Ethics of Medical Innovation, Experimentation, and Enhancement in Military and Humanitarian Contexts (Military and Humanitarian Health Ethics)

Contents
Chapter 1: Ethics of Medical Innovation, Experimentation, and Enhancement in Military and Humanitarian Contexts. Introduction to the Volume
	1.1 Introduction
	1.2 The Distinction Between Medical Practice, Research & Innovation
		1.2.1 Medical Practice and the Limits of Research
		1.2.2 Innovation – Practice Beyond the Ordinary But Not (Necessarily) Research
	1.3 Ethical Restrictions of Research in Medicine
		1.3.1 A Precondition: Scientific Design of the Research
		1.3.2 Respect for Persons: The Necessity of Voluntary Informed Consent
		1.3.3 Beneficence: Distribution of Risk and Benefit
		1.3.4 Justice: Selection of Research Participants and Distribution of Resources
		1.3.5 Ethics Review Boards: Apply the Abstract Principles on Project Level
	1.4 Some Specifics of the Military and Humanitarian Contexts Compared to Clinical Research
		1.4.1 A First Concern: Military Interests
		1.4.2 Context: Research in Conflict and Disaster Settings
		1.4.3 A Second Concern: Vulnerable or Captive Populations
	1.5 Human Medical Enhancement as a Specific Example of Research and Innovation
	1.6 Synopsis – Outline of the Volume
		1.6.1 Part I – Research and Research Ethics in Military and Humanitarian Contexts
		1.6.2 Part II –Human Medical Enhancement in the Military: “Science-Fiction” in Reality
	1.7 Research and Innovation in Military and Humanitarian Contexts: Necessary But to Be Approached with Caution
	References
Part I: Research and Research Ethics in Military and Humanitarian Contexts
	Chapter 2: Innovation or Experimentation? Experiences from a Military Surgeon
		2.1 Introduction
		2.2 Definitions
		2.3 The Grey Area of Innovation and Experimentation in (Military) Surgery
		2.4 Innovation in Practice
		2.5 Experimentation
		2.6 Safeguards
		2.7 Conclusion
		References
	Chapter 3: The Impact of the Duty to Obey Orders in Relation to Medical Care in the Military
		3.1 The Impact of the Duty to Obey Orders in Relation to Medical Care in the Military
		3.2 Obedience
			3.2.1 The Communitarian Shift
			3.2.2 Military Obedience
			3.2.3 Military Obedience and Medical Treatment
			3.2.4 Military Personnel, Obedience and Medical Experimentation
		3.3 Two Potential Solutions
			3.3.1 General Orders vs Life Order
			3.3.2 Classification of Soldiers as Vulnerable
		3.4 Conclusion
		References
	Chapter 4: Medical Prophylaxis in the Military: A Case for Limited Compulsion
		4.1 Introduction
		4.2 Current Ethical Guidance
		4.3 Individual Autonomy in the Military Setting
		4.4 Medical Autonomy in the Military Setting
		4.5 Individual Autonomy and Collective Consequences
		4.6 Exploring Consent and Compulsion
		4.7 Conclusion: The Case for a Greater Sensitivity to the Circumstances in Which Military Doctors May Be Practicing
		References
	Chapter 5: From the Lab Bench to the Battlefield: Novel Vaccine Technologies and Informed Consent
