The Ethics of Human Enhancement: The Argument Against Savulescu By Kyle Underwood The evolution of technology has been

hand in hand with the human subjugation of earth, but the question persists, when does the use of technology go too far? Advances in medical science have improved tremendously the average human lifespan and the quality of life for individuals. Medical science and biology are steadily arriving at new ways to alter humans by the use of advanced genetic alteration. This technology gives rise to the question of how this new technology ought to be used, if at all. The idea of human enhancement is a very general topic, since humans are constantly enhancing themselves through the use of tools. In referring to human enhancement, I am referring specifically to the use of genetic intervention prior to birth. Julian Savulescu, in his, Genetic Interventions and the Ethics of Enhancement of Human Beings, argues that it is not only permissible to intervene genetically, but is morally obligatory. In this paper, I will argue that it is not morally obligatory to intervene genetically even if such intervention may be permissible under certain conditions. I will show, in contrast to Savulescus view, that the moral obligation to intervene is not the same a s the moral obligation to prevent and treat disease. In short, I will show that Savulescus arguments are not sufficient even to establish the moral permissibility of human enhancement much less the moral obligation. The first argument given for the obligation of genetic enhancement is the postulate of the Neglectful Parents. Savulescu considers the case of two types of parents, the neglectful parents and the lazy parents. The neglectful parents have a child that has a condition wherein a

simple, cheap dietary supplement must be given so that the child maintains an advanced intellect. The parents, being neglectful, do not bother with the supplement, and therefore the childs advanced intellect drops into the normal range. The lazy parents have a child wit h an intellect in the normal range, but the same dietary supplement would allow the child to achieve an advanced intellect. The lazy parents are in fact lazy, so the child does not receive the supplement, and therefore the childs intellect remains in the normal range. Savulescu suggests that in the aforementioned cases diet be substituted with biological intervention. The children in both cases would have had an advanced intellect had the parents biologically intervened, but as they did not the children remained normal with regard to their intellect. Savulescu argues that the inaction of the parents is a wrong to their children (Savulescu 420). However, there is a problem with the argument that Savulescu has put forward. The analogical argument Savulescu uses is based on the assumption that genetic intervention is sufficiently similar to dietary supplementation. However, this assumption is unfounded because there is a significant difference between the respective durations of the two procedures, one that greatly weakens the analogy. Genetic intervention is a onetime choice that is irreversible. The dietary supplementation is a procedure that must be continued throughout the life of the child, but may be stopped if desired by the child or by the parents. The argument from Savulescu suggests that at every point the parents would need to maintain the dietary supplementation, and to miss a supplement would be a moral violation. However, parents often allow their children to eat foods that are not conducive to the health of their children, yet this is not normally considered immoral. Moreover, the child might, perchance, injest something that is contra-optimization not because the parents are neglectful or lazy, but

rather because they are busy fulfilling other obligations they clearly do have to their children. According to this argument, Savulescu would have to conclude that it is immoral to allow a child to ingest anything that was not aimed at optimization of at least one of the traits of that child; hence, his argument fails because the analogy breaks down. Savulescu suggests in his second argument that environmental interventions and biological intervention are one and the same (Savulescu 420). The argument begins with examples of environmental interventions: education, diet, and training. These interventions into a childs life lead to various improvements in the child. Parents generally seek out the best schools and the best possible care for their children in order to provide their children with the greatest of opportunities. The key to the argument is the recognition of the fact that the environment does in fact change biology, and changes it not just momentarily, but for life. The question Savulescu raises is, why should we allow environmental manipulations that alter our biology but not direct biological interventions? For Savulescu the use of environmental interventions and the use of direct biological intervention are within the same moral framework, and therefore should be used in the aim of producing the child with the greatest possibilities for life. Savulescu argues that biological intervention is the same as environmental interventions, but this is not the case. The difference between genetic intervention and environmental intervention is that environmental intervention does not involve an instantaneous alteration to the child, but rather requires work on both the part of the child and the parent or trainer. The environmental interventions that improve children allow each child to develop itself by rigorous training and practice. Genetic interventions, on the other hand, are already in place once the child is born.

