“Se vogliamo che tutto rimanga come è, bisogna che tutto cambi.”
“If we want things to stay as they are, things will have to change.”
—Tomasi de Lampedusa, The Leopard
Wouldn’t it be wonderful if we humans could live longer healthier lives with immunity to many of the diseases like cancer and HIV/AIDS that currently beset us? Even more wonderful might be the possibility of increased mental powers, powers of memory, reasoning, and concentration, or the possibility of increased physical powers, strength, stamina, endurance, speed of reaction, and the like. Wouldn’t it be wonderful?
Many people think not. The idea of improving on human nature has been widely rejected. Decisive interventions in the natural lottery of life, to enhance human performance, improve life, and perhaps thereby irrevocably to change our genetic constitution, have met with extreme hostility. This hostility is, as we shall see, misplaced. In this book I hope to convince you that human enhancement is a good thing and that our genetic heritage is much in need of improvement.
Whatever people say, no one, I believe, actually thinks that there is anything in principle wrong with the enhancement of human beings. This seeming contradiction, paradoxical as it may appear, is resolved when we reflect on the familiarity and acceptability of existing enhancement technologies and on their history. Many of us are already enhanced (do you wear glasses, for example?) and all of us without exception have benefited from enhancing technologies. (For example, have you ever been immunized? And even if you haven’t, you will have benefited from the so-called “herd immunity” created by the fact that others have.)
Not only do we all approve of enhancement, we approve for good reasons—we approve because we are decent moral people who want to protect each other from harm and who want to benefit ourselves, and others.
In terms of human functioning, an enhancement is by definition an improvement on what went before. If it wasn’t good for you, it wouldn’t be enhancement. There is a continuum between harms and benefits and the reasons we have to avoid harming others or creating others who will be born in a harmed state are continuous with the reasons we have for conferring benefits on others if we can.1
We have reasons for declining to create or confer even trivial harms and we have reasons to confer and not withhold even small benefits.2 The opportunity to create healthier, longer-lived, and altogether “better” individuals is one that there are moral reasons to take.
As with all opportunities, we have also to consider the risks that they may entail and there is of course a relation between the magnitude and probability of the benefit and the degree and size of risk we are prepared to run to get it.
I will argue that enhancement is also an opportunity that it is in the interests of society and government to take. On this view, parents would act ethically if they were to attempt to achieve such an objective for their children, and those of us who are autonomous enough to consider such questions have good reasons to confer such benefits on ourselves.3 I will further show that governments have prudential as well as moral reasons to support parental and individual choice in such matters. Indeed, although this chapter is partially intended to introduce the themes of this book, it also initiates the argument and attempts to place the argument in a tradition of thinking about attempts to shape human nature and to rethink the destiny of humankind.
The freedom of citizens to do what’s right ethically and what’s personally prudent is not only self-evidently sensible, it is, as we shall see, enshrined in our moral and political theory. Now, and in the chapters that follow, I will show why and how human enhancement is in the interests of all of us personally and in the interests of society. The principal objections to human enhancement will be examined in detail and I will argue strongly not only for the freedom, but also for the obligation to pursue human enhancement.
Threats to human life and dramatic policies and practices to meet them are all too frequent in human history. My own interests in this process began in the early sixties of the last century.
In 1961 the philosopher Bertrand Russell published a book (a pamphlet really) asking a pertinent and agonizing question. That question had arisen because of threats posed by scientific advance and humankind’s apparent inability to deal sensibly with the consequences. In 1961 the perceived threat was to all human life and it came from the policies of “mutually assured destruction” which were at the heart of strategies on both sides in the cold war concerning the use of nuclear weapons. Thinking about a rational response to what he perceived as the real possibility of the extinction of all human life, Russell’s book asked the question and took the title: Has Man a Future? This book asks effectively the same question, and seeks to examine whether the answer might not lie in humankind’s ability to realize its potentialities. We should be clear that, while the question “has humankind a future?” seems to be empirical, this is not the case. The question invites reflection on the nature of humankind and on the desirability of humankind’s continued existence or further evolution.
Russell imagines a conversation with God:
If I were the pleader to Osiris for the continuation of the human race, I should say: “O just and inexorable judge, the indictment of my species is all too well deserved, and never more so than in the present day. But we are not all guilty and few of us are without better potentialities than those that our circumstances have developed.… It is not only what to avoid that great men have shown us. They have shown us also that it is within human power to create a world of shining beauty and transcendent glory.… Lord Osiris we beseech thee to grant us a respite, a chance to emerge from ancient folly into a world of light and love and loveliness.”
