaccination programs protect not only the individual’s health but prevent the feasible spreadof infectious diseases that could harm multiple service members on a mission at once, suchbiomedical interventions are legally justified in terms of balancing between individualinterest and the protection of the rights and freedoms of others. However, implantation ofdevices that replace whole body parts comprises a severe intrusion into the human body andinterference with the right to bodily integrity. The human body is intruded upon physically toa far greater degree, so the coercee might be pressured significantly to obey to beenhanced.

Second, the above discussed regulations and framework concern predominantly biomedicalinterventions in peacetime. It is unclear whether in time of war service members would beable to actually opt out of any treatment with enhancements or implantation ofexperimental devices such as artificial limbs and muscles facing the death punishment incase of insubordination. During wartime the “common welfare” is placed above the respectof human rights and that is why the Geneva Conventions were adopted. In that context, it isa grey area whether enhancements, or enhanced soldiers, are a “weapon” or a “means ormethod of warfare”, or if they should be deemed “biological agents.” while, under theHague Convention, warfighting that disturbs the “public conscience” is forbidden.123 Due tothe objective obstacles to bring any cases for coercive enhancement before courts duringwartime, court rulings regarding violations of the right to bodily integrity in the terms ofcoercive enhancement with artificial limbs or muscles might depend merely on post-wartribunals’ trials. What is more, in light of the considerations related to striking a fair balancebetween individual human rights and general interest the latter might outweigh theviolation of certain individual human rights by reason of the greater goal pursued. As a non-absolute, the right to bodily integrity will have to compete with the virtue of public interestand violations might be justified on these grounds. Unlike in peacetime, the duty ofgovernments to care that climate arises in which the constitutional right to inviolability ofthe human body indeed comes to expression might be unthinkable. What is more, mattersof national security and general interest are taken into account to a higher degree inwartimes. In such situations the extent of coercive enhancement ordered by superiorauthorities towards service members and military personnel might in fact become quite

122 Greely, Henry T --- "Regulating Human Biological Enhancements: Questionable Justifications and International Complications" [2005]UTSLawRw 4; (2005) 7 University of Technology Sydney Law Review 87123 Efthimios Parasidis, Emerging Military Technologies: Balancing Medical Ethics and National Security, 47 Case W. Res. J. Int'l L. 167(2015) Available at: http://scholarlycommons.law.case.edu/jil/vol47/iss1/13, p.180


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stretchable. The notion based on the collective interests trumping individual interest inmatters of national security is described as “military exceptionalism”.124 Concept in thisfashion is founded on the pillars of all exceptions of constitutional rights and freedomsimposed to soldiers in the name of national security. Conclusions in that manner arereinforced by some disturbing news coming from politicians around the world related togovernments “planning to opt out of some international human rights law duringwartime”.125 Given the preceding, balancing medical ethics and the right to bodily integrityon the one side and common welfare and national security on the other, an impression isgiven that the emerging military technologies are being developed and employed in a greyarea in the legislation in USA. However, the question of extent of admissible coerciveenhancement in respect to military becomes increasing complex and global impact shouldbe considered without any doubts. Other countries such as Russia, China, U.K. and Japan arenot far behind and also invest tremendous resources into research and development ofmilitary human enhancement technologies that will allow their warfighters to outperformthe enemy on the battlefield. It is a matter of time to witness troopers partly machines,party humans on duty.

124 Ibid, p.183125 "Britain To Opt Out Of Human Rights Law In Wartime", Newsweek, 2016 <http://europe.newsweek.com/theresa-may-european-court-human-rights-wartime-soldiers-prosecution-iraq-505802?rm=eu> [accessed 29 January 2017].


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Chapter 5: Conclusion

Since human enhancement has been benefiting humankind for thousands years, nowadayshuman enhancement technologies are more advanced and progressive than ever. Inaddition, the ongoing research and development in that broad field suggests improvingspecifications of the devices. In that context, artificial limbs and muscles are among therapidly developed technologies that might transform the human body in the future to apartly machine, partly human. Based on the combination of breakthrough inventions in thefields of artificial limbs and muscles, the substantiate opinions and sheer discussions atacademic level supported by market reports, the thesis outlined a possible establishment ofa state of abundance of artificial limbs and muscles models in future. Given the preceding,coercion as a harmful outcome has been recognized quite regularly and so the implicationsof such phenomenon should be assessed in the perspectives of law and ethics by legislators.Implantation of artificial limb or muscle into human body implies access to the person’sbody. Such an operation might violate the right to bodily integrity. The thesis attempted toassess how explicit coercive enhancement interferes with the right to bodily integrity interms of common law and EU case law. The right to bodily integrity is called upon to securethe body inviolability of human beings. As considered in the scope of personal integrity andprivacy, the right to bodily integrity guarantees that no interventions and invasions towardshuman body against the will of the person are inadmissible. On the other hand, there arelegal exceptions in terms of the right to bodily integrity when this right is permissible to bebypassed on certain legal grounds. In light of these considerations, the protection of therights and freedoms of others or in other words common welfare requires striking a fairbalance between the public interest and individual human rights. With regard to that, everysingle case of explicit coercive enhancement should be assessed in the aspect of theindividual interest and the general one. On top of that, national security and militaryobjectives might demand extraordinary measures and direct coercive enhancement mightbe evaluated in the perspective of the prevailing public interest and national security duringwartime.

Artificial limbs and muscles in the near future might become even a more pressing topic inconnection with their designation and legal implications. Consequently, the relationbetween their multiple applications and employment might determine completely newapproach to the right to bodily integrity in terms of law and human enhancement. Thedebate is open and here to stay.


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