Few moral issues attract as much attention from moral philosophers these days as the ethics of human enhancement—of using pharmacological agents, genetic engineering, or biomedical implants to improve our memory, intelligence, strength, endurance, agility, or personality. To analyze the morality of enhancements, we must consider new technologies, review scientific developments, make predictions about the future, entertain hypotheticals that border on science fiction, and ponder novel moral dilemmas. Contemplating this compelling brew of fact, fantasy, and value certainly beats rehashing old disputes about abortion, affirmative action, and capital punishment.
In addition, offering one’s views on enhancements has this distinct advantage: since arguments about enhancements depend to a significant extent on what might happen, it is difficult for others to prove one’s moral position unsound. Armchair moralizing has rarely been as much fun—or as speculative.
Nonetheless, despite substantial factual and moral uncertainty, some relevant empirical claims and moral judgments have a sufficiently solid, defensible basis that we can use to assemble a rough moral guide to the development and use of enhancements. I will provide this rough guide by listing a few key facts and moral principles and then focus on some specific issues relating to personality enhancement—which in my view raise some more difficult questions, in part because our concepts of personality are themselves quite vague.
Four Key Points About Enhancements
1. The availability of significant enhancements in coming decades is highly probable. It would be exceedingly difficult and/or counterproductive to ban their production and use. Both proponents and opponents have tended to overstate the proximity of enhancements, suggesting they are just around the corner. Genetic enhancements, in particular, are a few decades away, at best, especially for complex traits such as intelligence or a “happy” personality. These traits are not associated with any single gene. Moreover, if and when we locate the genes associated with certain traits, it is not only that set of genes that we would have to modify but also the genes located in other areas of the person’s genome that regulate the expression of the genes in question. Genes interact in very complicated patterns with other genes.
However, biomedical implants and reliable pharmacological agents are much closer to fruition. Indeed, there is already widespread “off-label” use of certain drugs that can be used as cognitive enhancers. Drugs prescribed for those suffering from ADHD (Attention Deficit Hyperactivity Disorder), such as Ritalin and Adderall, are used by people without this disorder to improve their mental alertness and acuity. This illustrates one major problem of trying to ban the production of enhancements. Enhancements often arise as by-products of efforts to develop therapies. Some people have a clear therapeutic need for Ritalin and similar drugs, so prohibiting the production of such drugs because of their utility as cognitive enhancers would prevent many from achieving “normal” functioning. Likewise, the pill that can restore an Alzheimer patient’s memory can provide someone else with super-memory; the pill that alleviates one patient’s depression may provide someone else with a highly social, agreeable personality (think of Prozac).
In theory, we could limit the use of such drugs to those who have a diagnosed disorder. Yeah, right. The administrative and regulatory bureaucracy required to prevent the “off-label” use of therapies would be staggering and would probably entail serious abridgment of personal liberties. Urine tests for all would become a daily routine.
In addition, banning enhancements would create a black market, giving the wealthy greater access to enhancements than others. Concern about inequity of access is one of the reasons some oppose enhancements; yet banning enhancements would likely worsen disparities in access to them.
Biomedical implants and genetic engineering would be easier to regulate: you can’t buy a genetic engineering kit at your local drugstore and probably won’t able to until Manhattan disappears underwater. (Maybe you’ll be able to design gills for yourself.) But drugs can deliver most of what people want from enhancements, and, as indicated, banning their production and use would be inadvisable.
2. Enhancements are not intrinsically immoral or “unnatural.” As is true with some other issues in bioethics, the debate over the morality of enhancements has suffered from the instinctive reactions of many against any technology that is new and different. How many times have we heard the argument that some new technology/procedure should be rejected because it is “unnatural” or would require us to “play God”? These objections are singularly uninformative. Indeed, saying that something is “unnatural” is simply a superficially more impressive way of saying “I don’t like this, but I can’t say why.”
Scores of books and articles have been written about the supposed horror of human enhancements. But why are some people so horrified by enhancements? If we understand an enhancement as something that allows human beings to expand their capacities—that is, to enable them to function in ways that human beings in the past were not able to—then for most of our existence as a species we have been pursuing enhancements. Consider literacy, one of the most consequential human cognitive enhancements ever achieved. Literacy has greatly increased our communicative capabilities as well as our ability to engage in complex planning.
Enhancements are essentially a means of improving ourselves. And is there anything intrinsically wrong with self-improvement or with helping others to improve their capacities? Doing so is not only permissible but in some cases arguably obligatory. Consider the education and training that people pursue for themselves and that they try to provide for their children. Don’t we normally regard education as a good thing?
