The enhancement debate in neuroscience and biomedical ethics tends to focus on the augmentation of certain capacities or functions: memory, learning, attention, and the like. Typically, the point of contention is whether these augmentative enhancements should be considered permissible for individuals with no particular “medical” disadvantage along any of the dimensions of interest. Less frequently addressed in the literature, however, is the fact that sometimes the _diminishment_ of a capacity or function, under the right set of circumstances, could plausibly contribute (...) to an individual's overall well-being: more is not always better, and sometimes less is more. Such cases may be especially likely, we suggest, when trade-offs in our modern environment have shifted since the environment of evolutionary adaptation. In this article, we introduce the notion of “diminishment as enhancement” and go on to defend a _welfarist_ conception of enhancement. We show how this conception resolves a number of definitional ambiguities in the enhancement literature, and we suggest that it can provide a useful framework for thinking about the use of emerging neurotechnologies to promote human flourishing. (shrink)

Understanding the ethics of enhancement begins with getting clear about the concept, as well as the factors likely to move people to pursue biomedical enhancement. This article first considers the usefulness of the distinction between therapy and enhancement for understanding the ethics of enhancement. Once the conceptual underbrush has been cleared away, we can move on to ethics. The next section examines critically a number of arguments that have been offered to defend biomedical enhancement, or, at least, to claim that (...) efforts to deter it are either ethically or practically mistaken. Finally, the article considers a set of arguments that take the ethics of enhancement to be a serious matter and that gives reasons to question whether some biomedical enhancements, for some purposes, may be ethically suspect. (shrink)

In this issue, Ahmadi1 reports on the practice of hymenoplasty—a surgical intervention meant to restore a presumed physical marker of virginity prior to a woman's marriage. As Mehri and Sills2 have stated, these women ‘want to ensure that blood is spilled on their wedding night sheets.’ Although Ahmadi's research was carried out in Iran specifically, this surgery is becoming increasingly popular in a number of Western countries as well, especially among Muslim populations.3 What are the ethics of hymen restoration?Consider the (...) role of the physician. Two of the doctors interviewed by Ahmadi reported being in ‘a perpetual state of guilt because of the surgery's inherent aim at deceiving the groom’ and noted their ‘personal conflict’ at being involved in this deception. Yet: "None of the doctors believed that the surgery was unethical, arguing that the girl could be ‘abused’ and ‘can even die’ if she is discovered not … ". (shrink)

“Love hurts”—as the saying goes—and a certain amount of pain and difficulty in intimate relationships is unavoidable. Sometimes it may even be beneficial, since adversity can lead to personal growth, self-discovery, and a range of other components of a life well-lived. But other times, love can be downright dangerous. It may bind a spouse to her domestic abuser, draw an unscrupulous adult toward sexual involvement with a child, put someone under the insidious spell of a cult leader, and even inspire (...) jealousy-fueled homicide. How might these perilous devotions be diminished? The ancients thought that treatments such as phlebotomy, exercise, or bloodletting could “cure” an individual of love. But modern neuroscience and emerging developments in psychopharmacology open up a range of possible interventions that might actually work. These developments raise profound moral questions about the potential uses—and misuses—of such anti-love biotechnology. In this article, we describe a number of prospective love-diminishing interventions, and offer a preliminary ethical framework for dealing with them responsibly should they arise. (shrink)

We argue that the fragility of contemporary marriages—and the corresponding high rates of divorce—can be explained (in large part) by a three-part mismatch: between our relationship values, our evolved psychobiological natures, and our modern social, physical, and technological environment. “Love drugs” could help address this mismatch by boosting our psychobiologies while keeping our values and our environment intact. While individual couples should be free to use pharmacological interventions to sustain and improve their romantic connection, we suggest that they may have (...) an obligation to do so as well, in certain cases. Specifically, we argue that couples with offspring may have a special responsibility to enhance their relationships for the sake of their children. We outline an evolutionarily informed research program for identifying promising biomedical enhancements of love and commitment. (shrink)

