Starting from the sensuous perception of what is seen, an attempt is made at re-casting a Husserlian theory of constitution of the object of intuition, as one leaves the natural attitude through a transcendental method, by positing several theses so as to avoid the aporias of philosophical binary oppositions such as rationalism and empiri-cism, realism and idealism, logicism and psychologism, subjectivism and objectivism, transcendentalism and ontologism, metaphysics and positivism. Throughout fifty-five theses on constitution, the Husserlian proposal of continuously reforming philosophizing (...) by transcendental reduction is revisited, leaving the latter incomplete as new conversions are required by noetic-noematic correlations between world and consciousness. (shrink)

Biomedical technologies can increasingly be used not only to combat disease, but also to augment the capacities or traits of normal, healthy people – a practice commonly referred to as biomedical enhancement. Perhaps the best‐established examples of biomedical enhancement are cosmetic surgery and doping in sports. But most recent scientific attention and ethical debate focuses on extending lifespan, lifting mood, and augmenting cognitive capacities.

Some philosophers and theologians have argued against the idea of Human Enhancement, saying that human beings should not play God. A closer look, however, might reveal that the question of who is playing Whom is far from being so clear-cut. This chapter will address the idea of human enhancement from the standpoint of theistic theology, arguing that human enhancement and theistic theology may not be so very incompatible, after all.

The question of enhancement occupies a prominent place not only in current bioethical debates but also in wider public discussions about our human future. In all of these, the problem of enhancement is usually articulated via two sets of questions: moral questions over its permissibility, extent and direction; and technical questions over the feasibility of different forms of regenerative and synthetic alterations to human bodies and minds. This article argues that none of the dominant positions on enhancement within the field (...) of bioethics is entirely satisfactory due to the limited, monadic, pre-technological and non-cultural conception of the human that is adopted in these models. Critically engaging with both opponents of enhancement (Habermas) and its advocates (Harris, Agar, Bostrom, Dworkin), Zylinska also takes some steps towards outlining a nonnormative ethics of enhancement. The latter sees its human and non-human subjects as always already enhanced, and hence dependent, relational and coevolving with technology. (shrink)

One approach to defining enhancement is in the form of bodily or mental changes that tend to improve a person’s well-being. Such a “welfarist account”, however, seems to conflict with moral enhancement: consider an intervention that improves someone’s moral motives but which ultimately diminishes their well-being. According to the welfarist account, this would not be an instance of enhancement—in fact, as I argue, it would count as a disability. This seems to pose a serious limitation for the account. Here, I (...) elaborate on this limitation and argue that, despite it, there is a crucial role for such a welfarist account to play in our practical deliberations about moral enhancement. I do this by exploring four scenarios where a person’s motives are improved at the cost of their well-being. A framework emerges from these scenarios which can clarify disagreements about moral enhancement and help sharpen arguments for and against it. (shrink)

Non-therapeutic performance enhancement in sport is a contentious issue for some time but the issue of therapeutic enhancements has only recently entered the sport vernacular. The purpose of therapeutic assistive devices so far is widely seen as lifting as impaired perceived people back to species-typical norms. However, ?therapeutic? body devices developed to mimic species-typical body structures and expected body functioning, as a side effect, increasingly allow the wearer to outperform the species-typical body in various functions. Unsurprisingly, then, this brings the (...) prospect of people labelled as impaired outperforming the so called non-impaired person in general and the paralympic athlete outperforming Olympic athletes. The ?cheetah? prosthetic legs worn by the South African Paralympic amputee Oscar Pistorius are one example of a ?therapeutic? device that might in the future outperform the species-typical body. Although it does not yet, it has already been labelled as a techno doping device. Others that already outperform are wheelchairs; however, they are rather invisible in the dispute around therapeutic enhancements and sport. This essay highlights various issues attached to this paradigm shift of the ability relationship between disabled and so called non-disabled people, Paralympic and Olympic athletes and what this might mean for Olympism and the Paralympic and Olympic Games. (shrink)

Has the time come to put to bed the concept of a harm threshold when discussing the ethics of reproductive decision making and the legal limits that should be placed upon it? In this commentary, we defend the claim that there exist good moral reasons, despite the conclusions of the non-identity problem, based on the interests of those we might create, to refrain from bringing to birth individuals whose lives are often described in the philosophical literature as ‘less than worth (...) living’. (shrink)

