This book, written by four internationally renowned bioethicists and first published in 2000, was the first systematic treatment of the fundamental ethical issues underlying the application of genetic technologies to human beings. Probing the implications of the remarkable advances in genetics, the authors ask how should these affect our understanding of distributive justice, equality of opportunity, the rights and obligations as parents, the meaning of disability, and the role of the concept of human nature in ethical theory and practice. The (...) book offers a historical context to contemporary debate over the use of these technologies by examining the eugenics movement of the late nineteenth and early twentieth centuries. The questions raised in this book will be of interest to any reflective reader concerned about science and society and the rapid development of biotechnology, as well as to professionals in such areas as philosophy, bioethics, medical ethics, health management, law, and political science. (shrink)

In this article I explain why cognitive science (including some neuroscience) matters for normative ethics. First, I describe the dual-process theory of moral judgment and briefly summarize the evidence supporting it. Next I describe related experimental research examining influences on intuitive moral judgment. I then describe two ways in which research along these lines can have implications for ethics. I argue that a deeper understanding of moral psychology favors certain forms of consequentialism over other classes of normative moral theory. I (...) close with some brief remarks concerning the bright future of ethics as an interdisciplinary enterprise. (shrink)

This article states that drugs could be used to produce, if not more intelligent individuals, at least individuals with better cognitive functioning. Cognitive functioning is something that we might strive to produce through education, including of course the more general health education of the community. Enhancements are good if and only if they make people better at doing some of the things they want to do including experiencing the world through all of the senses, assimilating and processing what is experienced, (...) remembering and understanding things better, becoming more competent, and experiencing more. Beneficial neural changes have been reported for such familiar technologies as reading, education, physical exercise, and diet. Smart drugs create irresistible competitive pressures such that once they are used everyone is forced to follow in order to keep up, and this is coercive and corrosive. (shrink)

In discussions of the ethics of human gene therapy, it has become standard to draw a distinction between the use of human gene transfer techniques to treat health problems and their use to enhance or improve normal human traits. Some dispute the normative force of this distinction by arguing that it is undercut by the legitimate medical use of human gene transfer techniques to prevent disease - such as genetic engineering to bolster immune function, improve the efficiency of DNA repair, (...) or add cellular receptors to capture and process cholesterol. If disease prevention is a proper goal of medicine, these critics argue, and the use of gene transfer techniques to enhance human health maintenance capacities will help achieve that goal, then the “treatment/enhancement‘ distinction cannot define the limits of legitimate gene therapy. In this paper, I argue that a line can be drawn between prevention and enhancement for gene therapy (and thus between properly medical and nonmedical uses of gene therapy), but only if one is willing to accept two rather old-fashioned claims: 1) Some health problems are best understood as if they were entities in their own right, reifiable as processes or parts in a biological system, with at least as much ontological objectivity and theoretical significance as the functions that they inhibit. 2) Legitimate preventive genetic health care should be limited to efforts to defend people from attack by these more robust pathological entities, rather than changing their bodies to evade social injustices. (shrink)

One objection to enhancement technologies is that they might lead us to live inauthentic lives. Memory modification technologies (MMTs) raise this worry in a particularly acute manner. In this paper I describe four scenarios where the use of MMTs might be said to lead to an inauthentic life. I then undertake to justify that judgment. I review the main existing accounts of authenticity, and present my own version of what I call a “true self” account (intended as a complement, rather (...) than a substitute, to existing accounts). I briefly describe current and prospective MMTs, distinguishing between memory enhancement and memory editing . Moving then to an assessment of the initial scenarios in the light of the accounts previously described, I argue that memory enhancement does not, by its very nature, raise serious concerns about authenticity. The main threat to authenticity posed by MMTs comes, I suggest, from memory editing. Rejecting as inadequate the worries about identity raised by the President’s Council on Bioethics in Beyond Therapy , I argue instead that memory editing can cause us to live an inauthentic life in two main ways: first, by threatening its truthfulness, and secondly, by interfering with our disposition to respond in certain ways to some past events, when we have reasons to respond in such ways. This consideration allows us to justify the charge of inauthenticity in cases where existing accounts fail. It also gives us a significant moral reason not to use MMTs in ways that would lead to such an outcome. (shrink)

