Table Of ContentMoral Enhancement and the
Public Good
Currently, humans lack the cognitive and moral capacities to prevent the
widespread suffering associated with collective risks, like pandemics, climate
change, or even asteroids. In Moral Enhancement and the Public Good, Parker
Crutchfield argues for the controversial and initially counterintuitive claim
that everyone should be administered a substance that makes us better
people. Furthermore, he argues that it should be administered without our
knowledge. That is, moral bioenhancement should be both compulsory and
covert. Crutchfield demonstrates how our duty to future generations and
our epistemic inability to promote the public good highlight the need for
compulsory, covert moral bioenhancement. This not only gives us the best
chance of preventing widespread suffering, compared to other interventions
(or doing nothing), it also best promotes liberty, autonomy, and equality.
In a final chapter, Crutchfield addresses the most salient objections to his
argument.
Parker Crutchfield is Associate Professor of Medical Ethics, Humanities,
and Law at Western Michigan University Homer Stryker M.D. School of
Medicine. He writes in bioethics and epistemology, teaches medical ethics
to medical students and resident physicians, and provides clinical ethics
consultations.
Moral Enhancement and the
Public Good
Parker Crutchfield
First published 2021
by Routledge
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and by Routledge
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Routledge is an imprint of the Taylor & Francis Group, an informa
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© 2021 Parker Crutchfield
The right of Parker Crutchfield to be identified as author
of this work has been asserted by him in accordance with
sections 77 and 78 of the Copyright, Designs and Patents Act
1988.
All rights reserved. No part of this book may be reprinted
or reproduced or utilised in any form or by any electronic,
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ISBN: 978-1-032-01885-0 (hbk)
ISBN: 978-1-032-02086-0 (pbk)
ISBN: 978-1-003-18179-8 (ebk)
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Contents
Preface viii
Acknowledgments ix
Introduction 1
1 Disease and Treatment 10
Treatment and Enhancement 12
Health and Disease 15
Comparative Health 16
The Traditionalist Response 18
Contextualism About Health and Disease 20
Contextualism and the Treatment/Enhancement Distinction 26
2 Preventing Harm 28
Ultimate Harm 29
Preventing Extinction 29
Duties to Future Persons 30
Duty to Protect 35
Duty to Protect in Nonidentity Cases 38
3 An Epistemic Argument for Compulsory Moral
Bioenhancement 42
The Problem 44
Epistemic Burdens 50
What’s on the Menu 51
The Epistemic Burdens of Available Options 52
From Epistemic Burdens to Enhancement 54
Bioliberal Moral Psychology 58
Compulsory Moral Bioenhancement 61
Conclusion 63
vi Contents
4 A Moral Argument for Compulsory Moral
Bioenhancement 64
Agar on Moral Post-persons 64
Moral Exemplars 66
We Should Engender Moral Post-persons 68
From Moral Post-persons to Compulsory Moral
Enhancement 70
5 The Proposal 74
6 The Epistemology of Moral Bioenhancement 80
The Reflection Problem 80
The Moral Hallucination Problem 82
The Trustworthiness Problem 83
The Rational Irrationality Problem 84
The Free Rider Problem 86
Recommendation 87
7 Covert Moral Bioenhancement 90
Compulsory Moral Bioenhancement Is a Matter of Public
Health 90
Public Health Ethics Frameworks 92
Covert Moral Bioenhancement 93
Values in Public Health Ethics 93
Conditions in Public Health Ethics 97
Implementation 98
Objections 101
It’s Unrealistic 101
It’s Dishonest 102
It’s Unlike Other Public Health Programs 102
It’s Paternalistic 104
It Diminishes Autonomy 104
It’s Inegalitarian 107
Incompetent Administrators 108
Conclusion 109
8 Transparency 111
What Justifies Transparency? 112
Respect for Persons 112
Trust and Transparency 116
Accountability 119
Public Justification 120
Stealth Democracy 122
Contents vii
Covert Compulsory Moral Bioenhancement and Stealth
Democracy 126
Paternalism 127
Private Institutions in Public Health 128
9 Libertarian Covert Compulsory Moral Bioenhancement 131
Liberty and Ultimate Harm 132
Clean Hands 134
Clean Hands and Covert Compulsory Moral
Bioenhancement 136
Minor Intrusions 139
Compatibility Between Covert Compulsory Moral
Bioenhancement and Libertarianism 142
Covert Compulsory Moral Bioenhancement Is a Minor
Intrusion 144
What Difference Does Covert Make? 147
Right to Privacy 149
Egalitarianism 151
Conclusion 152
10 Conclusion 154
Objections 154
The Covert Enhancement Hypothesis 162
The City Walls 163
References 164
Index 172
Preface
I argue for one central claim: someone should administer a biological inter-
vention upon our moral capacities and should do so covertly, without the
people who are receiving the intervention believing that they are receiving
it. This is a radical and, initially, deeply counterintuitive claim. I am often
asked if I really believe it. The answer is: I think the arguments in favor of
it are better than the arguments against it. The arguments that follow are
as much about the limits of the burdens we are willing to accept and the
sacrifices we are willing to make to ensure survival as they are about moral
enhancement. What I hope emerges is the idea that our moral capacities are
extremely limited, relative to the task of ensuring survival. I attempt to offer
a method of repairing this limitation. Maybe there are other ways. Do I walk
around believing that we really should covertly manipulate everyone’s moral
capacities? No, but the alternative needs defense, especially in the face of
what I think are good arguments against it. In part, this project is an invita-
tion to others to offer such a defense.
The project began merely as a way of testing the limits of bioethics. The
central claim challenges the foundation of the field, something which those
in bioethics do too rarely. An underlying premise for my central claim is
that, taken as a collective, we are all quite bad at figuring out what to do.
We are bad at thinking and bad at acting in ways that achieve the things
we think we want to do. In short, we are incompetent. I am no exception.
I have been persuaded by the arguments and I hope that they persuade those
who read this book. However, my central aim of the book is not to convince
others of the central claim. It’s simply to make the claim seem less counter-
intuitive, less reactionary. Perhaps others will pick up where this project fails
and develop something that may end up saving us.
As the argument developed, so did my confidence that the conclusion is
right. Unsurprisingly, my confidence that we will all be fine went down.
I am a realist and this is a realistic book. But all professed realists are just pes-
simists in bad disguise. There is no reason for optimism. Realistically, we, or
the next generation, or the generation after that, are all doomed. Evidence
for hope or optimism is easily defeated by the mountains of evidence that
we are lost.
Acknowledgments
I am grateful to many colleagues and friends for their role in helping to
shape the ideas in this book. I am especially grateful to Tyler Gibb, Mike
Redinger, and Scott Scheall for offering support, feedback, and discussion
over the several years that the ideas in this book developed. I also thank
the anonymous reviewers for Routledge, Jonathan Anomaly, Jason Eberl,
Andy Khoury, and Mark Navin for offering feedback on some of the chap-
ters. Fabrice Jotterand and Devan Stahl brought to my attention some of
the objections in the final chapter, for which I am grateful. Thank you to
Andrew Beck at Routledge, whose support made this book possible.
Chapter 7 was originally published in Bioethics, 2019, 33(1), 112–121,
and is reprinted here with permission from John Wiley and Sons. Other
chapters were adapted from a series of papers. Chapter 3 is adapted in part
from Crutchfield (2016). Chapter 4 is adapted from Crutchfield (2020b).
Throughout the book, I have incorporated considerations partly drawn from
Crutchfield (2020a). Some of the objections in Chapter 10 are motivated by
and adapted from considerations originally explored in Crutchfield (2018).
