Although bionics have been part of science fiction for quite some time (a well-known example is the Six Million Dollar Man), the reality of prosthetics has long been rather disappointing. But, thanks to America’s endless wars and recent advances in technology, bionic prosthetics are now a reality. There are now replacement legs that replicate the functionality of the original organics amazingly well. There have also been advances in prosthetic arms and hands as well as progress in artificial sight. As with all technology, these bionic devices raise some important ethical issues.
The easiest moral issue to address is that involving what could be called restorative bionics. These are devices that restore a degree of the original functionality possessed by the lost limb or organ. For example, a soldier who lost the lower part of her leg to an IED in Iraq might receive a bionic device that restores much of the functionality of the lost leg. As another example, a person who lost an arm in an industrial accident might be fitted with a replacement arm that does some of what he could do with the original.
On the face of it, the burden of proof would seem to rest on those who would claim that the use of restorative bionics is immoral—after all, they merely restore functionality. However, there is still the moral concern about the obligation to provide such restorative bionics. One version of this is the matter of whether or not the state is morally obligated to provide such devices to soldiers maimed in the course of their duties. Another is whether or not insurance should cover such devices for the general population.
In general, the main argument against both obligations is financial—such devices are still rather expensive. Turned into a utilitarian moral argument, the argument would be that the cost outweighs the benefits; therefore the state and insurance companies should not pay for such devices. One reply, at least in the case of the state, is that the state owes the soldiers restoration. After all, if a soldier lost the use of a body part (or parts) in the course of her duty, then the state is obligated to replace that part if it is possible. Roughly put, if Sally gave her leg for her country and her country can provide her with a replacement bionic leg, then it should do so.
In the case of insurance, the matter is somewhat more complicated. In the United States, insurance is mostly a private, for-profit business. As such, a case can be made that the obligations of the insurance company are limited to the contract with the customer. So, if Sam has coverage that pays for his leg replacement, then the insurance company is obligated to honor that. If Bill does not have such coverage, then the company is not obligated to provide the replacement.
Switching to a utilitarian counter, it can be argued that the bionic replacements actually save money in the long term. Inferior prosthetics can cause the user pain, muscle and bone issues and other problems that result in more ongoing costs. In contrast, a superior prosthetic can avoid many of those problems and also allow the person to better return to the workforce or active duty. As such, there seem to be excellent reasons in support of the state and insurance companies providing such restorative bionics. I now turn to the ethics of bionics in sports.
Thanks to the (now infamous) “Blade Runner” Oscar Pistorious, many people are familiar with unpowered, relatively simple prosthetic legs that allow people to engage in sports. Since these devices seem to be inferior to the original organics, there is little moral worry here in regards to fairness. After all, a device that merely allows a person to compete as he would with his original parts does not seem to be morally problematic. This is because it confers no unfair advantage and merely allows the person to compete more or less normally. There is, however, the concern about devices that are inferior to the original—these would put an athlete at a disadvantage and could warrant special categories in sports to allow for fair competition. Some of these categories already exist and more should be expected in the future.
Of greater concern are bionic devices that are superior to the original organics in relevant ways. That is, devices that could make a person faster, better or stronger. For example, powered bionic legs could allow a person to run at higher speeds than normal and also avoid the fatigue that limits organic legs. As another example, a bionic arm coupled with a bionic eye could allow a person incredible accuracy and speed in pitching. While such augmentations could make for interesting sporting events, they would seem to be clearly unethical when used in competition against unaugmented athletes. To use the obvious analogy, just as it would be unfair for a person to use a motorcycle in a 5K foot race, it would be unfair for a person to use bionic legs that are better than organic legs. There could, of course, be augmented sports competitions—these might even be very popular in the future.
Even if the devices did not allow for superior performance, it is worth considering that they might be banned from competition for other reasons. For example, even if someone’s powered legs only allowed them a slow jog in a 5K, this would be analogous to using a mobility scooter in such a race—though it would be slow, the competitor is not moving under her own power. Naturally, there should be obvious exceptions for events that are merely a matter of participation (like charity walks).
Another area of moral concern is the weaponization of bionic devices. When I was in graduate school, I made some of my Ramen noodle money writing for R. Talsorian Games Cyberpunk. This science fiction game featured a wide selection of implanted weapons as well as weapon grade cybernetic replacement parts. Fortunately, these weapons do not add a new moral problem since they fall under the existing ethics regarding weaponry, concealed or otherwise. After all, a gun in the hand is still a gun, whether it is held in an organic hand or literally inside a mechanical hand.
One final area of concern is that people will elect to replace healthy organic parts with bionic components either to augment their abilities or out of a psychological desire or need to do so. Science fiction, such as the above mentioned Cyberpunk, has explored these problems and even come up with a name for the mental illness caused by a person becoming more machine than human: cyberpsyhcosis.
In general, augmenting for improvement does seem morally acceptable, provided that there are no serious side effects (like cyberpsychosis) or other harms. However, it is easy enough to imagine various potential dangers: augmented criminals, the poor being unable to compete with the augmented rich, people being compelled to upgrade to remain competitive, and so on—all fodder for science fiction stories.
As far as people replacing their healthy organic parts because of some sort of desire or need to do so, that would also seem acceptable as a form of life style choice. This, of course, assumes that the procedures and devices are safe and do not cause health risks. Just as people should be allowed to have tattoos, piercings and such, they should be allowed to biodecorate.