The treatment-enhancement distinction draws a line between services or interventions meant to prevent or cure conditions that we view as diseases or disabilities and interventions that improve a condition that we view as a normal function or feature of members of our species. The line drawn here is widely appealed to in medical practice and medical insurance contexts, as well as in our everyday thinking about the medical services we do and should assist people in obtaining.

Neuroscientists have made significant advances in identifying drugs to dampen the intensity of traumatic memories. Such drugs hold promise for victims of terrorism, military conflict, assault, car accidents, and natural disasters who might otherwise suffer for many years from intense, painful memories. In 2003, the President's Council on Bioethics released a report entitled Beyond Therapy: Biotechnology and the Pursuit of Happiness, which analyzed memory dampening in some detail. While the Council acknowledged the potential benefits of memory dampening, some Council members (...) were concerned that it may: (1) discourage us from authentically coping with trauma, (2) tamper with personal identity, (3) demean the genuineness of human life and experience, (4) encourage us to forget memories that we are obligated to keep, and (5) inure us to the pain of others. In this Article, I describe possible legal and ethical implications of memory dampening. For example, I note that traumatic events frequently lead to legal proceedings that rely on memories of those events. Drugs that dampen traumatic memories may someday test the boundaries between an individual's right to medically modify his memories and society's right to stop him from altering valuable evidence. More broadly, I respond to the Council by arguing that many of its concerns are founded on controversial premises that unjustifiably privilege our natural cognitive abilities. While memory dampening may eventually require thoughtful regulation, broad-brushed restrictions are unjustified: We have a deeply personal interest in controlling our own minds that entitles us to a certain freedom of memory. (shrink)

The virtue of integrity does not appear explicitly in either the Aristotelian or the Judaeo- Christian list of virtues, but elements of both ethical systems implicitly acknowledge the importance of a unified and integrated life. This paper argues that integrity is indispensible for a good human life; the fragmented or compartmentalized life is always subject to instability, in so far as unresolved psychological conflicts and tensions may threaten to derail our ethical plans and projects. Achieving a stable and integrated life (...) requires self-awareness; and (drawing on insights from the psychoanalytic tradition) it is suggested that self-awareness is not a simple matter, but requires a complex process of self-discovery. The paper’s final section argues that although vitally necessary for the good life, integrity cannot be sufficient. Against the view of influential writers such as Bernard Williams and Harry Frankfurt, our commitment to our chosen projects, however authentic and integrated, cannot in itself give our lives meaning and value. The good and meaningful life cannot be a matter of authenticity alone, but requires us, whether we like it or not, to bring our projects into line with enduring objective values that we did not create, and which we cannot alter. (shrink)

Personhood is a foundational concept in ethics, yet defining criteria have been elusive. In this article we summarize attempts to define personhood in psychological and neurological terms and conclude that none manage to be both specific and non-arbitrary. We propose that this is because the concept does not correspond to any real category of objects in the world. Rather, it is the product of an evolved brain system that develops innately and projects itself automatically and irrepressibly onto the world whenever (...) triggered by stimulus features such as a human-like face, body, or contingent patterns of behavior. We review the evidence for the existence of an autonomous person network in the brain and discuss its implications for the field of ethics and for the implicit morality of everyday behavior. (shrink)

It is my view that one essential difference between persons and other creatures is to be found in the structure of a person's will. Besides wanting and choosing and being moved to do this or that, men may also want to have certain desires and motives. They are capable of wanting to be different, in their preferences and purposes, from what they are. Many animals appear to have the capacity for what I shall call "first-order desires" or "desires of the (...) first order," which are simply desires to do or not to do one thing or another. No animal other than man, however, appears to have the capacity for reflective self-evaluation that is manifested in the formation of second-order desires. (shrink)

