Of course, he doesn't phrase it that way. He starts by skimming past a standard set of questions: Will the technology make life better? Will it encounter enough ethical problems or skepticism to require an extra layer of approval? Then he sets the stage for the real discussion: "One of the most profound questions is about whether humans should begin to enhance themselves." He quickly follows that up with a concern about humanity being "redefined by a techno-logic, driven primarily by technical and economic feasibility."
Dr. Bruce's proposed response: "This suggests we may need to draw lines to limit some technological possibilities but promote others." As I said, this is not the kind of ethics that asks probing questions, but the kind that tells you what to think. Let's see what else we are supposed to think:
Beyond a certain basic point of physical survival and necessity, what matters most to humans are not functional and material things but the relational, the creative and the spiritual.
Well, I can survive for months with a toothache, but both I and those I'm in relationships with would prefer that I didn't suffer severe pain -- it makes me distracted, self-centered, and crabby. Now, if I were happy and sunny 100% of the time, my friends might get bored with me; it could be argued that modifying myself so that I'm never upset would be too much of a good thing. But do I need to have a diagnosis of depression before I'm allowed to modify myself?
That last question uncovers a major flaw in Dr. Bruce's argument. All through the article, he contrasts enhancement with healing as though the two were separable. In fact, they are not. Not, that is, without forming an arbitrary and artificial line between 'healthy' and 'sick' and declaring that people who are healthy should receive no further assistance. As Dr. Bruce says, "On a global scale, enhancements for a privileged few may seem a misuse of resources when faced with potentially treatable diseases..."
In other words, Dr. Bruce does not want healthy people to benefit from medical treatment. He worries that "seeing humans as functions to be improved" is only a short step away from eugenics, which "accepted others in society only if they were seen as functionally 'fit'." Unfortunately, his solution is the negative mirror image of what he fears: it creates the same division between 'fit' and 'unfit' -- but for the purpose of denying treatment to anyone who is insufficiently sick. (And he accuses transhumanists of having "an impoverished view of humanity"!) Since he would have this regime imposed, limiting the applications of technology, this division would be created in fact, rather than existing as a nebulous possibility to be tempered by the complex interplay of broader society.
It is said that one should not criticize without offering a better alternative. My alternative does not consist of proclamations -- I have already said that ethics at its best offers questions rather than statements. So what is a good source of questions?
Modern science is showing us, in example after example, that moderation is more functional than extremes. Moderation does not imply stasis -- complexity and dynamism are necessary to keep systems from stagnating. So I would ask: How can medical technologies, including nanotechnologies, help us to reach our best potential as humans in human society?
Of course this question has no simple answer. Three things seem clear: First, that identifiable medical problems should be solved where possible. Here, Dr. Bruce and I would agree. Second, that where things are "good enough," change should be undertaken slowly and cautiously. Incautious or excessive amplification of human traits may lead to situations not dissimilar from drunkenness, mania, or even autism. Third -- and here I part company with a number of proclamatory ethicists -- that there is room for improvement in today's human societies, and that whether you call it treatment or enhancement, medical technologies have the potential to make things better if used wisely by non-sick people.