Nanotechnology and Human Performance Enhancement (Part 8 – Final)

The following is an excerpt from my thesis (Master of Bioethics), which was completed in 2004. I’ll be reproducing it here in a series of posts.

6. Summary and Conclusions

6.1 – Summary

I have been discussing the tensions that exist between utilitarianism and the Danielsian conception of justice in healthcare when attempting to identify the most appropriate principles to apply to decisions about resource allocation. That is, the tension between the teleological desire to maximise welfare and the deontological ideal of fairness. These competing points of view result inn significantly different conclusions when considering the moral permissibility of nanotech performance enhancement. The main points of note are referenced below.

6.1.1 – Therapeutic Enhancement

The utilitarian is less concerned with the morality of actions; they do not hold that the positive/negative distinction is of any moral significance. The only method by which decisions should be made in relation to the allocation of healthcare resources is by calculating the Quality Adjusted Life Year (QALY) benefit of any action, and subsequently seeking to maximise the total welfare that is produced. Alternatively, Daniels is of the opinion that the positive/negative distinction is morally relevant, and appeals to our intuitions about fairness by contending that we should act to improve the lot of the worst-off among us as a matter of priority, prior to giving consideration to interventions that are designed to benefit the welfare of those who are better-off. In this regard, the notion of normal species functioning is central, as it is thought to provide a baseline against which we can priorities who should get what treatment.

6.1.2 – Augmentation

Likewise with augmentation, the utilitarian is only concerned with the maximisation of the positive contribution to welfare. There is no distinction to be made between decisions to help the worst-off over enhancing the best-off. This is such that we may potentially find ourselves under a moral obligation to prefer a course of action that provides one person with superhuman abilities, over returning normal species functioning to another. Nor do they believe that any restriction should be placed upon how either public or private healthcare dollars are to be spent, over and above the requirement that we maximise QALYs. Daniels, on the other hand, suggests that priority be give to improving the worst-off in society over providing superhuman abilities to the better-off. In addition, Daniels would be opposed to the provision of private healthcare dollars towards augmentation, if doing so impacted upon the fair equality of opportunity experienced by individuals, as determined by their natural talents and abilities.

6.1.3 – Designed Evolution

designed evolution represents a further point of departure between our two competing viewpoints. Not only is the utilitarian supportive of programs of designed evolution, but this approval would extend to justify paternalistic polices intended to ensure participation and compliance. This would be permissible even against the wishes of the individuals involved, provided that doing so maximised QALYs. The deontic position avoids this conclusion by instead requiring a form of democratic mandate. The prospect of such programs does, however, raise interesting questions about the hybrid notion of normal species functioning that Daniels employs. Designed evolution could drastically alter social norms for functioning extremely rapidly, casting doubt on Daniels’ “uncontroversial baseline”.

6.2 – Conclusions

I have been attempting to determine how best to apply the two dominant competing principles of resource allocation in healthcare when considering nanotech performance enhancement. Both of these principle, then utilitarian QALY maximisation approach, and there Danielsian focus on justice, make assumptions about the scarcity of resources. The strength of the approach taken by Daniels is that it gives a voice to our intuitions about fairness. Yet, what is it that drives these intuitions? It would seem that the underlying feeling behind appeals to fairness consists in the idea that given a situation involving scarce resources, any decisions we make with regards to the distribution of those resources should not serve to promote social inequality. However, on the most optimistic predictions of futurists, nanotechnology may bring about a state of affairs in which the standard assumptions that are made in relation to the scarcity of resources will not hold true. How does this change our intuitions concerning which principle(s) to apply?

The utilitarian would no doubt be delighted by such a scenario, given the possibilities that it brought for increasing overall welfare via the satisfaction of individual preferences. On the other hand, Daniels is of the opinion that it is wrong to increase inequities in society. Yet, as we have seen, this assumes that the resources that were distributed to the well-off could, in fact, have been otherwise distributed to the worst-off. But what are we to make of actions that increase inequity even after we have assisted the worst-off as much as we can? That is to say that it may be possible for us to provide therapeutic enhancement to every person who required it so that they could return to normal levels of human biological functioning. But if it were the case that there were sufficient resources to also provide for augmentation to those already well-off (e.g. the wealthy), then social inequality between the worst-off and the well-off would still increase. Our question here becomes one of: is the inequity (i.e. the gap itself) immoral? This is certainly not the argument that is made by Daniels with respect to healthcare, and nor is it a position that is included in the theory of justice as fairness proposed by Rawls. There does not appear to be a remaining intuition with respect to inequity in and of itself. If this is the case, it would seem that we are left with utilitarianism as the most appropriate principle for guiding our decision making process with respect to the allocation of healthcare resources; i.e. that those resources be directed in the manner that will produce the greatest increase in overall welfare.

The possible benefits to be derived from nanotech performance enhancement are great, especially with respect to the potential for improving human welfare. IN fact, so great is the potential upside with respect to individuals, that allowing access to superhuman enhancement (i.e. augmentation) in a climate in which resources are finite, at the expense of the worst-off in society, is likely to produce social inequalities of a magnitude not yet witnessed. This represents an offense to our intuitions regarding fairness. As such, if we are confronted by circumstances in which the traditional assumptions about scarcity of resources are well founded, then I am of the opinion that the Danielsian approach is the one that should be employed. That is to say that our decision making process should involve the setting of priorities for healthcare expenditure, on the basis of perceived needs. Priority would be given to restoring normal functioning (i.e. therapeutic enhancement) over raising it to heretofore superhuman levels (i.e. augmentation).

In the absence of scarce resources, the framework developed by Daniels tells us nothing about how we should distribute our healthcare resources. Furthermore, in the event that it is possible to make nanotech augmentation available to everybody, there would presumably be those who simply elected not to alter themselves to incorporate such superhuman capabilities. These people might refrain from using the technology for any number of reasons, including:

  • On religious grounds,
  • Out of a preference to be “natural”.

This would have the potential to divide the human race in a manner not experienced since the evolutionary split between Neanderthals and Homo sapiens, and raises many compelling questions for future consideration. These questions include:

  1. What might be the social ramifications of such a split?
  2. What would happen to those left behind in the transition from human to trans-human?
  3. Is such a scenario desirable?
  4. Should society act to encourage/develop such technologies for the purpose of brining about this state of affairs, or instead seek to inhibit such an outcome?

In contemplating these issues, the utilitarian will only be concerned about the maximisation of welfare; i.e. if, on balance, more people are happier then it’s worth pursuing. At the same time, the conception of justice proposed by Daniels and Rawls appear inadequate if assumptions about the scarcity of resources are not true, rendering them unable to support our intuitions about inequality.

