Human enhancement (HE) has gained increased visibility and popularity in the last decades. This is as a result of a substantial increase in the number of fields interested in the topic, namely: nanotechnology, biotechnology, information technology, and cognitive science (NBIC). The rapid innovation in these fields has created a theoretical space for speculation over the moral acceptability of aiming to improve or expand human capacities through the implementation of genetic engineering, drugs and technology so to give rise to a number of subgroups such as cognitive enhancement (CE), moral enhancement (ME) and emotional enhancement (EE).
Many academics in the Western world, including both scientists and philosophers, now favour the enhancement of human beings with the tools of science, and the motto: “if we can, we should” is sometimes used to summarise this position. The appeal of reducing human “weakness” and potentially improving a range of human abilities is obvious, but both moral and political questions remain as sources of dissent. We can make a general distinction between those arguing in favour of HE (described as bioliberals, posthumanist or transhumanists depending on the context) and those against interventions on the human condition that go beyond “standard” function (this latter group is that of the bioconservatives).
What do we mean when we talk about Human Enhancement?
Since the inception of this discussion, Nick Bostrom and Rebecca Roache have demonstrated that exponential developments in nanotechnologies, synthetic biology, neurology and genetic engineering have created the premises for a reconsideration of what it means to be human, as well as in which way(s) and to what extent we should interfere with humanity’s “natural disposition”. Now not only can the most basic human capacities of an individual be restored to their initial levels before an injury, illness; these basic capabilites can also be enhanced.
A comparison between enhancement and therapy is instructive. While therapy aims to fix a problem or dysfunction and thereby allow the individual to regain a status of “normality,” enhancement aims to break the barriers of normality and go beyond the “natural limits” of mankind. This controversial distinction needs to be clarified. Here, therapeutic treatment is defined as: a) designed to re-establish a standard level of functionality; b) reversible; c) less invasive and expensive than enhancement. In contrast, enhancing treatment is: a) designed to move the level of functionality above the standard; b) not easily reversible; c) more invasive and expensive than therapy. The following example elucidates the above definitions. The availability, purchase -and use- of a pair of glasses could be justified as part of the therapeutic treatment of poor vision, whereas, the process of neural implantation aimed at increasing one’s memory by 20% would not. While the overlapping threshold between therapy and enhancement is open to debate, it is nonetheless important to have a frame of reference for the terms considered.
The famous example of the South-African runner Oscar Pistorius encapsulates the current difficulties in drawing a distinction between enhancement and therapy. Born without fibulae, he had his legs amputated below the knee at a very young age and replaced with prosthetic legs. Thanks to his commitment to training and to the implementation of a pair of Flex-Foot Cheetahs, in 2005 Pistorius managed to win the T44 200m gold medal.
When his results started to match and pass those of the “normal” runners however, the debate over therapy and enhancement turned into a polemic. In 2007, the International Association of Athletic Federations (IAAF) reported that “Pistorius was able to run at the same speed as able bodied athletes while using less energy and that his prosthetic limbs gave him an advantage over able-bodied athletes.” (http://oscarpistorius.com/) By common standards, when Pistorius started using prosthetic legs as a child, he had merely undergone therapeutic treatment. Yet, in a situation where his artificial limb prostheses were identified to be a technical advantage, he was considered to have undergone enhancement. Of course, this makes his case even more germane to the ethical and political dimensions of the therapy versus enhancement debate: is it ‘enhancement’ if the person in question is responding to a congenital condition over which she had no control?
Enhancements like those in the Pistorius case, are “merely” physical ones, hence -in a sense- less problematic (though part of the HE agenda and surely definable as physical, we will leave the more controversial issue of life extension for the chapter on environmental ethics and technology) than those enhancements that instead are aimed at improving (or simply changing) some of our less immediately visible characteristics such as predispositions and attitudes towards life and people, as well as our intellectual abilities and response. Yet, before moving to analysing the various types of non-physical enhancements, we should briefly consider some of the arguments made for and against HE.
