Biomediese verbetering : maakbaarheid of onttowering?

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Suid-Afrikaanse Akademie vir Wetenskap en Kuns
This essay examines some of the most important ethical questions surrounding biomedical enhancement in the light of the question whether such enhancement does not specifically add to the disenchantment problematic in current-day philosophy. The disenchantment of the world associated with the enlightenment onset of modernity may be viewed as the process whereby mystical or supernatural causes and solutions to practical, everyday problems came to be replaced with rational and scientific explanations and technological solutions. This intellectualisation was on the one hand viewed in a positive manner as the increasing mastery of humanity over its existence, not only in terms of the resulting eradication of disease and illness, but also in terms of the improvement of life in general. On the other hand, the intellectualisation and concomitant disenchantment of the world have been associated with negative outcomes. Technology with its resulting emphasis on material existence has, according to many, alienated humanity from other forms of experience – particularly religious experience, blunting our sense of awe and wonder at the unknown. The author posits enhancement as a striving for the improvement of our existing capacities, as being in congruence with endeavours which have long characterised human existence. Examples range from early attempts to improve and organise life, such as numeracy and literacy, through the development of institutions, up to contemporary preventative medicine such as vaccination against a host of diseases. On the other hand, this drive to improve is increasingly leading to the possibility of self-directed evolution, resulting in a radical transformation of the biological identity of the human being and even the possible creation of a new species (“trans-humanism”). This latter interpretation of the possible outcomes or consequences of enhancement has elicited much debate concerning the enhancement project. Arguments against biomedical enhancement are often founded upon a distinction between treatment and enhancement, whereby the former as an intervention to restore normal functioning is deemed permissible. A noted proponent of such a stance is Norman Daniels (2009) who argues that the risks involved in the utilisation of genetic interventions in cases of serious genetic diseases are outweighed by the potential benefits, whereas the same may not hold in cases of enhancement, which can be distinguished from treatment or therapy. The author, however, points out in accordance with thinkers such as Harris (1998) and Holtug (1998), that the enhancement/treatment distinction is not tenable and collapses in the face of particular situations as evidenced by various examples he discusses. The second argument against enhancement discussed by the author is the objection that enhancement compromises the autonomy of those who are enhanced – an argument of which Habermas (2003) is the primary exponent. For Habermas, the association of enhancement with eugenics is inescapable. He views such interventions as a violation of the equality and autonomy of human beings due to their subjection to the intentions of third parties. Responses to this position are discussed, such as Buchanan’s (2011) counter-argument that such a position is indicative of genetic determinism in its exclusive focus on genotype and its denial of the vastly influential role played by environmental factors in forming the identity of an individual. A third argument against enhancement discussed by the author, is put forward by Sandel (2007). Sandel regards the aim to enhance as characterised by a desire for perfection and control over the world, a denial of the “giftedness of life” as well as an erosion of the typical love and acceptance a parent ought to feel for its child “as it is”. The author argues that Sandel’s admonishments to appreciate the giftedness of life are evidence of a deeper objection to the perceived disenchantment of life wrought by technological change. However, objections to this argument generally draw attention to its inconsistency. Sandel regards changes achieved through genetic manipulation as a violation of the giftedness of life, but appears to have no objection to the non-genetic modes of influence and manipulation that we exert upon our offspring in an attempt to shape them to our perceived desires. The example highlighted by the author relates to the way in which we “direct and shape the development of children” and thus aims to improve them through education. Why, he asks, does Sandel see such aims of improvement as acceptable but not improvement through genetic interventions? Further objections to Sandel’s argument are discussed, such as the implications of granting moral preference to the gifted or given state of life, as well as Sandel’s seemingly teleological view of evolution. The author then discusses “transhumanism”, a movement advocating radical enhancement which may ultimately result in the emergence of a new species that developed out of human beings. Objections to the transhumanist acceptance of such a possibility have focused on the moral imperative to keep human nature intact. Various responses to this position are discussed, one of which is Daniels’ argument (2009), which views human nature as a “dispositional, selective population concept”. A further objection to radical enhancement is also discussed, namely concern regarding the practical implications of the creation of a highly superior transhuman species for humans who choose to remain unenhanced. Wikler (2009), for example, asks in this respect whether such a species would be justified in assuming a paternalistic attitude towards the unenhanced in the same way we make decisions regarding the well-being of children and mentally disabled people. Buchanan’s response in terms of the devising of a threshold level of competence is then explained and preferred by the author. The author also engages with several suggestions regarding the seeming impasse with which the enhancement debate has been characterised. As he points out, humanity has always tried to improve itself, thus to oppose enhancement is in a sense to oppose the inevitable. This inevitability suggests that we should focus upon specific projects of enhancement that may be more problematic than others, rather than rejecting enhancement outright. Our guiding principles for adjudicating such projects ought to be whether or not they are to our benefit or disadvantage as a species, as well as whether or not they respect human rights, persons and human dignity. Useful work that may be used as a guide is Bostrom and Sandberg’s (2009) heuristic which challenges alleged intuitions regarding the “wisdom of nature”. In addition, Buchanan’s (2011) “cautionary guidelines for future research” provide valuable suggestions regarding the avoidance of “cascading negative consequences”. Rather than viewing biomedical enhancement as a disillusionment of the world or a blunting of our sense of mystery and awe, the author concludes that we should allow the possibilities opened up by modern science to stimulate our sense of wonder. A sense of awe need not be limited solely in response to the unknown but may also arise from a disclosure of the unknown. An enchantment with the world need not be the outcome of darkness but rather an anticipation and result of discovery.
Please cite as follows:
Van Niekerk, Anton A. 2012. Biomediese verbetering : maakbaarheid of onttowering?. Tydskrif vir Geesteswetenskappe, 52(4), 581-595.
The original publication is available at
Medical innovations -- Moral and ethical aspects, Medical ethics, Genetic engineering -- Philosophy, Bioethics
Tydskrif vir Geesteswetenskappe
Van Niekerk, Anton A. 2012. Biomediese verbetering : maakbaarheid of onttowering?. Tydskrif vir Geesteswetenskappe, 52(4), 581-595.