Perhaps our prayer will be heard. In any case, it is because of such possibilities, which, so far as we know, exist only for Man, that our species is worth preserving.4
Russell was concerned with a nuclear catastrophe that might destroy all life and end in a permanent nuclear winter. He was pleading for the survival of the human species: not a survival that would preserve it with all its faults and follies, but rather a survival that would enable the realization of our “better potentialities.” At the conclusion of Has Man a Future?, Russell restates his hopes for a future free from the fear of the threat that loomed largest in 1961:5
Man has not only the corresponding capacities for cruelty and suffering, but also potentialities of greatness and splendour, realised, as yet very partially, but showing what life might be in a freer and happier world. If man will allow himself to grow to his full stature, what he may achieve is beyond our present capacity to imagine. Poverty, illness and loneliness could become rare misfortunes … And with the progress of evolution, what is now the shining genius of an eminent few might become a common possession of the many. All this is possible, indeed probable, in the thousands of centuries that lie before us.6
Russell might initially be taken to be saying that the survival of humans as we know them has value. But if we scratch the surface we see that for him what matters is the preservation and expansion of what is good about humans. We too should prioritize improving on humans over preserving the species in its present form.7
This “progress of evolution” is unlikely now to be achieved accidentally or by letting nature take its course. If illness and poverty are indeed to become rare misfortunes, this is unlikely to occur by chance, even with the thousands of centuries that Russell envisages and evolution requires. It may be that a nudge or two is needed: nudges that will start the process, trailed in the introduction to this book, of replacing natural selection with deliberate selection, Darwinian evolution with “enhancement evolution.” This book is concerned with the ethics and indeed with the policy dimensions of providing the required nudges.
If we wish humankind to achieve its potential (which has so far almost universally been assumed to be an inevitable part of evolutionary progress), this might require some deliberate changes. It is possible that, however conservative we are and however much we wish for things to go on as they are, things will have to change. If this is right, then conservatives for whom the sanctity of the existing human genome or the preservation of the species is an article of faith may need to accept change to preserve if not the totality, at least the essence, of what they value.
The epigraph for this chapter, which perhaps also serves as a salutary reminder of the connection between the impulse to conservatism and the temptations of revolutionary change, is Lampedusa’s wonderfully memorable idea that “If we want things to stay as they are, things will have to change.”8 It is worth recalling the context in which this paradox is introduced.
Don Fabrizio, Prince of Salina, the “Leopard” of the title of Lampedusa’s famous novel, is a deeply conservative hereditary prince in a still feudal Sicily. When we meet him in May 186o, Garibaldi’s “revolution” is about to topple the Bourbon monarchy and the “Kingdom of the Two Sicilies.” Ten years later, a united Italy, a phenomenon not seen since the fall of the Roman Empire, will be proclaimed, with Rome as its capital, and the Risorgimento will have completed its final phase. The Prince of Salina wants things to go on as they always have and yet he eventually accepts that his nephew Tancredi is right to think that even revolutionary change may sometimes be the only way to protect things as they are and that “if we want things to stay as they are, things will have to change.”9 The very different possibilities that are the subject of this book raise the same questions that faced Tancredi and Don Fabrizio: whether or not change is required and what will have to be sacrificed to achieve it, whether the changes constitute a revolution or the continuation of the status quo by other means. The crucial question, however, concerns whether or not the proposed changes enable the survival of what matters and permit the flourishing and further improvement of life for everyone (which is what all decent conservatives, liberals, and revolutionaries desire).
Russell’s question is thus also the Prince of Salina’s dilemma. It is a question and a dilemma that has been sharpened in our own times by the revolutionary possibilities for human enhancement developed and developing in science and technology.
This book looks seriously at the possibility of revolutionary change in human powers and capacities as well as in human nature. Whether this revolutionary change will prove conservative or radical is of course a further and complex question. Potentially, supporting human enhancement is as conservative as the Prince of Salina and as revolutionary as Tancredi; it shares with both of them their love of life and of love, their respect for science, for tradition, and acceptance of the necessity, sometimes, for decisive action.
It is doubtful that there was ever a time in which we ape-descended persons were not striving for enhancement, trying to do things better and to better ourselves.
Shelter, learning and teaching, tool using, body decoration, clothing, gathering and hunting, cooking, storing, cooperation, cultivation, animal taming and domestication, farming, social living, language, and education are all enhancement techniques or technologies. With the help of some of these tools we have built institutions and relationships, families, villages and cities, societies and civilizations, schools, universities, markets, commercial organizations, and other mechanisms of cooperation and competition. We have created literature, art, and music; we have created agriculture and industry, science and medicine, and technology and engineering.