With regards to how best to allocate our healthcare resources when considering the proposed of nanotech performance enhancement, it does appear that if traditional assumptions about resource scarcity are invalid, then we should favour a utilitarian model of decision making. In this event, it needs to be stated that the utilitarian’s victory is not final. The way remains open for the development of a fresh deontological moral argument to the effect that any inequity created is immoral, in and of itself. This would need to be demonstrated to be the case, even after we have helped the worst-off in society as much as we can.

References

  • Broderick, Damien, The Spike: Accelerating into the Unimaginable Future, Reed Books, Melbourne, 1997.
  • Canton, James, “Designing the Future: NBIC Technologies and Human Performance Enhancement”, Institute for Global Futures, http://www.futureguru.com/articles, 2003 (Downloaded August 2004).
  • Crandall, B.C. (ed.), Nanotechnology: Molecular Speculations on Global Abundance, MIT Press, Cambridge, 1996.
  • Daniels, Norman, Just Health Care, Cambridge University Press, New York, 1985.
  • Daniels, Norman, “Equal Opportunity and Health Care”, in Bonnie Steinbock, John D. Arras, and Alex J. London (eds.), Ethical Issues in Modern Medicine, pp. 164-167, McGraw-Hill, New York, 2003.
  • Glover, Jonathan, What Sort of People Should There Be?, Penguin Books, New York, 1984.
  • Grey, William, “The Ethics of Human Genetic Engineering”, Australian Biologist, Vol. 9, No. 1, pp. 50-56, 1996.
  • Hardorn, David, “The Oregon Priority-Setting Exercise: Quality of Life and Public Policy”, Hastings Centre Report, Vol. 21, No. 3, pp. 11-16, 1991.
  • McKie, John, Richardson, Jeff, Singer, Peter & Kuhse, Helga, The Allocation of Healthcare Resources: An Ethical Evaluation of the ‘QALY’ Approach, Dartmouth: Ashgate, Aldershot, 1998.
  • Nanotechnology Victoria, Industry Focus: Textiles and Manufacturing, http://www.nanovic.com.au, October 2004.
  • Pethokoukis, James, “The Red-Green Divide Over Human Enhancement”, Tech Central Station, www2.techcentralstation.com, 2004 (Downloaded August 2004).
  • Rawls, John, A Theory of Justice, Harvard University Press, Cambridge, 1971.
  • Swiss Re, “Nanotechnology: Small Matter, Many Unknowns”, Risk Perception Series, http://www.swissre.com, 2004 (Downloaded August 2004).

Nanotechnology and Human Performance Enhancement (Part 7)

The following is an excerpt from my thesis (Master of Bioethics), which was completed in 2004. I’ll be reproducing it here in a series of posts.

5.2 – Daniels: Justice in Healthcare

A Danielsian assessment of any form of nanotech performance enhancement will naturally be predicated on a notion of social justice. In determining whether or not we should grant people access to nanotech performance enhancement, the pertinent question to be addressed is whether or not it is justified for a healthcare system to provide access to such services. That is to say that we are not concerned in this section with the morality of acts of human performance enhancement, but rather the question of whether or not it is fair or appropriate for access to such services to be provided. Further, this is a question that can be asked separately of both public and private health systems. To do this we must bear in mind the two central questions raised in Section 4.2 with regards to access (see post ‘Nanotechnology and Human Performance Enhancement (Part 4), published on 28 March 2022); namely:

  1. Access for whom?
  2. Access to what?

5.2.1 – Therapeutic Enhancement

Unlike the utilitarian analysis, Daniels is of the opinion that the positive/negative distinction is morally relevant. This is evident by the role played by “normal species functioning” in his conception of just healthcare, and the moral importance which he ascribes to it (Daniels, 1985, pp. 32-33). On this conception, therapeutic enhancement would be accepted as referring to those bodily interventions that were intended to restore some aspect of human functioning to its normal level. This might take the form of eliminating disease (e.g. cancer destroying nanobots), or treating physical disabilities (e.g. robotic limbs). As a result of the impact that afflictions of this nature have on an individual’s opportunity range, they represent precisely the kind of service that Daniels would contend should be provided by public healthcare systems. What is more, there is a requirement that they be provided to people irrespective of their non-medical features; e.g. race, sex, location, wealth (Daniels, 1985, pp. 11-12).

On this point, it should be noted that Daniels does make very clear that these normal ranges are relative to the particular society that is being examined, to the extent that “…the same disease [or disability] in two societies may impair opportunity differently and so have its importance assessed differently” (Daniels 1985, p. 34). That is to suggest that the social importance of particular diseases or disabilities is thought to be relative (Daniels, 1985, p. 34). It is of no importance whether or not Society A believes that the provision of a particular medical intervention should be a higher priority than it iOS for Society B. Rather, what matters is that each society determines its own priorities. It may be the case that one society considers a particular bodily intervention to be a therapeutic enhancement, and, as such, acts to prioritise its provision, whilst another views it as augmentation and elects instead to devote its healthcare resources towards other ends. The example offered by Daniels is that of dyslexia. Supposing that we could cure dyslexia by means of some kind of medical intervention, Daniels suggests that “…it may be less important to treat in an illiterate society than in a literate one” (Daniels, 1985, p. 34).

5.2.2 – Augmentation

Is nanotech augmentation the kind of thing that healthcare systems should provide to people? It is broadly accepted that some of the shrives that are provided in healthcare systems are explicitly directed at saving or extending life, whereas the purpose of others is to improve the quality of life experienced by the recipient. In considering self-regarding nanotech augmentation, we are examining services that are desired by individuals with the intent to positively impact the quality of one’s life, either by improving job functioning or increasing the enjoyment derived from their preferred recreational activities. As such, it is not obviously apparent to me that the provision of nanotech augmentation services inappropriate when considered from a Danielsian point of view, because quality of life improvement is a legitimate function of a just healthcare system. (Acknowledging that this view is dependent on what other healthcare needs exist in a given society.)

The status of nanotech augmentation is perhaps less favourable when examined more closely with respect to the second question posed by Daniels; i.e. access to what? Daniels incorporates into his conception of just healthcare a definition of medical needs that is directly related to normal species type functioning. This is clearly not a description that could be applied to the type of bodily alteration that is being contemplated in this section (e.g. 30/20 vision). On this basis, the position of Daniels might be to oppose the provision of nanotech augmentation services, at least within the public healthcare system. The type of decisions that her;thcare system are necessarily required to make concerning resource allocation and the rationing of services would dictate that those systems not provide nanotech augmentation services to those that simply desired them. It would be considered more just that the focus of attention went towards providing services that people required in order that they be returned to a normal level of functioning, rather than to a level that supersedes it. Yet, the question still remains with respect to the permissibility of providing augmentation services in the private health;lthcare market; i.e. to those that can afford it. Likewise, it would seem that Daniels would be opposed to any distribution of healthcare resources that serve to increase social inequalities.

