The Brocher Foundation, and the Universities of Oxford and Geneva are pleased to announce the Symposium:

Human Enhancement: What should be permitted? 20-21 October 2009, Brocher Centre, Geneva, Switzerland _____________________________________________________________________________________________________

 

Biomedical science is increasingly yielding technologies that can be used to enhance the capacities of healthy people, as well as to treat disease. This two-day workshop will aim to advance the debate on the ethics of human enhancement by considering

(1) What enhancements are likely to become possible?

(2) What enhancements will be ethically permissible?

(3) What enhancements should be legally permitted?

(4) What criteria should be used to answer 2 and 3?

THE PROGRAMME WILL INCLUDE SESSIONS ON:

Enhancement in sport

Life extension

Neuro-enhancement

Enhancement in general

The full list of speakers/respondents is: Eric Juengst, Paul Root Wolpe, Hank Greely, John Harris, Tom Murray, Gaia Barazzetti, Aubrey de Grey, Mike McNamee, Andy Miah, Stella Reiter-Theil, Ilina Singh, Astrid Stuckelberger, Sigmund Loland, Nicole Vincent, Massimo Reichlin, Ingmar Persson, Margareta Baddeley, Julian Savulescu, Alex Mauron, Bengt Kayser, Verner Moller, Tom Douglas, Norm Fost (TBC).

ORGANISERS

Julian Savulescu, Alexandre Mauron, Bengt Kayser, Verner Moller, Tom Douglas

TO ATTEND THE EVENT,

you are kindly requested to fill in the registration form and to send it back to the Brocher Foundation by mail, e-mail or fax before 5 October 2009. Places are limited and will be allocated on a first come first served basis.

Fondation Brocher 471 rte d’Hermance, 1248 Hermance, Switzerland E-mail: scientificprog@brocher.ch Fax: 0041 22 751 93 91

Here are some notes from the day:

Enhancement in sport (chaired by Julian Savulescu, Oxford)

0930 – 1020: Anti-doping: Not the only matter of concern for elite sport

Bengt Kayser (Director, Institut des Sciences du Mouvement et de la Médecine du Sport, University of Geneva)

Discuses cases of enhancement use throughout life

-       21 med student uses ritalin

-       75 retired athlète

anti-doping leading to excessive surveillance in sport

more harm to society than it prevents

slippery slope

arg against doping – against rules

doping-like behaviour – conduite dopante

why anti-doping rule ?

-       fair play, health, rôle model, spirit of sport

thèse reasons for anti-doping are flawed

what is the objective ?

-       eradication?

  • no

-       decrease prevalence?

-       decrease prevalence in mass sport ?

-       decrease in society ?

talk about GPS tracking

-       to identify athlete’s whereabouts

for 2012 Olympic Games – condition of entry to search athletes

false negatives

false positives

why do people transges

new law in france (2008) – 5 yrs in prison and €75,000 for possession for trade

strict liability – presumption of guilt as reversal of justice

Article 6 (2) ECHR – presumed innocent until proven

Can anti-doping be successful?

-       illusion

-       shows signs of fantacism

side effects

-       public belief that doping works

-       hidden because illegal

-       criminalization

-       dangerous behaviour

increase in prevalence

other problems

-       other collateral damage

Respondent: Mike McNamee (Professor of Applied Ethics, Swansea University, Wales)

Privacy – public and private distinction – with internet now, why should this worry us particularly?

Why does cost of strict liability rule matter so much?

If someone forcibly injected with steroid, would not have been their fault.

If different syste and don't test, but only advise, is sports world culpable?

Clean sport and doped society

-       if likely, then still sport could claim desire to maintain freedom from these technologies

ME: if society accepts medicalization of enhancement, can sports prevent such freedoms?

Strict liability – not an attribution of guilt, but of negligence

Can never prove intentionality of doping behaviour

John harris: this debate is bedevilled by confusion about the debate – rules can be whatever people want them to be – prob comes when dress up anti-doping as if is an ethical issue – not an ethical issue, is a matter of the sport’s rules –

Julian Savulescu – test only for health thresholds – rules also often about making better spectacle – what makes sport more exciting?

