Enhancement: What Is biomedical enhancement?

In this Wi-phi video, we’re going to ask: what’s the difference between a medical treatment and an enhancement? In deep brain stimulation, electrodes are surgically implanted in the patient’s brain. A neurostimulator sends electrical impulses into the electrodes, changing the brain’s activity in the targeted areas. This can be an effective treatment for patients with Parkinson’s disease, and may help with a variety of other conditions, such as epilepsy, Tourette’s syndrome, major depression, and obsessive-compulsive disorder. Deep brain stimulation is just one of the latest entries in humankind’s long and ingenious history of medical treatment technologies. It will eventually take its place alongside bandages, crutches, and canes, pacemakers, dialysis machines, and cochlear implants. In addition to using technology to treat health problems, people have used tools and technology to enhance their bodies and natural abilities for just as long. As the technological frontier advances, possibilities that were recently science fiction may really be on the horizon: What if you could implant a chip in your brain to access the internet in thought? What if you could edit the genes of your future children to ensure that they live at least 100 years? What if you could take a pill that made you smarter, harder-working, and more virtuous? Transhumanists believe we are on the cusp of such advances. And, as their name suggests, they advocate embracing them as the next step in our evolution beyond humanity. Opponents of transhumanism are skeptical about the wisdom of this path. Isn’t there something deeply worrisome about such invasive modifications to normal human functioning? Well, you might respond, what about deep brain stimulation? “Surgically burying electrodes deep in your brain and sending pulses of electricity through them to modify neural functioning” is no less invasive than most proposals transhumanists embrace. We need to think more carefully about the difference between a medical treatment and an enhancement. This distinction doesn’t just concern futuristic technologies. Take cosmetic surgery, for example. Cosmetic surgery to correct the disfiguring injuries suffered by a burn victim is a medical treatment. By contrast, a surgical facelift to smooth your wrinkles and help you look younger is an enhancement. Treatments aim to repair an injury, relieve a symptom, or combat a disease. Treatments are intended to cure. If you need a cure, then you’re somehow sick. Treatments are always responses to real or perceived problems with your health. Enhancements, by contrast, have nothing intrinsic to do with ill health. A facelift makes you look younger -it doesn’t cure your face. Wrinkles aren’t a disorder. You may wish you had a supercharged memory, but that doesn’t mean there’s anything wrong with your brain. Enhancements aim not to cure you, but to upgrade you -to help you go beyond what a healthy person is capable of doing. One and the same intervention might be a treatment or an enhancement, depending on why it’s performed. To borrow the language of insurance companies, treatments must be medically necessary In other words, their justification is that they are required to restore or protect your health. Of course you might have a range of treatment options, none of which is individually necessary. But what makes those your options is that they’re all ways of restoring you to health. You need to do something on the list of treatments, or else you’ll stay sick. For example, prescription eyeglasses count as a medical treatment, because they’re meant to assist people whose vision isn’t functioning as it should. Augmented reality glasses, by contrast, count as an enhancement, because they help you move beyond a normal level of function. So, transhumanists advocate medical technologies that help us go beyond the level of functioning typical of a healthy human being, regardless of their utility as treatments for ill health. Imagine that every great disease has been cured, or was easily treatable. Given the choice, few if any of us would turn down the opportunity to live in this alternative reality. Everybody would be healthy. Now imagine that medical enhancements were commonplace. Self-improvement efforts would be just as likely to involve genetic editing, electronic implants, drug cocktails, or plastic surgery as they would to center on diet and exercise, meditation, charity work, or joining a book club today. You might regularly run into people who were smarter than the greatest genius who’s ever lived. Some of your friends might be 150 years old. Instead of going to the gym, you might go to the muscle factory to pick up a new set of abs. While a world of perfect health is pretty easy to imagine, it’s very hard to envision a world of extensive technological enhancement. So it’s reasonable to pause and ask: is this a world we want? What do you think?