**1. Introduction**

Rapid advancements in technology have seen a rise in innovative ways to enhance human capabilities. This is the case for technologically advanced militaries seeking to enhance soldier capabilities. This paper explores challenges associated with technological interventions being developed that could o ffer soldiers a chance to enhance their cognitive functions and, by extension, to enhance their autonomy in a warfighting context. We propose that technologies that enhance an individual's cognitive functions, such as decision-making capacity, situational awareness, memory enhancement, and increased vigilance, all have the potential to also enhance an individual's autonomy and moral decision-making capabilities. In a medical bioethics context, such interventions require informed consent of the recipient in order for that intervention to go ahead. However, when considering particular enhancements used in the military, the nature, purpose, and context of the enhancement used may significantly undermine the capacity of a recipient to say no to these enhancements. This is a common problem for informed consent; how do we ensure that the recipients of medical or biotechnological interventions consent to these interventions freely? We sugges<sup>t</sup> that the 'nature' of these enhancements presents a conceptual challenge; can a person autonomously say no to an option that will enhance their autonomy? Further to this, if the purpose of these enhancements is to improve moral decision-making, can a person justifiably say no to an option that will lead to them make better morally relevant decisions? In addition, we sugges<sup>t</sup> that in the military context, this becomes even more complicated because soldiers are not just expected to follow commands, but are trained and inculcated in the

practice of following commands, and bear certain loyalties to their comrades. We propose that these contextual elements form the basis to consider soldiers as a vulnerable group with regards to obtaining informed consent. Finally, the fact that soldiers have signed up to be part of the military and accept the military doctrine means that they might have to accept these enhancements as part of the job. In combination, we find that these conditions mean that in certain circumstances, a soldier cannot say no to an enhancement. However, as we show in the concluding section, this is not a broad statement; there is still a range of conditions that must be met in order for particular enhancements to be obligatory in the military context.

### **2. Cognitive Enhancements as Autonomy-Enhancing Technologies**

Cognitive enhancements are those technologies with a demonstrated or potential ability to alter or modify physiological processes such as decision-making, reasonability, memory, judgement, situational awareness, attention span, and complex problem solving. We propose that cognitive enhancements could be viewed as "enhancing" technologies as they improve or have the ability to improve the physiological processes of how we acquire and process knowledge and understand the world around us. These cognitive processes, when enhanced, also enhance an individual's autonomy, i.e., ability to self-govern (see below for more on this). The two types of cognitive enhancements discussed in the following paragraphs are: Brain–Computer Interface (BCI) and Non-Invasive Brain Stimulation (NIBS). As we will discuss below, there is significant disagreement about whether such interventions do in fact act to enhance one's moral decision-making.

### *2.1. Brain Computer Interface (BCI)*

BCIs consist of a direct communication pathway between the brain and an external device (usually a computer platform) via one-way or two-way communication. It is a system that captures brain signals (neural activity) and transforms these signals into commands that can be controlled by an external application or instrument [1]. BCIs have four broad characteristics: Ability to detect brain signals, provide feedback in real time or near time, read/decode brain activity, and provide feedback to the user on the success of the task or goal attained [2]. Broadly, there are two general uses for which BCIs can be used with respect to human performance enhancement: (1) Direct signals from the brain used to direct/alert/command external equipment as an auxiliary to human actions, to control prostheses, robotics, or weapons platforms, or (2) enhanced sensory or information input and/or control signals to enhance individual performance [3]. The earlier goals of BCIs—controlling external equipment—have research origins in medical research and are widely studied for their ability to control prostheses. As the scope of this paper focuses on human enhancement and not therapeutic uses of technology, we focus on those technologies that are hoped to improve particular cognitive functions.