Uma forma de compreender o humano é pela sua biologia, a qual pode ser vista como ambígua. Por um lado, há características biológicas correlacionadas a capacidades extremamente especializadas e complexas, as quais abrem possibilidades que lhe são particulares, distinguindo-o ‘positivamente’ dos outros seres vivos. Por outro, como todo ser vivo, há características que tornam a vida humana finita e relativamente vulnerável, as quais costumam ser ‘negativamente’ interpretadas. Em ambos os casos, há características biológicas que, em si, não são boas nem (...) más, apenas são, constituindo uma espécie biológica. No debate bioético, tem havido uma passagem direta de fatos para valores, de modo que o fato do humano ser biologicamente vulnerável justificaria uma opção valorativa pela superação de algumas características biológicas. Postulando uma tensão entre fatos e valores, nosso objetivo é mostrar a pertinência de submeter os meios biotecnocientíficos de melhoramento humano à regulação proveniente da proteção da liberdade de escolha baseada na autocompreensão existencial do indivíduo (que chamaremos de escolha hermenêutica), medida fundamental para evitar ou combater formas de opressão num contexto biopolítico. (shrink)

No artigo, abordo a ideia de melhoramento humano (MH), visando a contestar três frustrantes tendências dos seus críticos, a saber, as ideias de: (1) que a natureza humana será artificializada, sugerindo que estaremos diante de algo novo e incomparavelmente perigoso, bem como que ainda seja possível preservar uma separação radical entre natureza e técnica; (2) que é possível abordar e criticar o MH a partir de uma singularidade semântica; e, diretamente relacionada à anterior, (3) que há univocidade entre os defensores (...) do MH acerca de como os indivíduos devem lidar com os meios biotecnocientíficos disponibilizados, a saber, como uma ingênua e acrítica obrigação de melhorar. In this paper, I discuss the idea of human enhancement (HE). My goal is to refute three frustrating trends in the HE criticism, namely the ideas that: (1) human nature will become artificial, suggesting that we will be facing something new and uniquely dangerous, and that it is still possible to preserve a radical separation between nature and technique; (2) it is possible to address and criticize HE from a semantic uniqueness, which is directly related to the previous item; and (3) there is an univocity among the HE's defenders on how individuals should handle the available bio-techno-scientific tools made available, namely, as a naive and uncritical obligation to become enhanced. (shrink)

Although the philosophical literature on the ethics of human prenatal genetic alteration purports to inform us about how to act, it rarely explicitly recognizes the perspective of those who will be making the PGA decision in practice. Here I approach the ethics of PGA from a distinctly virtue-based perspective, taking seriously what it means to be a good parent making this decision for one’s child. From this perspective, I generate a sound verdict on the moral standing of human PGA : (...) given the current state of the art, good parents have compelling reason not to consent to PGA for their child, especially as part of the first wave of PGA research participants and especially for non-medically oriented purposes. This is because doing otherwise is inconsistent with a plausible and defensible understanding of virtuous parenting and parental virtues, founded on a genuine concern for promoting the overall flourishing of the eventual child. In essence, given the current and foreseeable state of the art, parents who allow prenatal genetic alteration of their children are less-than-virtuous parents to those children, even in cases where they have a right to do so and even if PGA turns out to be beneficial to the eventual child. (shrink)

In the second half of the twentieth century, humanism— namely, the worldview that underpinned Western thought for several centuries—has been severely critiqued by philosophers who highlighted its theoretical and ethical limitations. Inspired by the emergence of cybernetics and new technologies such as robotics, prosthetics, communications, artificial intelligence, genetic engineering, and nanotechnology, there has been a desire to articulate a new worldview that will fit the posthuman condition. Posthumanism is a description of a new form of human existence in which the (...) boundaries between humans and nature and humans and machines are blurred, as well as a prescription for an ideal situation in which the limitations of human biology are transcended, replaced by machines. The transition from the human condition to the posthuman condition will be facilitated by transhumanism, the project of human enhancement that will ultimately yield the transformation of the human species from the human to the posthuman. As an intellectual movement, transhumanism is still very small, but transhumanist ideas exert deep and broad influence on contemporary culture and society. This essay highlights the religious dimension of transhumanism and argues that it should be seen as a secularist faith: transhumanism secularizes traditional religious themes, concerns, and goals, while endowing technology with religious significance. Science‐Religion Studies is the most appropriate context to explore the cultural significance of transhumanism. (shrink)

Germ-line gene therapy, like many other medical technologies, raises questions of special concern to Christians. It not only raises questions about medical effects, actual or possible, of genetic interventions that would be inherited from one generation to another but also, more importantly, raises anthropological questions and so questions about parental attitudes. These are questions about the dignity and value of human life, about inter-human relations and about the God-human relationship.1 For this reason the paper starts with an exploration of the (...) implications of Christian anthropology, viewed from a Roman Catholic perspective. A set of conditions will be specified in the light of which germ-line gene therapy’s compatibility with Christian attitudes, a Christian understanding of the human being, and the meaning of human life can be assessed. (shrink)

