Do we want smarter, faster, better humans? Opportunities and risks of human enhancement
25 Sep 2013
There is a great deal we know about human enhancement; there is a lot we do not know. We know that moderate caffeine consumption is harmless; we do not categorically know that taking Ritalin among otherwise healthy patients is not. There are significant potential financial costs to human enhancement not visible today. As such it is important for re/insurers to observe the usage of enhancement products within society and the risks they may pose.
To defy boundaries is an ambition as old as humankind itself. Indeed, humankind has come far in that endeavour – with manned space travel, human genome sequencing and global access to the Internet to count among its achievements. Similarly, humankind has always sought to push the limits of the human body's physical abilities and appeal. Advances in science and technology are opening up new opportunities to live these age-old dreams. While some yearn to transform their body and mind at will, others object to and resist the very idea.
Struggling to keep up
Human enhancement aims to improve the capacities and characteristics of the human body. Precisely what "improvement" means, however, comes down to a value judgment. Different sectors of society will have different perspectives. To some, a beautiful body is achieved through rigorous workouts and disciplined weight control; others prefer a more natural appearance that speaks of an unstressed joie de vivre. Moreover, prevailing tastes can change over time. In the 1970s, neuroenhancement was seen primarily as a path to mind expansion; today it is employed more and more in the pursuit of professional and personal success.
Human enhancement involves a range of techniques and technologies, from botox injections and plastic surgery to transcranial magnetic stimulation and artificial implants. The most widely available and advanced approach is enhancement through pharmacological agents. These includes potent illegal drugs such as cocaine as well as prescription drugs like Modafinil. However, pharmacological agents are also at the base of "everyday" enhancement including coffee and energy drinks, cosmetics and nutritional supplements as practised by a vast segment of the Swiss population, largely without any side effects.
To date, no large-scale studies are available to indicate how widely used more potent forms of pharmacological enhancement are or what the motives and experiences might be of those who use them. Yet there has been research on sub-segments such as neuroenhancement among students and pharmacological enhancement in the workplace. The findings of such research suggest that the use of more serious neuroenhancers is not primarily the domain of high-flying overachievers, contrary to what we might infer from media coverage of doping practices in professional sports or of drug use among commercially successful musicians. More often than not, those resorting to illegal substances or prescription drugs to enhance their performance appear to be people who struggle to compete in today's performance-driven society – employees in fear of failing to live up to the demands of their jobs; students battling to pass exams; juveniles bulking up their physique to combat their low self-esteem.
Enhancement and risk
Currently, only a small fraction of the population uses illegal substances or prescription drugs for enhancement purposes. Among Swiss men and women, safety concerns appear to outweigh any perceived benefits, especially with regard to neuroenhancement. Many also fear for their individual identity and feel it is wrong to push the natural limits of human performance. Their concerns are valid, for the benefits shown in scientific studies on neuroenhancement have been modest at best. At the same time, users risk developing a dependency mentally and often physically, suffering side effects or enhancing some abilities at the expense of others.
People who use prescription drugs to enhance their performance sometimes buy those products online. In some cases, family members, friends or acquaintances share their prescription medication with healthy individuals. There are also physicians who prescribe drugs for enhancement purposes. A key deciding factor in that regard is where a given doctor draws the line in the grey area between "healthy" and "sick". Is a student suffering from debilitating exam performance anxiety simply highly anxious or is he suffering from a proper anxiety disorder? Is it justifiable to prescribe him a beta blocker for his coming exams? Different doctors may have different answers to these questions.
At this stage, the use of more potent pharmacological enhancement is not widespread. There is little prospect of technological breakthroughs that would pave the way to wider use of enhancement practices. Like other areas of science, the pace of change is frequently slower than many perceive or would hope.
Individualism and meritocracy
All the same, it is imperative at a political level to keep monitoring human enhancement as it develops, because the forces driving the wider adoption of human enhancement are powerful, and once human enhancement is established, it might gather momentum. Social developments such as meritocracy and individualism today are paving the way for human enhancement. Modern medicine and the health care system are the pathways by which human enhancement is making inroads into society: certain symptoms and mental states that used to be considered part of the normal spectrum are increasingly diagnosed as an illness or disorder, giving rise to biomedical intervention. Medicalisation refers to the tendency to diagnose ordinary variations in mood or behaviours as illnesses, and to treat them biomedically. One can add to this the off-label use of prescription drugs, anti-ageing and preventive treatments, which open further doors to human enhancement. The market for more potent enhancement products is potentially lucrative and therefore likely to attract suppliers to actively develop such products. Moreover, there is the prospect of a more effective enhancement product with few side effects quickly establishing itself within our society, whether approved by the local regulator or not.
For society, human enhancement comes with significant risks attached. These include health risks for users, especially long term risks that show only years later. Human enhancement also makes for an unlevel playing field in competitive situations; doping among athletes is a case in point. In the future, human enhancement may require usage regulation in the educational and professional arenas, although enforcing such rules will likely prove difficult. Human enhancement tends to make our society less diverse. When large numbers of people pursue the same ideals with a leg up from biomedicine, some of the productivity and wealth we gain through diversity is lost. Crucially, once established, effective human enhancement gains a momentum of its own that will leave us with fewer personal liberties. Who will be able to resist human enhancement in the workplace once their office colleague is pulling miles ahead as a result?
The society we want
The current debate around human enhancement in society presents us with a major window of opportunity. To some degree, however, human enhancement is already a reality in our society. We stand to gain much valuable insight by taking a closer look at the blurred lines between health and illness, the grey areas between legal and illegal uses of biomedical aids, both with regards to current and future usage. Ultimately, human enhancement raises certain fundamental questions for our political leadership but that are no less vitally important for each and every one of us: what kind of society do we want? How much do we want to change who we are?
The various issues surrounding human enhancement are discussed in greater detail in a study published by TA-SWISS. TA-SWISS assesses the likely impact of new technologies and provides recommendations to aid Parliament and the Federal Council in its deliberations and decision-making, in particular on controversial technology issues. The findings of the Human Enhancement Project are available for download at http://www.ta-swiss.ch/human-enhancement/ (in German).
Anne Eckhardt was a speaker at the Centre's conference Human enhancement technologies: pushing the boundaries.
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