1020 – 1110:                                     The Ethics of Sport Enhancement and the Meaning of Sport

Tom Murray (President of The Hastings Center)

Why baseball is the best game – john rawls

-       perfectly adjusted to human skills

Rawls – virtuous perfection of natural talents

Excellence in sports – 1) natural talents 2) virtuous perfection of those talents (that would be admirable for a variety of reasons)

ME: is it necessary for athletes to originate those things that they do as admirable? Of course, they replicate established knowledge

Are vaccines an enhancement – can protect against H1N1 but make us more

Enhanced interrogation – bush administration – ie. Torture – most would not regard as a morally valuable pursuit

Enhancement for what ends?

Implications for flourishing?

Individual and society concerns

Powerlifting (non-olympic) vs weight lifting (Olympic)

-       Jan Todd

Powerlifting as case study

-       use of drugs and shirts

fracturing of powerlifting movement

-       19 organizations in USA

Ernie Frantz – advert for the sport – no testing – but some countries do want to test

In drug free powerlifting association – likely that drug use is evident

Longhorn Open Championships  - award 109 trophies to 98 lifters competing

By 1985 – concerns that powerlifting had degenerated

Powerlifting – the shirts

-       assist in bench press – many layers of denim, Kevlar, etc

-       600pound benchpress in superheavyweight would be great in a raw event, but in powerlifting would not be competitive – shirts make the difference

system of justice – should be to accommodate whole system not just the athletes

claims of incoherency

line drawing problem – is any line going to be defensible

baseball 60ft and 6 inches

athletes we spoke to wanted effective doping control – reasonable assurance, not guarantee

non-trembling surgeon – point is not to demonstrate technical skill of surgeon

sport – point of practice?

reflective equilibrium

not the means

sport vs society

-       use of drugs in sport different from society

‘when you come to a fork in the road, take it’

-       if health is cited, isn’t it unjustified paternalism

-       would you ban low harm drugs?

-       Or permit all drugs?

Mehlman 2009 – handicapping of pure ability

-       but what about unearned adv due to pain tolerance?

How handicap?

-       how do you handicap for height?

In what spheres of practice do we insist that only unearned virtue prevail?

Far poorer world if we handicap people because they unfairly possess unearned advantages.

Respondent: Bennett Foddy (Postdoctoral Fellow in Bioethics, Princeton University)

If permit doping not right to say that choice to use harms other substances, when prefer to not use, cf. training hours

Coercive pressure in itself not a harm

If sport is about identifying most genetically talented performance, then why not count gender for eg?

-       ME: this isn’t what tom says

Admirable activities

-       why are enhancements less admirable comparing technologies?

Standardize equipment? Or remove it?

If about effort – then gender segregation can make sense.

Why not allow evening out of genetic differences

If about a close comp, why not handicap hard workers too?

Or award prize to biggest personal improvement?

Swimsuit – changed to floating and paddling, rather than slicing through the water

Lasik for tiger woods

Tommy john’s surgery

1110 – 1140:                                    COFFEE

1140 – 1220:                    Genetics and Ethics in Sport

Sigmund Loland (Professor of Sport Philosophy, Norwegian University for Sport and Physical Education)

Genetic predisposition can be necessary, but not sufficient

In short, embrace value of phenotypic superiority

-       more reliable than genetic test

agree that crude fairness argument won’t work

we are interested in justification for breaking rules

no problem that different systems of justice in medicine and in sports

-       ME: but what about their intersection? The purpose of medicine is to support individuals in undertaking activity that will be detrimental to their health.

Relevant vs irrelevant risk

Sport not about equality, but perhaps equal opportunity

It is meritocratic and interested in inequality – but not any kind

Thin interpretations – do not link to thick ethical concepts

-       Fairness - prosthetics vs ordinary legs’ body ‘in tact’

-       Sociologically naïve – not grown up people entering sports, but are reliant on sport systems to protect – coerciveness is a concern too – don’t see what it adds to sport

ME: sports competitions measure natural talent, virtuous perfection and technological competition

Don’t want to measure inequality of equipment but skill of athlete

-       ME: skill is not separate from the use of technological means

ME: you develop your natural talent in combination with what Jacque Ellul would call ‘la technique’ the combined ways in which science imparts knowledge to create technological systems which remove performance inhibitors or

Scepticism to expert-administred biotechnological enhancements

-       ME: imagine a world where all athletes go through an educational system while competing – many do, many do sport science degrees – in what sense are they not experts in their own administration?

