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Transhuman psychiatry: prospecting challenges and opportunities

Journal of Psychiatry Reform vol. 11 #4, April 2024

Author: Abraham Rudnick, MD, PhD, FRCPC, CCPE, CPPRP, MCIL, DFCPA, mMBA,

Professor, Departments of Psychiatry and Bioethics and School of Occupational Therapy, Dalhousie University,

Clinical Director, Nova Scotia Operational Stress Injury Clinic,

Nova Scotia Health Authority, 210-100 Eileen Stubbs Avenue, Dartmouth, Nova Scotia B3B1Y6, Canada.

Email: [email protected]

 

Abstract

Abstract: Transhuman is a term applied to describe   people  who  have received  technological enhancements  to  some of their abilities and other characteristics, by means of hardware, software, omics and/or other technology. This process  is expected to grow with the further development of technology. Current and future mental health challenges may be experienced by transhumans. This article prospects challenges and opportunities related to behavioral and mental health challenges as well as abilities of transhumans, and calls to prepare for transhuman psychiatry.

 

Keywords: Health, mental, psychiatry, technology, transhuman

Technology is rapidly developing across the world, which has considerable implications for health care and research, including for psychiatry. For example, electronic brain implants for neuromodulation such as deep brain stimulation have recently been shown to help some people with treatment refractory mental disorders such as in relation to obsessive compulsive disorder, depression, and even anorexia nervosa[1-3] . And pharmacogenomics for psychopharmacology is lately shown to be effective in predicting and hence trying to minimize adverse effects of psychotropic medications[4] . In parallel, such technology is being used for neuroenhancement, i.e., the increase and creation of brain and mind abilities beyond the restoration of so-called normal abilities, including for people who have no known brain pathology nor mental disorder, with related ethical concerns[5] .

More generally, technological enhancement of human’s bodies and/or minds unrelated to remediation of physical and/or mental disorders involves the generation of “transhumans”, i.e., humans who have technologically enhanced abilities and other characteristics by means of hardware, software, omics and/or other technology; this is distinct from “transhumanism” that is a philosophical and intellectual movement that advocates the enhancement of the human condition by developing and making widely available sophisticated technologies that can greatly enhance longevity, cognition, and well-being[6] . Current technology – especially robotics combined with advanced software such as artificial intelligence (AI), and biotechnology involving omics (genomics, proteomics and more) – is estimated to have generated at least a few thousands if not more transhumans to date, and their prominence is reportedly growing rapidly[7].

The mental health implications of the generation of transhumans have not been addressed much if at all, at least not in a systematic manner. Hence this article presents an outline of such mental health related issues to consider in relation to transhumans, recognizing the need for transhuman psychiatry to address both challenges and opportunities as prospects of the generation of transhumans. The issue of transhumanism as an ideological approach is not addressed in this paper. Addressing transhumans does not logically require consideration of transhumanism as it can be approached using other approaches which are arguably less ideological and more suitable for healthcare. Transhumanism as ideology is out of scope for this paper.

First, a philosophical problem has to be addressed. Arguably, transhumans, especially those whose brains and/or minds are considerably enhanced, may be so far removed from ordinary human experience, that psychiatry as we know it would not even fathom how to understand them, even more so how to help them if they need mental health related help; The metahuman (a term referring to a transhuman with supernatural powers) character . The fictional character Doctor Manhattan, from the seminal graphic novel Watchmen, may illustrate this, recognizing that such metahumans are extreme – and likely rather dissimilar[8].  Examples of transhumans and are by definition fictitious. They serve as speculative although somewhat useful thought experimentation. From a practical perspective, although every human (and arguably every other sufficiently highly evolved being) is mentally unique and cannot be fully understood, psychiatry and other mental health care professions have been able to sufficiently understand many if not all people and help them to some extent. From a more theoretical perspective, although personal experiences are at least partly subjective, they have shared aspects with others, such as their form or structure[9]. Hence, the mental distinction if any of transhumans may not be an insurmountable obstacle for psychiatry (perhaps especially if some psychiatrists become transhuman, although their transhumanity may be considerably different from that of some if not all of their transhuman patients and may also pose both challenges and opportunities with their human patients).