Imagine being a child learning the English language for the first time, and imagine the practice and work that it takes to utilize such a complex system of grammar and vocabulary. The child not only learns language, but the work required to better oneself. The use of environmental interventions in a child does in fact change the child, but the parents still have the option of withdrawing from the environmental interventions. For example, suppose a child attends an after-school daycare that provides homework help and tutoring, but the parents of the child discover that no homework is being done. Since, the parents initially placed the child in the facility so that she could receive homework help and tutoring, the parents decide to withdraw the child from the daycare and put her in a daycare that actually helps her with her homework. The parents in this example of an environmental intervention are capable of altering or removing the intervention in the childs life. This is far different from direct biological intervention; as such intervention is permanent and unchanging. Using Savulescus argument, parents would be in moral violation whenever the child attended a school wherein the child did not receive the best education possible. The parent would wrong the child whenever one of the childs traits was not being optimized to the maximal degree possible. While it can be said that our biology is affected by environment, this is not sufficient to show that direct biological intervention is the same as environmental interventions. Savulescus third argument claims that enhancement is no different than the treatment and prevention of disease. The argument here is that health is instrumentally valuable in the pursuit of the good life, and that the moral obligation to treat and prevent disease is derived from the idea that health is a necessary condition for leading a good life (Savulescu 421). Aside from the fact that this proposition is highly questionable in itself, as many diseased individuals

have lived great lives, e.g., Stephen W. Hawking, it is clear that Savulescu intends optimization. If the treatment and prevention of disease are aimed at allowing a person to have opportunities to lead a good life, then it follows that an enhancement would allow a person greater possibilities to lead a good life, and ultimately to lead the best possible life. Examples of attributes that would be eligible for enhancement would be intelligence, memory, patience, empathy, and impulse control (Savulescu 422). These attributes are generally regarded as valuable in that a person endowed with them may have more and better opportunities in life. It is clear that genetics and biology affect the life of an individual, so genetic and biological enhancement may lead to more opportunities for the individual. Savulescus argument is explicit in his summary: What matters is human well-being, not just treatment and prevention of disease. Our Biology affects our opportunities to live well. The biological route to improvement is not different from the environmental. Biological manipulation to increase opportunity is ethical. If we have an obligation to treat and prevent disease, we have an obligation to try to manipulate these characteristics to give an individual the best opportunity of the best life (Savulescu 423). The suggestion that the moral obligation to treat and prevent disease entails that human beings ought to employ direct biological enhancement in order to provide the best opportunity for life requires a discussion of the aims of medicine itself. In other words, before Savulescus claim can be accepted, we must consider the distinction between treatment and enhancement. What are the fundamental goals of medicine as such? This question must be answered in order to establish an understanding of the moral implications of enhancement. Given the array of human illnesses, diseases, mutations, and congenital defects, medicine may benefit from the use of direct biological interventions, such as genetic alterations. The required understanding lies in the conception of what constitutes a proper bill of health. Determining

a universally accepted notion of health is problematic as there are various aspects that constitute a healthy individual, including the physical and mental aspects. A person in a state of physical health is well rested, well nourished, and exhibits proper bodily function (Nordqvist). The other aspect to human health, mental health is defined by the World Health Organization a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. From this view mental health is not just the lack of disease, or lack of function, but an all inclusive sort of well-being. The World Health Organization maintains that health is, a state of complete physical, mental, and social wellbeing. Given this vague and general definition of health, determining the primary aims and goals of medicine is difficult. The treatment/enhancement distinction requires further inquiry. The most reasonable model for the distinction between treatment and enhancement is the normal function model. The normal function model is based on the realization that humans have a range of talents and traits, and are not born onto an equal playing field (Parens S2). To accept this model one only has to contemplate a long standing human tradition, the Olympic Games. The Olympic Games exhibit the range of human capabilities through physical feats and through mental determination. Not every athlete is capable of competing in every event. Some have tailored their training for specific events based on their endowed talents and abilities. The Olympic Games make obvious that humans are naturally diverse with respect to abilities in both cognitive and physical functioning. The normal function model limits the goals of medicine to the restoration of normal physical and mental functioning so as to provide opportunities to live life free of disability or disease; therefore, any attempt to surpass the normal range of

