Cognitive Bioprediction and Moral Responsibility: Foreseeability, Control and the Ethics of Anticipated Cognitive Impairment.

Bioprediction uses biomedical data, biomarkers, and algorithmic tools to forecast future physiological states or impairments. As predictive technologies increasingly enable individuals to anticipate loss of cognitive capacity before it occurs, they raise a fundamental ethical question: how should moral responsibility be assessed when impairment becomes foreseeable in advance of its onset? We argue that biopredictive technologies can alter both the epistemic and control conditions that ground moral responsibility. In some cases, this generates obligations to respond to predictive warnings of cognitive decline; in more limited circumstances, it may also ground obligations to acquire and use biopredictive technologies where these represent a proportionate and least restrictive means of risk reduction. We further argue that emerging individual responsibilities generate corresponding obligations for states. Where access to biopredictive technologies is necessary to meet morally significant expectations of risk management, fairness, and legitimacy require attention to affordability, accessibility, and institutional support.