Biomediese verbetering : maakbaarheid of onttowering?
Date
2012-12
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Suid-Afrikaanse Akademie vir Wetenskap en Kuns
Abstract
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.
Description
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 http://www.scielo.org.za
Van Niekerk, Anton A. 2012. Biomediese verbetering : maakbaarheid of onttowering?. Tydskrif vir Geesteswetenskappe, 52(4), 581-595.
The original publication is available at http://www.scielo.org.za
Keywords
Medical innovations -- Moral and ethical aspects, Medical ethics, Genetic engineering -- Philosophy, Bioethics
Citation
Tydskrif vir Geesteswetenskappe
Van Niekerk, Anton A. 2012. Biomediese verbetering : maakbaarheid of onttowering?. Tydskrif vir Geesteswetenskappe, 52(4), 581-595.
Van Niekerk, Anton A. 2012. Biomediese verbetering : maakbaarheid of onttowering?. Tydskrif vir Geesteswetenskappe, 52(4), 581-595.