human ability would be considered an enhancement, and not the treatment or prevention of disease. Savulescus argument for the moral obligation for enhancement treats the normal range of human abilities as a hindrance to the opportunities that one has to the best life. This is apparent in his statement, unless there is something special and optimal about our childrens physical, psychological, or cognitive abilities it would be wrong not to enhance them (Savulescu 420). Clearly, for Savulescu, to treat the natural range of human capabilities as hindrance upon an individuals possibility for the best life is to require maximal enhancement in all cases. The claim of Savulescu that normalcy is a hindrance to the possibilities for the best life is not reasonable. This claim attempts to prove that opportunities for the best life are directly attributable to optimal traits that are defined by genetics. If opportunities are limited by normal abilities, according to Savulescu, then we are obliged to treat normal human abilities as in need of enhancement. There is one problem with the argument for the moral obligation to enhance children. This is the notion of what constitutes the best of possible lives for a human being. Savulescu is not arguing that there is one life that is clearly better than the other possible lives that a child could lead. Savulescu refers to John Stuart Mills account of autonomy to pursue experiments in living in order to demonstrate that there does not exist one possible life that is better than others (Savulescu 425). One criticism of the obligation to intervene genetically in a child is that the idea of the best possible life for that child is very complex. In order for genetic intervention to take effect the intervention must take place at the earliest stages of life. This means testing an embryo in order to decide the genetic makeup of a child prior to birth. This is demonstrated by Michael Parker in his essay The Best Possible Child. Parker argues, Complex concepts,

such as those of the good life, the best life, and human flourishing, are not reducible to simple elements or constituent parts which might be identified through the testing of embryos (Parker 281). The testable genetic characteristics of an embryo would not be able to determine the type of life that would be led by the embryo once it had developed. The complexities of what constitutes the good life or the best life for any individual are far beyond the scope of knowledge available to parents at the time intervention would have to occur. Although studies may show a correlation between certain traits and an individuals ability to be successful in life, this correlation is not sufficient to establish cause and effect; hence, the obligation to enhance these traits has not been established by Savulescu. The lack of a moral obligation to enhance children is not to say that enhancement is not morally permissible. Enhancement, with respect children, while not obligatory, might be able to be established as permissible under certain conditions. The implications of enhancement, especially those of direct genetic alteration, are an important ethical concern. The possibilities for immoral conduct are significant, and must, therefore, be explored to the fullest extent possible. Savulescu outlines 8 criteria according to which an enhancement would be morally permissible: 1) 2) 3) 4) Is in the persons interest Is reasonably safe Increases the opportunity to have the best life Promotes or does not unreasonably restrict the range of possible lives open to that person 5) Does not unreasonably harm others directly through excessive costs in making it freely available 6) Does not place that individual at an unfair competitive advantage with respect to others, for example mind reading

7) Is such that the person retains significant control or responsibility for her achievements and self that cannot be wholly or directly attributed to the enhancement 8) Does not unreasonably reinforce or increase unjust inequality and discrimination- economic inequality, racism (Savulescu 429)

Savulescu asserts each criterion as a necessary condition for any enhancement, and that jointly they are sufficient for moral permissibility. This would mean that the enhancement cannot violate any of these criteria if it is to be morally permissible, but it also means that if each criterion is met, then the enhancement is morally permissible. It would seem to follow, for Savulescu, that if an enhancement is morally permissible, then it is morally obligatory. But, any enhancement would appear to violate criterion 6. The aim of an enhancement is to increase abilities to the maximal degree possible, but as this occurs an unfair competitive advantage is created. For example, a persons intelligence might be genetically altered to allow the greatest possible degree of intelligence in a human being. However, this would be an unfair competitive advantage over other people who did not receive the enhancement, as they will not achieve such a degree of intelligence. The enhancement would have to be used universally in order to satisfy 6, as any enhancement that is not done universally would create an unfair competitive advantage. Recognizing that human beings are naturally endowed with different abilities and capacities, and that these natural differences create competitive advantages, just as in the case of enhancement, the real concern is whether or not the competitive advantage is unfair. If the enhancement satisfies criterion five, then the competitive advantage is not unfair, just as the natural competitive advantage is not unfair. But, in order for the enhancement to be morally permissible, it must not only be widely available to parents who think that the enhancement