Connection between the human brain and a computer interface is established via two methods: (1) Invasive connections that requiring surgery to implant/connect an electrode inside the skull and (2) non-invasive connections whereby electrodes are placed on the outside of the skull, either attached to a cap or helmet. For use in the military as an enhancement (and not for veterans' medical/therapeutic purposes), we assume that non-invasive BCIs would be preferred, as this poses less risk to the individual and is relatively easily reversible compared to invasive/implanted devices. This type of technology is attractive for use in the military, as it provides the opportunity to increase the brain's computational power, information load, and processing speed, which then allows for an enhanced human performance. BCIs allow for the human brain to handle larger quantities of information in a shorter time frame compared to the brain's normal/average functioning. In a military context, where individuals are required to process significant amounts of information in a short period of time, BCIs provide the possibility to increase human performance with regards to complex decision-making and situational awareness. For example, research in this area has indicated that BCIs can improve facial recognition as well as target detection and localisation in rapidly presented aerial pictures [4,5].

In reference to BCIs, the US Air War College indicated, "This technology will advance computing speed, cognitive decision-making, information exchange, and enhanced human performance. A direct connection between the brain and a computer will bypass peripheral nerves and muscles, allowing the brain to have direct control over software and external devices. The military applications for communications, command, control, remote sensors, and weapon deployment with BCI will be significant" [6].

The United States' (US) interest in identifying novel ways to enhance human cognition beyond current capabilities is evident in the projects undertaken by the Defense Advanced Research Projects Agency (DARPA)1, such as: Restoring Active Memory Replay (RAM Replay), which is a brain interface project to investigate ways to improve memories of events and skills by studying neural replays; Targeting Neuroplasticity Training (TNT), aimed to improve cognitive skills training by modifying peripheral nerves and strengthening neural connections; and Next-Generation Nonsurgical Neurotechnology (N3), which uses bi-directional BCIs that can control external equipment and applications such as unmanned aerial vehicles and cyber defence systems [7]. These are all examples of projects aimed at identifying ways to enhance cognitive functions that extend beyond therapeutic purposes [8].

### *2.2. Non-Invasive Brain Stimulation (NIBS)*

Non-Invasive Brain Stimulation (NIBS) technologies stimulate neural activity by using either a transcranial electrical stimulation (tES) or transcranial magnetic stimulation (TMS). TMS and tES have been demonstrated to improve the cognitive domains responsible for perception, learning, memory, and attention spans [9]. Research shows that an individual's ability to detect, visually search, or track specific targets can be improved by NIBS [10]. Similarly, tES can be used to improve complex threat detection tasks [11] and to increase risk-taking behaviour [12]. Stimulating specific regions of the brain that are active when performing complex threat detection tasks and risk-taking behaviour provides possibilities for use in military operations. The following paragraphs examine the capability of NIBS to enhance memory, vigilance, and attention, as well as its applicability in a military context.

Memory enhancement research has focused on using TMS and tES to improve working memory and learning capacities in individuals. Using a direct current stimulation on the dorsolateral prefrontal cortex (critical for working memory functions) improves the implicit learning of sequential motor sequences, motor learning, probabilistic learning, explicit memory for lists of words, spatial memory, and working memory [13,14]. Monitoring the mental state of users allows for enhanced performance by adapting the user interface to the changes in mental state. Target detection is one area where this type of technology has been tested. The adaptive interface adjusts accordingly to the feedback given by an electroencephalogram (EEG) and other physiological measures. Complex flight and driving simulation tasks have been used to test the usability of attention-increasing technologies. Studies have investigated the applicability of this technology in air tra ffic controllers [15] and in military-relevant training scenarios [16]. Enhanced declarative memory is another area that has military applicability. Memory enhancement impacts individual performance on tasks relating to situational awareness, which is of use for fighter pilots and point-shooting [17]. DARPA's RAM Replay project is aimed at identifying ways to enhance memory formation and recall to help individuals identify specific episodic events and learned skills, with research outputs to be applicable in military training activities [18]. Another area where research is done to augmen<sup>t</sup> cognitive capabilities useful for the military is to increase vigilance. Vigilance here refers to the ability to maintain sustained attention in areas of high workloads and to be able to shift/divide attention between tasks [15,19,20]. Reaction time tasks, stimulus discrimination, and target counting have been used to measure individuals' reaction times, and this information is used to increase vigilance.