5.2.3 – Designed Evolution

How are we to apply the theory proposed by Daniels to the prospect of engaging in programs of designed evolution? Daniels is concerned with giving priority to those services that restore normal functioning (i.e. negative interventions). It would seem that when we are discussing designed evolution, what we are essentially considering are plans to bring about species-wide changes to our functionality; changes which are intended to transcend normal functioning at this point in our natural evolution. Furthermore, as opposed to both therapeutic enhancement and augmentation, wherein we are contemplating the moral permissibility of self-regarding nanotech intervention decisions, consideration needs to also be given to the impact that such a program would have on future generations.

There is a further problem for the Danielsian account in this analysis. As was outlined in Section 4 (see post ‘Nanotechnology and Human Performance Enhancement (Part 4), published on 28 March 2022), the notion of normal functioning that Daniels employs is a hybrid concept that incorporates the biological (i.e. medical, our underlying physical nature) and social (i.e. “normal” is relative to actual social average). To date, at least in most cases, there is not much that we can do in relation to the biological deficiencies except restore functioning on. limited basis. An explosion of positive nanotech performance enhancement may serve to alter the social norms extremely rapidly. This is particularly the case when considering programs of designed evolution. Such programs could have profound implications for the positive/negative distinction. It might be the case that those medical interventions that were previously deemed to be enhancing human functionality over and above what is considered normal (i.e. augmentation), could, in a social sense come to be viewed as a component of average or normal functioning. This would result in it becoming morally obligatory to provide such enhancements to the worst-off in order that they attain the “new” (i.e. higher) minimum standard with respect to normal functioning.

With reference to Daniels’ example of the social relativity of a disease such as dyslexia (see above), what if we instead consider the impact on an individual’s normal opportunity range if they were lacking in some nanotech augmentation that most of their peers had adopted. For example, enhanced memory or other such cognitive ability. Surely in this situation the individual in question would be seen as functioning below the norm for that society, and therefore in need of augmentation themselves so as to reach a basic level. This is perhaps a limitation of the traditional biological approach to defining health, at least when health is viewed through the nano-enhanced eyes of a not-too-distant future. In addition, as opposed to the utilitarian claim that paternalistic polices might be justified, the deontic position would require some form of democratic mandate for this type of state sponsored designed evolution program. Even if a government did require public approval for such a program, questions would remain as to how those that did not wish to participate might be permitted to opt out.

References

  • Daniels, Norman, Just Health Care, Cambridge University Press, New York, 1985.

Nanotechnology and Human Performance Enhancement (Part 6)

The following is an excerpt from my thesis (Master of Bioethics), which was completed in 2004. I’ll be reproducing it here in a series of posts.

5.1 – The Utilitarian Approach

The standard utilitarian approach towards assessing the moral permissibility of any act is to evaluate the contribution of said act to the welfare of the individual, and society in general. When considering matters pertaining to healthcare, the utilitarian maintains that this can be calculated as a function of maximising Quality Adjusted Life Years (QALYs). However, as referred to in Section 4.2 (see post ‘Nanotechnology and Human Performance Enhancement (Part 4), published on 28 March 2022), in order to substantiate this position, utilitarians must first seek to attack the positive/negative distinction that is sometimes drawn between different types of medical interventions (i.e. between therapeutic enhancement and augmentation). This might be done either by arguing that this distinction is of no moral significance; or, that the increased possibility for human performance enhancement provided by new technologies, such as nanotechnology, effectively blows any distinction away. If it is accepted that there is no inherent reason for giving preference to one over the other.

If it were to be granted that there was a distinction to be drawn, the utilitarian can still argue that the benefit to be gained by an individual as a result of augmentation, as measured in QALYs, may be greater than that derived by another individual who requires a therapeutic enhancement to restore normal functioning. For example, we may be comparing the positive e contribution to overall welfare of augmenting Person A with nano-enabled robotic limbs, in order that they were better equipped to pursue their preferred Nobby of rock-climbing; versus that derived by wheelchair bound Person B, who requires therapeutic enhancement to restore his or her ability to walk.

It may be the case that Person A loves rock-climbing so much that the QUALYfied benefit that they enjoy as a result of their intervention far outweighs that experienced by Person B. In this situation, the utilitarian would conclude that the morally appropriate course of action would be to provide Person A with the means to obtain greater pleasure from their hobby, at the expense of Person B’s ability to walk again. That said, the utilitarian maintains that in the majority of cases the greatest overall QALY benefit is more likely to be achieved by treating the worst-off in society first. It is believed that such action (i.e. providing treatment to Person B) will generally result in the largest net increase in welfare (McKie et al, 1998, pp. 11-12). That is to say that it is ordinarily easier to make an unhappy person happy than it is to make an already happy person twice as happy. However, if doing so would not serve to maximise welfare, the utilitarian would forgo the provision of treatment to Person B, in favour of providing augmentation to Person A. Such a conclusion is contrary to certain widely experienced intuitions regarding fairness. These intuitions will play a prominent role in discussing the theoretical framework developed by Daniels (refer to Section 5.2).

As a further interesting note, the utilitarian position may also be used to direct our decisions with respect to allocating resources towards research. If a comparison between nano-treatments and traditional treatments reveals that nanotechnology offers a wider range of affordable possibilities for medical intervention(s), then the utilitarian would favour putting more research dollars towards nano. That is to say, that if a QLAYfied analysis of the probability of the benefit(s) to be achieved as a result of nanotechnology supported such a decision, then utilitarians would more actively support the advancement of nanotechnology over putting money towards research involving more conventional technologies.

5.1.1 – Therapeutic Enhancement

On a utilitarian conception, we are not to concern ourselves with the morality of bodily intervention in and of itself. Rather, what is important is for us to be able to calculate any benefit that is enjoyed as a consequence of a particular bodily intervention. As such, there is no broad moral prohibition to be placed on a class of intervention, such as therapeutic enhancement. Furthermore, it is entirely appropriate for individuals to be provided with access to therapeutic enhancement(s) via public healthcare systems, as long as doing so results in the maximisation of overall welfare. In fact, if this were indeed the case, not only would it be appropriate for governments to provide for such services, the should consider themselves under a moral obligation to do so. he adoption of a utilitarian approach would determine that people should be granted access to therapeutic enhancement, with no restriction placed on who should be able to receive it. The sole proviso is that it be done in the manner that results in the maximum overall welfare. Furthermore, the allocation of public healthcare resources should be specifically directed towards this end, with no limitation on the manner in which individuals elect to spend their private healthcare dollars.

