Bioethics: The Real Story of Our Age

I am reading an extraordinary document, Beyond Therapy: Biotechnology and the Pursuit of Happiness, issued by the President’s Council on Bioethics, and commend it to everyone. The writing is colloquial, yet literate, technical but not condescending. Its authors display a breadth far beyond mere science.

We have reached a point where medical issues confront us every day, insistently. Biotechnological developments and our efforts to formulate a corresponding ethos might be the real story of our age, despite the current concerns about Iraq, the economy and the stock market. Witness the stories that have bobbed to the surface in the past few days: family members disagree over whether to continue feeding a Florida woman who may never recover from her vegetative state; a risky, very expensive operation has separated conjoined twins; genes from another species may have been implanted in a human embryo; use of the “abortion pill” (RU-486) may have caused a teenaged girl’s death; a popular radio show host has been using painkilling drugs that may have contributed to his on-air performance.

Earlier I have noted the sports/designer steroid scandal in my posts below. Why are we so disquieted? A flavor of Beyond Therapy’s approach is shown below:

The central question becomes: which biomedical interventions for the sake of superior performance are consistent with (even favorable to) our full flourishing as human beings, including our flourishing as active, self-aware, self-directed agents? And, conversely, when is the alienation of biological process from active experience dehumanizing, compromising the lived humanity of our efforts and thus making our superior performance in some way false—not simply our own, not fully human?

Better nutrition seems an obvious good, a way of improving our bodily functioning that serves human flourishing without compromising the “personal” nature or individual agency of what we do with our healthy, well-nourished bodies. But moving outward from there, the puzzle gets more complicated. Where in the progression of possible biological interventions do we lose in our humanity or identity more than we gain in our “performance”? Is there a way to distinguish coffee and caffeine pills to keep us awake from Modafinil to enable us to avoid sleep entirely for several days, from amphetamines to keep us more alert and focused, from human growth hormone, steroids, and EPO to improve strength and endurance, from genetic modifications that make such biological interventions more direct and more lasting? All of them alter our bodily workings; all of them to varying degrees separate self-directed experience from underlying biology.

Beyond Therapy is divided into subtopics of Biotechnology and the Pursuit of Happiness, Better Children, Superior Performance, and Ageless Bodies. Each section discusses the current and possible future state of the applicable technology, but most of the report is spent on the philosophical implications of the technology. The 300+ pages seem daunting but are very readable. If you have time, read the whole thing.