Not all of these are equally beneficial of course, and any human construct can be misused or ill-used; but all mechanisms which make possible (though not of course inevitable) better life and better lives are means of enhancement in some sense. Substances that are effective analgesics in small doses are often poisons in larger doses; heroin is a derivative of morphine and both are derived from opium. The fact of widespread and disastrous heroin addiction does not discredit morphine as an important source of pain control and hence as a “beneficial” compound.
It is important to be clear that when we call something an “enhancement” or an “enhancing” technology or therapy we are not saying that is always its effect, any more than when we call something an “analgesic” we imply that it will in every case and every dose reduce pain or that “stimulants” will always stimulate or that “carers” always care or “healers” always heal. There is no sensible way in which we must take the possibility of misuse into account before determining that something is an enhancement. When we call something a form or method of human enhancement, we are pointing to a likely improvement that it can (will typically) effect if used in ways best calculated to achieve that effect. Aspirin is a painkiller which can also have many other beneficial “enhancing” effects, including reducing the risk of stroke. It is also a well-known killer and is often used to attempt suicide.
Writing is one of the most significant enhancement technologies.10 In addition to providing ways of recording speech and setting down ideas, it supplements memory and has indeed made, among many other things, recorded history possible for the first time. Writing, and everything that goes with it—reading, books, printing, libraries, education, universities, computers, etc.—would never have taken off if its incredibly expensive and elitist beginnings had been like the serpent in the egg “killed in the shell.”11 Think how expensive, rare, and elitist were manuscript books, school and university education, and printed books. Remember too that, until comparatively recently, the ability to read, and in turn to teach literacy and numeracy and everything which depends on these, was very thinly spread, not only throughout the world but within most nation (and city) states.12 Imagine if someone had said (and been heeded) that we should not invest in books and in literacy and education because it was expensive and elitist and could not be provided for all, or that we should not do so until it could be provided for all.
When the college at which I studied as a graduate student was founded in Oxford somewhere around 1263, university education was available to very few (and they were not the elite). The books the scholars read were in manuscript form and university education for all who might benefit was not even an idea, let alone an ideal. The same went for the founding of schools. Now in much of the world all children have some schooling, and university education is in many countries available for a majority of those who can (and who wish to) benefit. Schools and universities are incredibly expensive institutions but, despite this, it is not an exaggeration to say that the world aspires to universal provision. While this has not yet been achieved, few say that we should not further invest in education in Western Europe or North America, for example, until the same levels can be reached in the rest of the world. Equally we do not (and I believe should not) think that in investing in education we are trying to steal an advantage over people in countries who spend less.
If there is a lesson here, it is that we should be slow to assume that a good is too expensive, rare, or elitist to be pursued in the hope that eventually it can be made generally available, and that it therefore does not merit investment. Still less are there reasons to prevent the investment of others in the development of enhancing technologies and procedures.
Our collective origin as human beings occurred, almost certainly, in Africa between five and seven million years ago. Throughout the entire subsequent period we have been actively involved in enhancement, as well as passive or at least unwitting participants in an evolutionary process. To take one very simple example, every time we learn something new we change our brains: connections form in the brain which physically change its structure; these changes occur, if not permanently, then at least for a considerable period, and almost certainly improve our cognitive functioning.13
In a wonderful essay “Gaps in the mind,”14 Richard Dawkins conducts the following thought experiment.
He asks us to imagine a contemporary woman (you or your sister) holding her mother’s hand on the coast of Africa. She in turn holds her mother’s hand, and she her mother’s, and so on. Each daughter is as much like her mother as daughters usually are. Each person takes up a about a meter, a yard, of space as they hold hands back into the past. In just 300 miles (a small distance into Africa) the imaginary human chain reaches our common ape ancestor.
Now imagine our ape ancestor holding by her other hand her daughter, and she hers, and so on, back to the coast. Again each daughter looks as much like her mother as mothers and daughters usually do. By the time the chain reaches back to the coast, two contemporary females are looking at one another, each holding the hand of her mother stretching in seamless connection back to a common ape ancestor. The two “women,” shall we call them, looking into each others’ eyes are a modern human and a modern chimpanzee.