A key issue to address in relation to psychiatry for transhumans is whether their related differences result in disruption to them and/or to others, and if so whether that is malleable and hence possibly remediable versus whether it is unchangeable. If it is remediable, a more problem focused approach may be most helpful, whereas if it is irremediable, a more emotion-focused approach may be most helpful (recognizing that unrelated to transhumans, the distinction between problem-focused and emotion-focused coping is not absolute nor is it sometimes helpful for remediation related to mental health challenges[10].

Such disruption may be behavioral and/or mental (cognitive and/or emotional). For example, a person’s transhumanity may result in their asociality (similar to that of Doctor Manhattan who eventually loses interest in humanity and leaves the earth); if that is not disruptive to them mentally, at the very least related care and support may be needed for their family and friends who are left behind (metaphorically if not literally). A person’s transhumanity may also result in their cognitive disruption; for example, if they become savants in some areas of thinking but not in others, such as if their sustained attention improves considerably but their short term memory does not, their working memory may actually worsen, for which they may need (likely specialized) neurocognitive remediation. And a person’s transhumanity may result in their emotional disruption; for example, due to their distress associated with other disruptions as noted above.

A further issue is that although metahumanity as such is not a plausible option in the foreseeable future, transhumanity may involve metahuman-like abilities that may seem similar to supernatural powers, e.g., telekinetic-like use of brain waves to remotely move objects by means of a computer interface (which is already used with primates as well as with physically disabled humans). If these abilities are incompatible with other abilities, involving hard choices such as whether to enhance limb strength and speed by amputating and replacing a limb with a smart prosthesis, that conflict may generate emotional as well as moral distress. And some of these superhuman abilities may eventually become the norm by universal design in some if not all of society, in which case it is more likely that those who do not gain these abilities may feel left behind in relation to that and hence may develop related mental health challenges that psychiatry may address as a spin off problem of humans.

Furthermore transhuman related technology – hardware, software, genomic and other – may malfunction, which could cause mental health challenges. These challenges could be primary, i.e., a direct result of the malfunction (such as brain injury related to malfunction of a brain electronic implant), or secondary, i.e., an indirect result of the malfunction (such as emotional distress and cognitive distraction as a reaction to the malfunction, as well as anxiety and depression if the malfunction becomes permanent and hence the person transitions back from being a transhuman to being a human and may not adjust well to that mentally). Psychiatrists providing care to transhumans may have to collaborate with engineers and other technologists in service provision, perhaps similar to orthopedists who provide care to amputees who use smart prostheses. Such psychiatrists may also have to develop classifications, assessments and interventions distinct to mental health issues of transhumans, if current and future approaches of psychiatry to humans are not adequate or at least not sufficient for transhumans.

Last but not least, the generation of transhumanity may be particularly challenging ethically if it involves strictly enhancement rather than remediation unless that is acceptable at least based on common morality. For example, generating transhumans for military purposes is especially challenging ethically, as that would contravene a foundational principle of ethics that persons should not be used only as means to ends (arguably, even if they agree to that). More complex is the issue of the generation of transhumanity related to remediation, as this may not only rectify illness and disability (whether as a restorative or a compensatory measure), but it may also result in enhancement beyond ordinary human ability. For example, hypothetical remediation of attention deficit by neuromodulation and/or omics may be enhance attention beyond its restoration, providing an unfair – educational or employment – competitive advantage to that person. Admittedly, such an issue is not new, as stimulant medications have been used similarly, including by medical students, with related risk to their health. Indeed, personal as well as societal risk of generating transhumans for purposes of remediation and/or enhancement should not be ignored. Even more complex is the issue of changing standards of health in relation to the generation of transhumans, as at least after a while enhanced abilities may become the norm[11]; this may result in different health expectations for different people, e.g., higher standards for transhumans, which could be considered as unfair to others.

All of these issues and more require visioning and strategic planning as well as use of technical, moral and other approaches to address various biopsychosocial problems and ethical challenges that may arise for transhumans and their mental health. That said, transhumanity is also likely to generate unexpected behavioral and mental strengths beyond those intended. A person-centered approach to mental health and its determinants[12], involving transhumans as decision makers in care and research about them, would be needed. Although transhumanity is not an urgent issue for psychiatry at this stage, preparation for transhuman psychiatry may be needed soon considering the rapid development of related technology. Special attention may also be needed for transhuman psychiatrists who may experience both challenges and opportunities in relation to their own transhumanity.

References

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