9: Enhancement - Reading Flashcards
What should we take into account when considering enhancements?
- who is affected by enhancement
- what values/ends the enhancement serves
what 2 questions does Juengst borrow from Parens for conversation
- limits of biomedicine
- ethics of self-improvement
enhancement is often used to mark off…?
moral boundaries within the realm of biomedicine
enhancement is often contrasted with …?
medical indicated treatments
explain enhancement as a moral boundary / boundary marker
Health professionals find enhancement a useful boundary marker setting a difference between what they’re not ethically obligated to do (enhancements) from what patients require (therapeutic interventions) aka their moral obligations
do hospitals offer enhancement services?
not obliged to set up ‘enhancement’ clinic, but might for profit (ex. cosmetic surgery)
example of boundary marker between enhancement and therapy
Obligation to prescribe beta blockers for heart disease, but not to an athlete to increase intervals for shooting sports
how do enhancements help set biomedical research moral boundaries?
make us ask what risks to human subjects of research are permissible if there are no health benefits
how does enhancement act as a signpost warning?
- acts as a moral signpost warning that we are approaching unsettled moral territory
- does not settle moral questions, but alerts values may be at stake
do non-biomedical enhancements exist? are they common?
parents regularly seek non-biomedical enhancements
ex. music lessons, tutoring
T or F: calling something an enhancement tells us a lot about what our moral attitude towards the intervention should be
F: tells us little
What do the intrinsic properties of an enhancement not tell us?
don’t tell us whether it is ethically wrong, permissible or required
T or F: all therapy can be understood as enhancement
T
▪ Physicians build upon healing process of body and mind, aiming to restore body’s homeostasis
▪ Antibiotics can be understood as means to enhance body’s capacity to fight infection
what is an example of an enhancement seen purely as a biomedical intervention?
vaccines
how do vaccines work as an enhancement?
form of enhancement directed at usual aims of therapy = preserving health & preventing disease
- enhance immune systems capacity to respond to infectious agents
some biomedical interventions work on a continuum between therapeutic intervention and outright enhancement by operating through the same pathway. Example?
Human growth hormone to make children taller
- biological remedy for kids with no active hGH
- enhancement for kid with normal projected height
can biomedical enhancements be achieved through only one way?
No - a variety of means
▪ Many take selective serotonin reuptake inhibitors (SSRIs) for psychological goals
▪ meditation, prayer, enhance psyche by building self-confidence
Difficulties with assuming for biomedical interventions, the key distinction is between enhancement <—–> therapy
- all therapy can be understood as an enhancement
- Biomedical interventions aiming at health but are clear forms of enhancement: vaccines
- Some biomedical interventions occupy a continuum between what appears to be a clearly ‘therapeutic’ application and an outright pursuit of enhancement
- Same goal may be reached by variety of means
what makes alteration of human form/function an enhancement?
some human end or value must be served
T or F: not all desired goal-directed changes are enhancement
T
what does the goodness of enhancement depend on?
(ends vs means)
the goodness of the goal to which it is directed
ex. EPO - hormone increasing red blood cell produc.
- chronic anemic: more energy, better health
- cyclist: enhance performance by oxygen flow
means = similar … more red blood cells
ends = relieving anemia to restore health is therapy, take EPO for cyclists is enhancement
ex. hGH
means = increased height
ends = enhance life, social advantage
5 arguments defending biomedical enhancements?
- incoherency argument
- line-drawing objection
- liberty argument
- resistance is futile
- willful self-design
what is the main claim of the incoherency argument?
there is no rational basis for distinguishing between acceptable and unacceptable means of enhancement
according to an implicit premise of the incoherency argument, no ethical distinction can survive unless…
it is based upon a coherent conceptual distinction
argument claims that no such conceptual distinction can be found in the case of biomedical enhancement
- ex. steroids are then no different from improved running shoes
criticisms of the incoherency argument?
a. Implies all means of reaching a goal are equivalent
- some means are ethically prohibited (not permitted to threaten/injure opponents
b. Forgets means matter too, not just ends
- means chosen to reach end may be morally valued
c. ignores complexity of ends
- Fitness, strength, perseverance , focus, courage
what is the main point of the line-drawing objection?
we can see differences between the ends of the spectrum, but insist drawing a line anywhere on continuum is arbitrary therefore indefensible
flaw of line-drawing objection?
loses moral force when one can offer good reason for drawing the line
- arbitrary, yet defensible
main point of the liberty argument?
people should be free to choose whatever ends they value and whatever means desired to reach said ends
issues with liberty argument?
