Beyond Therapy (Biotechnology and the Pursuit of Happiness).

347 Pages·2003·4.58 MB·English

by  Judy Crawford

BBBEEEYYYOOONNNDDD TTTHHHEEERRRAAAPPPYYY
BEYOND THERAPY

BIOTECHNOLOGY AND THE
PURSUIT OF HAPPINESS

A Report of
The President’s Council on Bioethics

Washington, D.C.
October 2003

www.bioethics.gov

v

CONTENTS

LETTER OF TRANSMITTAL TO THE PRESIDENT xi

MEMBERS OF THE PRESIDENT’S COUNCIL ON BIOETHICS xv

COUNCIL STAFF AND CONSULTANTS xvii

PREFACE xix

1 BIOTECHNOLOGY AND THE PURSUIT OF HAPPINESS 1

I. THE GOLDEN AGE: ENTHUSIASM AND CONCERN 4
II. THE CASE FOR PUBLIC ATTENTION 7
III. DEFINING THE TOPIC 10
IV. ENDS AND MEANS 11
V. THE LIMITATIONS OF THE “THERAPY VS.
ENHANCEMENT” DISTINCTION 13
VI. BEYOND NATURAL LIMITS:
DREAMS OF PERFECTION AND HAPPINESS 16
VII. STRUCTURE OF THE INQUIRY:
THE PRIMACY OF HUMAN ASPIRATIONS 20
VIII. METHOD AND SPIRIT 21
ENDNOTES 24

2 BETTER CHILDREN 25

I. IMPROVING NATIVE POWERS:
GENETIC KNOWLEDGE AND TECHNOLOGY 28
A. AN OVERVIEW 28
B. TECHNICAL POSSIBILITIES 30
1. Prenatal Diagnosis and Screening Out. 32
2. Genetic Engineering of Desired Traits
(“Fixing Up”). 35
3. Selecting Embryos for Desired Traits
(“Choosing In”). 38
C. ETHICAL ANALYSIS 42
1. Benefits. 44
vi CONTENTS

2. Questions of Safety. 45
3. Questions of Equality. 49
4. Consequences for Families and Society. 51
II. CHOOSING SEX OF CHILDREN 55
A. ENDS AND MEANS 57
B. PRELIMINARY ETHICAL ANALYSIS 59
C. THE LIMITS OF LIBERTY 64
D. THE MEANING OF SEXUALITY AND PROCREATION 66
III. IMPROVING CHILDREN’S BEHAVIOR:
PSYCHOTROPIC DRUGS 69
A. BEHAVIOR MODIFICATION IN CHILDREN
USING STIMULANTS 72
1. What Are Stimulant Drugs? 75
2. Behaviors Inviting Improvement
through Stimulant Drugs. 77
3. The “Universal Enhancer.” 81
B. ETHICAL AND SOCIAL CONCERNS 83
1. Safety First. 84
2. Rearing Children: The Human Context. 85
3. Social Control and Conformity. 86
4. Moral Education and Medicalization. 89
5. The Meaning of Performance. 90
IV. CONCLUSION: THE MEANING OF CHILDHOOD 92
APPENDIX: DIAGNOSTIC CRITERIA FOR ATTENTION-DEFICIT/
HYPERACTIVITY DISORDER 93
ENDNOTES 96

3 SUPERIOR PERFORMANCE 99

I. THE MEANING OF “SUPERIOR PERFORMANCE” 100
II. SPORT AND THE SUPERIOR ATHLETE 104
A. WHY SPORT? 104
B. THE SUPERIOR ATHLETE 105
C. DIFFERENT WAYS OF ENHANCING PERFORMANCE 106
1. Better Equipment. 107
2. Better Training. 108
3. Better Native Powers. 108
III. MUSCLE ENHANCEMENT THROUGH BIOTECHNOLOGY 109
A. MUSCLES AND THEIR MEANINGS 109
B. MUSCLE CELL GROWTH AND DEVELOPMENT 111
C. OPPORTUNITIES AND TECHNIQUES FOR
MUSCLE ENHANCEMENT 113
CONTENTS vii