Despite the advent of CRISPR, safe and effective gene editing for human enhancement remains well beyond our current technological capabilities. For the discussion about enhancing human beings to be worth having, then, we must assume that gene-editing technology will improve rapidly. However, rapid progress in the development and application of any technology comes at a price: obsolescence. If the genetic enhancements we can provide children get better and better each year, then the enhancements granted to children born in any given (...) year will rapidly go out of date. Sooner or later, every modified child will find him- or herself to be “yesterday’s child.” The impacts of such obsolescence on our individual, social, and philosophical self-understanding constitute an underexplored set of considerations relevant to the ethics of genome editing. (shrink)

Since the first sex reassignment operations were performed, individual sex has come to be, to some extent at least, a technological artifact. The existence of sperm sorting technology, and of prenatal determination of fetal sex via ultrasound along with the option of termination, means that we now have the power to choose the sex of our children. An influential contemporary line of thought about medical ethics suggests that we should use technology to serve the welfare of individuals and to remove (...) limitations on the opportunities available to them. I argue that, if these are our goals, we may do well to move towards a “post sex” humanity. Until we have the technology to produce genuine hermaphrodites, the most efficient way to do this is to use sex selection technology to ensure that only girl children are born. There are significant restrictions on the opportunities available to men, around gestation, childbirth, and breast-feeding, which will be extremely difficult to overcome via social or technological mechanisms for the foreseeable future. Women also have longer life expectancies than men. Girl babies therefore have a significantly more “open” future than boy babies. Resisting the conclusion that we should ensure that all children are born the same sex will require insisting that sexual difference is natural to human beings and that we should not use technology to reshape humanity beyond certain natural limits. The real concern of my paper, then, is the moral significance of the idea of a normal human body in modern medicine. (shrink)

In ‘in vitro eugenics’ (IVE), I outlined a theoretical use of a technology of artificial gametogenesis, wherein repeated iterations of the derivation of gametes from embryonic stem cells, followed by the fusion of gametes to create new embryos, from which new stem cells could be derived, would allow researchers to create multiple generations of human embryos in the laboratory and also to produce ‘enhanced’ human beings with desired traits. As a number of commentators observed, my purpose in publishing this paper (...) was to provoke ethical discussion of a largely unremarked upon technological possibility and surrounding issues. Even if this was, as Murphy observes archly, to aim ‘low’, discussion of IVE is valuable for three reasons. First, it may render us better prepared should IVE become practical. I noted of my original discussion that it was speculative and several of the respondents suggest that IVE is even less likely to come about than I allowed there. Nevertheless, second, discussion of IVE is valuable for what it reveals about the ethics of new reproductive technologies (NRTs) more generally and, third, about the ethics of genetic human enhancement in particular. The responses to my paper demonstrate this nicely by (a) illustrating the selective way in which arguments about risk are mobilised in debates about NRTs and (b) highlighting the tension between any obligation of ‘procreative beneficence’ and a concern for genetic relatedness. Even if IVE should never be pursued, then, discussion of this possibility may help us better understand the ethics of other NRTs and means of genetic human enhancement. (shrink)

In this paper, I respond to recent criticisms, by Paula Casal, of my arguments about the implications of John Harris and Julian Savulescu's influential arguments for human enhancement for sex selection. I argue that, despite her protestations, her paper relies upon the idea that parents have a moral obligation to have children that will serve the interests of the nation. Casal’s use of dubious claims about inherent psychological differences between men and women to make her hypothetical case for moral enhancement (...) and her troubling references to “evolved humans” only exacerbate the political dangers involved in the argument for human enhancement. (shrink)

Disability activists influenced by queer theory and advocates of “human enhancement” have each disputed the idea that what is “normal” is normatively significant, which currently plays a key role in the regulation of pre-implantation genetic diagnosis (PGD). Previously, I have argued that the only way to avoid the implication that parents have strong reasons to select children of one sex (most plausibly, female) over the other is to affirm the moral significance of sexually dimorphic human biological norms. After outlining the (...) logic that generates this conclusion, I investigate the extent to which it might also facilitate an alternative, progressive, opening up of the notion of the normal and of the criteria against which we should evaluate the relative merits of different forms of embodiment. This paper therefore investigates the implications of ideas derived from queer theory for the future of PGD and of PGD for the future of queerness. (shrink)