If enhancement becomes the norm, how can sport deal with this?

Father of serena Williams actively looked for partner who could produce optimal genetic composition for athletic performance

Germline no role in sport – ME: so what?

Question: since we are advancing claims about what sports are, I would want to add to your and tom’s natural talent and virtuous perfection through the exploration of a relationship with technology.

Psychological enhancements more important – ME: but the swim suit is the psychological

Empowered athlete

Respondent: Ingmar Persson (Professor of Practical Philosophy, Gothenburg University, Sweden)

1220 – 1300: Who Guard the Guardians? – A Critical Reflection on Recent  Developments in the Fight against Doping

Verner Moller (Professor, Department of Sport Science, University of Aarhus, Denmark)

if anti doping is corrupt, then debates about what should be permitted are irrelevant

anti-doping officials have sacrified prnciples upon which anti-doping was founded and have lost credibility

Michael Rasmussen case 2007-9 – was overall leader of the Tour de France – alleged that he received warnings for whereabouts  - presented by press as doping possibility – pressure built up around him –

Marshall mcluhan – government by news leak

Danish Cycling Federation – has code it thinks is higher than WADA Code

Tom Boonen – also removed from Tour because of cocaine positive test – which is not an out of competition substance – why was this leaked to the press?!

1300 – 1400:                                    LUNCH

Life-extension (chaired by Verner Moller, Geneva)

1400 – 1450: The Foreseeability of Real Anti-Aging Medicine: Focusing the Debate

Aubrey de Grey (Chief Science Officer, « SENS » Strategies for Engineered Negligible Senescence)

Gerontology approach not sufficient – ie. To clean up metabolism

Instead, maintenance approach better

Do not interfere with metabolism

Longevity escape velocity (LEV)

-       rate at which rejuvenation

rate of progress

2 types of breakthroughs

radical vs incremental

e.g flight – 1903 aeroplanes, then rapid progress

Phonex and de Grey

Therapies double efficacy only every 42 years

Equity

-       would extending life widen the divide between haves and have nots?

-       Unlikely to be a problem – already v expensive to keep elderly alive

-       Correct precedent is not existing medicine, but basic education

-       Economically suicidal to not make available to everybody

Respondent: Gaia Barrazetti (Researcher, EPFL, University of Lausanne)

Translational process from research to implementation

Idea of life extension as ‘personal benefit’

Time for making a decision about reversing ageing process – as early as possible is ideal

-       ME: pre-embryonic?

Aubrey

-       It’s a question of too late, rather than too early – no point applying at age 20 or 30 as will not have accumulated much damage – better at around age of 60 when begun but not pathological

-       Distinguish between sociological and ethical

  • Sociologically, particularly difficult to implement.

Question: Life span vs expectancy

-       interventions have increase expectancy, but not span

suicide rate in elderly popuation highest

cell phone used to cost a lot, now available

ME: evidence that least affluent pay for the cutting edge technology

1450 – 1530: Anti-ageing: Results of a Swiss study

Astrid Stuckelberger (Institut de Médecine Sociale et Préventive, University of Geneva)

www.ta-swiss.ch

1950s – ageing as natural decline

1980s successful ageing

1990-2000

aging – failure of the

1530 – 1600:                                    COFFEE

1600 – 1650: Prevention and Life Extension

Eric Juengst (Professor of Medical Ethics, Oncology, and Philosophy of Science, Center for Biomedical Ethics, Case Western Reserve University)

Chloroplasties to prevent malnutrition

What doe ‘aging’ mean for us?

-       not simply getting older or wearing out

-       maturation  - growing older – progressing through developmental life cycle

case of my department chair at 65 – ‘I have the cv of a much younger man’

intervene in 11 yr old – freeze body in development so puberty postponed to allow cognitive development – would this view of promoting maturation fit in honouring life cycle – I think not

Beyond Therapy – cheating ourselves

The stages of life –

Dan Callahan – life cycle traditionalism

Respondent: Massimo Reichlin (Professor of Moral Philosophy, Università Vita-Salute San Raffaele, Milano)