Student: Aleksandar Aleksandrov
Course: PHI 220a: Ethics
Professor: Diego Lucci
The Bioethics of Enhancement
Introduction
This paper discusses the bioethics of enhancement, explaining the circumstances in which enhancement could
be considered justifiable and ethical, as well as the circumstances in which enhancement is unjustifiable and
unethical. The paper compares the viewpoints of two renowned ethicists, experts in the field of bioethics,
Thomas H. Murray and Julian Savulescu. Despite the fact that both of them present arguments for and against
enhancement, Thomas H. Murray is more balanced and neutral, while Julian Savulescu takes a stand, arguing
for enhancement and claiming that “enhancement is something we should aspire to achieve”. Based on the
scientific discussion, I will present my own opinion about the matter, taking into consideration the views of the
experts.
Enhancement is the process of increasing, elevating, and expanding the physical or mental capabilities of a
being. Considering the fact that enhancement requires an outside intervention, which is not achieved through
training or practice, enhancement seems to be unfair and unethical. In fact, very often, it is. However, there are
many cases, which require the usage of enhancement as the only alternative for an individual to have a better
and longer life.
Enhancement in Healthcare and Medicine
In his essay, Thomas H. Murray analyses enhancement in the context of healthcare and medicine. He claims
that enhancement is the professional moral obligation that physicians are required to provide to their patients –
therapeutic interventions. After all, this is their job and this is what the Hippocratic Oath obliges them to do –
everything possible, in order to heal their patients. For example, an internist (a doctor of internal medicine) has
the obligation to prescribe a beta blocker to a patient with heart disease, because this medicine would help the
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patient manage his cardiac arrhythmias and would protect his heart from a second heart attack that would
probably end with death. Therefore, enhancement in this case is ethical and absolutely justifiable because it
would save a human life. However, if the same internist prescribes the same drug to an athlete, say an archer,
who wants the drug in order to increase the interval between his heartbeats and thus have a longer time to aim
and release the arrow, this enhancement would be considered unethical because the athlete would gain an unfair
advantage over his opponents. The internist would be guilty of malpractice and breaking the medical
deontology because he is intentionally prescribing a medicament for a healthy person that could otherwise be
sold to an ill person. The archer would be guilty of cheating because he would use a forbidden type of
enhancement, in order to boost his/her performance. The actions of both the internist and the archer would be
unethical; therefore the enhancement would be unethical.
Enhancement in Human Growth
Thomas H. Murray further discusses enhancement in the context of genetic intervention. Parents who are
concerned about the average or small height of their children, inject the human growth hormone, in order to
boost their height. The author describes their actions as unethical because by artificially boosting the height of
their children, they go against nature. According to him, it is only nature or God that determines for whom how
much. Parents justify their actions by blaming the unjust gifts of nature. The reasons they want to enhance the
height of their children are quite many, but all of them are influenced by concerns about their child`s future.
Many parents believe that if their children do not grow enough, they might suffer from complex of inferiority
and have a low self-esteem, simply because they are short. They might have difficulties, especially boys, to find
a girlfriend, since it is a common truth that girls usually like tall boys. As adults, they might be discriminated on
the workplace, and might not be chosen for certain positions, not because they do not have the knowledge and
skills, but because they do not look that representative and respectable for their companies. Many international
surveys report that 90% of all CEOs worldwide are above average height. The reason for this is that since the
CEO bears the image of the company, he has to be tall, thus implying that he is a leader of a big corporation.
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Many parents who have enhanced the height of their children using the human growth hormone do not regret
for doing this. In fact, they consider their actions ethical because they have helped their children.
The Strive for the Perfect Child
According to the author, one of the biggest mistakes of some young parents is to treat their kids like their
possessions, not as individuals. In this aspect, parents prevent their children from developing a personal opinion
and individual character. This serious parental mistake leads to the strive for the perfect child, which in itself is
unethical act because only God is perfect. This is actually the main reason that Thomas H. Murray points out to
be the driving force of parents to enhance their children’s growth. He argues that the human growth hormone is
often used not for the sake of therapy, but for the sake of modeling perfection. Parents have to accept the
“givenness” of their children – as they are, with their strengths and weaknesses, with their appetites and
enthusiasms, fears and aspirations, not to model them, according to their own preferences, even if that personal
reality might diverge from their idealized image of the child they dreamt for. If we engineered perfect children,
the world would be a sterile, homogeneous and monotonous place where everyone was the same, and the
mystery and surprise of life would be gone. Moreover, it is impossible to create perfect children. We can only
attempt to create children with better opportunities for a better life. This should be the leading principle for
parents. However, for many parents, it is not.