A series of recent scientific results suggest that, in the not-too-distant future, it will be possible to create viable human gametes from human stem cells. This paper discusses the potential of this technology to make possible what I call ‘in vitro eugenics’: the deliberate breeding of human beings in vitro by fusing sperm and egg derived from different stem-cell lines to create an embryo and then deriving new gametes from stem cells derived from that embryo. Repeated iterations of this process (...) would allow scientists to proceed through multiple human generations in the laboratory. In vitro eugenics might be used to study the heredity of genetic disorders and to produce cell lines of a desired character for medical applications. More controversially, it might also function as a powerful technology of ‘human enhancement’ by allowing researchers to use all the techniques of selective breeding to produce individuals with a desired genotype. (shrink)

The idea that a world in which everyone was born “perfect” would be a world in which something valuable was missing often comes up in debates about the ethics of technologies of prenatal testing and preimplantation genetic diagnosis . This thought plays an important role in the “disability critique” of prenatal testing. However, the idea that human genetic variation is an important good with significant benefits for society at large is also embraced by a wide range of figures writing in (...) the bioethics literature, including some who are notoriously hostile to the idea that we should not select against disability. By developing a number of thought experiments wherein we are to contemplate increasing genetic diversity from a lower baseline in order to secure this value, I argue that this powerful intuition is more problematic than is generally recognized, especially where the price of diversity is the well-being of particular individuals. (shrink)

I argue that the existence of sexual dimorphism poses a profound challenge to those philosophers who wish to deny the moral significance of the idea of ‘normal human capacities’ in debates about the ethics of human enhancement. The biological sex of a child will make a much greater difference to their life prospects than many of the genetic variations that the philosophical and bioethical literature has previously been concerned with. It seems, then, that bioethicists should have something to say about (...) the choice between a male and a female embryo. Either, 1) parents have reason to choose boys over girls; (2) parents have reason to choose girls over boys; or, (3) parents have neither reason to choose girls over boys nor reason to choose boys over girls. Embracing either of the first two alternatives has strongly counterintuitive – and arguably morally repugnant – consequences. To motivate the third option we must either make reference to the idea of ‘normal human capacities’ or argue that parents should consider the interests of society when thinking about what sort of children they should bring into the world – an implication that should be extremely controversial in debates about the ‘new eugenics’. I conclude, then, that the idea of ‘normal human capacities’ is properly crucial to reasoning about the ethics of shaping future persons. (shrink)

This article discusses the ethics of the use of preimplantation genetic diagnosis to prevent the birth of children with intersex conditions/disorders of sex development , such as congenital adrenal hyperplasia and androgen insensitivity syndrome . While pediatric surgeries performed on children with ambiguous genitalia have been the topic of intense bioethical controversy, there has been almost no discussion to date of the ethics of the use of PGD to reduce the prevalence of these conditions. I suggest that PGD for those (...) conditions that involve serious medical risks for those born with them is morally permissible and that PGD for other “cosmetic” variations in sexual anatomy is more defensible than might first appear. However, importantly, the arguments that establish the latter claim have radical and disturbing implications for our attitude toward diversity more generally. (shrink)

In this paper, there were presented ethical arguments concerning the application of modern techniques of genetic intervention in human procreation. In particular, the rationalistic arguments in favour of genetic interventions were critically presented, namely the argument on ethical neutrality of technology, liberal argument on procreative freedom and argument on genetic enhancement. There were also analysed the negative emotional reaction to genetic engineering. The main aim of the paper was to express the cognitive element from these emotions enabling a wider understanding (...) of human procreation and the values of parent-child relations. (shrink)

In his book Reasons and Persons, Derek Parfit suggests that people are not harmed by being conceived with a disease or disability if they could not have existed without suffering that particular condition. He nevertheless contends that entities can be harmed if the suffering they experience is sufficiently severe. By implication, there is a threshold which divides harmful from non-harmful conceptions. The assumption that such a threshold exists has come to play a part in UK policy making. I argue that (...) Parfit’s distinction between harmful and non-harmful conceptions is untenable. Drawing on Kant’s refutation of the ontological argument for God’s existence, I suggest that the act of creation cannot be identical with the act of harming—nor indeed of benefiting—however great the offspring’s suffering may be. I suggest that Parfit is right that bringing children into existence does not usually harm them, but I argue that this must be applied to all conceptions, since Parfit cannot show how the harm threshold can be operationalised. If we think certain conceptions are unethical or should be illegal, this must be on other grounds than that the child is harmed by them. I show that a Millian approach in this context fails to exemplify the empirical and epistemological advantages which are commonly associated with it, and that harm-based legislation would need to be based on broader harm considerations than those relating to the child who is conceived. (shrink)

Based on the empirical findings correlating disgust with conservatism, most disgust scholars have fed arguments for its moral unreliability and concluded with moral condemnation of this emotion. In this paper, I will examine common arguments about whether relying on disgust in the moral domain is to be considered good or bad. I will problematize the suggestion that we are justified in firmly believing that disgust is an ethically «dumb» – or an ethically «smart» – emotion. It rather seems that moral (...) disgust can be rational or irrational, pro-social or anti-social, liberal or conservative depending on the eliciting contexts, and that such case-by-case conclusions rely on additional meta-ethical premises. (shrink)

