Resnik-therapyenhancement20morality

Introduction

• The therapy-enhancement distinction is central in human genetics discussions.

• Debate focuses on the morality of genetic interventions, with gene therapy seen as legitimate, while enhancement raises ethical concerns.

• This essay examines the moral implications of this distinction, questioning if enhancement is inherently immoral.

Types of Genetic Interventions

• Somatic Interventions: Modifies somatic (non-reproductive) cells.

• Germline Interventions: Modifies germ (reproductive) cells, affecting future generations.

• Four Types of Interventions:

  • Somatic Genetic Therapy (SGT)

  • Germline Genetic Therapy (GLGT)

  • Somatic Genetic Enhancement (SGE)

  • Germline Genetic Enhancement (GLGE)

• Potential risks of SGT affecting germ cells complicate ethical considerations.

Concepts of Health and Disease

• Morality of genetic interventions hinges on definitions of health and disease.

• Value-Neutral Approach: Defines health and disease based on biological functions and capacities typical of the species (e.g., Boorse's statistical normality).

• Value-Laden Approach: Defines health and disease based on social and cultural norms, allowing for subjectivity in interpretations of conditions like schizophrenia or homosexuality.

• Implication: Neither approach alone can provide solid moral boundaries between therapy and enhancement.

The Goals of Medicine

• Examination of what constitutes the goals of medicine:

  • Treatment and prevention of diseases.

  • Promotion of human health and well-being, and relief of suffering.

• Enhancement procedures can serve medical goals similarly to therapeutic procedures, raising questions about ethical boundaries.

Humanness and Its Alterations

• Arguments against enhancement: it changes human characteristics, while therapy preserves them.

• Defining traits that constitute our humanity is complex; ethical concerns arise if such traits are altered.

• Philosophical perspectives suggest:

  • Utilitarianism: Changes to humanness could be morally right or wrong based on outcomes.

  • Kantian Ethics: Changes may violate dignity and autonomy only under certain conditions.

  • Natural Law Theory: Argues that altering the human form is inherently wrong due to inherent moral worth.

The Rights of the Unborn

• Arguments against genetic enhancement often cite violation of unborn children's rights due to:

  • Experimental nature of interventions.

  • Rights to unmanipulated genomes or an open future.

• Consideration of proxy consent and interests can complicate these assertions, suggesting that enhancement could benefit future choices.

Eugenics

• Genetic interventions raise concerns of eugenics (manipulation of the gene pool).

• Positive vs. Negative Eugenics:

  • Positive seeks favorable genes; negative aims to limit harmful genes.

• State-sponsored eugenics raises significant moral concerns, while parental eugenics is often viewed as acceptable.

Conclusion: Reevaluating the Therapy-Enhancement Distinction

• Rachels challenged moral distinctions within medical ethics.

• The author stresses that both therapy and enhancement can be morally justified or unjustified based on circumstances and outcomes.

• Implications for public policy should consider potential risks, benefits, and ethical considerations beyond mere classification.

• The therapy-enhancement distinction may mostly address societal fears and hopes regarding genetic interventions rather than define strict moral boundaries.