Fears from the past
As enhancements (especially the psychical ones) could also be genetic, once that the political dimension enters the debate, it is unescapable to think of eugenics. Even though the ideology had its genesis in Great Britain and found much success in the United States, the field of eugenics is associated with Nazi Germany, and the atrocious consequences of their projects. It is no surprise that the terrible and recent experience of the National Socialist era makes discussion of -let alone policy about- HE in Europe an especially difficult topic. Among others, the great German sociologist and philosopher Jürgen Habermas, in his book “The Future of Humanity” has brought forward the following argument against eugenics: the application of any form of genetic enhancement to our offspring would undermine the autonomy of those yet-to-be-born individuals.
Among other critiques against Habermas’ view, two are particularly relevant and worth of consideration in this context. First, one could argue that the limitations of physical autonomy that a severely disabled person might have to suffer as a result of a lack of implementation of accessible genetic enhancement tools will be a much greater destabilising factor on the individual’s freedom to pursue her own priorities in life than the knowledge that her parents chose her genes scientifically. Second, we could apply the famous argument put forward by Nicholas Agar in his work “Liberal Eugenics”: if we accept -as we do- environmental enhancement (e.g. private schools, music lessons, exclusive sport facilities and so on) as acceptable parental behaviour, why should we not think of genetic enhancement as a variant of the same principles?
Of course, the counterargument to this assessment of what should be permissible could also be made. Namely, we could affirm that, given that environmental enhancement is producing an ever-growing gap between the ‘haves’ and the ‘have-nots,’ and in light of the negative moral and political results that this entails, it would probably be wise not to implement genetic enhancement either.
Politics and Enhancements
Sarah Chan and John Harris accurately describe “an enhancement (as we are using the term) is something of benefit to the individual.”² This commonly shared transhumanist definition of enhancement could be seen as sufficient proof that distributive justice is not truly a central consideration of HE ideology. After all, at the root of HE, there is a Hegelian vision of progress. Relevantly, the same Harris draws a parallel between HE and the use of candles, affirming that we should not ban the former in light of the benefits that we can perceive to have achieved through the use of the latter. The only things we have to work on, Harris says, are working hours, minimum wages and so on.
In response to this historical analysis (and, as a result, of the potential outcomes of future implementations of HE), it might be worth applying a Left-Hegelian perspective to consider that the example proposed by Harris may demonstrate that the advent of candles may have been the point at which the level of exploitation of workers reached a tipping point. The industrial revolution has certainly resulted in certain benefits and progress for a part of humanity, but it is equally true that it represented a turning point in delineating once and for all the gap between rich and poor countries. If such a gap has been consistently increasing since its inception, are we sure that we want to start another revolution that might run along the same tracks? Most importantly, could we convincingly affirm that this process would constitute an enhancement for humanity as a whole rather than only for a select or lucky few?
It appears clear that there are a number of issues related to HE, but before proceedings in analysing the specificity of the biochemical enhancers, we should first look at recent techniques that use instead electricity to re-calibre our interactions with other human beings.
Non-Invasive Brain Stimulation³
Non-Invasive Brain Stimulation (NIBS) are divided into a number of subgroups.
Transcranial magnetic stimulation (TMS) uses magnetic induction to produce electric current through the scalp and the skull allowing for both neurostimulation and neuromodulation. The main uses of repetitive TMS (rTMS) are currently linked to the diagnosis and treatment of certain disorders, as well as the study of brain functioning, thanks to the ability also to block the activity of certain brain areas in a selective and reversible manner (polarizing neuronal membranes).
Transcranial current stimulation (tCS) uses electrodes placed on the scalp to deliver a weak current (1-2 mA) to the brain. There are several techniques of tCS – tDCS (transcranial direct current stimulation), tACS (transcranial alternating current stimulation) and tRNS (transcranial random noise stimulation) – but most studies are focused on tDCS, which is mainly used to modulate excitation and inhibition and to alter and improve cognitive functioning.
