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Cosmetic Neurology: Sliding Down the Slippery Slope?

Published online by Cambridge University Press:  12 March 2010

Extract

In an editorial to a recent issue of Neurology, Richard Dees expresses the same criticism in an even more rigorous epistemic tone: “Slippery slope arguments are always fallacious, and they always hide an agenda. However they are used, they are meant to make us accept a conclusion that we would otherwise reject.”

Type
Special Section: Philosophical Issues in Neuroethics
Copyright
Copyright © Cambridge University Press 2010

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References

1. Gazzaniga MS. The Ethical Brain. New York: Dana Press; 2005:xvii.

2. Dees RH. Slippery slopes, wonder drugs, and cosmetic neurology. Neurology 2004;63:951–2.

3. See Williams B. Which slopes are slippery? In: Lockwood M, ed. Moral Dilemmas in Modern Medicine. Oxford: Oxford University Press; 1985:126–37; Lamb D. Down the Slippery Slope: Arguing in Applied Ethics. London: Croom Helm; 1988:1–9; van der Burg W. The slippery slope argument. Ethics 1991;102:42–65; Holtug N. Human gene therapy: Down the slippery slope? Bioethics 1993;7:402–19.

4. See note 3, Williams 1985:126–7; Lamb 1988:1–9; Holtug 1993:402–3.

5. See Trianosky GW. Rule-utilitarianism and the slippery slope. The Journal of Philosophy 1978;75:414–24 at p. 415; van der Burg W. Slippery slope arguments. In: Chadwick RF, ed. Encyclopedia of Applied Ethics, vol. 4. San Diego, CA: Academic Press; 1998:129–42 at p. 138; Walton DN. Slippery Slope Arguments. Oxford: Clarendon Press; 1992.

6. See note 5, van der Burg 1998:134.

7. Chatterjee A. Cosmetic neurology and cosmetic surgery: Parallels, predictions, and challenges. Cambridge Quarterly of Healthcare Ethics 2007;16:129–37 at p. 129.

8. See note 7, Chatterjee 2007:130–1; Chatterjee A. Cosmetic neurology: The controversy over enhancing movement, mentation, and mood. Neurology 2004;63:968–74 at pp. 969–70; Chatterjee A. The promise and predicament of cosmetic surgery. In: Glannon W, ed. Defining Right and Wrong in Brain Science. New York: Dana Press; 2007:302–11 at pp. 303–5.

9. See note 8. See also Farah MJ. Neuroethics: The practical and the philosophical. Trends in Cognitive Sciences 2005;9:34–40; Yesavage JA, Mumenthaler MS, Taylor JL, Friedman L, O'Hara R, Sheikh J, et al. Donepezil and flight simulator performance: Effects on retention of complex skills. Neurology 2002;59:123–5; Glannon W. Psychopharmacological enhancement. Neuroethics 2008;1:45–54; Schermer M, Bolt I, de Jongh R, Olivier B. The future of psychopharmacological enhancements: Expectations and policies. Neuroethics 2009;2:75–87.

10. See note 9. See also Farah MJ. Emerging ethical issues in neuroscience. Nature Neuroscience 2002;11:1123–9.

11. In the words of John Harris, “no one … actually thinks that there is anything in principle wrong with the enhancement of human beings.” Harris and Gazzaniga go as far as to say that in some cases human neuropharmacological enhancement may even be a moral duty. See note 1, Gazzaniga 2005:73; Harris J. Enhancing Evolution: The Ethical Case for Making Better People. Princeton: Princeton University Press; 2007:8–35. See also Caplan AL, McHugh PR. Shall we enhance? A debate. In: Glannon W, ed. Defining Right and Wrong in Brain Science. New York: Dana Press; 2007:271–88 at p. 273; Greely H, Sahakian B, Harris J, Kessler RC, Gazzaniga M, Campbell P, Farah MJ. Towards responsible use of cognitive-enhancing drugs by the healthy. Nature 2008;456:702–5.

