Thursday, April 30, 2020

Is Biomedical Enhancement Good or Evil?


Human enhancement, especially biomedical enhancement, has and continues to raise many ethical questions in society. Is human desire for mastering and possessing nature through technology good or bad? Is it ethical to use biomedical enhancement not only to treat disease, but also to intervene or improve human life? This paper focuses on the work of two philosophers, Michael J. Sandel’s The Case Against Perfection and Allen Buchanan’s Better Than Human. Sandel discussed some potential dangers that non- biomedical and biomedical enhancements bring to human society from the athletic domain to the aspect of genetic choice. On the other hand, Buchanan focused on the benefits of biomedical enhancement and how it has and will continue to improve human well being and help people adapt to their rapidly changing environments. Therefore biomedical enhancement poses threats to human nature, yet it is necessary to some point.
Sandel defined biomedical or genetic enhancement as “employ[ing] medical means for nonmedical ends – ends unrelated to curing or preventing disease, repairing injury or restoring health.”[1] Sandel claimed that enhancements alter human nature. He says: “The predicament is that our newfound genetic knowledge may also enable us to manipulate our nature – to enhance our muscles, memories, moods; to choose the sex, height, and other genetic traits of our children; to improve our physical and cognitive capacities; to make ourselves ‘better than well’.”[2] He is particularly against biomedical enhancement for the following reasons. It destroys the appreciation of those who are naturally gifted. In other words, it creates unfairness with other people who do not use or have access to enhancement. It violates the child’s right to autonomy. In additiona, Sandel urges people to accept life as a gift. People are to be open to the unbidden and give room for humility and solidarity.
One of the Sandel’s issues about the use of enhancement is that it destroys appreciation for those who are naturally gifted. For example in athletics the desire for perfection by using performance-enhancement, such as steroids, destroys the appreciation of those who are naturally gifted in athletics. Many people are concerned about the integrity of the game. Is the achievement of an athlete based on natural talents or pharmaceutical enhancement? Or, as Sandel puts it, “How can we distinguish changes that improve from those that corrupt?”[3] Sandel suggests that there is need to differentiate between lawful and unlawful enhancement. For example, running shoes enhance a runner’s natural ability to run, and this is legitimate, while taking steroids is not.
Sandel furthers argued that the use of performance-enhancement creates unfairness toward those athletes who do not have access to enhance their ability in a game. He furthers said that if enhancements of all sorts are allowed in a game, then people will no longer appreciate the individual athlete competing. Rather the game has been reduced to a mere exhibition, and the athletes take no responsibility for their performances. The use of performance- enhancement changes the nature of the game. Therefore, the use of performance-enhancement in athletics threatens the integrity of the game. He writes: “It is sometimes thought that genetic enhancement erodes human responsibility by overriding effort and striving. But the real problem is the explosion, not the erosion, of responsibility. As humility gives way, responsibility expands daunting proportions. … Athletes become responsible for acquiring, or failing to acquire, the talents that will help their team win.”[4]
Another crucial reason why Sandel objects to biomedical enhancement is the question of parental choices or, as he rightly puts it, “Designing Parents.”  Parents’ desire to choose their children’s traits poses a threat because parents want to overcome chances that are natural to human nature. Rather, parents want to “master the mystery of birth.”[5] Children are gifts, and they are to be cherished and loved unconditionally for who they are and not for the gifts that they possess. It is true that one can choose one’s friends and spouse, but children are gifts; and gifts are not chosen, they are given. Parents’ love must not depend on their children’s attributes or traits.
Consequently, when parents choose their children’s traits, they are taking sole responsibility for the child’s future Sandel argued. He further said that “we attribute less to chance and more to choice. Parents become responsible for choosing or failing to choose, the right traits for their children.”[6] When parents choose a child’s traits, they are choosing the child’s future, therefore, taking the place of God. Sandel encourages parents to resist the drive for mastery and control and instead embody an openness to the unbidden.[7]
Parents’ choice of their children’s traits does not only threaten the mystery of birth, but it also violates children’s right to autonomy. Sandel argued that biomedical enhancement violates the liberal principles of autonomy and equality of the children who are involved. He said: “It violates autonomy because genetically programmed persons cannot regard themselves as ‘the sole authors of their own life history’”[8] Sandel is concerned primarily about the vice of over-reaching, for “parents bent on enhancing their children are more likely to overreach, to express and entrench attitudes at odds with the norms of unconditional love.”[9] Parents who are preoccupied with enhancing their children biomedically will eventually determine and choose the future of their children, therefore inhibiting their right to autonomy and self- determination.
Sandel argued that we must advocate an ethics of humility and giftedness to replace the tendency to overreach. “The problem with eugenics and genetic engineering is that they represent the one-sided triumph of willfulness over giftedness, of dominion over reverence, of molding over beholding.”[10] If human nature is something made rather than given, then human beings are responsible for everything that they do and become. They can no longer appeal to chance or luck or God for any error that occurs.[11]