5.1.2 – Augmentation

Based on the arguments outlined above, the utilitarian does not consider that nanotech augmentation should be viewed as being morally different to therapeutic enhancement. Provided that it is the case that a given bodily intervention contributes positively to the calculable amount of QALYs in the world, then the utilitarian believes that it merits consideration. If a choice between competing interventions needs to be made as a result of resource allocation issues, then the intervention that is to be preferred is the one that produces the greatest net benefit to overall welfare. Again, it may be the case that in a given scenario we are morally obliged to prefer a course of action that provides one person with superhuman abilities, over returning normal functioning to another (i.e. rock-climber vs. wheelchair example). In this framework, as was the case with the utilitarian response to therapeutic enhancement, augmentation should be made available to whosoever desires it. No priority need be given to those who require treatment to restore normal human functioning over those who wish to surpass it. As to the question of whether these services should be provided publicly or privately, the utilitarian supports whichever means of distribution will result in the greatest calculable overall benefit, as a function of the number of QALYs produced.

5.1.3 – Designed Evolution

The treatment of designed evolution, in particular, represents a key point of difference between consequentialists and rights-based theorists such as Daniels. The application of utilitarian principles to the question of the permissibility of such programs would provide support for them, provided that they made a positive contribution to overall welfare. In fact, not only would they be supportive of government-driven designed evolution programs, they would also demonstrate a willingness to coerce citizens to participate in them, if it were the case that doing so would maximise the total welfare of the society. That is to say that an adherence to utilitarian principles would justify the use of paternalistic policies over the personal autonomy of individuals.

Not surprisingly, given their willingness to support coercive action directed at citizens on the part of governments, utilitarians are also unmoved by objections that designed evolution would impinge upon the interests (or preferences) of those not yet born. For instance, it might be considered that programs like this were objectionable because they did not show due respect for the personal autonomy of unborn people, by limiting the range of opportunities that were open to them in some way. Even if consideration was to be afforded to future generations, the utilitarian would presumably claim that the preferences of the living should be given more weight than any supposed preferences of future generations. As such, designed evolution would still be considered morally permissible, subject to QALYs being maximised.

References

  • McKie, John, Richardson, Jeff, Singer, Peter & Kuhse, Helga, The Allocation of Healthcare Resources: An Ethical Evaluation of the ‘QALY’ Approach, Dartmouth: Ashgate, Aldershot, 1998.

Nanotechnology and Human Performance Enhancement (Part 5)

The following is an excerpt from my thesis (Master of Bioethics), which was completed in 2004. I’ll be reproducing it here in a series of posts.

5. Assessing the Moral Permissibility of Nanotech Performance Enhancement

With nanotechnology comes the prospect of dramatically increasing the possibilities for human performance enhancement. The moral issues under consideration revolve around the following questions:

1. Should people be granted access?
2. If so, who?
3. On what basis should this access be distributed (i.e. public vs. private healthcare)?

In attempting to answer these questions we are faced with a choice between two distinct principles. On the one hand we have the utilitarian, armed with Quality Adjusted Life Years (QALYs), who is focused on maximising overall welfare. On this view, the distribution of that welfare is irrelevant. Therefore, it is permissible to act in a manner which serves to increase social inequalities. As an alternative to this position, Daniels (from Rawls) suggests that direction is to be found by setting priorities. In order to address our intuitions about fairness, we must act to raise the position of the worst-off in society. Yet, this entails placing restrictions upon what people are permitted to do to alter themselves.This is contrary to current general practice in western liberal societies (e.g. cosmetic surgery). These competing standards diverge sharply when applied to nanotechnology and the performance enhancement interventions that are likely to accompany it. That is to say, in such a scenario vastly different outcomes a re produced when these principles are applied to our decision making with respect to the allocation of healthcare resources.

Liberal societies already permit people to enhance their physical appearances. For instance, via cosmetic surgery people can choose anything from collagen lip injections, to liposuction, to breast augmentation. We also permit them to alter their appearance in accordance with their individual preferences, such as by dying their hair various colours, getting piercings and/or tattoos. In light of these factors, it remains to be demonstrated precisely on what basis we could justifiably deny people what they perceive to be their right to augment their natural capabilities for either professional benefit (i.e. to improve their ability to function in their chosen job), purely recreational; purposes (i.e. amateur athletes, or in any other manner they feel might improve the quality of their lives. It may be the case that there is no moral prohibition against nanotech performance enhancement, in and of itself, but this view does not entail that public health systems are obliged to provide such services (as is currently the case with respect to cosmetic surgery).

Both of the philosophical frameworks under discussion are underpinned by assumptions regarding the scarcity of available resources. Therefore, making decisions about how best to allocate those resources necessarily requires some form of evaluation. The utilitarian employs a QALY-based economic evaluation to test the desirability of a given distribution of the available resources. Daniels, on the other hand, elects to predicate his account on the notion of fair equality of opportunity and the impact that an individual’s health status has on their ability to enjoy a fair share of the normal opportunity range. Furthermore, such “…opportunity costs only arise because resources are finite” (McKie et al, 1998, p. 15). Opportunity cost as considered here is defined as “…the value of any opportunity or benefit forgone because of resources that have been used [elsewhere]” (McKie et al, 1998, p. 15). That is to suggest that because resources are believed to be finite, anytime that they are put towards a particular end (e.g. Project A), this necessarily entails that there are alternative ends towards which those resources have not been directed (e.g. Project B). The loss of the ability to pursue Project B represents there opportunity cost in this example.

Yet, there are some futurists who believe that one of the key benefits of a fully developed nanotechnology;ogy lies in the potential to reduce the manufacturing costs associated with making almost any product, such as the type of augmentation devices under consideration here, to virtually nothing (Broderick, 1997, Chapter 2: Everything for Free, pp. 30-59). That is to say that if advancements in nanotechnology impact significantly on resource costs (i.e. the cost of producing / providing), then opportunity costs will see a commensurate decrease. If this is the case, then such deices should be widely available to just about anybody who wants to augment themselves. In such a scenario assumptions regarding the scarcity of resources might no longer be applicable. As a result, it appears that the justice concerns that Daniels appeals to are rendered irrelevant. With a plentiful supply of nanotech performance enhancement devices easily available to all those who desire to upgrade themselves, it would seem to be the case that questions of social justice and resource allocation may no longer need to be addressed. Daniels provides us with a theory about how to choose between treatment options that gives voice to out intuitions about fairness; an argument that is set against background assumptions about the scarcity of resources. However, as will be developed further in Section 6, if it is the case that resources are abundant and that, therefore, we do not have to choose between competing expenditures, then Daniels’ theory is silent about how we should decide.

In the subsequent section(s) / posts, these issues around the moral permissibility of nanotech performance enhancement will be examined in detail, with specific reference to the two distinct philosophical perspectives outline above; namely:

1. Utilitarianism
2. Daniels’ (Rawlsian) framework for justice in healthcare.

In addition, within the context of both these perspectives, I will seek to independently address the three categories of human performance enhancement that were described in Section 2.1; i.e. therapeutic enhancement, augmentation and designed evolution (see post ‘Nanotechnology and Human Performance Enhancement (Part 2), published on 24 March 2022).

