Abstract
The enhancement debate in neuroscience and biomedical ethics tends to focus on the augmentation of certain capacities or functions: memory, learning, attention, and the like. Typically, the point of contention is whether these augmentative enhancements should be considered permissible for individuals with no particular “medical” disadvantage along any of the dimensions of interest. Less frequently addressed in the literature, however, is the fact that sometimes the diminishment of a capacity or function, under the right set of circumstances, could plausibly contribute to an individual's overall well-being: more is not always better, and sometimes less is more. Such cases may be especially likely, we suggest, when trade-offs in our modern environment have shifted since the environment of evolutionary adaptation. In this article, we introduce the notion of “diminishment as enhancement” and go on to defend a welfarist conception of enhancement. We show how this conception resolves a number of definitional ambiguities in the enhancement literature, and we suggest that it can provide a useful framework for thinking about the use of emerging neurotechnologies to promote human flourishing.
Highlights
Advances in neuroscience and related fields have allowed for an unprecedented increase in our ability to intervene in brain-level processes, thereby influencing a wide range of higher-order functions and behaviors
After all, is the meaning of “enhance” if not to heighten, to augment, to intensify? we see articles asking whether non-invasive brain stimulation should be used to enhance learning (e.g., Cohen Kadosh et al, 2012); whether we should be worried about university students taking Ritalin to improve focus (e.g., Outram, 2010); whether doctors have an obligation to ingest ergogenic drugs to stay awake during late-night surgery (e.g., Greely et al, 2008); and whether the use of mood brighteners is getting out of hand (e.g., Farah, 2002)
We identified two additional ways of understanding enhancement—the sociological-pragmatic approach and the ideological approach—and proceeded to outline a new account of enhancement, which we argued was preferable to the others: the welfarist approach
Summary
Advances in neuroscience and related fields have allowed for an unprecedented increase in our ability to intervene in brain-level processes, thereby influencing a wide range of higher-order functions and behaviors. Note the specific focus here on capacities, moods, or functions that might be improved by the pharmacological (or other) intervention—“improved” in the sense of facilitating more of whatever it is that the function normally does (see Dresler et al, 2013 for a recent review) We can summarize this sort of approach as follows: The Functional-Augmentative Approach to Enhancement: Interventions are considered enhancements insofar as they improve some capacity or function (such as cognition, vision, hearing, alertness) by increasing the ability of the function to do what it normally does. The debate typically turns on whether the proposed capacity-enhancement should be considered permissible for someone who does not suffer a “medical” disadvantage along that dimension (Daniels, 2000; Allhoff et al, 2009) In this context, a distinction is frequently drawn between “enhancement” (on the one hand) and mere “treatment” or “therapy” (on the other), with the implication often being that the former may be morally problematic in ways that the latter may not be. We conclude by discussing some of the advantages that this welfarist conception has over other common definitions
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