Again, Sandel argued that if biomedically enhanced children become widespread, there will be a break-down of solidarity. If human nature can be shaped and determined prior to birth, then those who have these genetic advantages will reproach those who lack them.[12] In other words, if human beings succeed in eliminating the eventuality of life, it will deeply alter the human sense of humility, responsibility and solidarity.
In contrast to Sandel’s view, Buchanan is in support of biomedical enhancement. He argues that biomedical enhancements are the same as other non-biomedical enhancements. Appealing to evolution, Buchanan claimed that evolution itself is a process of enhancement. He defined enhancement as “…an intervention – a human action of any kind – that improves some capacity (or characteristic) that normal human beings ordinarily have or, more radically, that produces a new one.”[13] Biomedical enhancement, however, “uses biotechnology to cause an improvement of an existing capacity by acting directly on the body (including human brain).”[14] He argued that it is in human nature to strive for self-improvement; and, since biomedical enhancement is able to do this for us, we should be open to it. This way, we are able to choose what will better our nature rather than allowing nature to select for us at random.[15]
However, Buchanan’s objections concerning Sandel’s arguments on biomedical enhancement are not well supported. For example, Buchanan protested that “Trying to enhance human capacity doesn’t mean you are trying to achieve perfection or total control.”[16] He said that there are many reasons why people choose to enhance, not necessarily strive for perfection. However, Buchanan never actually gave any reason why enhancement is not desire for mastering. His claim is rather too broad and general.
In contrast, Sandel clearly explained that the desire for mastering by employing biomedical enhancement is misplacing our place in creation and confusing our role with God’s. With many examples such as “Designing Parents” as explained earlier, Sandel is able to convey his message to his readers.[17]
Buchanan opposed Sandel’s argument about the need for parents to be open to the unbidden and love their children unconditionally. Instead of giving a sound and convincing argument why he thinks Sandel is wrong, Buchanan seems to be attacking Sandel personally and not Sandel’s stand concerning genetic enhancement. For instance, he writes: “If I have a child with cleft palate, I’m a callous jerk if I say to the surgeon who wants to repair it: ‘No thanks: I’ve got unconditional love for my child; his cleft palate was unbidden. I’m remaining open to it. I appreciate the giftedness in life.’”[18] He totally misunderstood Sandel, or rather, he is being sarcastic.
On the contrary, Sandel said that “To appreciate children as gifts or blessings is not to be passive in illness or disease. Healing a sick or injured child does not override her natural capacities but permits them to flourish.”[19]He also said that “Medicine is governed, or at least guided, by the norm of restoring and preserving the natural human functions that constitute health.”[20] In other words, Sandel is not against treating sickness and disease like cleft palate as Buchanan argued. Rather he supports biomedical enhancement that has to do with restoring health back to normal and not to deliberately want a child to be “better than well.”
I agree with Sandel because considering the happenings in our society, biomedical enhancement is both good and dangerous. If we continue to give way to biomedical enhancement, human value and nature will deteriorate. There will be no more consideration for what is good or what is not so good. For instance, if every couple decided to have their children through In Vitro Fertilization (IVM), then in the next thirty years at least, those who will be making ethical decisions will be products of IVM. Of course IVM will become a way of life. We can be sure that more of such “intervention” as Buchanan argued will be invented.
However, human enhancements are also necessary in the sense that we use them to improve human conditions. For example, a child born with some defects such as cleft palate, Attention Deficiency Disorder (ADD), cancer and many more, can be restored to normal health through the use of biomedical enhancement. As Mill said that, “ … of ill-regulated desires, or of bad or imperfect social institutions. All the grand sources, in short, of human suffering are in a great degree, many of them almost entirely, conquerable by human care and effort.”[21] Therefore, we have a moral duty within our capacity to continue to improve ourselves to promote happiness.
Also, using biomedical enhancement to select children’s traits is treating others as a means to our selfish end. As Kant pointed out, we have the moral obligation to treat others as an end in themselves and not as a mean towards a certain end.[22]
In conclusion, we have to always remember these words of Sandel that “To acknowledge the giftedness of life is to recognize that our talents and powers are not wholly our own doing, nor even fully ours, despite the efforts we expend to develop and to exercise them. It is also to recognize that not everything in the world is open to any use we may desire or devise. ”[23]



[1] [1] Michael J. Sandel, The Case Against Perfection: Ethics in the Age of Genetic Engineering. Cambridge, Mass.: Harvard University press, 2007. 8
[2] Sandel., 5-6
[3] Sandel.,37
[4] Sandel., 87
[5] Sandel 82
[6] Sandel 87
[7] Sandel 45 -46
[8] Sandel 80
[9] Sandel 49
[10] Sandel 85
[11] Sandel., 87
[12] Sandel., 91-92
[13] Allen Buchanan, Better Than Human, New York: Oxford University Press, 2011, 5
[14] Buchanan., 5
[15] Buchanan., 38
[16] Buchanan., 152
[17] Sandel., 85
[18] Buchanan 158
[19] Sandel 46
[20] Sandel., 47
[21] John Stuart Mill, Utilitarianism, Indianapolis, IN: Hackett Publishing Company, 2001, page 15
[22] Dr. Dwyer, Lecture PowerPoint, Summer 2014, slide 3.
[23] Sandel., 27

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