References

  • Broderick, Damien, The Spike: Accelerating into the Unimaginable Future, Reed Books, Melbourne, 1997
  • McKie, John, Richardson, Jeff, Singer, Peter & Kuhse, Helga, The Allocation of Healthcare Resources: An Ethical Evaluation of the ‘QALY’ Approach, Dartmouth: Ashgate, Aldershot, 1998.

Nanotechnology and Human Performance Enhancement (Part 4)

The following is an excerpt from my thesis (Master of Bioethics), which was completed in 2004. I’ll be reproducing it here in a series of posts.

4. Theoretical Background and Key Concepts

In this section I will briefly outline some of the key philosophical concepts and frameworks that will be central to my evaluation of the moral permissibility of nanotech performance enhancement.

4.1 – Utilitarianism: QALYs

For utilitarians, a key driver in decisions concerning the distribution or access to healthcare resources is the desire to maximise Quality Adjusted Life Years (QALYs). The standard utilitarian approach is to evaluate the contribution of any medical intervention to the welfare of the individual, and society in general, as a function of maximising QALYs. This method is designed to allow the integration of “…the quality-of-life effects of treatment with its associated impacts on life expectancy” (Hardorn, 1991, p. 13). Interventions may have value as a result of their substantial impact on life expectancy (e.g. an appendectomy), or alternatively, because of their effect on the quality of one’s life (e.g. medication for arthritis). Some interventions will necessarily involve a trade-off between both quality and quantity of life, such that an increased life expectancy “…may come at the expense of various side-effects from treatment, resulting in a possible decrease in quality of life” (Hardorn, 1991, p. 13).

Perhaps the most distinctive aspect of the QALY approach lies in its connection to the preferences that individuals have about different states of health (McKie et al, 1998, p. 25). This requires that effort be made to undertake the following two (2) steps:

a.) Any given health state must be both observed and described

b.) The individuals whose preferences are sought must attach a numerical value to that description.

(McKie et al, 1998, p. 25)

By doing this, the utilitarian is able to develop an index that is reflective of the manner in which people rate the quality of life associated with different states of health. As a consequence, what is quantified is the praise extent to which individuals would prefer to be healthy, rather than suffering from various medical afflictions. Many studies of this kind have been undertaken, resulting in the publication of a number of useful tables that effectively represent exchange rates between both aspects of health cited by Hardorn (i.e. both quality and quantity of life) (McKie et al, 1998, pp. 22-23). These indexes can provide guidance as to how best to allocate healthcare budgets, including nanotech performance enhancements.

It should be noted that maximising QALYs does not simply equate to maximising utility, because people invariably have preferences for things that are not related to improving or maintaining their health. For instance:

“…two individuals may enjoy the same health-related quality of life and yet one may be happier than the other because they have a more interesting job or more fulfilling marriage or live in a better neighbourhood. More of their other preferences are satisfied. Thus, there is more to maximising utility than maximising QALYs…” (McKie et al, 1998, p. 39).

This point is important in expressing the utilitarian account, because it highlights an intended limitation of the purpose of QALYs. This limitation stems from the fact they they were explicitly created “…to assist with economic evaluations of health programs” (McKie et al, 1998, p. 39).

In addition, comment is required in relation to the fact that utilitarians seek to attack the positive/negative distinction that is drawn between the different categories of intervention (refer to Section 3.1 in ‘Nanotechnology and Human Performance Enhancement (Part 3)). It can be argued that this distinction is not morally significant, or that the increased possibility for human alteration provided by new technologies serves to blow any distinction away. With reference to the current debate, the general utilitarian position does not hold there to be a morally relevant distinction between therapeutic enhancement and augmentation. The only thing that is of interest to the utilitarian is the total net welfare benefit that is generated by a given action. As such, it is of importance to note that intuitions about fairness (i.e. social justice) when considering these matters are unavailable to utilitarians. This point is a key area of difference between consequentialists and deontologists, and one which will become more apparent in the analysis that can be found in Section 5 (to be included in a subsequent post).

4.2 – Daniels: Justice in Healthcare

As most of the nanotech enhancements floated in this paper can broadly be described as medical interventions of various degrees, I will examine their moral permissibility through the lens of the existing healthcare framework put forward by Daniels. Daniels begins his work by considering a series of pertinent questions; including:

  • What kind of a social good is healthcare?
  • What are its functions and do these make it different from other commodities?
  • Are there social obligations to provide healthcare?
  • What inequalities in its distribution are morally acceptable?
    (Daniels, 1985, p. ix)

Daniels determines that there is, in fact, such a thing as a right to healthcare. Furthermore, he provides a comprehensive framework within which to examine issues of distributive justice in the context of healthcare as a social good. To achieve this, he expands on the general theory of justice as fairness (i.e. contractarian theory) proposed by John Rawls (Rawls, 1971, especially Chapter 1: Justice as Fairness, pp. 3-53). Rawls places a high priority on the principle of fair equality of opportunity, such that there is a requirement to restrict social and economic inequalities when they provide certain individuals with a material advantage relative to others (i.e. inequalities that are not ultimately of benefit to all) (Rawls, 1971, pp. 60-61). This view entails that we are not under a moral obligation to make those individuals in society that are worst-off, maximally well-off; that is to say, as well off as they can be. This idea has been described as “maximin”, because it “…directs us to maximise the minimum level of welfare” (McKie et al, 1998, p. 14). Daniels contends that this is an appropriate conception to apply to the allocation of healthcare resources, and that healthcare institutions “should be among those governed by a principle of fair equality of opportunity” (Daniels, 1985, p. 41).

Daniels emphasises a society’s obligation to both maintain and restore the health of its citizens. With reference to the current discussion, this position suggests that there is no moral right to performance enhancement that supersedes normal levels of functioning (i.e. augmentation). Whilst not Whilst not opposed to augmentation per se, Daniels would be opposed to the inequitable distribution of access to it. On this view, priority is to be given to the health-related needs of individuals, rather than the. mere satisfaction of their preferences. In constructing such an argument, he makes reference to questions of social justice and how best to organise the allocation of finite resources. It is important to note that this entails making an assumption about the nature of resources involved in the provision of healthcare services; i.e. that those resources are, in fact, scarce. This is a point that I will return to in later suctions.

In developing his argument, Daniels endeavours to deal with the issue of access to healthcare. This is an approach that involves explicitly addressing two (2) questions, which he does in the following manner:

a.) Access for whom?: Anyone in “medical need” (related to normal species-type functioning). Non-medical features should have no bearing upon whether or not individuals have access to healthcare. Such non-medical features include race, sex, location and wealth.

b.) Access to what?: Healthcare services are not homogenous. Some services are directed t saving or extending lives, whereas others are intended to improve an individual’s quality of life.