Enhancement from a Utilitarian Perspective
According to Julian Savulescu, there is nothing morally wrong and unacceptable about enhancement, as long as
it makes us happy and satisfied, without harming the welfare of others. This utilitarian perspective is a leading
idea in Savulescu’s philosophy. “We want to be happy people, not just healthy people”, he postulates. Julian
Savulescu claims that happiness is an important reason for people to use enhancement. After all, according to
the U.S Constitution, it is one of the three “unalienable” human rights – life, property, and the pursuit of
happiness. The author supports enhancement by giving examples from the cosmetic surgery industry. Many
women, who do not feel comfortable and sexually desired by men, undertake all kinds of plastic intervention,
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such as breast enlargement, Botox and nasal surgery, in order to transform their image. Beauty is undoubtedly
one of the greatest endeavors for every woman and the first thing that every man sees in the opposite gender.
Although physical beauty is determined by nature, all women use makeup, which is still a type of enhancement,
in order to look more attractive. Using enhancement for such purposes is absolutely ethical and justifiable
because it makes women happy, without cheating or harming other people.
Enhancement in Bodybuilding
Julian Savulescu further justifies enhancement by giving an example with bodybuilding. Bodybuilding is the
only type of sport, in which enhancement in the form of anabolic steroids, is absolutely permitted. Moreover,
enhancement there is not only allowed but required. Since this is an aesthetic sport that aims to present to the
public athletes with incredibly big and perfectly shaped muscles and the type of “Hulk” bodies, athletes cannot
achieve this naturally, and therefore have to use enhancement in the form of anabolic steroids. All bodybuilders
in the world use enhancement, otherwise they would not be called bodybuilders, and this sport respectively
would not exist. By using enhancement, the contestants do not cheat because everyone is allowed to use it as
much as he needs to. The winners in bodybuilding are usually not the people who have used the greatest amount
of anabolic steroids because the more enhancement you use, the more you have to train, and your body might
not be able to absorb and respond well to such treatment. The winners are usually the people who have managed
to find the perfect ratio between enhancement and training and who are more genetically predetermined to form
bigger and/or more beautifully carved muscles. Enhancement in bodybuilding is a required tool, but it is not the
only tool that bodybuilders use to win. Although the use of anabolic steroids as a type of enhancement might
lead to detrimental health issues, if the sportsman knows this and uses them only on him in the context of
bodybuilding, without forcing others to do the same, he is not harming anyone. Therefore, enhancement is
justifiable and ethical.
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Personal Observations and Thoughts about Enhancement
In our everyday life, we use many types of support and help for accomplishing different types of tasks. We use
machines, we work in a team with people for the completion of a task that would be hard to be done only by
ourselves. External help or support is also considered enhancement. As individuals, we are not self-sufficient
and we often need the company and support of others, which is absolutely normal. Otherwise, we would be
anti-social human beings, living in isolation from the world. Therefore, I consider enhancement to be ethical
only if it is done with the means of doing something faster and more efficiently, in harmony with the common
good, or even contributing to it.
However, when people decide to use enhancement in the form of medicament, they should use it only when
they are sure that this is the only choice and nothing else works because the consequences of using such type of
enhancement are negatively related to the health of the individual. Referring back to the case with heightism, I
personally do not approve the parental use of human growth hormone for enhancing the height of their children.
The height of a human-being can be increased naturally through stretching exercises, practicing sports like
basketball, volleyball and swimming, and making pull ups on a bar. Moreover, regarding the concerns about the
relationships with women, height is not the only factor that determines the male success with the opposite
gender. For example, my previous roommate, Edor, who was far shorter than me, used to tell me that with my
height and my physique, I could have any girl. However, he was the one who was more successful with girls.
They just adored his blue eyes. Growth enhancement using the human growth hormone is an extreme
intervention that could bring about serious health problems to the individual and for me is unethical and
unjustifiable. After all, height should not be the reason for developing a complex of inferiority among short
people because it is not the most important and the most determining factor for men.
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Conclusion
All in all, this paper examined the ambiguous bioethics of enhancement and showed its multifaceted nature.
With the development of medicine and technology, enhancement is something that many people use for
different purposes. After all, since it exists, it has to be used. It should not be disregarded. However, people
need a clear conceptual map of the possible types of enhancement combined with a perfect understanding of the
goods sought, the dangers encountered, and the social and institutional context into which each putative
enhancement would be implemented. Sometimes it is better things to happen naturally. Enhancement is a
serious biological intervention that can alter the human life forever, so prior to deciding whether to use it or not,
people should ask themselves the question: do I really want to enhance?
Sources:
Murray, Thomas. (Enhancement). The Oxford Handbook of Bioethics. Oxford: Oxford University Press, 2007.
Print. 491-514.
Savulescu, Julian. (Genetic Interventions and The Ethics of Enhancement of Human Beings). The Oxford
Handbook of Bioethics. Oxford: Oxford University Press, 2007. Print. 516-533.
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