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will be good for their children. It must be used. If the enhancement is not used, then the competitive advantage would become unfair. Parents who want their children to experience the value of intelligence in itself, would then have the option of altering their childs intelligence prior to birth, and they would make that choice. But, suppose that certain parents chose against the enhancement. It would seem to follow that these would be the parents who would be harming their children by placing them at a competitive disadvantage by not using the enhancement. But clearly, the parents who choose not to alter intelligence are not doing harm to the child. The childs possibilities for a good life are not defined by the testable capacities of certain traits such as intelligence. Because we cannot know in advance whether enhanced intelligence will increase the opportunity for a particular individual to have the best life, criterion three cannot be satisfied. While criterion three cannot be satisfied this does not mean that an enhancement is not permissible. It just means that there is no moral obligation to enhance. However, if there is no obligation to enhance, then criterion 6 fails, and the enhancement would not be permissible, as it is claimed to be a necessary condition. Enhancements are never obligatory, but may well be permissible if available to all in a free society. But, Savulescus criterion 6 is self-defeating. It not only fails as a criterion for permissibility, it renders any enhancement morally forbidden. Criterion 3 also needs some work. Perhaps it should say that the enhancement should be aimed at the improvement of the individual, not just in opportunities, but for the intrinsic values of the enhanced ability. This can be shown by using the previous example of altered intelligence. Intelligence is not just of instrumental value in this case, it is valuable in itself. The increased capacity for intelligence

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allows not just for better practical achievements, but also for pleasures, such as reading and understanding Shakespeare. The claim that parents are morally obligated to enhance their children unless something is already optimal about the child is simply too strong. If it were true, then parents who did not enhance their children constantly and in every possible way would be guilty of moral wrongdoing. The fact is that human beings exist within a natural range of abilities and capacities and are not thereby prevented from living a good life. The obligation to enhance simply cannot be derived from the obligation to treat and prevent disease, as this treats the normal range of human function as a hindrance. It is my understanding that enhancements made widely available in a free society, may well benefit a person, not in opportunities for life, but as benefits in themselves. Increasing certain capacities such as intelligence, are not just instrumentally valuable, but valuable for a person as a source of pleasure and understanding. It would be a wrong to suggest that a parent should not desire an alteration for a child that would allow the child increased pleasure at the use of the childs capacities. Genetic intervention may also have far reaching implications for the treatment and prevention of disease restoring more individuals to the normal range of human functioning. Genetic alteration should be explored cautiously, but vigorously with aim at creating not instrumental values for humans, but values for the individual within the use of altered capacities. It may be that ethical enhancements lead to a development of a better humanity as a whole.

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Works Cited "What is Mental Health?." World Health Organization. World Health Organization, 3 September 2007. Web. 4 Apr 2011. <http://www.who.int/features/qa/62/en/index.html>. Nordqvist , Christian. "What Is Health? What Does Good Health Mean?." Medical News Today 21 May 2009: n. pag. Web. 1 Apr 2011. <http://www.medicalnewstoday.com/articles/150999.php>. Parens, Erik. "Special Supplement: Is Better Always Good? The Enhancement Project." Hastings Center Report 28.1 (1998): s1-s17. Web. 1 Apr 2011. <http://0www.jstor.org.library.acaweb.org/stable/3527981>. Parker, Michael. "The Best Possible Child." Journal of Medical Ethics 33.5 (2007): 279-283. Web. 1 Apr 2011. <http://0-www.jstor.org.library.acaweb.org/stable/27719859>. Savulescu, Julian. Genetic Interventions and the Ethics of Human Beings. Readings in the Philosophy of Technology. Ed. David Kaplan. 2nd ed. Lanham: Roman & Littlefield, 2009. 417-430.