- Treated as rhetorical trump card
main point of “resistance is futile”?
boundaries were shattered in the past, so boundaries will fall in the future
boundaries falling are an unavoidable outcome of …
values, social forces, incentives
problems with resistance is futile argument?
- not a moral claim - doesn’t say all forms of enhancement are defensible, simply states attempts to restrict will fail bc people will pursue them anyways
- Crime occurs all the time, don’t remove laws just bc “it’ll happen anyways”
main point of willful self-desing aka why it should be valued?
it is a distinctly human enterprise
what proves ones view on human nature can have significant moral content
Essence of human nature is its plasticity
what are the 3 elements of human nature as a guide?
- human nature as raw material
- human nature as contours of the given
- human nature as normative guide
what does seeing human nature as raw material argue?
Human nature (with 1 exception) has no moral significance
* exception = ability to intend coupled with the skill to remake ourselves according to our own designs
Human nature as raw material prescribes what view?
romatic-promethean (plasticity is all, affirms individual power)
how does Human nature as raw material view tinkering?
tinkering is celebrated as an affirmation of human will and cleverness
what does Human nature as contours of the given argue?
Acknowledges we are creatures of a particular kind
○ Embodied, finite, capable of courage/abiding love
○ Capable of cowardice, treachery, indifference
- our complex nature tells us about the boundaries of what is possible and desirable
how does human nature as contours of the given
contrast to romantic-Promethean views?
○ Does not assume human nature is limitlessly manipulable
○ Does not elevate human willfulness/technical skill over all other human capacities
○ Suggests modesty is in order both concerning our abilities to alter our natures and our wisdom in deciding which alterations are desirable
main points of Humans nature as normative guide ?
- only if there is something precious in our given human nature (beyond the fact of its giftedness) can what is given guide us in resisting efforts that would degrade it
- the ‘given’ (human nature) can be a ‘positive’ guide to our choices concerning enhancement if and only if what is given is also ‘good and worth respecting’
- aspects of our nature need to be defended against our deliberate redesign
criticisms of human nature as normative guide
- insistent on looking inward
- argues (wrongfully) that only that which is given and natural can be good, and all that is other than natural and given is suspect
what are some reasons for ethical concern about enhancement?
- Undermining Human Nature
- The Denial of Giftedness
- Temptation to Tyranny
- Undermining the Relationship of Parents and Children
- A Foolish Waste of Resources
- Complicity with Unjust Norms
- Justice and Equal Access
- The Meaning of Practice
Fear of “Undermining Human Nature”?
biotechnologies will rob us of what gives shape and motivation to human lives
- Without prospect of death, become more self-centered
- fantasy of unlimited life is a colossal distraction from actual challenges posed by enhancement
meaning of The Denial of Giftedness ?
Enhancement threatens to blind us to the giftedness of life (threatens human agency)
- difficult to view our talents as gifts we’re indebted, instead achievements for which we’re responsible
- impacts humility, responsibility, solidarity
**enhanced giftedness strips athletic excellence, undermines athletes natural talent
meaning of temptation to tyranny?
Parents attempting to enhance every aspect of their child
how is Undermining the Relationship of Parents and Children achieved?
by allowing parents to mould children into their own fantasies through enhancement
example of A Foolish Waste of Resources ?
hGH for children who would be average or above heigh = straightforward enhancement
example of Complicity with Unjust Norms ?
Cosmetic surgery undermines power of norms of physical appearance that most aging/young bodies cannot meet
main point of Justice and Equal Access? How to achieve Equal access?
Need to distinguish between person undergoing vs benefiting from enhancement
- when social value is added, people other than he who is enhanced may benefit
equal access to enhancement = key of distributive justice = fair allocation of burdens and benefits
main point of Meaning of the Practice
Athletes ask to compete on a level playing field (free of enhancement drugs) = plea for justice
- drug use by one affects all
*natural talent + virtuous perfection = sport (form of social practice)
- virtuous perfection from hard work/dedication, not drugs
performance principle in meaning of practice?
Maximum performance is all that counts, competitors may use any/all means to achieve that end
- Alternative to talent and virtue being @ center of sport
good vs bad enhancement lies in …?
the meaning of practice
what shapes the contours of our moral world?
nature