This chapter presents David Foster Wallace's views about three positions regarding the good life—ironism, hedonism, and narrative theories. Ironism involves distancing oneself from everything one says or does, and putting on Wallace's so-called “mask of ennui.” Wallace said that the notion appeals to ironists because it insulates them from criticism. However, he reiterated that ironists can be criticized for failing to value anything. Hedonism states that a good life consists in pleasure. Wallace rejected such a notion, doubting that pleasure could (...) play a fundamental role in the good life. Lastly, narrative theories characterize the good life by fidelity to a unified narrative -- a systematic story about one's life, composed of a set of ends or principles according to which one lives. Wallace believed that these theories turn people into spectators, rather than the participants in their own lives. (shrink)

The prospect of using memory modifying technologies raises interesting and important normative concerns. We first point out that those developing desirable memory modifying technologies should keep in mind certain technical and user-limitation issues. We next discuss certain normative issues that the use of these technologies can raise such as truthfulness, appropriate moral reaction, self-knowledge, agency, and moral obligations. Finally, we propose that as long as individuals using these technologies do not harm others and themselves in certain ways, and as long (...) as there is no prima facie duty to retain particular memories, it is up to individuals to determine the permissibility of particular uses of these technologies. (shrink)

This essay is meant as a form of philosophical exorcism. The goal is to dispel the view that there are general secular grounds for holding human germline genetic engineering to be intrinsically wrong, a malum in se, or a morally culpable violation of human nature. The essay endorses the view that major obligations of prudence and care attend the development of this technology. However, these justifiable moral concerns can be seen more clearly when one has dispelled what must, from a (...) secular perspective, be regarded as pseudo-issues. (shrink)

We like to think we own our memories: if technology someday enables us to alter our memories, we should have certain rights to do so. But our freedom of memory has limits. Some memories are simply too valuable to society to allow individuals the unfettered right to change them. Suppose a patient regains consciousness in the middle of surgery. While traumatized by the experience and incapable of speaking, he coincidentally overhears two surgeons make plans to set fire to the hospital. (...) Assuming there is no way to erase his traumatic memories of intraoperative awareness and still prosecute the surgeons, a patient may well have a moral duty to retain the memories for the greater good. And if the patient has such a moral duty, I argue in this brief comment, then the state plausibly has the right to limit our abilities to erase memories when necessary to protect public safety or prosecute offenders. (shrink)

*The opinions expressed are the views of the author and do not necessarily reflect the policy of the National Institutes of Health, the Public Health Service, or the U.S. Department of Health and Human Services.

Book reviewed in this article: Toward a More Natural Science: Biology and Human Affairs. By Leon R. Kass.

Recombinant DNA technology will soon allow physicians an opportunity to carry out both somatic cell- and Germ-Line gene therapy. While somatic cell gene therapy raises no new ethical problems, gene therapy of gametes, fertilized eggs or early embryos does raise several novel concerns. The first issue discussed here relates to making a distinction between negative and positive eugenics; the second issue deals with the evolutionary consequences of lost genetic diversity. In distinguishing between positive and negative eugenics, the concept of malady (...) is applied as a definitional criterion for identifying genetic disorders that could qualify for Germ-Line therapy. Because gene replacement techniques are currently unavailable for humans, and because even if they were possible the number of people involved would be quite small, the loss of diversity concern seems moot. Finally, we dissuss the issue of iatrogenic disorders associated with gene therapy and discuss several ‘real world considerations.’. (shrink)

Can we understand what makes someone the same person without understanding what it is to be a person? Prereflectively we might not think so, but philosophers often accord these questions separate treatments, with personal-identity theorists claiming the first question and free-will theorists the second. Yet much of what is of interest to a person—the possibility of survival over time, compensation for past hardships, concern for future projects, or moral responsibility—is not obviously intelligible from the perspective of either question alone. Marya (...) Schechtman encourages us to adopt a more unified perspective. (shrink)