The use of NIBS is the combination of some of its unique characteristics with the spread of its use for enhancement purposes in both cognition and sport performance. Not surprisingly, the gradual spread of the use of NIBS -and tDCS in particular- was first motivated by its therapeutic value.
The insight that the application of electric current can modify the function of the nervous system has found it progressive confirmations and today we know that TMS can be used to normalize areas of abnormal activity due to illness. Indeed, several studies have shown that rTMS can have a positive effect on mood in patients with depression, while tDCS can have an apparent therapeutic potential for chronic neuropathic pain, Parkinsonism, stroke recovery, tinnitus, traumatic spinal cord injury, depression, and drugs addiction, even though tDCS has not been approved by the FDA for any therapeutic applications and these treatments are presently considered an “off-label” application.
Among other areas of enhancement, those are worth of special attention perhaps: memory, reading, mood, learning, perception, mathematical cognition, decision-making, motor skills, creativity, motivation, and moral reasoning.
On the practical side, it is interesting to take into account that athletes of the national ski-jumping team of the United States and some sprinters of various nations that took part in the Rio Olympics allegedly experimented with the handset for tDCS developed by Halo Neuroscience so to improve their athletic performance. In particular, stimulating motor areas during training would improve coordination, strength and fatigue resistance. This has also attracted the interest of the World Anti-Doping Agency, which is monitoring the use of tDCS to improve athletic performance to evaluate whether to include it in the list of treatments forbidden by the International Olympic Committee. The main criteria to be included in the list are risks for the athlete’s health and potential violation of sportsmanship.
Other important issues have arisen from the debate on the ethical guidelines that should govern this technology. It has been documented that relatively low cost and easiness of manufacturing of tDCS could led to a ‘DIY-tDC’ phenomena. Indeed, equipment is cheap, easily available, and apparently very simple to use. Hence, some private companies have put on the market devices for NIBS, such as Foc.us, which was advertised as being able to improve attention and memory so as to make users better at video games. Actually, a scientific study has found that the effects are not at all what had been promised; indeed, stimulation with the device in question seems to worsen the user’s memory. However, Do-It-Yourself brain stimulation seems to be growing, as testified by various studies.
As a response to this “social risk” deriving from an unregulated use of NIBS, a group of leading neuroscientists in the field has recently published an Open Letter warning about the risks of stimulation if not monitored by experts. In the letter, the scholars note that: (1) stimulation affects more of the brain than a user may think; (2) stimulation interacts with ongoing brain activity so that the specific activities carried out during stimulation modify the effects of tDCS itself; (3) enhancement of some cognitive abilities may come at the cost of others; (4) changes in brain activity (intended or not) may last longer than a user may think; and (5) small differences in tDCS parameters can have a big effect. In short, safety considerations seem therefore very important and also require, in addition to ethical ones, attention from the scientific community and the social and political authorities in view of choices of regulation, given the growing spread of self-administered NIBS. The use of tDCS was also discouraged in military and security services.
Finally, it should be taken into consideration that, when it comes to neurocognitive enhancement, there seem to be reasons to set limits to total personal autonomy. In particular, in competitive-selective contexts - such as job interviews - issues of fairness and overall social efficiency are at stake and should be addressed.
Developments in neuroscience are gradually exposing more and more the way in which our brain responds to substances -shaping our interaction with the world in accordance. This is usually referred to in the literature as CE. For example, amphetamines such Ritalin or Adderall (initially meant to be used “only” for therapeutic use by people affected by ADHD or narcolepsy) are now widely used in academic and military contexts as ways of boosting one’s attention, responsiveness and ability to focus beyond normal level. They can also significantly reduce fatigue and hunger making their use extremely appealing for students stressing out for the submission of a paper or armies for having more efficient soldiers serving.
