The Enhancement Debate: Bona Fide or Frivolous?

John Lantos, MD
John B. Francis Chair in Bioethics
jlantos@practicalbioethics.org

The debate about “enhancement” is one of the most difficult debates in bioethics today.

The difficulty arises because the line between therapy and enhancement is so fuzzy and indistinct as to almost disappear. In domains of medicine as different as reconstructive surgery, psychopharmacology, genetic screening, or hormone replacement, some uses of biomedical technology seem to be bona fide treatments of disease while others seem to be frivolous lifestyle enhancements or luxury consumer goods.

This review by Ryan Lawrence of three recent books makes me want to go read the books for their defense an expanded notion of therapy. Then, I’ll need to read the report of the President’s Bioethics Council, Beyond Therapy: Biotechnology and the Pursuit of Happiness. (http://www.bioethics.gov/reports/beyondtherapy/index.html) for a critique of such views.

Then I’ll reread Carl Elliott’s wonderful book, Better Than Well, about the ways in which our desires for self-improvement transcend medical treatment.
Biomedical technology offers many possibilities for better health. It also offers irresistible opportunities for other forms of self-fulfillment – better athletic performance, more attractive appearance, better sleep.

Ultimately, the key question may not be whether such uses of biotechnology are morally acceptable but, instead, which of them ought to be publicly-funded entitlements and which should be privately purchased commodities.

Link: Practice Makes Perfect, The Weekly Standard, June 30