Russell Blackford on human enhancement

A couple weeks ago, I interviewed Australian philosopher Russell Blackford for the podcast that I’ve been trying to get started for awhile… and the recording didn’t turn out for reasons I still don’t understand. Aside from spelling the end of my podcasting efforts, I thought Russell had done a great job answering my questions, so I’m going to try to reproduce as much of the interview as possible from memory. (The following was written with some assistance from Russell.)

The interview was focused on a book Russell is currently working on, though which I understand won’t be out until next year, titled Humanity Enhanced. It’s specifically about technologies that would try to, in some way, influence children’s genetics: reproductive cloning, preimplantation screening, and outright genetic engineering. I knew going in that the book would be, in some ways, up Russell’s alley: it’s based on his PhD dissertation, Russell has mentioned bioethics being a focus of his on his blog, and Russell is also the editor in chief of the Journal of Evolution and Technology.

What I didn’t know, though, is that the topic of the book has actually been the main focus of Russell’s peer-reviewed academic articles, which was a bit odd for me to realize, given that I mainly know him as an atheism blogger. Specifically, with his background in law, he’s particularly interested in the issues of legal and political philosophy that surround attempts to control human genetics. This focus on legal and political philosophy is reflected in the book’s subtitle, “Genetic Choice and the Challenge for Liberal Democracies,” and also shows up in his recently published book Freedom of Religion and the Secular State.

One thing that came up early in our interview was the distinction between treatment and enhancement. Many people would like to say that genetic engineering or embryo selection or whatever to treat genetic diseases is OK, but enhancement is not. In an appendix to Humanity Enhanced, however, Russell argues that the distinction between treatment and enhancement is difficult to make. For one thing, what’s considered a disease is often a political issue–Russell gave the example of the classification of homosexuality as a disease, even though it is not inherently debilitating, and its subsequent declassification in the 1970′s. Both of these were, in one sense or another, political choices.

But, I said, wouldn’t many people say that that was a case where political action was necessary because people were being hurt by the definition of homosexuality as a disease, but ultimately it really wasn’t a disease? Well, Russell said, the decision made in the 1970’s was the correct one. We have good reasons for saying homosexuality isn’t a disease, particularly if you use a criterion based on human well-being. But once you start using well-being as your criterion, he said, you open the door to doing whatever will be best for human well-being, rather than saying you’ll only use genetic technologies to treat the the things you’ve classified as diseases.

Maybe better examples, I suggested, would be things like height or ADHD. If we’re doing whatever’s best for human well-being, then well being too tall might have some drawbacks, but there are still benefits to being quite a bit taller than average, so does that mean it would be okay to genetically engineer baby boys to eventually group up to be around 6’3″, if that’s what would be best for their well-being? (We might shoot a bit lower for girls.) Or: many people are horrified by the idea of giving Ritalin or Adderall to kids who don’t really have anything wrong with them, but on Russell’s well-being based perspective, it would seem we should just give kids however much of those drugs is best for their well-being, regardless of whether we’re treating a “disease.” Russell’s answer was that, yes, he’d be okay with all that, subject to considering the collective social impact of it. (To be clear, I lean towards that view myself, but I think many people would have a hard time swallowing that.)

The other big thing we then talked about was the potential social impact of these technologies, which Russell thinks is the most substantial argument for regulating them. In particular, we talked about an objection that’s come up in previous threads on this blog on human enhancement, the fear that if only the rich can afford these technologies, they will widen the gap between the rich and the poor.

Russell, somewhat to my surprise, was fairly sympathetic to these arguments, but argued we’d have to look at how likely it would be to actually be a problem with specific technologies. For example, if a technology came about very suddenly that gave the children of the rich a huge advantage in intelligence over the children of the poor, that could definitely cause problems and would be grounds for regulation.

But the actual technologies being discussed here don’t seem likely to cause that kind of scenario. It’s hard to see how unequal access to reproductive cloning would cause problems. Embryo selection is already causing problems in some countries, where it’s skewing the sex ratio, and in those places there might be grounds for regulation, but that kind of thing seems unlikely to happen in places like the US or Australia (there is actually some relevant research on this). And with therapeutic genetic engineering, it would be unfortunate if the poor didn’t have access to new cures for genetic diseases, but even there it’s not clear how that would have a big impact on inequality. Ideally, we’d also want state health plans to provide treatments for genetic diseases, to “level up” rather than down, though it might be harder to make that happen in places like the US than in Australia or countries in Western Europe.

I’m very curious to hear readers’ reactions to this. I worry this short summary didn’t do justice to Russell’s answers in the interview, but maybe readers will largely end up agreeing with his points anyway.

  • eric

    Russell, somewhat to my surprise, was fairly sympathetic to these arguments, but argued we’d have to look at how likely it would be to actually be a problem with specific technologies. For example, if a technology came about very suddenly that gave the children of the rich a huge advantage in intelligence over the children of the poor, that could definitely cause problems and would be grounds for regulation.

    But the actual technologies being discussed here don’t seem likely to cause that kind of scenario.