(Daniels, 1985, pp. 11-12)

The answers to these questions will drive decisions about resource allocation and the rationing of services provided by a just healthcare system. This includes services relating to the provision of simply preferred interventions intended to equip individuals with functionality above and beyond species’ norms. On this point, Daniels argues that:

“…not all preferences are of equal moral importance and that when we judge the importance of meeting someone’s preferences we use a selective or truncated measure of well-being. Among the kinds of preferences to which we tend to give special weight are those which meet certain important categories of need. I have argued that among the important needs are those necessary for maintaining normal functioning for individuals, viewed as members of a natural species.” (Daniels, 1985, pp. 32-33)

In this context, Daniels employs a notion of normality that is a hybrid of two distinct models. Namely, he believes it to have both biomedical and social aspects to it. On the former, disease is taken to be representative of “deviations from the natural functional organisation of a typical member of a species” (Daniel, 1985, p. 28). That is to say that it draws on a descriptive account of our underlying physical natures. At the same time, Daniels notes that, at least to a certain extent, normal functioning is relative to actual societal means. This notion opens the door to more normative assessments about what constitutes disease. Nonetheless, Daniels’ account is predicated on a perceived ability to determine a “…generally uncontroversial baseline of species-normal organisation” (Daniels, 1985, p. 31), that is primarily fixed by nature. The idea that normal human functioning can be identified by reference to a base level that is not controversial is an assumption that is central to the position taken by Daniels. This conception of what constitutes normal will be of significance in the treatment of the Danielsian position that is offered in Section 5 (to be included in a subsequent post).

It is Daniels’ contention that normal species functioning possesses special moral significance. This is believed to be as a consequence of the relation ship that it has with the range of opportunities that are ordinarily available to individuals (Daniels, 2003, p. 165). The concept of normal opportunity range is of importance, because it refers to “…the array of life plans reasonable persons in…[a given society]…are likely to construct for themselves” (Daniels, 2003, p. 165). For any given society, the normal range is dependent upon certain key facts about that society. For example, pertinent social features that are believed to impact upon this opportunity range include:

  • Stage of historical development
  • Degree of technological advancement
  • Level of material wealth
  • Cultural factors.
    (Daniels, 2003, p. 165)

On the conception of social justice endorsed by Daniels, fair equality of opportunity does not require that everybody has access to precisely the same range of opportunities. This is due to the fact that the share of the normal opportunity range that is open to any particular individual is fundamentally tied to that individual’s natural talents and abilities. Rather, what is important is that people have access to the same range of opportunities as other individuals that possess similar talents and abilities (Daniels, 1985, p. 33). In this sense, what is deemed to be fair does not necessarily constitute equal. It I the notion of fair equality of opportunity that is central to the approach to healthcare taken. by Daniels; with his position contending that:

“…impairment of normal functioning through disease and disability restricts an individual’s opportunity relative to that portion of the normal range his skills and talents would have made available to him were he healthy. If an individual’s fair share of the normal range is the array of life plans he may reasonably choose, given his talents and skills, then disease and disability shrinks his share from what is fair.” (Daniels, 1985, pp. 33-34)

On this point, it must also be noted that some diseases and disabilities will have a more substantial impact upon the range of opportunities available to people than others (Daniels, 1985, p. 34).

In short, Daniels takes the approach of drawing an explicit connection between considerations of justice (i.e. fair equality of opportunity) and decision making in healthcare (i.e. access for whom, access to what?). As such, the justice considerations of Daniels would favour access to therapeutic enhancement over access to augmentation interventions, with the former being related more directly to normal species functioning. That is to say that therapeutic enhancement would have first priority. At the same Tim, Daniels acknowledges that there is a question as to whether or not “…the demand for healthcare extends beyond some decent adequate minimum” (Daniels, 1985, p. 56). That is to ponder whether it is appropriate to permit the availability of non-basic services (i.e. augmentation) via private’s healthcare markets.

References

  • Daniels, Norman, Just Health Care, Cambridge University Press, New York, 1985.
  • Daniels, Norman, “Equal Opportunity and Health Care”, in Bonnie Steinbock, John D. Arras, and Alex J. London (eds.), Ethical Issues in Modern Medicine, pp. 164-167, McGraw-Hill, New York, 2003.
  • Hardorn, David, “The Oregon Priority-Setting Exercise: Quality of Life and Public Policy”, Hastings Centre Report, Vol. 21, No. 3, pp. 11-16, 1991.
  • McKie, John, Richardson, Jeff, Singer, Peter & Kuhse, Helga, The Allocation of Healthcare Resources: An Ethical Evaluation of the ‘QALY’ Approach, Dartmouth: Ashgate, Aldershot, 1998.
  • Rawls, John, A Theory of Justice, Harvard University Press, Cambridge, 1971.

Nanotechnology and Human Performance Enhancement (Part 3)

The following is an excerpt from my thesis (Master of Bioethics), which was completed in 2004. I’ll be reproducing it here in a series of posts.

3. What are the Ethical Issues?

3.1 – What are the ethical issues raised by nanotech performance enhancement?

There are a number of ethical issues that are raised in association with the prospect of nanotech performance enhancement. Some of these concerns are already familiar to us from debates regarding the morality of genetic intervention. For example, there are noted philosophical difficulties associated with the positive/negative distinction that is often drawn between those interventions that are intended to return functionality to normal levels (i.e. negative: therapeutic enhancement), as opposed to those that are intended to increase or supersede what would be considered to be a normal level of functionality (i.e. positive augmentation). In this context, negative interventions are sometimes described as being directed at the elimination of defects (or genetic mistakes; i.e. disease). Conversely, positive interventions are aimed at improving essentially normal individuals. However, it is not always possible to draw a neat line of demarcation between the two, and in such cases the distinction may break down. For instance:

“Some conditions are genetic disorders whose identification raises little problem. Huntington’s chorea or spina bifida are genetic ‘mistakes’ in a way that cannot be seriously disputed. But with other conditions, the boundary between a defective state and normality may be more blurred.” (Glover, 1984, p. 31)

Putting the positive/negative distinction to one side, there is room for debate as to where precisely one should draw the line between those positive interventions that are deemed to be permissible (if any), and those that are perceived as being morally objectionable; i.e. permissible vs. impermissible technological adjustments to our beings. For instance, it is one thing to decide that it is acceptable for an individual to acquire 30/20 vision as a result of undergoing nanotech performance enhancement, Burt another altogether to permit someone to upgrade themselves in order that they may satisfy their desire to possess builletproof skin. Again, whilst this example might seem clear enough, the line is not always so easily drawn. If it is the case that we are unable to draw a precise line between those interventions that are to be permitted and those that are not, the general prohibition of the practice can be argued with reference to slippery slope objections (Grey, 1996, p. 53). With reference to the more specific question as to how we should allocate healthcare resources, for those interventions that are deemed to be morally permissible, does this entail that public healthcare institutions have an obligation to provide such services? If not, does it make a difference if they are to be provided only via the private healthcare market to those that can afford to purchase them?

