Enhancement

Human body scan on blue background

Biomedical technologies, such as drugs and surgical techniques, can increasingly be used not only to combat disease, but also to augment the capacities of normal, healthy individuals, a practice commonly referred to as biomedical enhancement. The best-established examples of biomedical enhancement are cosmetic surgery and doping in sports. But most recent scientific attention and ethical debate focuses on extending lifespan, lifting mood, and augmenting intellectual capacities. A number of drugs used to treat narcolepsy and attention deficit hyperactivity disorder have already been shown to have small enhancing effects on attention and memory in normal individuals, and there are range of drugs and other biomedical techniques on the horizon that hold out promise for more dramatic effects. One such technique is brain-machine interfacing, which some predict may allow human brains to be connected directly computers to improve our information processing abilities.

Over the last decade, biomedical enhancement has become the focus of one of the liveliest and widest-ranging debates in practical ethics. In 2003, President Bush’s Council on Bioethics published a report which raised a barrage of ethical concerns about biomedical enhancement. Two former members of the council, Michael Sandel and Leon Kass, even argued that biomedical enhancement is always ethically objectionable, and that biomedical technologies should be used only to combat disease. In response to claims such as these, a number of authors have come to the defence of biomedical enhancement, arguing that it would often be ethically permissible, or even desirable. Transhumanists argue that we should pursue certain kinds of biomedical enhancement even to the point that we are no longer recognizably human.

Those who universally object to biomedical enhancement may have public opinion on their side; the few surveys of the general public conducted to date have found considerable reluctance to countenance biomedical enhancement. However, it is unclear whether there are sound arguments to back up these concerns. One challenge is to explain how biomedical enhancement differs, in an ethically important way, from ordinary biomedical treatments, which are normally regarded as by-and-large unproblematic. Suppose two individuals have an IQ of 100, but the first previously had an IQ of 150, but then suffered a serious head injury, whereas the second has always had an average IQ. Increasing the IQ of the first person would conventionally count as a treatment, whereas increasing the IQ of the second would not. Yet it is not clear that there is any ethically significant difference here.

On the other hand, defenders of enhancement must confront the widespread assumption that biomedical enhancements are ‘zero-sum’ goods, conferring some advantages on those who use them, but also offsetting competitive disadvantages on those who remain unenhanced. They have sought to do this in various ways: some point out that widespread cognitive enhancements might increase the rate of scientific progress, thus benefitting almost everyone; others draw parallels with non-biomedical innovations like agriculture and information technology, suggesting that biomedical enhancements will increase overall human productivity, and can thus be seen as part of the story of human economic development; others present biomedical enhancement as a potential solution to human moral limitations like xenophobia and limited altruism; and others still outline how biomedical enhancements could improve the performance surgeons, pilots, jurors and others performing socially critical functions. 

Resources

Publications

  • Clarke, S., Savulescu, J., Coady, C. A. J., Giubilini, A. and Sanyal, S., Eds. (2016), The Ethics of Human Enhancement: Understanding the Debate. (Oxford: Oxford University Press) 
  • Savulescu, J. and Persson, I., (2012). Unfit for the Future: The Need for Moral Enhancement (Oxford: Oxford University Press).  Now also available in Portuguese (translated by Brunello Stancioli)
  • Savulescu, J., (2012) Decisiones peligrosas? Una bioética desafiante. Editorial Tecnos: Madrid (translation by Blanca Rodríguez López & Enrique Bonete Perales)
  • Savulescu, J., Ter Meulen, R., Kahane, G. (2011) eds. Enhancing Human Capacities. Oxford: Wiley-Blackwell (published 18/3/11)
  • Knopffler, N. and Savulescu, J., (Eds.) (2009). Der neue Mensch? Enhancement und Genetik, Verlag Karl Aber
  • Savulescu, J., Bostrom, N. (Eds.) (2009). Human Enhancement, Oxford: Oxford University Press

Multimedia

YOUTUBE: The Practical Ethics Video Series makes the most important and complex debates in practical ethics accessible to a wide audience through brief interviews with high profile philosophers in Oxford.  Video interviews on this and other topics can be found on our YouTube channel.

Pugh, J., (2019), 'BBC The Big Questions: 'Is it right to design babies?'', OUC Research Fellow, Dr Jonathan Pugh, participated in a debate 'Is it right to design babies?' for BBC1's The Big Questions, which ranged from ethical considerations of gene-editing technologies to NIPT (non-invasive prenatal testing).  Dr Pugh referenced the Nuffield Council on Bioethics report and discussed the need to balance the expected future well-being of children against the reproductive autonomy of parents.  Series 12 Episode 2 aired on 13 January 2019 and is available on iPlayer until 10 February 2019 (Dr Pugh's contribution appears at approx 18:40 on the clock).  Hosted by Nicky Campbell, 'The Big Questions' is a series of moral, ethical and religious debates. (13 January 2019).