		5.1 History
		5.2 The Future of Vaccine Production
			5.2.1 The Military Context
		5.3 Ethical Considerations and Novel Vaccine Technology
			5.3.1 Respect for Autonomy
			5.3.2 The Principle of Nonmaleficence
			5.3.3 The Principle of Beneficence
			5.3.4 The Principle of Justice
			5.3.5 Relevant Frameworks from Public Health Ethics & Research Ethics
		5.4 Conclusion
		References
	Chapter 6: Humanitarian Wearables: Digital Bodies, Experimentation and Ethics
		6.1 Introduction
		6.2 The Technologization of Humanitarian Space
		6.3 Risks and Humanitarian Experimentation
		6.4 Intimate Humanitarian Objects
			6.4.1 The Evolving Modalities of Wearables
			6.4.2 The Digital Body: An Initial Scoping
			6.4.3 Imagining Wearables as ‘Game Changers’ and Problem Cases
		6.5 Humanitarian Ethics as a Bundle of Approaches?
			6.5.1 Humanitarian Imperatives and Principles: Top-Down Approaches to Accountability
			6.5.2 RBA Revisited: A Bottom-Up Approach to Data and Digital Bodies in Humanitarian Aid?
			6.5.3 Data Justice: New Approaches to New Challenges
		6.6 Conclusion
		References
	Chapter 7: Value-Sensitive Design for Humanitarian Action: Integrating Ethical Analysis for Information and Communication Technology Innovations
		7.1 Introduction
			7.1.1 Scoping the Problem and Existing Literature
			7.1.2 Knowledge Gap
			7.1.3 Framework Development
		7.2 VSHI Framework
			7.2.1 Illustrative Example: Refugee Biometrics
		7.3 Prerequisites
		7.4 Conclusion
		References
Part II: Military Human Enhancement: “Science-Fiction” in the Real World
	Chapter 8: Military Enhancement: Technologies, Ethics and Operational Issues
		8.1 Introduction
		8.2 Human Enhancement in the Military
			8.2.1 Definition
			8.2.2 Controversies
		8.3 Military Physical and Cognitive Enhancement
			8.3.1 Historical Perspective
			8.3.2 Contemporary Military Human Enhancement
				8.3.2.1 The Role of DARPA
				8.3.2.2 Brain Stimulation
		8.4 Enhancements, Ethics and Operational Dilemmas
			8.4.1 Challenges to Army Values
			8.4.2 Ethics in the Military Profession and Combat
		8.5 Conclusions
		References
	Chapter 9: Human Enhancement, Transhuman Warfare and the Question: What Does It Mean to Be Human?
		9.1 Introduction
		9.2 A Reluctant Cyborg: Helmut Dubiel’s Struggle with Deep Brain Stimulation
		9.3 Human Enhancement: A Terminological Problem
		9.4 Transhuman Warfare
		9.5 What Does It Mean to Be Human?
		9.6 Conclusion
		References
	Chapter 10: Genetic Science and the Future of American War-Fighters
		10.1 Introduction
		10.2 Enhancement in the Military
		10.3 Genetic Screening
			10.3.1 Ethical Issues in Genetic Screening
		10.4 Gene-Editing
			10.4.1 Ethical Issues in Responsible Research Conduct
			10.4.2 War-Fighters for Life? Ethical Issues in Veteran Re-integration
		10.5 Conclusion
		References
	Chapter 11: Military Medical Enhancement and Autonomous AI Systems: Requirements, Implications, Concerns
		11.1 Introduction
		11.2 Praetor Suit
		11.3 Ethical Issues
			11.3.1 Monitor AI
			11.3.2 Evaluation AI
			11.3.3 Administration AI
		11.4 Human-AI Symbiosis
		11.5 Military Medic or Military Enhancer?
		11.6 Conclusion
		References
	Chapter 12: Experimental Usage of AI Brain-Computer Interfaces: Computerized Errors, Side-Effects, and Alteration of Personality
		12.1 Introduction
			12.1.1 Military Medicine Moral Obligation
			12.1.2 Military Medicine and Experimental Usage of AI BCI
		12.2 From Open to Closed Loop
		12.3 The Concerns for Safety
		12.4 Rita and Roberta: A Twin Analogy to Highlight cDBS Safety Issues for Personhood
		12.5 Reaching the “Toxic Level” of Stimulation
		12.6 Ethical Implications of Roberta’s Case and the Importance of Autonomy
		12.7 Conclusion
		References
	Chapter 13: Memory Modification as Treatment for PTSD: Neuroscientific Reality and Ethical Concerns
		13.1 Introduction
		13.2 Posttraumatic Stress Disorder
		13.3 Current Treatments and Their Limitations
		13.4 Neuroscience of Memory Modification
			13.4.1 Concept and Taxonomy of Memory
			13.4.2 Memory Formation and Consolidation
			13.4.3 Extinction Learning
			13.4.4 Flexibility of Memories
			13.4.5 Memory Reconsolidation
		13.5 Ethical, Legal and Social Issues
			13.5.1 Safety, Effectiveness and Equitable Access
			13.5.2 Identity and Authenticity
			13.5.3 Normal Recovery and Traumatic Growth
			13.5.4 A Duty to Remember?
			13.5.5 A Duty to Suffer?
		13.6 Conclusion
		References
	Chapter 14: “A Difficult Weapon to Confiscate” – Ethical Implications of Military Human Enhancement as Reflected in the Science Fiction Genre, Taking Star Trek as an Example
		14.1 Introduction
		14.2 Star Trek as an Object of Medical Ethics Study
		14.3 Therapy Versus Human Enhancement
		14.4 Pharmacological Enhancement
		14.5 Genetic Engineering
		14.6 Technically Invasive Enhancement
		14.7 Bioprinting
		14.8 Requirements for Enhancements
		14.9 Law of Armed Conflict: Help for the Adversary?
		14.10 Follow-on Cost and Disarmament of Enhancements
		14.11 Conclusion
		References
	Chapter 15: Supersoldiers and Superagers? Modernity Versus Tradition
		15.1 Superagers and Supersoldiers
		15.2 The Modern World View
		15.3 The Traditional World View
		15.4 Supersoldier or Simple Soldier?
		References