Now one might say at this point that the examples I have given are unlike pharmacological or genetic enhancements or biomedical implants because these newer technologies would affect our biological processes. But education and training also have biological consequences. Your teacher, the tape or CD you listen to, or the DVD that you watch all aim at bringing about changes in your brain, establishing new neurological pathways that ultimately will allow you to perform tasks that you could not previously perform. It has been shown that the brains of literate people are recognizably different than the brains of illiterate people. Education is not some mystical, supernatural process: just like an enhancing drug, education injects knowledge into your brain, simply through sensory inputs instead of through a pill!
3. Safety is a not a decisive objection to enhancements. Many who oppose enhancements argue that they are simply too risky, especially if we are considering neuroenhancers. We cannot guarantee their safety. Even if a drug has no immediate side- effects, harmful side-effects might appear ten or twenty years later. For example, a drug that improves your short-term memory may have the result of eroding your capacity for long-term memory.
We can never have absolute assurance about the safety of any new technology. (Does use of cell phones increase the risk of brain cancer?) But that shows precisely why the argument from safety cannot be sufficient to block any new technology, enhancements included. If we implemented this precautionary principle consistently, we would never accept any
new technology. Of course, enhancements should be tested rigorously to the extent possible before they are made widely available, but the safety concern does not in principle provide a compelling argument against enhancements.
4. In determining the utility of enhancements, we should not only consider the benefits to the individual but also the benefits to society. Enhancements have the potential for transforming our world. Moreover, if enhancements are as robust and as efficacious as some predict, we must admit that the extent of the transformation they will usher in can be only dimly perceived. Some regard this as a danger signal. They think enhancements may benefit the individual but that individual benefits must be weighed against the public good, and they fear that widespread use of enhancements will change our social relations in unpredictable ways. If we cannot predict the effects of introducing enhancements, then the default option is to ban them.
To some extent, this is a reprise of the flawed safety objection noted above, except that it is not the safety of the individual that is of concern but the “health” of society. This objection has another noteworthy defect, however: as typically posed, the objection relies on an improper framing assumption that any benefit to individuals must be weighed against possible detriment to society. But why assume that enhancements benefit only the individual? If we think about other enhancements—the development of literacy, the development of technology such as computers, and so forth—they have resulted in tremendous increases in productivity and well-being that benefited individuals and society alike. Why should pharmacological, genetic, or implant enhancements be any different?
If enlarging our ability to give shape and direction to our lives, to increase our productivity, and to accomplish our objectives are good things, enhancements likely will change our way of life for the better.
Moreover, multiple precedents indicate that our society can absorb and deal with the tremendous changes that may result from use of enhancements, and I’m not just referring to technological enhancements such as computers. Opponents of enhancements rarely acknowledge that for some decades, a pharmacological enhancement has been almost universally available that caused a revolution in our social and economic relations and has transformed the potential of half of humanity. Though many decried this enhancement when it was first introduced and some still reject it as “unnatural,” nowadays most hardly give it a second thought and regard its availability as routine. I am referring, of course, to oral contraceptives.
Now some may question whether oral contraceptives qualify as a biological enhancement. Of course they do. They are pharmacological agents that provide women with the power to prevent pregnancy. Moreover, they provide this power very quickly. If that does not qualify as a biological enhancement, what does?
Having a reliable means to prevent pregnancy vastly increased women’s capacity to control the direction of their lives and enabled them to accomplish much more than they would have been able to otherwise. It is not just a matter of sexual freedom. Look at law offices and corporate boardrooms today and compare them with similar establishments in the 1950s. Some will attribute the near-total absence of women in professional positions prior to the 1960s to sex discrimination, but that is only part of the explanation. The attitude that women were not suited to such positions was based partly on the concern that women could not reliably control whether and when to have children. With birth-control pills, women no longer had to choose between a career and a relationship.
Though individual women were the direct beneficiaries of the enhanced control over their bodies that oral contraceptives provided, society as a whole also benefited from this enhancement. The entry of women into careers previously closed to them resulted in significant contributions of intellectual capital and provided a great boost to economic productivity. The example of oral contraceptives shows that we can have an enhancement that brings about far-reaching social and economic consequences, as well as inducing changes in the behavior of millions, and not only survive the experience but welcome its effects.
Happy Pills, Happy People, Happy Society?
John Stuart Mill once notoriously observed that it is better to be Socrates dissatisfied than a fool satisfied. This observation captures one traditional objection to enhancements that would “improve” the mood of people by making them “happier”: doing so might place them out of touch with reality and/or interfere with their ability or desire to engage in productive activity. Numerous controlled substances make people feel better, but they are rigorously controlled because they also have detrimental effects, including causing users to focus on little more than obtaining additional supplies of the euphoria-inducing drug.
