The Price of Perfection: Individualism and Society in the Era of Biomedical Enhancement (review)
- The Price of Perfection: Individualism and Society in the Era of Biomedical Enhancement
At least since the NEH-funded Hastings Center project that resulted in the publication of Enhancing Human Traits: Ethical and Social Implications, biomedical ethicists' interest in issues raised by biological intervention to enhance human capacities has risen slowly but steadily. Recently, however, engagement with this topic has had a spurt of growth, as more and more writing about it appears. The standard attitude toward applying biomedical knowledge to achieve human enhancement also has evolved, for fewer bioethicists and policy makers exhibit unmitigated horror at the prospect and an increasing proportion opt for a more moderate, balanced view.
Very likely this change is the product of a confluence of events, including both a more nuanced understanding of human biology and a heightening level of comfort with the concept of regenerative medicine. As for the latter, the promise of effective capacity responses to widely suffered degenerative conditions such as Alzheimer's disease has been a powerful political motivator. As for the former, the prospect of producing a small elite with superpowers, leading to oppression of the [End Page 231] unenhanced, now seems both less immediate and less threatening than it did, possibly because many of the more plausible enhancement scenarios either do not offer to elevate powers with such capacity, or else carry drawbacks that constrict the benefits their biological improvements bestow. Moreover, neither regenerative medicine nor computational engineering seem posed to create a new version of Cro-Magnon man who will replace ordinary Neanderthalers. Indeed, new biological information about the evolution of primates challenges the old idea of a more perfect version of humans replacing a less perfect one.
In The Price of Perfection: Individualism and Society in the Era of Biomedical Enhancement, Maxwell J. Mehlman claims a place squarely in the middle of the moderate camp. By no means a transhumanist pressing for resources to develop enhancement technologies in order to remake humankind in dramatic ways, Mehlman also avoids the opposite extreme, namely, promoting alarmist interdiction of advances in bio-medicine that could elevate the effectiveness of human functionings beyond their current capacity. Mehlman concludes that biomedical enhancement technologies neither can nor should be banned but ought instead to be controlled, mainly by extending and enlarging existing mechanisms for regulation of medical research and treatment.
The book contains many proposals for more regulation. A recurrent theme is to enlarge FDA authority so as to reach to cosmetic applications. To give another example, Mehlman also advises returning to the Recombinant DNA Advisory Committee its former power of approval over molecular biological research.
Mehlman touches on but does not thoroughly examine the multiple aspects of enhanced regulation's feasibility. As a consequence, The Price of Perfection does not advance a sufficiently nuanced approach to the festering and agonizing conflict between patients demanding quick access to products of cutting-edge research they view as last-resort interventions, on the one hand, and on the other hand, regulators requiring deliberate and thorough testing of these same products. Mehlman does not, that is, resolve even in part the problem of developing a regulatory system for innovative medical intervention that brings risk-aversive policy into alignment with achieving the quickest, greatest, and most widespread benefit, and especially one that acknowledges the special "last resort" needs of otherwise hopeless patients. By no means is this an easy problem to tackle, but neither is it an avoidable one. The problem takes on additional depths of complexity because a repercussion of responsible ethical and political caution about making human performance and capacity better seems to be deceleration of access to regenerative medicine. [End Page 232]
Mehlman's position on enhancement in The Price of Perfection departs somewhat, and for the better, from the one that informed his earlier book, Wondergenes: Genetic Enhancement and the Future of Society (Indiana University Press, 2003). The Price of Perfection is about twice as long as Wondergenes, and (an improvement, in the view of this reviewer) the author is about half as...