<sup>1</sup> Former U.S President Barack Obama's BRAIN Initiative is supported by National Institute of Health (NIH) and DARPA.

The Halo Sport headset manufactured by the company Halo Neuroscience is one example of an NIBS product available on the market and tested in a military context. Aimed at increasing neuroplasticity, the headset has the ability to enhance physical performance; hence, their usage has been popular among professional athletes [21]. The aspect of the headset that we are interested in here is the ability to improve cognitive performance. The basis as to how Halo Sport headsets function is the same as in the general NIBS method; a Transcranial Direct Current Stimulation (tDCS) (a weak current of approximately 2 to 3 mA) is delivered to the scalp for a duration of several minutes. The current alters the neural activity in the motor cortex of the brain to impact cognitive functions [22]. The Halo Sport headsets, tested in a controlled laboratory environment, have been shown to increase accuracy in cognitive functions but not reaction times. In 2017, Rear Admiral Tim Szymanski, a commander of the US Navy Special Operations, expressed interest in human enhancement technologies with a focus on cognitive enhancement technologies. In his statement, the commander requested that the Defence industry develop and demonstrate technologies that could enhance cognitive performance in the Navy Special Operations forces [23]. A specific reference was also made to NIBS technologies that apply an electrical stimulation to the brain to improve performance. Halo Neuroscience's Chief Technology O fficer indicated that the Halo Sport headset has been tested on Navy Seals, showing promising results in improved cognitive performance [23]. According to the Naval Special Warfare Development group (SEAL Team Six), this technology has shown promising results for sleep-deprived individuals performing under hard training environments. At the time, this device was being tested at five military sites. Though the area that has shown the most promising improvements with the use of Halo Sport headsets is physical performance, testing regimens also showed significant improvements in cognitive functions, which has warranted its use for this particular purpose as well.

### **3. Decision-Making and Autonomy**

Autonomy is not only a complex notion, but is one of the most contested areas in philosophy and ethics. We do not expect to answer any of those open questions here, but draw attention to the connection between the technologies as described and autonomy. As Christman describes it, autonomy is the "idea that is generally understood to refer to the capacity to be one's own person, to live one's life according to reasons and motives that are taken as one's own and not the product of manipulative or distorting external forces" [24]. Our view on autonomy is that there is some relative equivalence between what a person does and the *reasons* that they have for acting.<sup>2</sup> This is a somewhat Kantian notion where reason and rationality play a key role in autonomy and, more generally, in ethics. This stands in the face of other views, like that of Haidt's social intuitionist model, in which reasons play far less of a role than the in Kantian model [28]. However, as Kennett and Fine argue, an "examination of the interaction between automatic and controlled reflective processes in moral judgment provides some counter to scepticism about our agency and makes room for the view shared by rationalists and sophisticated sentimentalists alike that genuine moral judgments are those that are regulated or endorsed by reflection" [29] (p. 78). The important point is that if technologies can change cognitive capacities and practices, they could play a role in improving moral decision-making. Our purpose is to draw attention to common elements of autonomy, and to see how they play out in relation to particular enhancement technologies when used in a military context.

In particular, of the technologies that we have reviewed, they are all expected and intended to impact upon and improve decision-making in di fferent ways. The connection to autonomy is that improved decision-making sits in part with the notions of autonomy as increasing "the capacity to be one's own person, to live one's life according to reasons that are taken as one's own." By increasing capacities like memory, attention, and vigilance, we sugges<sup>t</sup> that these technologies are increasing the recipient's autonomy by enhancing their decision-making capacity. Moreover, insofar as these

<sup>2</sup> For more on autonomy and self-identification [25,26] and for the argumen<sup>t</sup> about reasons and autonomy, see [27].

enhancements increase such decision-making while in positions of high cognitive demand and stress, like conflict, then they are minimizing the "distorting external forces." While more can be said about the connections between increased decision-making capacity and autonomy, the point here is to show that the technologies described are hoped to have some potential to enhance autonomy.