3.2 – Are these ethical issues any different to those posed by genetic enhancement?

I believe that there is one key difference that arises with respect to nanotech performance enhancement. With the exception of “gene therapy”, which may work to enhance existing individuals, genetic interventions essentially deal with situations where currently existing people make decisions affecting the properties that will be possessed by as yet unborn people.

On the other hand, nanotech interventions, with the exception of designed evolution programs driven by state authorities, concern the ability of individuals to be able to choose various enhancements for themselves. Characterised another way, this distinction is one between creating “designer babies” and simply enhancing oneself (i.e. self-regarding performance enhancement decisions).

Even if it is the case that nanotech performance enhancement, in and of itself, is believed in principle to be morally permissible, it may be judged offensive on the grounds that such practices could generate a further class division in our society. Those that have been enhanced may enjoy an unfair social advantage over an “un-enhanced underclass”. That said, it is somewhat difficult to see how this would be any different to the advantages already enjoyed by our “ruling class” as a result of factors like private education and inherited wealth; factors which, in liberal democracies, are unlikely to garner widespread public support for legislating against on the grounds that they are inherently immoral. Nonetheless, this does raise an interesting general question with regards to the morality of inequality. This is a point which will merit further discussion later on.

In addition, there are some who object to genetic interventions on the grounds that it causes harm to those not yet born, including producing a resultant reduction in their autonomy (Grey, 1996, pp. 54-55). Yet, to deny general nanotech performance enhancement involves reducing the autonomy of existing people such that they are prevented from satisfying certain of their preferences. Autonomously selected nanotech performance enhancement would (presumably) not be passed on to future generations, and thereby not impact directly on the autonomy of those to follow. However, the notion that governments might soon be able to pursue programs of designed evolution does raise questions as to how we should deal with the rights or interests of those who will be born into, or as a direct result of, such programs. If carried out in opposition to the desires of citizens, it also poses problems with respect to how binding such decisions are on individuals. Further, it is noted that there are also significant arguments relating to the risks presented by making nation or species wide alterations, both in terms of irreversibility and the potential for disaster (Glover, 1984, pp. 41-42).

References

  • Glover, Jonathan, What Sort of People Should There Be?, Penguin Books, New York, 1984.
  • Grey, William, “The Ethics of Human Genetic Engineering”, Australian Biologist, Vol. 9, No. 1, pp. 50-56, 1996.

Nanotechnology and Human Performance Enhancement (Part 2)

The following is an excerpt from my thesis (Master of Bioethics), which was completed in 2004. I’ll be reproducing it here in a series of posts.

2. Human Performance Enhancement: What, When, Why?

2.1 – What enhancements might individuals be able to make to their bodies as a result of nanotechnology?

The kinds of human performance enhancement capabilities that are envisioned as a consequence of developments in nanotechnology are generally considered to fall into three (3) categories. These categories can be broadly described as therapeutic, augmentation and designed evolution (Canton, 2003, pp. 5-7). More specifically, these different aspects of nanotech performance enhancement relate to the following type(s) of bodily interventions:

2.1.1 Therapeutic Enhancement

The intention of therapeutic enhancement is to restore human functioning to its normal level. This has great potential in the case of individuals who could be described as disabled or dysfunctional, either as a result of birth defects, disease or accidents. For example, developments in nanotechnology may make it possible to restore hearing and sight, as well as enabling us to return normal functioning to those who have been unfortunate enough to be deprived of their memory or mobility. In this respect, the applications of a viable nanotechnology extend to include the potential to introduce “nanobots” into human organisms. These nanobots would essentially be “medical repair systems that live inside the body…and keep cells rejuvenated and free of disease” (Broderick, 1997, p. 4). They could theoretically be capable of travelling through blood vessels to clear away plaque from artery walls, target cancer cells, or perform any number of other cell repair functions. Applications such as this would have obvious benefits to the general health of an individual, as well as improving the quality of his or her life.

2.1.2 Augmentation

Augmentation interventions are designed to increase “normal” human performance to superhuman levels. For example, nanotech brain-computer interfaces which connect us to artificial neural networks that are not themselves self-aware, may make it possible for us to amplify our own cognitive abilities (Broderick, 1997, p. 5). It has been suggested that the augmentation of existing capabilities would likely include a degree of individual customisation to reflect people’s careers or interests. Preferred uses might include things such as:

  • Enhanced memory (i.e. “total recall”)
  • Enhanced sight, night vision capabilities – ideal for police and security workers
  • Strength augmentation
  • Synaptic knowledge access port (i.e. direct internet connection)
  • High velocity robotic limbs – suitable for athletes or adventurers
  • Cognitive multi-tasking skills – designed for use by project managers
  • Implanted wireless communication devices – included for use by knowledge professionals.

(Adapted from Canton, 2003, p. 6)

2.1.3 Designed Evolution

This facet of enhancement refers to the ability to make alterations to the human genome that have been specifically chose by individuals or societies. There is the potential for different cultures to pursue their preferences for particular enhancements, perhaps in direct opposition to their citizens and/or other cultures. In this respect, such actions may not be any different to the types of political decisions that we are already familiar with, except that these decisions will have ramifications for the properties possessed by individuals. Such alterations could take almost any form imaginable. For example, the government of the United States might seek. to pursue a course of designed evolution generally intended to promote various entrepreneurial abilities, so as to better enable their citizenry as a whole to compete in global economic markets. Alternatively, the leadership of another nation, such as China, might prefer to follow a path designed to produce citizens that were more likely to be supportive of centralised government and state based decisions. Canton (2003, p. 7) has identified the following additional examples:

  • Longevity enhancement
  • Digitally engineered personalities (e.g. the US/China scenario described above)
  • Self-replenishing bones (i.e. self-assembly)
  • Anti-atrophy muscles resistant to degeneration.

2.2 – When are we likely to possess the technology to make these enhancements possible?

At this stage, it appears likely that individuals who desire it may have access to these types of performance enhancing technologies by as early as 2010. It is anticipated that the technology required for the manipulation and coercion of cellular systems, for example to stimulate the growth of body parts or re-grow nerve tissue, may be viable within as little as 5-7 years (Swiss Re, 2004, Appendix 2, p. 51). This view has been endorsed by another study, which suggests that general augmentation technologies will begin to appear during the next 5-8 years (Canton, 2003, p. 6). Designed evolution is considered is considered to be more long-term in its application, and is not expected too be viable for at least 8-15 years (Canton, 2003, pp. 6-7).

[Note: Whilst these timeframes appear overly optimistic, I believe that it is all but inevitable that we will develop the technological mastery to effect such enhancements. As such, the ethical issues raised by their use represent “when”, not “if” questions.]

2.3 – Who is likely to want to undergo bodily enhancement should it be made available?

