Mood Enhancement as a Legitimate Goal of Medicine: Rethinking the Treatment-Enhancement Dichotomy in the Context of Human Wellbeing
Date
2020-12
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH ABSTRACT: Human enhancement sparks intense debate and raises interesting moral questions, including the ethical implications for the medical profession as the potential gatekeeper of these technologies. Mood enhancement, as a subclass of human enhancement, raises particularly interesting moral questions regarding the relationship between neuroscience, technology and concepts of human identity, authenticity and the good life. The discussion surrounding these technologies has unfortunately been hampered by poorly articulated and convoluted notions of enhancement. It is typically assumed that enhancement is practically and normatively different from medical treatment. This distinction is based on a normative understanding of normal (species-typical) functioning.Consequently, enhancement is often considered prima facie morally suspect. This dissertation subjects the aforementioned distinction to critique by illustrating that treatment and enhancement occur along a continuum of interventions, which are all ultimately aimed at improving human wellbeing. The concept of normal functioning is critically examined in order to show that it lacks practical significance and normative force. With reference to a welfarist framework, it is argued that the moral evaluation of mood enhancement should turn on the extent to which it tends to increase the recipient’s chances of leading a good life, regardless of the presence or absence of pathology. Having concluded that the distinction between treatment and enhancement is not of central factual or moral importance, medicine’s relationship vis-à-vis enhancement is considered.Medicine is traditionally understood to have an internal and fixed telos. Physicians traditionally concerned themselves with improvements in health and the cure or prevention of disease to the exclusion of other aspects of their patients’ lives, such as the promotion of happiness or the relief of existential anxieties. However, the scope of the legitimate ends of medicine depends on one’s understanding of the concepts of health and disease. In this regard, an argument is made in support of a normative (subjective) understanding of health in terms whereof health is understood to be conceptually related to happiness and quality of life, and is considered instrumentally valuable insofar as it improves quality of life. Based on this characterization of health, mood enhancement is reconcilable with the traditional ends of medicine, including the traditional goal of health promotion. Even if mood enhancement is incompatible with the traditional ends of medicine (an argument which is rejected), these ends are not static or ontologically internal to the practice of medicine. Instead, the ends of medicine are intimately connected to the ends of living and social functioning, and cannot be defined independently of society’s interpretation thereof. Although mood enhancement is not unethical per se, there may be good reasons for limiting physicians’ involvement in specific circumstances. It is submitted that the principles of biomedical ethics –autonomy, beneficence, non-maleficence and justice –should guide physician involvement on a case-by-case basis. After considering mood enhancement in the context of a principlist framework, it is concluded that these technologies are prima facie ethically acceptable. However, in order to manage potential bioethical risks, a context-sensitive approach is recommended where each request for mood enhancement is evaluated on its own merits.
AFRIKAANSE OPSOMMING: Raadpleeg teks vir opsomming
AFRIKAANSE OPSOMMING: Raadpleeg teks vir opsomming
Description
Thesis (MPhil)--Stellenbosch University, 2020.
Keywords
Mood enhancements, UCTD, Bioethics, Cosmetic psychopharmacology, Welfarist psychiatry