IV. ETHICAL ANALYSIS 121
A. HOW IS BIOTECHNICAL ENHANCEMENT DIFFERENT? 122
B. FAIRNESS AND EQUALITY 129
C. COERCION AND SOCIAL PRESSURE 133
D. ADVERSE SIDE EFFECTS: HEALTH, BALANCE,
AND THE WHOLE OF LIFE 135
E. THE DIGNITY OF HUMAN ACTIVITY 138
1. The Meaning of Competition. 139
2. The Relationship between Doer and Deed. 141
3. Acts of Humans, Human Acts:
Harmony of Mind and Body. 143
F. SUPERIOR PERFORMANCE AND THE GOOD SOCIETY 149
ENDNOTES 155

4 AGELESS BODIES 157

I. THE MEANING OF “AGELESS BODIES” 158
II. BASIC TERMS AND CONCEPTS 161
III. SCIENTIFIC BACKGROUND 166
A. TARGETING SPECIFIC DEFICIENCIES OF OLD AGE 166
1. Muscle Enhancement. 166
2. Memory Enhancement. 167
B. GENERAL (BODY-WIDE) AGE-RETARDATION 170
1. Caloric Restriction. 171
2. Genetic Manipulations. 172
3. Prevention of Oxidative Damage. 175
4. Methods of Treating the Ailments of the Aged
That Might Affect Age-Retardation. 176
a. Hormone treatments 176
b. Telomere research 177
IV. ETHICAL ISSUES 179
A. EFFECTS ON THE INDIVIDUAL 181
1. Greater Freedom from Constraints of Time. 184
2. Commitment and Engagement. 185
3. Aspiration and Urgency. 185
4. Renewal and Children. 186
5. Attitudes toward Death and Mortality. 188
6. The Meaning of the Life Cycle. 189
B. EFFECTS ON SOCIETY 190
1. Generations and Families. 191
2. Innovation, Change, and Renewal. 193
3. The Aging of Society. 194
V. CONCLUSION 195
ENDNOTES 200
viii CONTENTS

5 HAPPY SOULS 203

I. WHAT ARE “HAPPY SOULS”? 208
II. MEMORY AND HAPPINESS 212
A. GOOD MEMORIES AND BAD 216
B. BIOTECHNOLOGY AND MEMORY ALTERATION 219
C. MEMORY-BLUNTING: ETHICAL ANALYSIS 223
1. Remembering Fitly and Truly. 226
2. The Obligation to Remember. 228
3. Memory and Moral Responsibility. 229
4. The Soul of Memory, The Remembering Soul. 231
III. MOOD AND HAPPINESS 232
A. MOOD-IMPROVEMENT THROUGH DRUGS 237
1. Mood-Brightening Agents: An Overview. 238
2. Biological and Experiential Effects of SSRIs. 240
B. ETHICAL ANALYSIS 249
1. Living Truly. 250
2. Fitting Sensibilities and Human Attachments. 253
3. What Sorrow Teaches,
What Discontent Provokes. 255
4. Medicalization of Self-Understanding. 258
5. The Roots of Human Flourishing. 261
6. The Happy Self and the Good Society. 263
IV. CONCLUSION 266
ENDNOTES 269

6 “BEYOND THERAPY”: GENERAL REFLECTIONS 273

I. THE BIG PICTURE 273
II. FAMILIAR SOURCES OF CONCERN 277
A. HEALTH: ISSUES OF SAFETY AND BODILY HARM 277
B. UNFAIRNESS 278
C. EQUALITY OF ACCESS 279
D. LIBERTY: ISSUES OF FREEDOM AND COERCION,
OVERT AND SUBTLE 281
III. ESSENTIAL SOURCES OF CONCERN 284
A. HUBRIS OR HUMILITY: RESPECT FOR “THE GIVEN” 285
B. “UNNATURAL” MEANS:
THE DIGNITY OF HUMAN ACTIVITY 288
C. IDENTITY AND INDIVIDUALITY 291
D. PARTIAL ENDS, FULL FLOURISHING 293
CONTENTS ix

IV. BIOTECHNOLOGY AND AMERICAN SOCIETY 299
A. COMMERCE, REGULATION, AND THE
MANUFACTURE OF DESIRE 301
B. MEDICINE, MEDICALIZATION, AND A
STANCE “BEYOND THERAPY” 303
C. BIOTECHNOLOGY AND AMERICAN IDEALS 306
ENDNOTES 309

BIBLIOGRAPHY 311