Stuart Derbyshire, 29 September 2006
By 2100 the typical American may attend a family reunion in which five generations are playing together. The great-great-great-grandma is 150 years old, and she will be as vital as she was when she was 30…She’ll be able to chat about the academic discipline – maybe economics – that she studied in the 1980s with as much acuity and depth of knowledge and memory as her 50-year-old great-granddaughter who is now studying the same thing. No one in her extended family will have ever caught a cold…Beyond their health and their wealth, they’ll be able to control things such as anti-social tendencies and crippling depression. And they’ll manage these problems by individual choice, through new biotech pharmaceuticals and personalized genetic treatments.
- Ronald Bailey, ‘Who’s Afraid of Human Enhancement? A Reason debate on the promise, perils, and ethics of human biotechnology’, Reason, January 2006
The future, according to science writer Ron Bailey, is bright so long as we allow the enhancement of human beings to move forward and adopt genetic, immune and neuropharmacological techniques to make life better. Bailey is not without support (Hughes 2004; Naam 2005). But amongst those who have spoken out, his positive view is in the minority. Neuroscientists such as Professor Steven Jones (8.5.2003), social commentators such as Francis Fukuyama (2003), and ethicists such as Leon Kass (2004) have raised considerable concerns about the negative consequences of neuropharmacological or genetic human enhancement. I will argue that the downside of human enhancement is being exaggerated but I will also argue that it hardly matters because human enhancement, at least on the scale described by Bailey, is simply not credible.
Let us first look at a small selection of the arguments waged against human enhancement.
Attempts at human enhancement will alter human nature
Fukuyama (2003) worries that engineering human beings to be smarter, stronger, faster and so forth will undermine the human essence, and ‘move us into a “posthuman” stage of history’. This argument lacks force because improving our own state of being is the most human thing we do. The development of medicine, industry, transportation, communication, clean water, a stable food supply, warm habitats and so on are entirely human affairs. There is nothing ‘posthuman’ about extending the manipulation of nature to our own bodily processes. We have already altered human nature by living longer and healthier lives than at any previous time in history. Most of us think this development is positive.
Attempts at human enhancement will hand over power to the pharmaceutical companies
Steven Rose (8.5.2003) talks of a powerful ‘neurogenetic-industrial’ complex holding sway over our inner lives. It is certainly true that pharmaceutical companies stand to make immense gains if they can manufacture products to bring about the kind of future Bailey describes. I have sympathy with those that object to the concentration of wealth and power in the hands of a few companies – but that is a social problem, not a problem of innovation as such. Innovation remains a good even in a society that distributes wealth and power inequitably.
Attempts at human enhancement will exacerbate inequalities
A related objection to human enhancement efforts is that they favour the rich. If there is a pill to make a person smarter, then the rich will buy it to become smarter. To suggest that human enhancement should halt so as to not make inequality any worse is, however, a grotesquely negative solution. It is an argument for innovation to stop, which would be bad for everybody. A pill to make you smarter and healthier could eventually be much more accessible than exclusive schools and private healthcare. We may object to the rich having preferential access to better education and healthcare, but we do not advocate abolishing education and healthcare to close the gap.
Attempts at human enhancement will make us all the same
If human enhancement will not exacerbate our differences, then perhaps it will smooth them all away until we are one bland ocean of sameness. It is desperately unlikely that any intervention can iron away all the variations in biology, environment and personhood. Regardless, if everybody becomes equally much smarter and equally much healthier, what is the problem?
Attempts at human enhancement will be coercive
If there is a pill to make us smarter, we may eventually be forced to take it lest we fall behind everyone else. It may become increasingly difficult to attend university, get a job or obtain life and health insurance if we don’t consume the human enhancement products. Pressure to consume a cheap, highly efficacious, easily available and safe pill to enhance performance is quite possible. The pressure to consume, however, would be comparable to adopting other seemingly more mundane practices. Families face pressure to buy a computer and provide internet access for their children. Young adults face pressure to go to university. Clearly we are able to manage these pressures and live with the decisions we make.
Attempts at human enhancement will undermine real achievement
Taking a pill is certainly easier than studying, but it is impossible, despite the diminished standards of current university education, to put a degree inside a pill. At best, the pill will make studying less of an effort. If a pill makes studying easier that might make the degree less of a challenge. But it could equally make it more of a challenge because the student is able to go deeper into their subject area. Real achievement would remain an option.
How effective can pharmacological or genetic human enhancement be?
The critics and advocates of human enhancement disagree as to the benefits but both camps seemingly agree that human enhancement will be dramatically effective. Farah and colleagues, for example, recently wrote: ‘Humanity’s ability to alter its own brain function might well shape history as powerfully as the development of metallurgy in the Iron Age [or] mechanization in the Industrial Revolution’ (Farah et al 2004).
