Limits to human enhancement: nature, disease, therapy or betterment?

2018

Transfus Med Hemother

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Connecting the circulatory system of old and young mice (parabiosis) is documented to have rejuvenating effects on cells, tissues, organs, and functions. A wide range of benefits are envisioned. Blood-based rejuvenation can come to totally change population health and aging. The first blood rejuvenation studies on humans with Alzheimer's disease have started. It puts blood at the center of therapy and revitalizes the historical line of humoral pathology from Hippocrates and Harvey, creating a new type of ‘bloodletting.' However, moving from mice to men requires careful consideration. Parabiosis actualizes well-known ethical challenges, such as just distribution of health care, avoiding disparities, and providing equal access to health care resources, as well as issues of human enhancement. However, it also poses new problems. Using internal substances in some persons as means to rejuvenate others calls for ethical reflection. New type of ‘blood bonds' may result from the continuous demand for specific types of blood. Even if rejuvenating substances from blood may be artificially and cheaply produced and justly distributed, problems arise: survival may have to be balanced against reproduction, as reproductive age increases. Eternal youth and endless bliss have always been vital human dreams. Although parabiosis may bring us closer to the fountain of youth than ever, it is still too early to provide full-fledged assessments of its implications or to foresee how it will change health, aging, medicine, and society. However, in order to bring our reflective abilities on par with our technical skills, we need to start reflection now.

Section: Invigorating Existing Challenges: Therapy Versus Enhancementmentioning

confidence: 99%

Young Blood Rejuvenates Old Bodies: A Call for Reflection when Moving from Mice to Men

2018

Transfus Med Hemother

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“…By unwarranted expansion of disease medicine broadens and blurs its borders. When "anything and everything" becomes disease, the concept of disease cannot be used to demarcate medicine (24).…”

Section: Inflating Disease -Depleting Medicine and Its Major Assetmentioning

confidence: 99%

Expanding disease and undermining the ethos of medicine

2019

Eur J Epidemiol

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The expansion of the concept of disease poses problems for epidemiology. Certainly, new diseases are discovered and more people are treated earlier and better. However, the historically unprecedented expansion is criticised for going too far. Overdiagnosis, overtreatment, and medicalization are some of the challenges heatedly debated in medicine, media, and in health policy making. How are we to analyse and handle the vast expansion of disease? Where can we draw the line between warranted and unwarranted expansion? To address this issue, which has wide implications for epidemiology, we need to understand how disease is expanded. This article identifies six ways that our conception of disease is expanded: by increased knowledge (epistemic), making more phenomena count as disease (ontological), doing more (pragmatic), defining more (conceptual), and by encompassing the bad (ethic) and the ugly (aesthetic). Expanding the subject matter of medicine extends its realm and power, but also its responsibility. It makes medicine accountable for ever more of human potential dis-eases. At the same time it blurs the borders and undermines the demarcation of medicine. Six specific advices can guide our action clarifying the subject matter of medicine in general and epidemiology in particular. To avoid unlimited responsibility and to keep medicine on par with its end, we need to direct the expansion of disease to what effectively identifies or reduces human suffering. Otherwise we will deplete medicine and undermine the greatest asset in health care: trust.

“…The argument appears to depend on a philosophical issue that has not been settled yet, and which appears to haunt the enhancement debate: what do we mean by "good"? (Hofmann 2017) No doubt, progress has been made and moral goodness has been considered to be something universal defined as "what gives each of us the sense that we are worthy human beings" and it is argued that we have "five moral spheres," i.e., harm, fairness, community (or group loyalty), authority and purity that "are universal, a legacy of evolution." (Pinker 2008) Despite these efforts, there still exists considerable disagreement on what is morally good for human beings.…”

Section: A1: We Know What Is Morally Good and What We Want To Obtainmentioning

confidence: 99%

The gene-editing of super-ego

Med Health Care and Philos

2018

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New emerging biotechnologies, such as gene editing, vastly extend our ability to alter the human being. This comes together with strong aspirations to improve humans not only physically, but also mentally, morally, and socially. These conjoined ambitions aggregate to what can be labelled "the gene editing of super-ego." This article investigates a general way used to argue for new biotechnologies, such as gene-editing: if it is safe and efficacious to implement technology X for the purpose of a common good Y, why should we not do so? This is a rhetorical question with a conditional, and may be dismissed as such. Moreover, investigating the question transformed into a formal argument reveals that the argument does not hold either. Nonetheless, the compelling force of the question calls for closer scrutiny, revealing that this way of arguing for biotechnology is based on five assumptions. Analysis of these assumptions shows their significant axiological, empirical, and philosophical challenges. This makes it reasonable to claim that these kinds of question based promotions of specific biotechnologies fail. Hence, the aspirations to make a super-man with a super-ego appear fundamentally flawed. As these types of moral bioenhancement arguments become more prevalent, a revealing hype test is suggested: What is special with this technology (e.g., gene editing), compared to existing methods, that makes it successful in improving human social characteristics in order to make the world a better place for all? Valid answers to this question will provide good reasons to pursue such technologies. Hence, the aim is not to bar the development of modern biotechnology, but rather to ensure good developments and applications of highly potent technologies. So far, we still have a long way to go to make persons with goodness gene(s).