    On the contrary, I think they are causing that scenario now and the case you discussed with Russel and in your previous post IS one of the examples: off-label use of drugs (like ritalin) to enhance performance rather than “truly” fix a problem (recognizing that the line between those two things can be blurry).
    I think its factually true, right now, that the rich have the time, resources, and influence to shop for doctors who will provide such prescriptions while the poor do not. Now, its possible that’s only an issue for the US – with socialized medicine, the European countries tend to make a lot more things over the counter and not ask questions about how they are being used. But I think the claim is equally true and the society level: wealthy countries (like the US and Australia) can provide greater and cheaper access to such drugs than poor countries. You probably can’t just walk into a doctor’s office in Mali and get ritalin, even if the doctor would be sympathetic to giving it to you. So, the rich get ritalin for their perfectly normal kid and use it to enhance his/her school performance; the poor cannot, and this impacts the social opportunities that kid will have in the future.
    The off-label use of drugs by the rich to benefit their kids somewhat parallels the most invidious problem of the abortion debate: unequal access. You have people like Santorum arguing against legal abortion even though his wife had one. Why? Well, most people suspect that at least part of the reason he’s okay with making it illegal is because he doesn’t think illegality will ever prevent his friends and family from getting access to it if they need it. That’s evil. Most people recognize that it’s evil. But what you have here is a somewhat parallel situation: off-label drug use is technically illegal, but the rich are perfectly fine with that (keeping it illegal) because the law isn’t a significant barrier to them, its only a barrier to poor people.
    I’m not a luddite, but anyone who thinks unequal access to medical improvements isn’t a significant problem right now has, IMO, their head in the sand. Its a problem within the US, and its a problem between wealthy and poor countries.

  • b33bl3br0x

    I renew the objection that I voiced in the past.

    Forget for a moment the question of whether or not it’s ethical to have the ability to tailor a baby’s traits; let’s go upstream of that. In practice, the steps one would need to undertake to hone the process of achieving the enhancements is morally reprehensible.

    We’re talking about treating unborn embryos to alter things that we don’t have a complete understanding of the genetic basis for, that we in fact can’t have a complete understanding of without messing around with them in our state of relative ignorance (particularly since interaction of entire gene networks are likely going to be involved in many of the traits that people would want to alter), and then forcing individuals to be born and live with our manipulations in place, to see what the effects of them are. Manipulations that could cause terrible pain and suffering and even death.

    The simple fact is that research into genetic enhancement is unethical because it requires human experimentation on people who can’t possibly consent and yet would be required to live with the effects of said experimentation, when there is nothing wrong with leaving them as they are.

    Therapeutic genetic manipulation may be a different issue for things that could be life threatening but long before we go back into people we need to better figure out how to do directed gene insertions in to live specimens.

    • Chris

      We’re talking about treating unborn embryos to alter things that we don’t have a complete understanding of the genetic basis for, that we in fact can’t have a complete understanding of without messing around with them in our state of relative ignorance (particularly since interaction of entire gene networks are likely going to be involved in many of the traits that people would want to alter), and then forcing individuals to be born and live with our manipulations in place, to see what the effects of them are. Manipulations that could cause terrible pain and suffering and even death.

      This seems like an argument for anti-natalism. Manipulations cause pain and suffering and death? Life causes pain and suffering and death. Is there any reason other than status quo bias to think that manipulations would cause more of it than we see already? We are shaped by evolution, and evolution is not our friend in the goal of attaining the good life. We can do better.

      • b33bl3br0x

        This seems like an argument for anti-natalism. Manipulations cause pain and suffering and death? Life causes pain and suffering and death. Is there any reason other than status quo bias to think that manipulations would cause more of it than we see already?

        Yes there is. If you’ve read the literature surrounding gene knock-outs and transgenics you should know that it’s common for them to be embryonic lethal, neonatal lethal, cause a shortened life span, cause congenital defects, cause auto-immune disorders, and/or cause cancers. Additional to those, they can also cause issues that are not apparent until one of a few particular conditions are met wherein the animal responds completely different and you get 100% lethality due to something that might normally cause 10% or even 0% lethality. Then you’ve got to take into account pleiotrophic effect (proteins that have more than one function depending on the local micro-environment), network effects (a small alteration to protein A could cause larger expression of protein B and, in turn, a huge overabundance of protein C), etc. All of these are things that you can’t know will happen until you do the experiments, but previous work demonstrates that similar results are unavoidable.

        If you give someone something that causes them cancer and they die, you’re guilty of manslaughter, does a procedure that predates their birth make you any less guilty of manslaughter?

        Or, since height was brought up in the article let’s look at that. We can expect that the first (probably several) attempts of alterations of height are going to result in some people who are very short and some who are very very tall (like 7 or 8 feet or above). We know that very very tall people have shortened life spans for reasons that are directly related to their size. An enlarged and weakened heart may kill them at 30 or 40 but it’s as inevitable as a bullet. Is the doctor who gave them the condition that will lead to their death as culpable as a gunman who fires a stray bullet and kills them? I think so. Anyone with enough knowledge to carry out the experimentation in the first place should know that the results are going to happen.

        We are shaped by evolution, and evolution is not our friend in the goal of attaining the good life.

        Evolution is a remorseless, pitiless, indifferent process that can lead to a lot of shit.

        We can do better.

        Facts not in evidence.

        We can do faster. With enough time and a high enough body count we can maybe do better. How many dead/diseased/disfigured people is it worth for you to be able to choose how tall your child will be?