Savulescu, J., (2017), Podcast for The Conversation, 'Speaking with: Julian Savulescu on the ethics of genetic modification in humans', What if humans are genetically unfit to overcome challenges like climate change and the growing inequality that looks set to define our future? (17 July).  http://theconversation.com/speaking-with-julian-savulescu-on-the-ethics-of-genetic-modification-in-humans-78249

Staicu, L. and Socaciua, E., (2017), 'The rise of postmedicine: some ethical concerns regarding biomedical technology; How Drug Patents Might Lead to Disincentives for Moral Bioenhancement', Erasmus Exchange Public Event: Double Seminar on Biomedical Technology and Moral Bioenhancement (30 May)

Savulescu, J., (2016) 'No pain, no praise: motivational enhancement and the meaning of life'.  MT16 Oxford-Valencia Neuroethics Workshop, Oxford Martin School (14 November) 

Gyngell, C., (2015), ''The case for genetically engineered babies' and accompanying podcast 'Should we genetically engineer humans?'', The Guardian (1 May). Article | Podcast

Savulescu, J., (2014). 'Making nice: Julian Savulescu and the case for moral bioenhancement'.  Philosopher and bioethicist Julian Savulescu joins host Peter Mares for a conversation on the potential for moral bioenhancement through direct brain stimulation, pharmacology or genetics, and the ethical implications of such interventions.  Up Close is an online, audio talk show of research, opinion and analysis, presented in English, from the University of Melbourne, Australia. Audio (MP3) |  Transcript

Erler, A., (2013), Sleep and Opportunity for Well-being (paper co-authored by David Birks and delivered at HT13 Uehiro Seminars in Practical Ethics) http://media.philosophy.ox.ac.uk/uehiro/HT13US_ERL.mp3

Savulescu, J., (2013). Pills that improve morality. TEDxBarcelona. (23 July)

Savulescu, J., (2012), Making Better Babies, Pro and Con. A Debate with Rob Sparrow http://www.arts.monash.edu.au/bioethics/--downloads/better-babies-debate-october-2012.mp3

CRISPR gene-editing

Papers

Media

In November 2018, Chinese researcher Jiankui He of Shenzhen announced that he had gene-edited two healthy embryos using CRISPR-Cas9 technology, which resulted in the birth of twin baby girls.  He claims to have edited a gene to make the babies resistant to HIV, although one of the girls has both copies of the gene modified while the other has only one (making her still susceptible to HIV).  Addressing the ethical concerns surrounding this claim, OUC Researchers have responded in blog posts and media interviews:

Blogs

TV and radio interviews

Devolder, K., (2018), Interviewed by Julian Worricker for BBC World Service Weekend episode 'The 80th Anniversary of the Kindertransport'. Dr Devolder discusses the ethical concerns surrounding Prof. Jiankui He's controversial gene-editing experiments (the gene-edited embryos resistant to HIV).

27 November. Interview with Julian Savulescu, ABC News (Australia) on birth of first gene edited babies.  

28 November 2018. Oxford bioethics expert: Gene editing itself is right, but healthy embryos should not take risks. Interview with Julian Savulescu on the case.  Jiemian News. Savulescu (in Chinese)

Quotes

Other media

Oxford Sparks Big Questions / Should we edit genes to make nicer people? Is it possible to edit someone's genes before they are born to make them a nicer, kinder, more moral person? Not only that - but, importantly, should we do this? When it comes to gene editing for moral enhancement, there are many ethical points to consider. Join us as we chat to Tess Johnson, a Philosophy PhD student at the Oxford Uehiro Centre for Practical Ethics, about this very big question (20 January 2021).

Savulescu, J., (2016), 'Why we should fine-tune the DNA of the future', Cosmos Magazine (16 August).

Gyngell, C., Douglas, T. and Savulescu, J., (2015), 'Engineering a Consensus: Edit Embryos for Research, Not Reproduction', Oxford Martin School Blog (2 December). 

Savulescu, J., (2015), 'Five reasons we should embrace gene-editing research on human embryos', The Conversation (2 December).

Gyngell, C., (2015), ''The case for genetically engineered babies' and accompanying podcast 'Should we genetically engineer humans?'', The Guardian (1 May). Article | Podcast