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."