Today’s technological-scientific prospect of posthumanity simultaneously evokes and defies historical understanding. On the one hand, it implies a historical claim of an epochal transformation concerning posthumanity as a new era. On the other, by postulating the birth of a novel, better-than-human subject for this new era, it eliminates the human subject of modern Western historical understanding. In this article, I attempt to understand posthumanity as measured against the story of humanity as the story of history itself. I examine the fate (...) of humanity as the central subject of history in three consecutive steps: first, by exploring how classical philosophies of history achieved the integrity of the greatest historical narrative of history itself through the very invention of humanity as its subject; second, by recounting how this central subject came under heavy criticism by postcolonial and gender studies in the last half-century, targeting the universalism of the story of humanity as the greatest historical narrative of history; and third, by conceptualizing the challenge of posthumanity against both the story of humanity and its criticism. Whereas criticism fragmented history but retained the possibility of smaller-scale narratives, posthumanity does not doubt the feasibility of the story of humanity. Instead, it necessarily invokes humanity, if only in order to be able to claim its supersession by a better-than-human subject. In that, it represents a fundamental challenge to the modern Western historical condition and the very possibility of historical narratives – small-scale or large-scale, fragmented or universal. (shrink)

A recent article on the front page of The Independent reported that the genetic ‘manipulation’ of IVF embryos is to start in Britain, using a new revolutionary gene-editing technique, called Crispr/Cas9. About three weeks later, on the front page of the same newspaper, it was reported that the National Health Service faces a one billion pound deficit only 3 months into the new year. The hidden connection between these reports is that gene editing could be used to solve issues related (...) to health care allocation. Improving the health of future generations might coincide with public health goals; it might improve the health of individuals and communities, and, if successful, might be seen as a public good. However, enhancing future generations will require In Vitro Fertilisation and Pre-implantation Genetic Diagnosis. Remarkably, the necessary involvement of women in an enhancing scenario has not been discussed by its proponents. The present discourse on moral obligations of future generations, although not referring to women, seems to imply that women might be required, morally, if not legally, to reproduce with IVF. Enhancing future generations will be gendered, unless the artificial womb is developed. These are challenging issues that require a wider perspective, of both women and men. Despite the lack of a unified feminist conclusion in the discussions about the merits and risks of human genome modification, there is an urgent need to clarify the role of women in this scenario. (shrink)

How should ethics help decide the morality of enhancing morality? The idea of morally enhancing the human brain quickly emerged when the promise of cognitive enhancement in general began to seem realizable. However, on reflection, achieving moral enhancement must be limited by the practical challenges to any sort of cognitive modification, along with obstacles particular to morality’s bases in social cognition. The objectivity offered by the brain sciences cannot ensure the technological achievement of moral bioenhancement for humanity-wide application. Additionally, any (...) limited moral enhancement will not easily fulfil ethical expectations. Three hypothetical scenarios involving putative moral enhancement help illustrate why. Philosophical concerns about the “Does-Must Dichotomy” and the “Factor-Cause Plurality,” as I label them, forbid easy leaps from views about morality on to conclusions about ways to enhance morality, and then further on to ethically justifying those enhancements. A modest and realistic approach to moral enhancement emerges from exploring these issues. (shrink)

Though the reputation of eugenics has been tarnished by history, eugenics per se is not necessarily a bad thing. Many advocate a liberal new eugenics—where individuals are free to choose whether or not to employ genetic technologies for reproductive purposes. Though genetic interventions aimed at the prevention of severe genetic disorders may be morally and socially acceptable, reproductive liberty in the context of enhancement may conflict with equality. Enhancement could also have adverse effects on utility. The enhancement debate requires a (...) shift in focus. What the equality and/or utility costs of enhancement will be is an empirical question. Rather than philosophical speculation, more social science research is needed to address it. Philosophers, meanwhile, should address head-on the question of how to strike a balance between liberty, equality, and utility in cases of conflict (in the context of genetics). (shrink)

Volume 19, Issue 7, July 2019, Page 28-30.

