BIOCONSERVATISM, BIOLIBERALISM , AND REPUGNANCE Rebecca Roache and Steve Clarke Forthcoming in Monash Bioethics Review ABSTRACT We consider the current debate between bioconservatives and their opponents-whom we dub bioliberals-about the moral acceptability of human enhancement and the policy implications of moral debates about enhancement. We argue that this debate has reached an impasse, largely because bioconservatives hold that we should honour intuitions about the special value of being human, even if we cannot identify reasons to ground those intuitions. We argue that although intuitions are often a reliable guide to belief and action, there are circumstances in which they are not reliable. Intuitions-including intuitions about enhancement-are subject to various cognitive biases rendering them unreliable in some circumstances. We argue that many bioconservative intuitions about enhancement are examples of such unreliable intuitions. Given this, it is unrealistic of bioconservatives to expect others to rely on their unexamined intuitions. Furthermore, refusing to engage in debates about the reasons and values that underpin their intuitions about enhancement will have the effect of making bioconservative voices less relevant in policy debates about enhancement than they would otherwise be. Bioconservatism, Bioliberalism, and the Wisdom of Reflecting on Repugnance 2 1. THE CURRENT IMPASSE The prospect of human enhancement-that is, the use of medicine and technology to raise our physical and mental capacities beyond the „normal‟ level 1 -raises interesting questions about what is valuable in our lives and how we can expect our biological limitations to change as technology advances. Consequently, in recent years, questions about whether enhancement is desirable, dangerous, and ethical have been keenly debated. Much of the debate concerns issues familiar from discussions of other new technologies, such as safety and equality of access. Another aspect of the debate-and one which is the focus of this paper-questions whether there is anything intrinsically morally wrong with human enhancement. On one side of this debate are bioconservatives, whom we take to subscribe to two main claims: the moral claim that human enhancement is intrinsically wrong, and the political claim that it should therefore be banned or severely restricted. Those who do not think that enhancement is intrinsically wrong, but nevertheless view the potentially undesirable consequences of particular enhancements as reason to restrict the use of those enhancements, we label biomoderates 2 . Biomoderates have not so far been very active participants in what has been a polarised debate. The chief opponents of bioconservatism, those who hold that enhancement is neither intrinsically wrong nor unusually risky, and should generally be permitted, we call bioliberals. A frequently discussed sub-category of bioliberalism, which we do not focus on here, is transhumanism, which involves not only the rejection of bioconservatism, but also the substantive claim that enhancement is desirable. Unfortunately, current debate between bioconservatives and bioliberals has stalled before reaching any meaningful consensus. In general, whilst bioliberals recognise that the availability of new technology requires us to address important questions regarding what sort of changes would constitute improvements, and how we could best introduce new technologies into society, they are clear that the availability of at least some enhancing technologies will be good for at least some people. Nick Bostrom views enhancement as a gateway to richer, more meaningful lives: Technologies such as brain-computer interfaces and neuropharmacology could amplify human intelligence, increase emotional well-being, improve our capacity for steady commitment to life projects or a loved one, and even multiply the range and richness of possible emotions. 3 Bioconservatism, Bioliberalism, and the Wisdom of Reflecting on Repugnance 3 Bioconservatives are less clear about precisely why enhancement is objectionable. Leon Kass asks, Why, if at all, are we bothered by the voluntary self-administration of agents that would change our bodies or alter our minds? What is disquieting about our attempts to improve upon human nature, or even our own particular instance of it? It is difficult to put this disquiet into words. We are in an area where initial repugnances are hard to translate into sound moral arguments. 4 And Michael Sandel writes, When science moves faster than moral understanding, as it does today, men and women struggle to articulate their unease. In liberal societies they reach first for the language of autonomy, fairness, and individual rights. But this part of our moral vocabulary is ill equipped to address the hardest questions posed by genetic engineering. The genomic revolution has induced a kind of moral vertigo. 5 These writers find it difficult linguistically to express their unease about enhancement because their objection to it involves an immediate, non-linguistic, gutfeeling reaction to the prospect of enhancement rather than the outcome of a process of reasoned evaluation about it. This reaction is a form of intuition. We follow Neil Levy in understanding intuitions as „spontaneous intellectual seemings‟, a definition that is compatible with a broad range of psychological and philosophical uses of the term 6 . Whilst bioconservatives‟ opposition to enhancement does not consist solely of appeals to intuition, their arguments are often built upon a brute insistence that there is something intrinsically valuable about being human, and that this would be undermined by enhancement. Sandel comments, I do not think the main problem with enhancement and genetic engineering is that they undermine effort and erode human agency. The deeper danger is that they represent a kind of hyperagency-a Promethean aspiration to remake nature, including human nature, to serve our purposes and satisfy our desires. The problem is not the drift to mechanism but the drive to mastery. And what the drive to mastery misses and may even destroy is an appreciation of the gifted character of human powers and achievements. 