Map of life expectancy at birth from Global Education Project.

Friday, May 16, 2008

Ist ein ubermensch!

Okay, so getting back to Dr. Bashir. Right now there is a rather heated debate going on in some quarters about whether it is ethical to use technology not merely to cure or ameliorate disease, but to enhance human abilities or other desirable characteristics, such as physical attractiveness or personality.

It doesn't take more than a moment's reflection to see that the question, taken at face value, is just silly. People have always looked for ways to make themselves more capable or more beautiful, and we accept it as a matter of course. Just to make this discussion manageable, let's consider athletics.

The big flap these days is obviously over performance enhancing drugs. Yes, they're against the rule -- or rather, some are but not others, as I'll show in a second -- but other than that, is there anything essentially different about steroids and other methods that athletes use all the time? Of course not. Athletes train at high altitude or, if that's inconvenient, in hyperbaric chambers. They consume carefully engineered diets and regimens of supplements. They use elaborate machinery to develop muscular strength, endurance, and flexibility, and to build patterned motions into their motor neurons. Baseball pitchers routinely undergo ulnar collateral ligament reconstruction, "Tommy John Surgery," which actually gives them a superior elbow, and often a faster fastball, than they had before. As for drugs, it's perfectly legal for athletes to take painkillers and anti-inflammatories, undergo, yes, steroid injections to reduce joint and tendon inflammation, and in most sports to consume caffeine and other herbal stimulants. Some people say, well, steroids present long term dangers to health but in fact, professional athletes typically suffer from osteoarthritis, post-concussion syndrome, and other ills after they retire. If the long-term effects on athletes' health really mattered to anyone, we would have to ban most professional sports.

Now consider medicine in general. There is a great deal of handwringing over the prospect that children who are healthy but just shorter than average are being given Human Growth Hormone, and over the possibility of "cosmetic psychopharmacology," in other words that people are taking antidepressants because they are unhappy with aspects of their personality, such as shyness or irritability, that were not considered diseases until the drug companies came along.

But let's consider some treatments that don't seem to bother anyone. When Social Security was established in the U.S., it wasn't very expensive. Most people didn't even make it to age 65, and few lived much past it. Nowadays it's a tragedy if somebody dies before age 70, and most of us fully expect to carry on well into our 80s, simply because of ongoing efforts to prevent and cure disease. That is beyond what used to be considered the normal human life span, of course, but I haven't heard anyone worrying about such a fundamental change in "human nature." Even so, it isn't good enough. Scientists are working on ways to slow or even halt the aging process, and they are already testing the compound resveratrol. If it turns out that it works, and let's us all live to be 120, believe me, there will be very few voices saying it's unethical to take it at all, and many more declaring that it's a human right to take it which needs to be extended to everybody.

What if there were a pill that would make children smarter? (Uh oh. It turns out there just might be one. The word hasn't really gotten around yet, but I'm waiting for the shit to hit the fan.) Assuming it had no dangerous long-term effects, parents would be clamoring for it. People would insist that it be added to school lunches, and I expect I'd be popping it every morning at my desk.*

So there seems to be an arbitrary quality about what sorts of technological "enhancements" do and do not offend people. If you think about it a bit more, it's hard to see how the extension of human intelligence represented by writing, and books, and now by the electronic digital computer, is fundamentally different from sci-fi concepts like getting computer chip implants that enhance memory or processing power. Technology, over time, has made us more capable, longer lived, healthier and yes, better looking. Cosmetic dentistry and wart removal are taken for granted. Face lifts and hair transplants are considered silly by some, but hardly objectionable for those who want them. So why object if parents don't want their children to be short? Why draw the line at some technologies and not others? What's the difference? To me, certainly, it is far from obvious.

So, here's the last step. Suppose we find out that resveratrol works, and everybody starts taking it. What's wrong, then, with inserting a gene into a human embryo so that the person will manufacture the chemical, and won't have to take the pill? The result is the same, only cheaper. And yes, she or he will pass the capability on to her offspring and we'll have a race of people who live to be 120. Why is that unethical, but accomplishing the same thing by taking a pill is not? The same goes for greater intelligence, or physical ability, or even temperament. If we can take pills so we won't be depressed or anxious, why not put happiness and equanimity in our genes. What's the difference?

You tell me.

* Of course intelligence is not a function of a single chemical. Success in school and at all intellectual work or pursuits depends on a combination of memory and information processing capabilities, an inquiring personality, concentration, diligence and hard work, all of which result from a genetic endowment unfolding in a particular environment, and which in turn may be enhanced or suppressed by good or incompetent teaching and mentorship. But a pill might still increase intellectual performance, ceteris paribus.

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