The hopes and fears expressed in the debate on human enhancement are not always based on a realistic assessment of the expected possibilities. Discussions about extreme scenarios may at times obscure the ethical and policy issues that are relevant today. This paper aims to contribute to an adequate and ethically sound societal response to actual current developments. After a brief outline of the ethical debate concerning neuro-enhancement, it describes the current state of the art in psychopharmacological science and current uses (...) of psychopharmacological enhancement, as well as the prospects for the near future. It then identifies ethical issues regarding psychopharmacological enhancements that require attention from policymakers, both on the professional and on the governmental level. These concern enhancement research, the gradual expansion of medical categories, off-label prescription and responsibility of doctors, and accessibility of enhancers on the Internet. It is concluded that further discussion on the advantages and drawbacks of enhancers on a collective social level is still needed. (shrink)

Medicine increasingly envisions health promotion in terms of reducing risk as determined by quantitative risk factors, such as blood pressure, blood lipids, or genetic variants. This essay argues that this vision of health care as risk reduction is dangerous for Christian bioethics, since risk can be infinitely reduced leading to a self-defeating spiral of iatrogenic effects. Moreover, it endangers character because this vision of health is connected to a reductionist vision of the body and an understanding of individual risk that (...) undermines the more communal virtue of solidarity. The essay concludes by discussing how recent Thomistic analyses in favor of physical enhancements illustrate some of the problems that envisioning health care in terms of risk reduction holds for Christian bioethics. (shrink)

Deep Brain Stimulation (DBS) is a treatment involving the implantation of electrodes into the brain. Presently, it is used for neurological disorders like Parkinson’s disease, but indications are expanding to psychiatric disorders such as depression, addiction and Obsessive Compulsive Disorder (OCD). Theoretically, it may be possible to use DBS for the enhancement of various mental functions. This article discusses a case of an OCD patient who felt very happy with the DBS treatment, even though her symptoms were not reduced. First, (...) it is explored if the argument that ‘doctors are not in the business of trading happiness’, as used by her psychiatrist to justify his discontinuation of the DBS treatment, holds. The relationship between enhancement and the goals of medicine is discussed and it is concluded that even though the goals of medicine do not set strict limits and may even include certain types of enhancement, there are some good reasons for limiting the kind of things doctors are required or allowed to do. Next, the case is discussed from the perspective of beneficence and autonomy. It is argued that making people feel good is not the same as enhancing their well-being and that it is unlikely—though not absolutely impossible—that the well-being of the happy OCD patient is really improved. Finally, some concerns regarding the autonomy of a request made under the influence of DBS treatment are considered. (shrink)

edited by Tuija Takala and Matti Häyry, welcomes contributions on the conceptual and theoretical dimensions of bioethics.

Medicalization has been a process articulated primarily by social scientists, historians, and cultural critics. Comparatively little is written about the role of bioethics in appraising medicalization as a social process. The authors consider what medicalization means, its definition, functions, and criteria for assessment. A series of brief case sketches illustrate how bioethics can contribute to the analysis and public policy discussion of medicalization.

Serving as a commentary on Kelly Oliver's essay, “Enhancing Evolution: Whose Body? Whose Choice?” this essay picks up on its themes of mastery, choice, the man-made, and the natural in order to further Oliver's critique of a particular liberal debate over the ethical permissibility of reprogenetics. The specific focus of the commentary is the hidden centrality of race to the reprogenetics debate, within which, I suggest, race serves as an implicit limit of acceptability in two important ways. First, on the (...) societal level, an explicitly racial focus marks the point at which a eugenic project becomes immoral, such that it is the refusal to mention race that renders the new eugenics acceptable. Second, in the realm of personal reproductive “choice,” race is portrayed as that which is naturally transmitted rather than deliberately chosen and, thus, serves as a limit on what are considered morally correct or even viable personal reproductive choices. The effect of this limiting and its naturalization is to obscure both the ways in which race has always been policed in reproduction and the social consequences of that policing and, thereby, to uphold the status quo of social inequality. (shrink)

Biomedical innovations are making possible the enhancement of human capabilities. There are two philosophical stances on the role that medicine should play in this respect. On the one hand, naturalism rejects every medical intervention that goes beyond preventing and treating disease. On the other hand, welfarism advocates enhancements that foster subjective well-being. We will show that both positions have considerable shortcomings. Consequently, we will introduce a third characterization in which therapies and enhancements can be reconciled with the legitimate objectives of (...) medicine inasmuch as they improve the capabilities that enable the freedom to pursue personal well-being. (shrink)

The ongoing revolution in molecular genetics has led many to speculate that one day we will be able to change the expression or phenotype of numerous complex traits to improve ourselves in many different ways. The prospect of genetic enhancements has generated heated controversy, with proponents advocating research and implementation, with caution advised for concerns about justice, and critics tending to see the prospect of genetic enhancements as an assault on human freedom and human nature. Both camps base their arguments (...) on the unquestioned assumption that the science will realize either their dreams or nightmares. In this paper, I show that their beliefs are based upon two fundamental mistakes. First, they are based upon an unwarranted reliance in a genetic determinism that takes for granted that the traits that we might most want to enhance, like intelligence, aggression, shyness, and even athletic ability, can be causally directed by specific genes. In so doing, character descriptions are reified to be concrete and discrete entities, in this case, genes. Second, they have accepted on faith that there is, or will be, a science to translate their hopes or worries into reality when, in fact, that is unlikely to occur because of the irreducible complexity of phenotypic expression. (shrink)

The ethics of human enhancement has been a hotly debated topic in the last 15 years. In this debate, some advocate examining science fiction stories to elucidate the ethical issues regarding the current phenomenon of human enhancement. Stories from science fiction seem well suited to analyze biomedical advances, providing some possible case studies. Of particular interest is the work of screenwriter Andrew Niccol (Gattaca, S1m0ne, In Time, and Good Kill), which often focuses on ethical questions raised by the use of (...) new technologies. Examining the movie In Time (2011), the aim of this paper is to show how science fiction can contribute to the ethical debate of human enhancement. In Time provides an interesting case study to explore what could be some of the consequences of radical life-extension technologies. In this paper, we will show how arguments regarding radical life-extension portrayed in this particular movie differ from what is found in the scientific literature. We will see how In Time gives flesh to arguments defending or rejecting radical life-extension. It articulates feelings of unease, alienation and boredom associated with this possibility. Finally, this article will conclude that science fiction movies in general, and In Time in particular, are a valuable resource for a broad and comprehensive debate about our coming future. (shrink)

Both, bioconservatives and bioliberals, should seek a discussion about ideas of human perfection, making explicit their underlying assumptions about what makes for a good human life. This is relevant, because these basic, and often implicit ideas, inform and influence judgements and choices about human enhancement interventions. Both neglect, and polemical but inconsistent use of the complex ideas of perfection are leading to confusion within the ethical debate about human enhancement interventions, that can be avoided by tackling the notion of perfection (...) directly. In the recent debates, bioconservatives have prominently argued against the ‘pursuit of perfection’ by biotechnological means. In the first part of this paper, we show that—paradoxically—bioconservatives themselves explicitly embrace specific conceptions of human perfection and perfectionist assumptions about the good human life in order to argue against the use of enhancement technologies. Yet, we argue that the bioconservative position contains an untenable ambiguity between criticising and endorsing ideas of human perfection. Hence, they stand in need of clarifying their stance on human perfection. In the second part of the paper, we ask whether bioliberals in fact (implicitly) advocate a particular conception of perfection, or whether they are right in holding that they do not, and that discussing perfection is obsolete anyway. We show that bioliberals also rely on a specific idea of human perfection, based on the idea of autonomy. Hence, their denial of the relevance of perfection in the debate is unconvincing and has to be revised. (shrink)

Is it necessary to have an ideal of perfection in mind to identify and evaluate true biotechnological human “enhancements”, or can one do without? To answer this question we suggest employing the distinction between ideal and non-ideal theory, found in the debate in political philosophy about theories of justice: the distinctive views about whether one needs an idea of a perfectly just society or not when it comes to assessing the current situation and recommending steps to increase justice. In this (...) paper we argue that evaluating human enhancements from a non-ideal perspective has some serious shortcomings, which can be avoided when endorsing an ideal approach. Our argument starts from a definition of human enhancement as improvement, which can be understood in two ways. The first approach is backward-looking and assesses improvements with regard to a status quo ante. The second, a forward-looking approach, evaluates improvements with regard to their proximity to a goal or according to an ideal. After outlining the limitations of an exclusively backward-looking view, we answer possible objections against a forward-looking view. Ultimately, we argue that the human enhancement debate would lack some important moral insights if a forward-looking view of improvement is not taken into consideration. (shrink)

‘Liberal eugenics’ has emerged as the most popular position amongst philosophers writing in the contemporary debate about the ethics of human enhancement. This position has been most clearly articulated by Nicholas Agar, who argues that the ‘new’ liberal eugenics can avoid the repugnant consequences associated with eugenics in the past. Agar suggests that parents should be free to make only those interventions into the genetics of their children that will benefit them no matter what way of life they grow up (...) to endorse. I argue that Agar's attempt to distinguish the new from the old eugenics fails. Once we start to consciously determine the genetics of future persons, we will not be able to avoid controversial assumptions about the relative worth of different life plans. Liberal eugenicists therefore confront the horns of a dilemma. Whichever way they try to resolve it, the consequences of widespread use of technologies of genetic selection are likely to look more like the old eugenics than defenders of the new eugenics have acknowledged. (shrink)