The point is not of course that we are descended from chimpanzees (we are not!); rather that both we humans and chimpanzees share a common ape ancestor, and we humans share our genetic origins with that ancestor and with chimpanzees. A mother shares 99.95% of her genes with her daughter but 99.90% of her genes with any randomly chosen person on the planet. Dawkins’s story is a salutary reminder of the dangers of making a fetish of a particular evolutionary stage. If our ape ancestor had thought about it, she might have taken the view adopted by so many of our contemporary gurus, Leon Kass, Michael Sandel, George Annas, Francis Fukuyama, and many others, that there is something special about themselves and that their particular sort of being is not only worth preserving in perpetuity, but that there is a duty not only to ensure that preservation, but to make sure that neither natural selection nor deliberate choice permit the development of any better sort of being.
There are also those, and they are many,15 who think that there are moral reasons to preserve not only human nature broadly conceived but also the human genome. They want it kept just as it is and regard it as a sort of genocide to think of further evolution into creatures that may no longer be human in the senses in which we understand the term. These conservatives may be like our imagined ape ancestor who (we have recklessly speculated) might have thought evolution had gone far enough and that her kind were at the very summit of imaginable evolution.
I personally am pleased that our ape ancestor lacked either the power or the imagination, or indeed avoided the errors of logic and/or morality, which might have led her to preserve herself at our expense. I hope that we will have the imagination, the power, and the courage to do better for ourselves and our descendants than the combination of chance, genes, and environment has done for us. This book is about the rights and wrongs of (and reasons for trying to) do just that. In the pages that follow I will not only set out the moral case for enhancement but indicate many of the ways in which enhancements can be ethically achieved.
I have emphasized the continuity of human enhancement and the fact that it has been part of human history from our first beginnings. This is an important reminder because it draws attention to our familiarity with the phenomenon of enhancement, the issues it raises, and the way in which it has changed and continues to change both ourselves and the world in which we live. This book is about the ethics and policy dimensions of human enhancement that have been occasioned by a new wave of technologies and possibilities that promise radical and different forms of enhancement than many of those with which we are familiar. It is also about contemporary fear of and reaction to these possibilities. This is my second book discussing this subject; the earlier work16 was a comprehensive look at the possibilities that developing technology, particularly biotechnology, might open for human beings. That book was largely speculative; the technologies then envisaged were in their infancy and very little that today would be classified as the new wave of human enhancement was then possible.17 Now, with a new wave of technologies, we also have renewed interest in and commentary upon human enhancement. There is also a new urgency, perhaps even a sense of panic in some quarters, now that possibilities formerly merely speculative are becoming a reality. In this book I will not attempt an exhaustive catalogue of the new ways in which human enhancement might be possible. I will, however, examine a sufficient range of the most likely avenues human enhancement might take to provide a comprehensive discussion of the ethics and policy issues they raise, and to try to resolve the most acute ethical dilemmas they pose. To do so, I will look not only at some of the most interesting and dramatic technologies, but at many of the most prominent reactions to them.
Many of the adverse reactions to human enhancement, as we shall see, take the form of dire predictions of the disasters that might attend on any attempts to change humans or human nature for the better. Of course we should take such possibilities seriously; dangers which might attend attempts at enhancement could wipe out any benefits and might indeed change things for the worse rather than for the better. However, unless we can see clearly how probable and serious the dangers are and have a realistic basis for balancing them against the probability and size of the benefits, we can have no rational basis for either precaution or enthusiasm. We will discuss the difficulty of such calculations in due course. I shall, however, suggest the appropriateness of a skeptical approach to such claims, demanding always an account of just what is allegedly harmful about the proposed course, rigorous assessment of the probability of such harms accruing, and a realistic basis for determining also their proximity. In short, we must know what reason there is to believe that it might be true that enhancements might be dangerous or indeed to think such a thing even plausible.
Again I am reminded of Russell’s supremely rational approach to such dilemmas. In the opening paragraph of his book Sceptical Essays, he proposes a radical idea:
I wish to propose for the reader’s favourable consideration a doctrine which may, I fear, appear wildly paradoxical and subversive. The doctrine in question is this: that it is undesirable to believe a proposition when there is no ground whatever for supposing it true. I must, of course, admit that if such an opinion became common it would completely transform our social life and our political system; since both are at present faultless, this must weigh against it. I am also aware (what is more serious) that it would tend to diminish the incomes of clairvoyants, bookmakers, bishops and others who live on the irrational hopes of those who have done nothing to deserve good fortune here or hereafter.18
With this radical proposal in mind we must now turn to the very complex question as to whether the proposition that enhancements are a threat to humankind is true, and, if it is, as to whether there are good reasons to believe that ceasing to be human is in any way problematic.