Wednesday, May 20, 2009

Making Human Enhancement Available is a Moral Imperative

I believe the title of this post adequately conveys my thesis herein, but allow me to restate it a bit more completely:

When and where it becomes technologically feasible and acceptably safe according to the same standards used to judge similar technologies, it is morally necessary for a society which desires to respect human rights and human equality to allow and make available the means for human physical and mental enhancement; drawing an entirely artificial and inconsistent line between "treatment" and enhancement is not ethical, as it is claimed to be, but instead serves only to damn those who were less fortunate in the lottery of genetics and rearing to being forever trapped in their native and functionally inferior states.

I realize that this may not sound like something particularly controversial, especially not phrased in such an overblown, highfalutin manner, and I think that the only person who might take issue at this stage is a sort of conservative-minded medical professional or medical researcher. Medical ethics seems to be the primary vector for discussion of this matter so far, but I assure you that it's much further-reaching and much less abstract than that makes it appear.

I'd also like to admit up front that I have been beaten to the punch on addressing this issue by the preeminent journal Science, which ran an editorial several weeks ago recognizing the increasing demand for enhancement and recommending that the scientific and medical communities take up the issue realistically. It was not an endorsement, but it was an admission of, ultimately, the inevitability of human demand for enhancement and the need to understand it and perform it as reliably and ethically as possible. I take the matter in a different direction, though I agree with the editorial's thrust.

What am I talking about? Well, for starters, I'm talking about athletes using steroids and other performance-enhancing drugs. I'm talking about students and researchers using Adderall and similar stimulants to improve academic performance. I'm even talking about recreational use of Viagra and related sexually active pharmaceuticals. I'm also talking about technologies that haven't arrived yet but promise to in the near or not-so-near future: prosthetic body parts with electronic components whose functionality exceeds baseline organic analogs; implanted computing; real mental enhancement by drugs or surgery, as contrasted to today's attention-enhancing stimulants; and who knows what else, since the progress of future technology always contains unexpected developments.

Many of these familiar examples highlight the complexity contained within the qualifier "acceptably safe according to the same standards used to judge similar technologies." Athletic performance-enhancing drugs can have catastrophic consequences if misused, leading to heart failure, higher incidences of cancer, or other unfortunate medical outcomes. The mental enhancement drugs available today often suffer from similarly grim side-effects; abuse of Adderall, now widespread and deeply entrenched on university campuses, can have a variety of attached problems including psychosis, immune degredation due to sleep deprivation, and even death in extreme cases. By and large these drugs are the extent of enhancement available to most of us today; the more "cybernetic" methods that might come to mind like robotic limbs are prohibitively expensive, too primitive to be beneficial, or illegal - sometimes all three.

You'll note, however, that those list of horrible harms were attached to the word "abuse." This was part of the thrust of the Science editorial and it's part of my point as well (though it's not a point that I think is likely to strike home in a nation which hosts a continuing and deeply nonsensical War on Drugs) - that if these things are going to exist and be widespread anyway, it is then our duty to make them as safe and as fair as possible.

Frankly, though, what we have now is only the barest, primitive leading edge of what may come as we continue to advance our technology. The tradeoff of side effects versus benefits of the drugs many people use makes it entirely debatable whether they're enhancement at all for any but a few in special situations; a major-league baseball player may benefit from steroid use, but anyone else would likely suffer more harm than the positive returns would rationally justify. Adderall may help desperate students study for an exam, but its tendency to make users jittery and sometimes panicky makes its routine use unpleasant and potentially dangerous for most people. Other drugs used for similar purposes have similar problems. We don't yet seem to have anything that qualifies as a clear "upgrade."

But we will. We will, and under certain circumstances we already do.

Consider the case of a victim of a hereditary degenerative disease - Huntington's chorea, for no particular reason. This person will not live the fullest and best possible life for someone in his societal situation. This person will suffer, and die early. We consider this person deserving of any available medical means to treat this disorder. But Huntington's is not a disease, per se; it's a genetic condition. This person is only living out the life determined by his genes. He's not suffering from any external negative influence, nor is he responsible for his condition as a result of his own actions. We consider this unfortunate, and we deem this person worthy of elevation by any available means to a better life than that predetermined by genes and circumstance.

Consider the case of a perfectly ordinary young man of average abilities who finds himself unable to grasp the subtleties of quantum physics at university. It is his dream to understand and work with the fundamental forces of the universe, and to use his knowledge to find new energy sources and new technologies, but he simply can't make the math line up in his head. He is using the brain his genes created for him and the training his parents and other influences gave him. He is living out the life - and the inadequacy - predetermined by his genes and circumstances. He faces an uphill struggle to comprehend the difficult problems facing him and a hopeles academic and professional disadvantage if he pursues his dream. Does this young man deserve the opportunity to obtain and use whatever drugs are available to focus and sharpen his mind and aid him in his studies? His case is qualitatively analogous to the victim of a genetic disease, and yet by and large our society frowns on his availing himself of any means of self-improvement other than hard work, which we like to imagine is all that is necessary - a fairy-tale view of morality, reward, and punishment which reality often fails to bear out.

Think of all the other conditions of life which we, today, vacillate about whether to treat as disorders or unfortunate but unalterable qualities of an individual: depression, anxiety, irritability, addictiveness, lethargy, physical weakness, poor memory, chronic pain, and a host more. Do we deserve to be damned with these small failings just because we were born with them? It is not the sufferer's fault if he is clinically depressed. It is similarly not the sufferer's fault if he is unintelligent, or if he is intelligent but unable to focus. Free will - if you accept its reality, which I do only provisionally - extends to our decisions, but not our basic natures. If anyone is to blame for a tendency to alcoholism or a small frame or arthritis, it is one's parents, and yet assigning blame helps us not at all.

I say, therefore and finally, that as we have the means, we must, if we would claim to be just and moral as a society, allow all individuals the means to make themselves the best they may be, to succeed as greatly as they may succeed. To do any less is to chain them to a primitive genetic determinism, is to enslave them - us! - to a place in life determined not by individual rights, nor even by merit, but merely by birth. We had as well return to the days of feudal aristocracy. No, it will not do. Making human enhancement available is a moral imperative.

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