Advances in reproductive technology have already revolutionized our culture in various ways, and future potential developments, particularly in genetics, promise more of the same. The practice of surrogacy threatens to upend the way we understand the family. Germline engineering of human embryos could, among other things, lead to the treatment of genetic diseases hitherto incurable; but the widespread use of such engineering could have broader ramifications for our culture, for better and for worse. Parents may eventually be able to select (...) for desirable traits in their offspring, whether by genetic modification at conception or by choosing to implant one of several genetically profiled embryos. Authors in this issue of The Journal of Medicine and Philosophy address some of the ethical implications of these technological and cultural changes. (shrink)

The purpose of this paper is to look into the question of whether considerable life extension should be seen as a form of human enhancement. Human enhancement, generally, refers to enhancing physical, psychological, and moral human capacities beyond the average or “normal” level. Much of the recent literature focusing on considerable life extension has been related to the human enhancement debate. I will examine whether considerable life extension and human enhancement are connected. I argue that they are not connected to (...) each other in the way that is presented by many philosophers such as John Harris, Nick Bostrom, and Nils Holtug, as well as Savulescu, Kahane, and Sandberg. Sometimes considerable life extension should be seen rather as a part of preventive care. Considerable life extension can result simply from preventive care. If we define considerable life extension as enhancement, it is interesting because it is related to many ethical questions. A quite common view, for example, is one that states that treatment should be supported financially by society, whereas enhancement should not. However, claiming that there is no strong conceptual link between considerable life extension and enhancement does not mean that the former should automatically be covered by public healthcare or insurance policies. The aim of this paper is not to present a strong view for or against the ethical desirability of considerable life extension. I argue that the importance of the human enhancement framework has been overstated in the case of considerable life extension. My point is simply that it is unclear why the possibility of radical extension in human life should be primarily discussed in the sphere of human enhancement. (shrink)

Comparisons between germline gene editing using CRISPR technology and a renewal of eugenics are evident in the current bioethical discussions. This article examines the different roles of such references to the past. In the first part, the alleged parallels between gene editing of the germline and eugenics are addressed from three perspectives: First, the historical adequacy of such comparisons is questioned. Second, it is asked whether the evils of the past can in fact be attributed to (future) practices of germline (...) gene editing. Third, it is discussed whether the alleged hazards of eugenics should in fact universally be condemned from a moral perspective. The article attempts to show that references to the eugenic past to rebut gene editing are highly selective and should be abandoned to allow for a more transparent ethical discourse. While the comparison with a eugenic past is frequently drawn by opponents of germline gene editing, the remaining part of this article investigates historic references from the proponents of germline gene editing. It is argued that they also employ different narratives of the past to justify their own liberal position. While such references are equally problematic, some lessons from the history of eugenics will be spelled out that can inform future debates on germline gene editing. (shrink)

The article explores some of the issues that have arisen in the discourse on pharmaceutical cognitive enhancement (PCE), that is, the use of stimulant drugs such as methylphenidate, amphetamine and modafinil by healthy individuals of various populations with the aim of improving cognitive performance. Specifically, we explore the presumed sizes of existing PCE user populations and the policy actions that have been proposed regarding the trend of PCE. We begin with an introductory examination of the academic stances and philosophical issues (...) involved in defining PCE. We then focus on an examination of the population sizes of presumed current PCE users that have been listed in the academic literature on PCE, on presuppositions, which have been problematized by some authors as based on anecdotal or misinterpreted survey data. We follow this with an empirical examination of a potential PCE user population in a national context (students at the University of Ljubljana in Slovenia). We then proceed to examine the regulatory options proposed in the academic literature to address PCE, finally comparing them with an empirical overview of the policy recommendations on PCE produced in the multinational context of several national ethics advisory bodies (EABs) in Europe. Our main conclusion is that there is still little debate among the national EABs on what type of public policy responses, if any, are needed to address PCE in European countries, and that the issues they do address are similar to those discussed and proposed in the academic articles on PCE. (shrink)

A prominent objection to non-cognitive moral bio-enhancements is that they would compromise the recipient’s ‘freedom to fall’. I begin by discussing some ambiguities in this objection, before outlining an Aristotelian reading of it. I suggest that this reading may help to forestall Persson and Savulescu’s ‘God-Machine’ criticism; however, I suggest that the objection still faces the problem of explaining why the value of moral conformity is insufficient to outweigh the value of the freedom to fall itself. I also question whether (...) the objection is compatible with Neil Levy’s parity principle. Accordingly, I go on to consider an alternative relational freedom-based objection to NCMBEs that aims to explain the fundamental moral importance of the freedom that NCMBEs would violate. I argue that although this strategy might allow the critic of NCMBEs to bypass a powerful criticism of Harris’ objection, it also weakens the freedom-based objection’s compatibility with the parity principle. (shrink)