In recent years, however, some advocates of mood enhancers have argued that there is no necessary connection between pills that make people happy and negative social effects. Quite the contrary, a causal connection is often claimed between happiness and socially desirable consequences such as increased productivity, better health, more satisfying social relationships, and the like. Some draw from this the conclusion that we should encourage people to enhance their mood through the pharmacy—we will all benefit. We can all be Socrates satisfied.
One can reliably infer from what I have stated already that I am not an opponent of enhancements in principle. But permit me to note some skepticism about the purported benefits of happy pills.
What is happiness, anyway? Studies of happiness are for the most part simply studies of self-reported subjective well-being. As of now, we cannot measure happiness apart from what people tell us about how they feel. (Possible advances in neurology may remove this limitation.) So in a typical study, participants are asked to complete questionnaires or keep diaries about their moods. Both the reliability and validity of such methods is open to doubt. Minor differences in circumstances, including even the weather, affect self-reporting. Moreover, survey respondents are notoriously influenced by what they think they should say. Being happy is perceived as a good thing; no one wants to be known as a “gloomy Gus.” So it is not really clear whether we are in a position to determine, outside of exceptional cases, whether someone is happy or not.
Correlation or causation? As indicated, some studies about happiness purport to show a causal link between being happy and being more productive, healthier, and so forth. But it is unclear whether there is a causal relation here or, if so, in which direction the causation flows. For example, it would not be unreasonable to argue that being healthy tends to make one happy, not the other way around. Or a simple correlation—people who are happy also are often healthy—may not establish that one condition causes the other. Anyone attending humanist conferences will notice a strong correlation between being white and over forty and attending such conferences. Does that necessarily indicate that being white and over forty predisposes one to attend humanist conferences? I do not think so. Bottom line: we need better evidence than has been produced so far to establish a causal connection between happiness and socially desirable consequences.
The link between status and happiness. Those who push happy pills seem to think that we can all be shiny, happy people. This treats happiness as an absolute rather than a relative state. But the data developed to date on happiness indicate that one’s sense of well-being is connected more reliably wit
h one’s relative productivity, health, and income as opposed to one’s absolute level of these goods. It’s how we see ourselves in relation to others that’s important for our sense of well-being.
This should not be unexpected if our biology and social dynamics materially resemble those of our primate cousins. Studies of monkeys, chimps, and apes show that high serotonin levels are connected with a high position within the group’s social hierarchy. High serotonin levels are correlated with self-esteem, confidence, and contentment. (Prozac, as is well-known, acts as a selective serotonin reuptake inhibitor.)
What does this imply for the happiness pill project? Well, unlike the mythical children of Lake Wobegon who are all above average, we cannot all enjoy high status. If happiness is linked to one’s relative position within society, then promoting a happiness pill on the grounds that it will lead to all of us being both happy and productive relies on a false premise. Happiness and productivity may well be correlated but not because happiness leads to greater productivity. We strive to be successful writers, activists, scholars, scientists, and so forth because we want to enjoy the rewards and status that come with success, and when we achieve relative success we are happy. Drug-induced happiness may provide us with a sense of contentment, but it may well be a sense of contentment divorced from productivity and achievement. Far from leading to increased productivity, widespread use of happy pills may lead to decreased productivity. Why work hard in our chosen endeavors when we can lower our expectations and feel just as happy as the more successful among us by taking a short trip to the medicine cabinet?
There is no good reason to oppose the development and use of enhancements in principle. However, there are differences between enhancements for some capacities—vision, strength, endurance, memory, and various cognitive capacities—and supposed enhancements for moods or personality traits. To begin, we do not have a reliable means for measuring most moods or personality traits, certainly not by comparison with our standards for measuring visual acuity, memory, and other capacities. Second, we do not have a consensus on which personality traits are desirable. Outside of the New Testament, meekness is not usually considered desirable, but assertiveness and an unyielding will to triumph over one’s competitors may not be desirable either—except in one’s lawyer or military commander. Finally, the connection between possession of certain moods or personality traits, such as happiness, and the overall benefit to society is far from clear. We need far more data—both empirical and normative—than we presently possess before we can endorse widespread efforts to change our brain chemistry. We need a well-founded consensus on a desirable design before we encourage designer personalities.
For a good, concise overview of happiness studies, see Andre van Hoorn, A Short Introduction to Subjective Well-Being: Its Measurement, Correlates and Policy Uses, available at http://www.oecd.org/dataoecd/5/58/38780041.pdf?contentId=38780042.