Miah, A. (2008) Engineering Greater Resilience or Radical Transhuman Enhancement,Studies in Ethics, Law and Technology, 2(1), 1-18.
"Previous analyses of the distinction between therapy and enhancement interventions can be grouped into two types of encounter. The first group focuses on debates about whether certain forms of therapy lead to a range of possible enhancements. The form of these debates is of a ‘slippery slope’, of which there are various forms (Burg 1991; McNamee 2005; Resnik 1994). A second type of encounter focuses on whether we should be preoccupied at all with the distinction between the two and these debates are mostly responses to claims that therapeutic interventions, taken to their logical end, also embrace a commitment to what we currently imagine as enhancements (Daniels 2000; Resnik 2000). These tend to focus on holding the line on therapeutic interventions, even if there seems some flexibility for the concept to allow some forms of enhancement. Each of these debates draws from discussions about rule making or line drawing within medical law and ethics.
Also for each, there is considerable lack of detail given to the various forms that either therapy or enhancement could take. This paper proposes a typology of human enhancements in order to make more rigorous and grounded the discussions in this area. On this basis, I consider that there are certain forms of human enhancement that should not feature in applied bioethical debates, particularly those of the second and third type of radical transhuman enhancement (interventions that are outside of the range of human functions and outside of all biological functioning). This type of enhancement often features in discussions about human enhancements, but they do not characterize instances of enhancement that bear much relation to the contemporary concerns of those who argue on behalf of human enhancements. Rather, they indicate broad philosophical problems associated with the limitless pursuit of good health, which are discussions that have concerned philosophers for centuries.
Importantly, this conclusion calls for a restrictive use of science fiction narratives within bioethics, through which one might explain the immediate and probable implications of human enhancement. For instance, within the third category of human enhancements discussions about ‘immortality’ should be treated differently from contemporary debates about extending healthspan and lifespan. The argument that the end goal of extending life span will be immortality, is too great a stretch of contemporary bioethical imaginations, as are its derivative discussions about the importance of death to give meaning to life. This is not to reject the value of such philosophical investigations, which have a crucial place in or moral deliberations, as outlined in Campbell (2003). Indeed, one might argue that the level of debate about such profound matters has reinvigorated bioethics.
However, such extrapolation from current biogerontology to discussions of immortality should be limited. The prospect of living to even 200 years old is considerably different from the prospect of immortality and it is the former bracket of probability that should concern us. After proposing this typology, I explored the limits of ethical justifications for medical therapy to elucidate whether and how justifications for human enhancements might differ. I conclude that the core concern of relieving suffering that arises form health-related biological dysfunction enables similar arguments to be made on behalf of enhancement, as for therapy. However, even accepting this possibility, I have explained a number of obstructions that are necessary to overcome before such interventions can be considered feasible from a medical perspective. Perhaps the main obstacle is overcoming the challenge of developing enhancement interventions for use with healthy people.
In this case, the objection that such actions would violate the traditional medical ethical principle of doing no harm remains robust at the point of innovation. Taken together, these obstructions are far from negligible. Moreover, one might advance the idea that a great majority of present-day forms of human enhancement reflect the more modest end of the typology, as forms of engineering greater resilience, rather than their being radical transhuman enhancements. For instance, providing beta blockers to students to assist revision for exams, falls into this category and this case is often used to appeal to the prevalence of human enhancements in society already. Alternatively, the often-cited case of cosmetic surgical intervention seems, at most, located within Category 2, as a contested modification (ie. somewhat subject to aesthetic appreciation).
Finally, it cannot be assumed that the moral justifications advanced to support one form of human enhancement will have the same persuasive force when applied to others. As I indicated at the outset of this paper, the arguments to support interventions that alter contested traits will find different substantive objections compared with extending human capabilities or even engineering greater resilience. In an era where these obstructions are met, the case for pursing human enhancements generally and without limitation is considerably strengthened, though this does not negate the need for consideration of what precisely is improved by any given enhancement."