Much excitement was generated when researchers reported improved memory and learning ability in two strains of genetically modified mice by altering a piece of the brain called the hippocampus (Farah et al 2004; Tang et al 1999; Manabe et al 1998). Given that the hippocampus is critical to human memory as well as to mouse memory, the implication is that manipulations of human hippocampal function will improve human memory. But there are important differences between memory and abstract knowledge. Knowledge for humans does not come from simple interactions with the environment, but from reasoning and formal acts of studying that cannot possibly be put inside a pill – War and Peace must still be read and digested by the mind, not eaten and digested by the stomach.
Much excitement was also generated by the development of the specific serotonin reuptake inhibitors (SSRIs) such as Prozac. Serotonin is a neurotransmitter believed to be responsible for regulating aspects of mood and a lack of serotonin is believed to play a key role in producing depression. If a pill can be used to make a sad person happy, logic suggests that the same pill can make a normal person happier. But again, the truth is much more complex. While low serotonin is a general marker of depression, depressed patients routinely have normal or elevated levels of serotonin. In addition, some antidepressants do not act upon the serotonin system at all but work on other neurotransmitter systems, while others work on the serotonin system in conjunction with other systems. In actual clinical practice, the SSRIs are rarely used in isolation and rarely provide evidence for recovery from depression by restoring the balance of serotonin to the brain. Actual treatment is a trial and error process which betrays very little evidence of understanding. In a description of his battle with depression, Andrew Soloman (12.1.1998) recounts his experience:
Zoloft made me feel as though I’d had fifty-five cups of coffee. Paxil gave me diarrhea, but fortunately Xanax, though it made me exhausted, was also constipating. Paxil seemed better than Zoloft, and I soon adjusted to its making me feel as though I’d had eleven cups of coffee – which was definitely better than feeling as though I couldn’t brush my own teeth.
Solomon was variously prescribed Zoloft, Xanax, Paxil, Navane, Valium, BuSpar and Wellbutrin in an effort to alleviate his depression. His list is relatively short, mainly because he did eventually get well. Whether Solomon got well because of the drugs or despite them is highly contentious. It is well known that placebos, sugar tablets with no pharmacological content, provide for a high rate of recovery that is close to, if not the same as, the SSRIs themselves (Kirsch et al 2002).
Two broad lessons should be taken from this brief discussion of serotonin. Firstly, there is no compelling rationale for why the SSRIs stop depression; there is no clear pathophysiology of depression that is being targeted by the SSRIs. Secondly, there is no rationale for believing that the SSRIs are the beginning of a new revolution in manipulating human emotions. Low serotonin has been under suspicion as the cause of depression for almost 50 years. Yet we still do not have a clear understanding of the role serotonin plays in regulating emotion or a universally effective treatment for depression.
The currently minimal effects of antidepressant medication and the almost certain failure of any drugs that promise to make us smarter is entirely understandable. There is no means by which human beings can be put inside drugs or even DNA. Neurons and DNA are not the place where distress, happiness and knowledge will be found, as is explained in important detail elsewhere (Tallis 2004).
In summary, there is much hand-wringing over a science that has barely begun. Both those who see the future as bright and those who see it as dark should calm down. Their expectations for the future are excessive – so let us relax and allow the scientists to do their work. Let them be curious. Let them explore. And let us see what the future brings.
Stuart Derbyshire is senior lecturer, School of Psychology, University of Birmingham
Farah, M.J., J. Illes, R. Cook-Deegan, H. Gardner, E. Kandel, P. King, E. Parens, B. Sahakian & P.R. Wolpe (2004) ‘Neurocognitive enhancement: what can we do and what should we do?’ Nat Rev Neurosci 5: 421-5.
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Hughes, J. (2004). Citizen Cyborg: Why Democratic Societies Must Respond to the Redesigned Human of the Future. New York, Basic Books.
Jones, S. (8.5.2003). ‘Brave new brain’. The Guardian. http://www.guardian.co.uk/life/lastword/story/0,13228,951057,00.html
Kass, L. (2004). Life, Liberty, and the Defense of Dignity: The Challenge for Bioethics. Washington, DC, AEI Press.
KirschI., T.J. Moore, A. Scoboria & S.S. Nicholls (2002). ‘The emperor’s new drugs: An analysis of antidepressant medication data submitted to the U.S. Food and Drug Administration’. Prevention and Treatment 5.
Manabe, T., Y. Noda, T. Mamiya, H. Katagiri, T. Houtani, M. Nishi, T. Noda, T. Takahashi, T. Sugimoto, T. Nabeshima & H. Takeshima (1998). ‘Facilitation of long-term potentiation and memory in mice lacking nociceptin receptors’. Nature 394: 577-81.
Naam, R. (2005). More Than Human: Embracing the Promise of Biological Enhancement. New York, Broadway Books.
Solomon, A. (12.1.1998). ‘Anatomy of melancholy’. The New Yorker: 46-61.
Tallis, R. (2004). The Knowing Animal: A Philosophical Inquiry into Knowledge and Truth. Edinburgh, Edinburgh University Press.
Tang, Y.P, E. Shimizu, G.R. Dube, C. Rampon, G.A. Kerchner, M. Zhuo, G. Liu & J.Z. Tsien. (1999). ‘Genetic enhancement of learning and memory in mice’. Nature 401: 63-9.
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