Abstract
In December 2008, a study group convened by Rockefeller University published a commentary in Nature recommending societal adoption of cognitive-enhancing medications by healthy persons. The group included a prominent bioethicist, John Harris, who for two decades has recommended various enhancements--pharmacological, hormonal, chemical, genetic--as beneficial to human beings. Harris's most systematic defense of enhancements, including germ line and embryo enhancements, is presented in his very provocative book, Enhancing Evolution: The Ethical Case for Making Better People. The biotech revolution has brought us to a point where human species, Harris contends, replace natural selection with deliberate selection, Darwinian evolution with 'enhancement evolution' (p. 4). Harris initiates his argument with a thought experiment: Given lengths many parents will go to seek best educational opportunities and social advantages for their children, why not instead achieve desired qualities--such as enhanced intelligence, better health and fitness, and improved physical and mental capacities--through such means as genetic engineering, regenerative medicine, reproductive technology, or nanotechnology, particularly by selecting for traits in human embryo? In either context, Harris suggests, our goals are same. We have simply changed from social engineering to genetic or pharmacological means. Once we have willed ends, we have necessarily willed means to realize those ends. This opening rhetorical reflection provides a compressed version of Harris's general argument on enhancements through medical interventions: Having embarked on path of making better people through education, athletic camps, music lessons, and like, it's not possible to claim these ends are offlimits to medical enterprise; indeed, we are more likely to succeed through medical and biotechnological methods. Enhancements have already been incorporated within medicine. For instance, if one follows trajectory from glasses to contact lenses to LASIK surgery, it seems arbitrary to draw a line against enhancements for night vision. Vaccinations against diseases like smallpox suggest we are morally committed to accept vaccinations that provide immunity against disease. And life-prolonging measures, such as organ transplants, usher us into a moral realm that endorses regenerative technologies to reverse aging or even to achieve a biological immortality, which Harris refers to as the Holy Grail of (p. 59). Harris sees no conceptual difference between therapy and enhancement, nor any defensible criteria of normal human functioning or flourishing that traditionally have grounded objections to enhancements. He denigrates religious considerations as superstition and expressions of prejudice. The philosophical basis he offers for enhancements shows how much ground has been traversed in supplanting Darwinian with enhanced evolution: Medicine can be described as 'the comprehensive attempt to frustrate course of nature' (p. 35). Remarkably, Harris offers no philosophical account or defense of this view of vocation of medicine, or of medicine's relation to nature, even though this claim opens way to a comprehensive medicalization of life, from preconceptual screening to end-of-life treatments. According to Harris, choice to use enhancement technologies is also protected by the democratic presumption. This presumption amounts to a twenty-first century restating of Mill's principle--that only ground for intervening with or restricting personal liberty is prospect of harm to others. For Harris, such harms must be real and present, not speculative and future. There are at least two issues here that Harris needs to address--one focusing on relationship of law and moral discourse (with latter here in danger of being eclipsed by former), and other on how we should address uncertainty about outcomes in moral deliberation. …
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