12. Kass LR. Ageless bodies, happy souls: Biotechnology and the pursuit of perfection. The New Atlantis 2003;1:9–28 at p. 17. Available at www.thenewatlantis.com/archive/1/TNA01-Kass.pdf.

13. Häyry (Gylling) H. How to assess the consequences of genetic engineering? In: Dyson A, Harris J, eds. Ethics and Biotechnology. London: Routledge; 1992:144–56 at p. 149.

14. Jacques Ellul, a well-known advocator of the technological imperative, writes: “Technique is autonomous with respect to economics and politics. … Technique elicits and conditions social, political, and economic change. It is the prime mover of all the rest, in spite of any appearance to the contrary and in spite of human pride, which pretends that man's philosophical theories are still determining influences and man's political regimes decisive factors in technical evolution.” Cited by Pitt JC. The autonomy of technology. In: Durbin PT, ed. Technology and Responsibility. Dordrecht: D. Reidel Publishing Company; 1987:99–114 at p. 99.

15. According to Chatterjee: “We are in the midst of a period of unprecedented and ongoing development in neuropharmacology. Reconstructive surgery toppled into cosmetic surgery as if pushed by a technological imperative. Will a similar technological imperative tip the clinical neurosciences into cosmetic neurology?” See note 7, Chatterjee 2007:131.

16. Launis V. Human gene therapy and the slippery slope argument. Medicine, Health Care and Philosophy 2002;5:169–79.

17. See note 7, Chatterjee 2007:129–37.

18. See note 7, Chatterjee 2007:132–3.

19. See note 7, Chatterjee 2007:133.

20. See note 7, Chatterjee 2007:133–5.

21. Pieters T, Snelders S. Psychotropic drug use: Between healing and enhancing the mind. Neuroethics 2009;2:63–73 at p. 63.

22. Chatterjee considers this condition in some detail but ends up thinking that it is merely the growth of cosmetic surgery that is inevitable, not the direction. See note 7, Chatterjee 2007:131–2.

23. Beauchamp TL, Childress JF. Principles of Biomedical Ethics, 3rd ed. Oxford: Oxford University Press; 1989:139.

24. See note 16, Launis 2002:169–79.

25. See note 3, Williams 1985:129–33 and van der Burg 1991:44–5; Govier T. What's wrong with slippery slope arguments? Canadian Journal of Philosophy 1982;12:303–16 at pp. 307–9.

26. See note 1, Gazzaniga 2005:71–2.

27. See note 11, Harris 2007:57; Juengst ET. Can enhancement be distinguished from prevention in genetic medicine? Journal of Medicine and Philosophy 1997;22:125–42.

28. See note 3, Holtug 1993:410.

29. See note 3, Williams 1985:129.

30. For examples of useful conceptual clarifications, see Synofzik M. Ethically justified, clinically applicable criteria for physician decision-making in psychopharmacological enhancement. Neuroethics 2009;2:89–102; Daniels N. Normal functioning and the treatment-enhancement distinction. Cambridge Quarterly of Healthcare Ethics 2000;9:309–22.

31. The already discussed versions of the slippery slope argument all fall under the category of argument properly called a reductio ad absurdum. The idea behind this way of arguing is that a line of reasoning can be invalidated by showing that it leads to absurd conclusions.

32. See note 3, Williams 1985:127. I believe it is possible to appreciate the structure of this argument without appreciating the relevance of the example Williams provides.

33. For an illuminating example of what can happen, see the following debate: Little MO. Cosmetic surgery, suspect norms, and the ethics of complicity. In: Parens E, ed. Enhancing Human Traits: Ethical and Social Implications. Washington, DC: Georgetown University Press; 1998:162–77; Ravelingien A, Braeckman J, Crevits L, De Ridder D, Mortier E. “Cosmetic neurology” and the moral complicity argument. Neuroethics 2009;2:151–62.

34. See note 3, Williams 1985:137.