Some commentators object to the use of embryonic and fetal diagnostic technologies by parents who wish to avoid disabilities in their children. In particular, they say this use is hurtful in the meaning it expresses, namely that the lives of people with disabilities are not valuable or are less valuable than the lives of others. Other commentators have tried to show that this meaning does not necessarily belong to parents' choices and is not therefore credible as a general moral objection. (...) However, this analysis overlooks the way in which the use of these technologies can be legitimately interpreted as hurtful. Once we admit to these hurtful effects felt by people with disabilities and those who hold them dear, it becomes important to ask whether that hurt can justify limits on parents' choices. Because the use of these technologies does not hurt people with disabilities directly and because there is no requirement that people having children work to ensure the continued existence of people with disabilities, no justification for limiting parents' choices is to be found in the hurt some people experience in steps taken to avoid disabilities in children. (shrink)

This paper reviews the evolutionary history and biology of love and marriage. It examines the current and imminent possibilities of biological manipulation of lust, attraction and attachment, so called neuroenhancement of love. We examine the arguments for and against these biological interventions to influence love. We argue that biological interventions offer an important adjunct to psychosocial interventions, especially given the biological limitations inherent in human love.

As cognitive neuroscience has advanced, the list of prospective internal, biological enhancements has steadily expanded. Education and training, as well as the use of external information‐processing devices, may be labeled as “conventional” means of cognition enhancement (CE). They are often well established and culturally accepted. By contrast, methods of enhancing cognition through “unconventional” means, such as ones involving deliberately created nootropic drugs, gene therapy, or neural implants, are nearly all to be regarded as experimental at the present time. Transcranial magnetic (...) stimulation (TMS), genetic interventions, brain‐computer interfaces and new senses are highly experimental and unlikely to be important over the next 15 years. Many of the concerns about enhancement are nonspecific to the tools used to achieve it, which means that enhancement–ethic scrutiny should also apply to nonbiological external enhancements. (shrink)

Research into the genetic component of some complex behaviors often causes controversy, depending on the social meaning and significance of the behavior under study. Research into sexual orientation—simplistically referred to as “gay gene” research—is an example of research that provokes intense controversy. This research is worrisome for many reasons, including the fact that it has been used to harm lesbians and gay men. Many homosexual people have been forced to undergo “treatments” to change their sexual orientation. Others chose to undergo (...) them to escape discrimination and social disapprobation. But there are other reasons to worry about such research. The very motivation for seeking an “origin” of homosexuality reveals homophobia. Moreover, such research may lead to prenatal tests that claim to predict for homosexuality. For homosexual people who live in countries with no legal protections these dangers are particularly serious. (shrink)

The ongoing ‘enhancement’ debate pits critics of new self-shaping technologies against enthusiasts. One important thread of that debate concerns medicalization, the process whereby ‘non-medical’ problems become framed as ‘medical’ problems.In this paper I consider the charge of medicalization, which critics often level at new forms of technological self-shaping, and explain how that charge can illuminate – and obfuscate. Then, more briefly, I examine the charge of pharmacological Calvinism, which enthusiasts, in their support of technological self-shaping, often level at critics. And (...) I suggest how that charge, too, can illuminate and obfuscate.Exploring the broad charge of medicalization and the narrower counter charge of pharmacological Calvinism leads me to conclude that, as satisfying as it can be to level one of those charges at our intellectual opponents, and as tempting as it is to lie down and rest with our favorite insight, we need to gather the energy to have a conversation about the difference between good and bad forms of medicalization. Specifically, I suggest that if we consider the ‘medicalization of love,’ we can see why critics of and enthusiasts about technological self-shaping should want (and in some cases have already begun) to distinguish between good and bad forms of such medicalization. (shrink)

This chapter concentrates mainly on biomedical cognitive enhancements, but many of the remarks apply equally to enhancements that work on non‐cognitive capacities, and to non‐biomedical means of enhancement. Proponents of a positive right to enhancements could argue their case on grounds of fairness or equality, or on grounds of a public interest in the promotion of the capacities required for autonomous agency. The societal benefits of effective cognitive enhancement may turn out to be so large and unequivocal that it would (...) be economically efficient to subsidize enhancement for the poor, just as the state now subsidizes education. The example on iodine deficiency illustrates that cognitive enhancement policy need not center on preparing the ground for sophisticated, yet‐to‐be‐realized technologies. “Smart policy” should, rather, take as its starting point the recognition that effective cognition is not only subjectively valuable to individuals, but also delivers significant social, cultural, financial, and scientific benefits. (shrink)