Harm and enhancement : philosophical and ethical perspectives

Hall, Susan (2012-12)

Thesis (PhD)--Stellenbosch University, 2012.

Thesis

ENGLISH ABSTRACT: The distinction between treatment and enhancement is often considered to be a morally significant boundary, which, at the very least, marks the limits of our moral obligations. This conviction holds despite the fact that treatment and enhancement are situated along a continuum of interventions that are directed towards the improvement of human functioning. The distinction between these two sorts of interventions is based upon a notion of normative normality, which suggests that we are morally obligated to provide interventions which are directed toward the achievement of normal functioning, but that no obligation exists to improve functioning beyond this point. This dissertation will subject this position to critique by examining the constitution of normal functioning, and by suggesting that this kind of functioning cannot operate as a normative standard which determines the limits of our moral obligations. The moral desirability which we attribute to the achievement of normal functioning is based upon the independent ethical imperative to promote the possibilities for well-being of moral agents. This motivation, however, equally suggests that we will be obligated to provide certain kinds of enhancement interventions which will be likely to promote the welfare interests of moral agents, when these become available. This argument also implies that the development of enhancement technologies will require us to rethink our ethical conception of harmful non-benefits. We currently think of the non-provision of medical treatment and some environmental enhancements, such as education, as harmful to the extent that state intervention is justified to rectify this. We recognise that such non-provision, and the resultant failure to promote the welfare interests of moral agents, where such promotion is possible, harms persons by putting them in a worse position than they could have been in, with regards to their chances of leading a good life. The new technological possibilities offered by the prospect of genetic enhancement mean that we might soon have a better alternative, in terms of our chances of leading a good life, to the level of functioning that we have thus far been able to achieve. This implies that the non-provision of these enhancements would be harmful to the extent that intervention to bring about this provision would be justified.

AFRIKAANSE OPSOMMING: Die onderskeid tussen behandeling (“treatment”) en verbetering (“enhancement”) word dikwels geag 'n skeiding daar te stel wat van morele belang is, in soverre dit ten minste, die perke van ons morele verpligtinge afbaken. Hierdie oortuiging geld ten spyte van die feit dat behandeling en verbetering op „n kontinuum van ingrype wat op die verbetering van menslike funksionering gerig is, geleë is. Die onderskeid tussen hierdie twee tipes ingrype is gebaseer op 'n bepaalde begrip van normatiewe normaliteit, wat suggereer dat ons moreel verplig is om ingrype te voorsien wat daarop gerig is om normale funksionering te bewerkstellig, maar dat geen sodanige verpligting bestaan om funksionering duskant hierdie punt te verbeter nie. Hierdie proefskrif sal laasgenoemde posisie aan kritiek onderwerp deur die manier waarop ons normale funksionering verstaan, te ondersoek, en deur aan die hand te doen dat hierdie tipe funksionering nie as normatiewe standaard wat die perke van ons morele verpligtinge bepaal, kan dien nie. Die morele gewenstheid wat ons toeskryf daaraan om normale funksionering mee te bring, is op die onafhanklike etiese imperatief om die moontlikhede vir welstand van morele agente te bevorder, gebaseer. Hierdie motivering doen egter eweseer aan die hand dat ons verplig sal wees om sekere tipes verbeteringsingrype te verskaf wat waarskynlik die welsynbelange van morele agente sal bevorder, wanneer sulke verbeteringsingrype beskikbaar word. Hierdie argument impliseer ook dat die ontwikkeling van verbeteringstegnologieë van ons sal vereis om ons etiese konsepsie van skadelike nie-voordele opnuut te deurdink. Tans dink ons dat die nie-voorsiening van mediese behandeling, sowel as sommige omgewingsverbeterings soos opvoeding, tot so „n mate skadelik is dat staatsinmenging met die doel om dit reg te stel, geregverdig is. Ons erken dat sulke nie-voorsiening en die gevolglike versuim om die welsynsbelange van morele agente te bevorder, waar sulke bevordering moontlik is, mense skade berokken deur hulle in „n slegter posisie te plaas as waarin hul kon gewees het, ten aansien van hul kanse om 'n goeie lewe te leef. Die nuwe tegnologiese moontlikhede wat die voortuitsig van genetiese verbetering ons bied, beteken dat ons binnekort 'n beter alternatief mag hê vir die vlak van funksionering wat ons tot dusver kon bewerkstellig, ooreenkomstig ons kanse om 'n goeie lewe te leef. Dit impliseer dat die nie-voorsiening van hierdie verbeterings skadelik sal wees tot die mate wat ingrype om hierdie voorsiening teweeg te bring, geregverdig sal wees.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/71893
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