He is the author, coauthor, or coeditor of several books on medical ethics and genetics, including Wondergenes ; The Encyclopedia of Ethical, Legal, and Policy Issues in Biotechnology ; and Access to the Genome. Introduction 1.
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The Technological Horizon 2. Self-Satisfaction 3. Social Reward 4. The Hegemony of Meritocracy 5. Access to Enhancements and the Challenge to Equality 6. Lack of Choice 7. Enhancements in Sports 8. The Lessons from Sports 9. The War on Enhancements Promoting Safety, Efficacy, and Informed Decisionmaking Protecting the Vulnerable Access and Inequality Abominations Research on Enhancement Conclusion Notes Index. In The Price of Perfection , Max Mehlman makes it clear that biogenetic enhancement is the human destiny. He provides an insightful tour of not only the pitfalls but also, more important, the tremendous benefits that biomedical enhancement offers humanity.
We humans will never be 'perfect,' but Max Mehlman persuasively explains why Americans will nonetheless continue to try whatever we think might make us 'better' and keep us on the road to perfection. In the process, he urges the public to face the ethical issues surrounding biomedical enhancement, lest our quest for perfection compromise our very humanity.
Subscribe Now. Table of Contents. The Price of Perfection. Individualism and Society in the Era of Biomedical Enhancement. Publication Date: Status: Available. Ancient Greek athletes swallowed herbal infusions before competitions. The Egyptians brewed a drink containing a relative of Viagra at least 1, years before Christ. But modern drug development and improvements in surgical technique are yielding biomedical enhancements that achieve safer, larger, and more targeted enhancement effects than their predecessors, and more extraordinary technologies are expected to emerge from ongoing discoveries in human genetics.
In addition, there are biomechanical enhancements that involve the use of computer implants and nanotechnology, which are beyond the scope of this article. What is also new is that biomedical enhancements have become controversial. Some commentators want to outlaw them altogether. Others are concerned about their use by athletes and children. Still others fret that only the well-off will be able to afford them, thereby exacerbating social inequality. Banning enhancements, however, is misguided.
Still, it is important to try to ensure that they are as safe and effective as possible, that vulnerable populations such as children are not forced into using them, and that they are not available only to the well-off. This will require effective government and private action. Despite the long history of enhancement use, there recently has emerged a view that it is wrong.
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The first manifestation of this hostility resulted from the use of performance enhancements in sports in the s, especially steroids and amphetamines. European nations began adopting antidoping laws in the mids, and the Olympic Games began testing athletes in Between and , Congress held hearings lambasting professional sports for not imposing adequate testing regimens. Drug testing has also been instituted in high-school and collegiate sports. The antipathy toward biomedical enhancements extends well beyond sports, however.
Officially, at least, the National Institutes of Health NIH will not fund research to develop genetic technologies for human enhancement purposes, although it has funded studies in animals that the researchers tout as a step toward developing human enhancements. It is a federal crime to use steroids to increase strength even if the user is not an athlete. Human growth hormone is in a unique regulatory category in that it is a felony to prescribe it for any purpose other than a specific use approved by the FDA.
For example, the FDA has not approved it for anti-aging purposes. There is an ongoing controversy about whether musicians, especially string players, should be allowed to use beta blockers to steady their hands.
Price of Perfection: Individualism and Society in the Era of Biomedical Enhancement
If the critics had their way, the government would ban the use of biomedical enhancements. It might seem that this would merely entail extending the War on Drugs to a larger number of drugs.
But remember that enhancements include not just drugs, but cosmetic surgery and information technologies, such as genetic testing to identify nondisease traits. So a War on Enhancements would have to extend to a broader range of technologies, and because many are delivered within the patient-physician relationship, the government would have to intrude into that relationship in significant new ways.
So there would have to be some way for the enhancement police to identify people for whom the drugs had been legally prescribed to treat illness, but who were misusing them for enhancement purposes. This leads to a far more profound difficulty. The War on Drugs targets only manufacture, distribution, and possession. There is virtually no effort to punish people merely for using an illegal substance.
In short, a ban on enhancements would have to aim at use as well as possession and sale. To imagine what this would be like, think about the campaign against doping in elite sports, where athletes must notify antidoping officials of their whereabouts at all times and are subject to unannounced, intrusive, and often indecent drug tests at any hour of the day or night. Even in the improbable event that regular citizens were willing to endure such an unprecedented loss of privacy, the economic cost of maintaining such a regime, given how widespread the use of highly effective biomedical enhancements might be, would be prohibitive.
A ban on biomedical enhancements would be not only unworkable but unjustifiable. Consider the objections to enhancement in sports. Why are enhancements against the rules? Is it because they are unsafe? Not all of them are: Anti-doping rules in sports go after many substances that pose no significant health risks, such as caffeine and Sudafed. A Romanian gymnast forfeited her Olympic gold medal after she accidentally took a couple of Sudafed to treat a cold. Even in the case of vilified products such as steroids, safety concerns stem largely from the fact that athletes are forced to use the drugs covertly, without medical supervision.
They do so only if the enhancements are hard to obtain, so that only a few competitors obtain the edge. But the opposite seems to be true: Enhancements are everywhere. Besides, athletes are also tested for substances that have no known performance-enhancing effects, such as marijuana. Not necessarily. Athletes still need to train hard. Indeed, the benefit from steroids comes chiefly from allowing athletes to train harder without injuring themselves.
In any event, success in sports comes from factors that athletes have done nothing to deserve, such as natural talent and the good luck to have been born to encouraging parents or to avoid getting hurt. Would the use of enhancements confound recordkeeping? If one athlete used enhancements, would every athlete have to, so that the benefit would be nullified?
No, there would still be the benefit of improved performance across the board—bigger lifts, faster times, higher jumps. In any case, the same thing happens whenever an advance takes place that improves performance.
Well, not exactly.