It has been argued that anybody that is a candidate for therapeutic treatments will also desire augmentation. It is already the case that in affluent western societies people are seeking to enhance themselves physically. Furthermore, they are doing so at an increasing rate. Figures indicate that more than 6.9 million plastic surgery procedures were performed in 2003 in the US alone. This represents an increase of 41% over 2002 (Pethokoukis, 2003). This phenomenon is such that “…interest in plastic surgery has grown so much that it’s now the focus of reality [TV] shows” (Pethokoukis, 2003, p. 1). Another likely driver for the uptake of human performance enhancement technologies is the large number of post World War 2 “Baby Boomers”. This segment of western societies represents the largest wealth concentration of any group on the world. It has been suggested that the Baby Boomers’ consumer demand for various performance enhancements (including increased longevity, improved intelligence/memory and sensory enhancement) will serve to make enhancements the key lifestyle trend of the future. As Canton writes:

“Not only will Boomers be living longer, they will demand human performance enhancement as their right. Enhancement will be he key lifestyle trend of the future. Generations that follow will not settle for less than their Boomer parents, they will want more enhancement at better prices. They will want all the upgrades. Their collective sense of entitlement of enhancement will be a decisive force that will win political elections, will set government and private sector scientific research agendas and will fuel a trillion dollar [US] enhancement marketplace.” (Canton, 2003, p. 5)

If the dynamic that Canton describes does in fact play itself out, then the pro-performance enhancement movement will be an extremely influential one. As such, the question as to what extent performance enhancement technologies should be made available becomes an important social issue that requires extensive discussion.

References

  • Broderick, Damien, The Spike: Accelerating into the Unimaginable Future, Reed Books, Melbourne, 1997.
  • Canton, James, “Designing the Future: NBIC Technologies and Human Performance Enhancement”, Institute for Global Futures, http://www.futureguru.com/articles, 2003 (Downloaded August 2004).
  • Pethokoukis, James, “The Red-Green Divide Over Human Enhancement”, Tech Central Station, www2.techcentralstation.com, 2004 (Downloaded August 2004).
  • Swiss Re, “Nanotechnology: Small Matter, Many Unknowns”, Risk Perception Series, http://www.swissre.com, 2004 (Downloaded August 2004).

Nanotechnology and Human Performance Enhancement (Part 1)

The following is an excerpt from my thesis (Master of Bioethics), which was completed in 2004. I’ll be reproducing it here in a series of posts.

1. Introduction

“Never before has any civilisation had the unique opportunity to enhance human performance on the scale that we will face in the near future.”

James Canton

Our ability to understand and manipulate the physical world is increasing at an ever accelerating rate. One particular area in which scientists and governments are making concerted efforts is the emerging field of nanotechnology, which is directed art developing the ability to manipulate matter at its most fundamental level. The term nanotechnology itself has its origins in the Greek word nanos, which translates as dwarf (Swiss Re, 2004, p. 5). Stated simply, the goal of nanotechnology is to facilitate “…the construction of a wide range of artifacts whose components are reasonably measured in nanometres, or billionths of a metre” (Crandall, 1996, p. 2). This involves the construction of products from the “ground-up”, potentially atom-by-atom. As such, it represents a profound shift in our general approach to manufacturing, which has traditionally been to take bulk quantities of a given material and seek to reduce it (or whittle it down), so as to create parts that are of the size required.

Whilst the desire to decrease the size of products is nothing new (e.g. computer chips, mobile phones etc), the point of difference with respect to nanotechnology is that:

“…the downsizing process has broken through a certain barrier; beyond it, the old laws no longer necessarily apply. Any material reduced to the size of nanoparticles can suddenly behave much differently than it did before. Electrically insulating substances…suddenly become conductive, and insoluble substances, soluble. Others change colour or become transparent – demonstrating completely new properties that open the door to novel applications and products, thus making them of great interest both to industry and society at large.” (Swiss Re, 2004, p. 5)

This offers a broad range of potential product applications, including everything from self cleaning shirts to transparent sunscreens. Some products incorporating distinctly nano qualities are already readily available on local markets (Nanotechnology Victoria, 2004).

More interestingly, with the prospect of a fully developed nanotechnology, we may soon find ourselves in possession of the necessary technical skills to alter and enhance our physical beings in ways that have previously only been entertained by science fiction writers. The emergence of such a technology brings with it the possibility of facilitating bodily interventions designed to change levels of individual functioning; levels that up until this point in human evolution have essentially been down to luck. What is more, we may be able to dramatically supercede what were previously thought to be the limits of human functioning, by enabling people to acquire superhuman levels of performance. It is suggested that there is a ready-made market in Western countries for human performance enhancement, as is demonstrated by the dramatic increase in take-up rates for cosmetic plastic surgery (Pethokoukis, 2004) and the like. All signs indicate the presence of a significant consumer demand for the type of interventions promised by nanotechnology.

However, the potential for nanotech based interventions is accompanied by pressing ethical concerns. Whilst some of the issues raised would not appear to be significantly different from those commonly discussed with respect to genetic interventions or manipulation (i.e. eugenics), there are perhaps some key points of difference which need to be addressed. As a consequence, it may be the case that the ethical frameworks that have traditionally been used to target eugenics may ultimately prove to be inadequate when it comes to dealing with the issues born of nanotech performance enhancement interventions. I will therefore examine nanotech performance enhancement issues from the point of view of existing philosophical frameworks, in an effort to test their adequacy, before drawing conclusions with respect to the moral permissibility of such enhancements. This will involve examining the tensions that exist between the two dominant ideologies with respect to how best to allocate our healthcare resources. These competing philosophies are the teleological position of the utilitarian, and the deontological framework for justice in healthcare provided by Norman Daniels.

References

  • Crandall, B.C. (ed.), Nanotechnology: Molecular Speculations on Global Abundance, MIT Press, Cambridge, 1996.
  • Nanotechnology Victoria, Industry Focus: Textiles and Manufacturing, http://www.nanovic.com.au, October 2004.
  • Pethokoukis, James, “The Red-Green Divide Over Human Enhancement”, Tech Central Station, www2.techcentralstation.com, 2004 (Downloaded August 2004).
  • Swiss Re, “Nanotechnology: Small Matter, Many Unknowns”, Risk Perception Series, http://www.swissre.com, 2004 (Downloaded August 2004).

A sad state of affairs…

Having trained in psychology as a younger man I’ve found it absolutely disgusting the way that our so-called leaders have embraced fear mongering over the coronavirus. They’re using fear as a mechanism of control. (Aided by ‘clickbait’ from large sections of the media.)

They want you to be frightened. They want you to be cowering at home, too scared to venture out into the light.

Don’t get me wrong, there are certainly things to be wary of in this world. But if you want to be afraid of something, be afraid of government; not this virus.

To paraphrase Benjamin Franklin:

“Those that are prepared to sacrifice liberty for security deserve neither and will ultimately lose both.”

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