In his article, Brey seeks to make an argument that medicine should expand their foci from just health and therapy to include research on human enhancement effects and implementation of those enhancements. He makes his case that there should be extensive trials in medical research and policy. While I agree with him to some extent, I think that throughout the piece he has overlooked, or did not include here, human enhancement technologies (HETs) throughout history and the way they have been handled for better or worse.
Therefore, while I agree that we need to explore the social implications, I think that to strengthen Brey’s argument there should be more inclusion and acknowledgement of the past to build up the logical reasons to shift the medical foci of the present or future. Consider questions such as, have we extensively done what he is calling for with other human enhancement technologies?
For example, with the introduction of birth control, which gave us control over our reproductive capabilities, did we analyze all the possible social effects that came with this? Did we hold off on our ability to enhance our reproductive systems based on similar types of research? Why or why not? How did this effect implementation of these technologies? How could it have been done better?
This is of particular interest when he asks the same of HETs and holds them to this standard because of the change in the methodological approach to enhancements, as I will discuss. He says that, “Human enhancement should then be carefully regulated based on the outcomes of such assessments.” There is an element of control here that he thinks medicine should have in the area of human enhancements that has/is not currently done with such rigor.
Take cosmetic surgery for example. It has been around since the Egyptians. We have a lot of history of social implications that can be examined to apply to today and the technology has been modified and is still around today with further need to examine the implications. I have published on the topic of cosmetic surgery, delving into the ethical and familial ramifications of cosmetic surgery. I do not know though that the field of medicine is the right place to look for an unbiased or unvested assessment of the social ramifications of HETs.
I would argue that while Brey is correct in what he calls for in his argument, it should be shifted instead to call for philosophers and culture critics outside of the immediate HET technologies to shed light on the social implications. Even then, the light needs to be shed on the implementation of these technologies through a variety of cultural lenses.
To delve further then into his argument’s pros and cons, I have an issue with his discussion of inequality or harm to self-esteem as a reason to hamper human enhancement technologies. Brey says that, “Very few prostheses that currently exist can be understood as genuine enhancements, since most of them are not capable of performing better than normally functioning organs.”
Currently, though, there are prosthetics that are in process and available that have become aesthetically more attractive; there are prosthetics that are improving natural capabilities. There is also discourse on the fact that it is reasonable to explore the reality of whether or not people might choose to have a prosthesis over a natural limb because of the advantages over a natural arm. Part of the advances of this particular research is coming from the government because of the soldier’s coming back from the war in Iraq and Afghanistan losing limbs. Should we deny them an option of an upgrade because of unfortunate accident or electivity because it will hurt someone else’s self-esteem?
He talks about what defines us as unique, but implies that those qualities by which we define our uniqueness only come from natural or experienced attributes. I would argue that the introduction of human enhancement should not be any different from those we come by naturally. The way you are regardless fits into this argument, and again has been going on for years, he overlooks the historical change that we have experienced and how that factors in to our personal identity. We are not stagnating as humans there has been change and there will be change. We are not perfect in our current state of evolution and we will not always be what we are, we will be different naturally or technologically regardless.
Brey says that, “Unenhanced human beings may come to see themselves as incomplete and inferior in comparison to new norms of normality, and their self-esteem is likely to suffer as a result.” His argument is that we allow no enhancement or selective enhancement based on the argument that some people are going to get their feelings hurt. But why limit ourselves in our expression because somebody will be offended? This has not stopped us before. This exists in society now, where some people are naturally advantaged over others and that lowers self-esteem, but we do not take away the enhancement or advantage because it brings a few people down. What if this same argument was applied to previous technologies that had an impact on esteem or identity which medicine deemed as having an ill effect?
His argument goes on that, “It has been argued that human enhancement may bring about a devaluation of achievement through the disposability of effort.” This argument was touched on earlier in the chapter and it seems, again, that a historical perspective would push this argument along better.
As we have seen through the example of Oscar Pistorius, despite enhancements or prosthetics, it is still necessary to put forth effort and achieve. Pistorius had prosthetic running legs, but he still had to qualify to participate in the Olympics and did not. There was more to him than his prosthesis. Once you move past a perceived aesthetic difference, it still comes down to the personal achievement of the human to get them somewhere beyond what they can achieve through enhancement alone.
At times, Brey fails to take into account the world around him through the lens he is trying to apply, in addition to overlooking the HETs of the past. He writes:
In modern societies, then enhancements will be goods that can be bought and sold. In other words, they will be commodities. Consumers can buy height, intelligence, beauty and a pleasant personality, and companies can sell such products.
He says this like it is far off into the future, which it is not. We have a form of these enhancements today and they are already commoditized, e.g. height in the form of high-heel shoes, intelligence we buy from universities or books, beauty through cosmetic surgery or make-up or over the counter treatments, and pleasant personalities through current prescriptions that make you happier or sadder depending on her personality “deficiency.”
We buy better eyes through contacts or Lasik, we buy better bodies through access to gym equipment, we buy better feet through athletic shoe technologies. He is correct; this is exacerbated with advertising and is imported to foreign countries through selling the white ideal as something that women in other countries have a hard time to aspire. Women are being sold to whiten their skin as a result, this is being researched, and those researchers are trying to address the cultural effects of this type of advertising.
The point that I am making then is that while the method of human enhancement technologies may be new, the overall idea behind them is not. This is similar to arguments made with writing and other media technologies. What Brey calls for in his argument is important; there should be examination of HETs for their social implications. It is important to understand what we as a society are getting into.
I would argue that Brey take into consideration some of the benefits of the HETs he is discussing and some of the history to push forward this overall argument more effectively.