Falling for It

Image adapted from a woodcut by Bernard Saloman

Image adapted from a woodcut by Bernard Saloman

Who decides whether technological modifications to a person are an enhancement or not? Theologian Ronald Cole-Turner asks this question in his introduction to Transhumanism and Transcendence.

The modification might be medicine that makes you smarter, an implant that gives you a ‘new’ memory, or perhaps a physical prosthetic that allows you to control devices with your brain.

Secular approaches to bioethics, he explains, inevitably end with the subject of the change deciding for themselves whether the modification is an improvement or not.

This leads Cole-Turner towards an interesting question:

What are we to think if, after the technological enhancement, there is a change of mind – literally? Before the modification, the person completely understands and truly believes that the change is an enhancement. After the modification, the person completely understands and believes that it is not an enhancement, not because anything went wrong but because the enhancement worked and the moral core of the person has been changed. In such case, is the change an enhancement?

The thought experiment is a reminder of a much older story:

The serpent was the shrewdest of all the wild animals the Lord God had made. One day he asked the woman, “Did God really say you must not eat the fruit from any of the trees in the garden?”

“Of course we may eat fruit from the trees in the garden,” the woman replied. “It’s only the fruit from the tree in the middle of the garden that we are not allowed to eat. God said, ‘You must not eat it or even touch it; if you do, you will die.’”

“You won’t die!” the serpent replied to the woman. “God knows that your eyes will be opened as soon as you eat it, and you will be like God, knowing both good and evil.”

The serpent convinces Eve to be disobedient by convincing her of the fruit’s enabling power. Eve quickly realises that though the serpent told the truth, the ‘enhancement’ was a trap:

“The serpent deceived me,” she replied. “That’s why I ate it.”

And according to the Christian story, the consequences are realised by Eve, humanity – and ultimately by God – at incalculable cost.

Raising the Bar: Therapy or Enhancement?

Cap

Image borrowed from Rolling Stone

In the Olympic games at Mexico in 1968, Dick Fosbury changed the high jump forever, when he left all other competitors behind and set an Olympic record of 2.24m. His winning technique of twisting his body and clearing the bar backwards is now universally adopted.

The Fosbury Flop has enabled high jumpers to clear new heights ever since, now over 2.4m. Dick Fosbury has since become a symbol of innovation, signed by Mazda to help advertise their cars in 2013. Fosbury’s new technique raised the bar for everyone.

As a ‘natural’ technique, the Flop was unusual but legitimate. Innovations that use technology to push human boundaries (in athletics or elsewhere) are more controversial, often becoming a discussion over whether the change is therapeutic or an enhancement.

For example, a prosthesis that allows an athlete with missing legs to compete with biological runners (as Pistorius did in the 2012 Olympic and Paralympic Games) is a therapeutic use, while a prosthesis that enabled speeds faster than biological legs would be enhancement.

The therapy vs. enhancement distinction sounds promising, but is ultimately less meaningful than you might think. The reason is that the definition of what is a ‘normal’ state of health has always changed over time – like in a high jump, the bar is moved from time to time.

Definitions of disease have altered over time, as well as differing between class, gender and culture. As we age, most of us expect our bones to break more easily, but osteoporosis was reclassified from a natural part of getting older into a disease by the WHO in 1994.

An opposite example is homosexuality, first thought of as an ‘act’ (and a capital offence in the UK after 1533), then a ‘state’, then a mental disorder, before finally removed as a listed disease from the American Psychiatric Association’s Diagnostic and Statistical Manual II in 1974.

Ronald Cole-Turner, a professor of theology and ethics writes about the line between therapy and enhancement:

“Disease” itself is a socially constructed category, not something unambiguous in nature, and the list of diseases changes over time, often in light of cultural preferences or the marketing of a new drug. If “therapy” treats “disease”, it treats a moving target.

Cole-Turner goes on to quote Leon Kass, former chair of the President’s Council on Bioethics who describes as “certainly no friend of technological enhancement”. Kass says:

Those who introduced this distinction [between therapy and enhancement] hoped by this means to distinguish between the acceptable and the dubious or unacceptable uses of biomedical technology: therapy is always ethically fine, enhancement is, at least prima facie, ethically suspect … But this distinction is inadequate and finally unhelpful to the moral analysis.

Kass continues:

Needless arguments about whether or not something is an ‘enhancement’ get in the way of the proper question: What are the good and bad uses of biotechnical power? What makes a use “Good”, or even just “acceptable”?