Aside from obvious concerns related to the safety of these drugs, probably the most problematic issue specifically related to CE (as in the case of NIBS that also represent a form of CE, though not biochemically based) is its interaction with distributive justice -more specifically still with the disclosure of its use in competitive-selective contexts. Would we consider to be fair for a person to get a job over another if we knew that she took advantage of a pill that allowed her to be more concentrated during the entrance test? Probably not.
One possible “internal” way of solving this issue -and others- of unfairness, some authors claim is to take the biochemical enhancement to the next level: instead of “only” improving our technical skills in achieving a certain goal, we should address more directly our (faulty) morality, so to ensure a greater good for humanity. Along those lines, Ingmar Persson and Julian Savulescu argue that if we are to survive as a species, we need to morally enhance ourselves (so to alter our empathy through an intake of oxytocin for the sake of being less aggressive for example). The idea derives from the reading of our biological history somehow not as evolved as our technological one: a single individual is able to create enormous damage with a dirty bomb say, while a lack of coordination (possibly moved by more or less conscious selfish interests) is not allowing us to face vital issues such as global warming. Calibrating ourselves towards a more cooperative way of interacting with society would produce benefits for society that we should seek.
Of course, this approach is far from unquestionable. Among other possible critiques, two seem particularly powerful.
On the one hand, there is a bioconservative worry. Such a tool is positive if we give for granted that the morality enhanced is universal and unquestionable, but surely we have plenty of examples were moral disagreement is in place. Scarier still, what would happen if those in charge of the moral enhancers would push for questionable -or even immoral- goals?
On the other hand, the critique arrives from within the posthumanist tradition itself. According to Harris for example, there is no moral justification in seeking to alter our “freedom to fall”. We can enhance our cognitive capacities so to be more likely understand what is best for us and others, but we should not alter our core structure that guarantees that we make a certain (moral or immoral) choice in accordance to our fallible -yet unique and autonomous way of seeing the world.
Finally, EE is the most recent of the subgroups within the cluster of biochemical enhancers, and it is possibly the most controversial of all. The idea at the bottom of this specific category of enhancers, is that why could and should use the knowledge that we are getting from studies on our brain to help us understand more what triggers our emotional responses and how we could control it.
The case is particularly powerful when considering instances of romantic love that creates unhealthy behaviours within ourselves (dependence) or from our partners (domestic violence). Hence, the portrayed scenario of having a pill that could help an abused lover to detach herself from an abusive and violent partner seems very tempting of course. Yet, the possibility of chemically redirect our emotions according to what we rationally decide is not free of worries. Could we no get rid of love altogether then? What would that leave us with? Also troubling, is the way in which this “emotional self-creation” could affect sexual minorities: if provided with the tools to “cure” themselves, many homosexuals might feel pressured by their conservative environment to change their “sexual tastes” and this scenario seems like restricting our freedom rather than broadening it.
¹ This part of the chapter builds on some of my previous work on the topic. Garasic, M.D. 2012. Human Enhancement in the EU, Australian and New Zealand Journal of European Studies 4, pp.31-41.
² Chan S. & J. Harris. 2007. In Support of Human Enhancement, Studies in Ethics, Law, and Technology, 1(1), pp.1-3.
³ Andrea Lavazza is to be thanked for his contribution in our co-authored paper to which I refer extensively in this part. Lavazza, A. & M.D. Garasic. 2017. How Non-invasive Brain Stimulation Might Invade Our Sphere of Justice, Journal of Cognitive Enhancement 1, pp.1-8.
Bostrom, N. 2010. Letter from Utopia, Studies in Ethics, Law, and Technology 2(1), pp.1-7.
Garasic, M. D. & A. Lavazza. 2016. Moral and social reasons to acknowledge the use of cognitive enhancers in competitive-selective contexts, BMC Medical Ethics 17(1)
Garasic, M. D. 2017. Enhancements 2.0: self-creation might not be as lovely as some think, Topoi
Sandel, M.J. 2002. What’s Wrong with Enhancement
Savulescu, J. & I. Persson. 2012. Moral Enhancement, Philosophy Now, Issue 91