7 Sandel never adequately defends 8 the view that human characteristics should be appreciated as „gifts‟ rather than seen merely as advantages arbitrarily bestowed by the natural genetic lottery. As a result, his ensuing argument is unlikely to convince anyone inclined to view human characteristics in the latter way they should be Bioconservatism, Bioliberalism, and the Wisdom of Reflecting on Repugnance 4 respected and left unenhanced. Despite this, Kass, quoting from an earlier draft of Sandel‟s paper, seconds his view 9 ; and Fukuyama expresses a related worry: [T]he deepest fear that people express about technology is ... a fear that, in the end, biotechnology will cause us in some way to lose our humanity-that is, some essential quality that has always underpinned our sense of who we are and where we are going, despite all of the evident changes that have taken place in the human condition through the course of history. 10 Despite stressing the need to protect and appreciate some special, intrinsically human quality, however, Kass, Sandel, and Fukuyama fail to spell out exactly what this special quality is. Kass and Sandel make little attempt to address this question; and whilst Fukuyama attempts it, his answer is unsatisfactory. He claims that „when we strip all of a person‟s contingent and accidental characteristics away, there remains some essential human quality underneath that is worthy of a certain minimal level of respect-call it Factor X‟ 11 , but concedes that „there is no simple answer to the question, What is Factor X?‟ 12 . The bioliberal response to this insistence that there is something special about being human, and that therefore we ought not to tamper with our nature by enhancing, is usually to try to break down this reverence for human nature (or aspects of it, such as Sandel‟s „giftedness‟) into its component beliefs and values, and to argue that these components are unwarranted, misconceived, or inconsistent with other deep-rooted beliefs and values. For example, Bostrom observes that it is not obvious that human nature should be respected and preserved, since „[o]ur own species-specified natures are a rich source of much of the thoroughly unrespectable and unacceptable- susceptibility for disease, murder, rape, genocide, cheating, torture, racism‟ 13 . Bioliberals also frequently challenge the moral relevance of the distinction between therapy and enhancement: those who find it morally acceptable to use medicines and technologies for therapeutic purposes, the argument runs, cannot coherently object to their use for enhancement 14 . Bioliberals may also question unsubstantiated claims made by bioconservatives. For example, it is not obvious, as Kass and Sandel both claim, that people in general are uneasy about enhancement. The increasing use of cosmetic surgery to make medically unnecessary improvements to physical appearance suggests that at least significant segments of societies like the UK and the US are Bioconservatism, Bioliberalism, and the Wisdom of Reflecting on Repugnance 5 increasingly accepting of at least certain types of enhancement 15 . Nor is it clear that, as Fukuyama claims, there is „some essential quality that has always underpinned our sense of who we are and where we are going, despite all of the evident changes that have taken place in the human condition through the course of history‟. It is questionable whether a male university professor in the US today shares much sense of who he is and where he is going even with many of his fellow Americans, let alone with people from different countries or different historical periods. Fukuyama‟s opponents may therefore suspect him of having over-generalised the homogeneity of the human species. Finally, even if the bioconservative claim that there is something valuable about being human is defensible, it does not follow that individuals who wish to enhance themselves should be prevented from doing so. The bioliberals‟ analytic approach attempts to identify exactly what bioconservatives wish to protect from enhancement; to assess its value; to question whether enhancement poses a significantly greater risk to it than existing common and accepted practices; and to consider whether, even if it does, enhancement should be banned. If what bioconservatives are trying to protect cannot be properly defined; or if, having identified it, it turns out not to be worth protecting according to values and principles that even bioconservatives must recognise; or if enhancement poses no greater threat to it than existing, accepted practices; then-the bioliberal argues- bioconservatives‟ opposition to enhancement is irrational and should be dismissed. This approach to the debate is an invitation to bioconservatives to engage, to delineate their values and concerns, to analyse and reflect on their beliefs about human nature and its future, and to defend their opposition to enhancement as rationally justified. Frequently, however, bioconservatives reject this invitation, and find the analytic approach taken by bioliberals objectionable. Kass has complained that Bioethics was founded by people who understood that the new biology touched and threatened the deepest matters of our humanity: bodily integrity, identity and individuality, lineage and kinship, freedom and self-command, eros and aspiration, and the relations and strivings of body and soul. With its capture by analytic philosophy, however, and its inevitable routinisation and professionalisation, the field has by and large come to content itself with analysing moral arguments, reacting to new technological developments and taking on emerging issues of public policy, all performed with a naïve faith that the evils we fear can all be avoided by compassion, regulation and a respect for autonomy. 16 He argues against an analytic approach: