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Enhancement as a Basic Human Right


Tanner Lectures on Human Values 2009. Julian Savulescu. Tanner ... Increased muscle mass through myostatin knockout. Occurs naturally in cows and humans. ... – PowerPoint PPT presentation

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Title: Enhancement as a Basic Human Right

Enhancement as a Basic Human Right
Professor Julian Savulescu
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  • Modafinil is a eugeroic
  • stimulating without causing peripheral effects or
    addiction/tolerance/abuse potential of the
    traditional stimulants
  • prescribed to treat narcolepsy, obstructive sleep
    apnea/hypopnea and shift work sleep disorder.
  • "wakefulness promoting agent" sometimes used for
    "excessive daytime sleepiness".
  • off-label for ADD/ADHD, depression or fatigue.

  • Ninety percent of the prescriptions are for
    off-label usage
  • Provigil's sales (Cephalon)
  • 2007-- 1 billion
  • 2005-- 500 million2004-- 289 million2003--
    200 million2002-- 150 million2001-- 75
  • If this growth were to continue, the market in
    2018 would be US70 billion!

Estimated 2018 Market US 7-10 billion
  • In April, 2008, an online survey of 1400
    individuals who read the journal Nature
  • 1/5 use prescription drugs to improve their
    focus, concentration, or memory (Nature)
  • methylphenidate (Ritalin) 62
  • modafinil (Provigil) 44
  • beta-blockers 15

  • Other drugs
  • Adderall, a drug prescribed for ADHD containing a
    mixture of amphetamines.
  • Centrophenoxine
  • Piracetam
  • dextroamphetamine sulfate
  • ginkgo
  • omega-3 fatty acids.

Top 10 Enhancers
Bubblers Piracetam, Ginkgo (improved blood
supply?), Alcohol (creativity), hormones (memory
enhancement), oxytocin (pair bonding, trust,
empathy), testosterone (spatial abilities?),
odorants (mood?), chewing gum (working memory!)
Anders Sandberg
Table 1. Top 10 genetic enhancements
  • The Doogie Mouse. Better memory through
    overexpression of the receptor subunit NR2B
  • Color Vision Mice. Adding human photopigment
    allows (at least females) to see new colors.
  • Methuselah Mice. By reducing growth hormone
    levels long-lived dwarf mice can be produced. The
    current record holder survived 4 years 11 months
    and 3 weeks, while normal mice have a two year
  • Monogamous VolesNormally polygamous voles can be
    turned monogamous (and more social) by changing
    the vassopressin V1a receptor. Regenerating MRL
    Mice. These mice regenerate holes punched in
    their ears as well as some injuries to heart

  • Schwarzenegger Mice and Belgian Blue Cows.
    Increased muscle mass through myostatin knockout.
    Occurs naturally in cows and humans.
  • Hard Working Monkeys. Monkeys tend to slack off
    until they get close to a reward they have to
    work for. If injected with a DNA construct that
    blocks the D2 receptor they work at an even rate.
  • Anticancer Mice. Immune systems that kill cancer
    cells efficiently and can even help other mice
    through blood transfusions.
  • Antiobesity Mice. Protected from obesity and
    diabetes by their lack the enzyme DGAT1. Their
    fat tissue can even reduce obesity and glucose
    buildup in other mice if transplanted.
  • Marathon Mice. Overexpress PPARd in their
    muscles- turn into slow twitch fibers that work
    well for long-distance running. More endurance
    and increased resistance to obesity.

Biology, Psychology and Disability
  • Welfarist Definition of Disability
  • A stable physical or psychological property of
    subject S that tends to reduce Ss level of
    well-being in circumstances C,
  • excluding the effect that this condition has on
    well-being that is due to prejudice against S by
    members of Ss society

Improving well-being/Reduce Disability
  • There are 4 ways to promote human well-being.
  • Natural environment
  • Social environment
  • Psychology
  • Biology

Change Society, Not People
  • We should alter social arrangements to promote
    well-being, not biologically alter people
  • Improve society not enhance people to increase
  • Related disability is socially constructed
  • Response
  • Biopsychosocial fit
  • We should consider all modifications, and choose
    the modification, or combination, which is best
  • Skin colour
  • Social modification and discrimination
  • Biological modification and environmental risk

Social Not Biological Enhancement
  • Good Reasons to Prefer Social Rather Than
    Biological Intervention
  • If it is safer
  • If it is more likely to be successful
  • If justice requires it (based on the limitations
    of resources)
  • If there are benefits to others or less harm
  • If it is identity preserving

Social Construction of Disability
  • disability is socially constructed when there
    are good reasons to prefer social intervention
    than direct biological or psychological
  • Biopsychosocial construction of disability
  • Must consider reasons for and against
    intervention at all levels
  • Social
  • Psychological
  • Biological
  • whether the modification will harm others or
    create or exacerbate injustice.

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Individual Effects Cognition important for good
life Environmental toxin models - lead 1 IQ
point 1.763 income (Schwartz), 2.094/3.631
(Salkever, m/f) Annual gain / IQ point US 55-65
billion 0.4-0.5 GDP Effects on schooling,
participation rate, social costs Weiss 1998 3
point IQ increase Poverty rate -25 Males in
jail -25 High school dropouts -28 Parentless
children -20 Welfare recipiency -18 Out-of-wed
lock births -15
Gottfredson 2002
Individual Effects
  • correlations between intelligence and income
    having a low IQ
  • increases the risks of a wide array of social and
    economic misfortunes, as well as impairing many
    everyday abilities
  • makes people vulnerable and reduces the range of
    jobs which they can select among, increasing
    competition within the same level of IQ.
  • require an IQ of about 90 to complete a tax
    return 120 to enter University

Cartoon by Nicholson from "The Australian"
newspaper www.nicholsoncartoons.com.au
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  • 1 in 3 people in the world dont get enough
  • large goiters that swell their necks
  • dwarfism
  • cretinism
  • mental slowness (largest cause)
  • Pregnancy
  • loss of 10 to 15 IQ points
  • loss of more than 1 billion I.Q. points around
    the world

  • iodine
  • vitamin A
  • iron
  • zinc
  • folic acid
  • Copenhagen Consensus (panel of top global
  • micronutrients at the top of the list of foreign
    aid spending priorities.
  • Probably no other technology offers as large an
    opportunity to improve lives ... at such low cost
    and in such a short time. World Bank
  • iodize salt costs only 2 cents to 3 cents per
    person per year

Biology as Disability
  • Self Control
  • In the 1960s Walter Mischel conducted impulse
    control experiments where 4-year-old children
    were left in a room with one marshmallow, after
    being told that if they did not eat the
    marshmallow, they could later have two.
  • Some children would eat it as soon as the
    researcher left.
  • Others would use a variety of strategies to help
    control their behaviour and ignore the temptation
    of the single marshmallow.

  • A decade later, they found that those who were
    better at delaying gratification had
  • more friends
  • better academic performance
  • more motivation to succeed.
  • Whether the child had grabbed for the marshmallow
    had a much stronger bearing on their SAT scores
    than did their IQ
  • Impulse control has also been linked to
    socioeconomic control and avoiding conflict with
    the law.
  • Poor impulse control is a disability

Socioeconomic Disparities Prefrontal Function
  • Kishiyama et al, J Cog Neurosci 2009
  • prefrontal-dependent electrophysiological
    measures of attention were reduced in LSES
    compared to high SES (HSES) children in a pattern
    similar to that observed in patients with lateral
    prefrontal cortex (PFC) damage
  • neurophysiological evidence that social
    inequalities are associated with alterations in
    PFC function in LSES children
  • number of factors associated with LSES rearing
    conditions that may have contributed to these
    results such as greater levels of stress and lack
    of access to cognitively stimulating materials
    and experiences
  • targeting specific prefrontal processes affected
    by socioeconomic disparity could be helpful in
    developing intervention programs for LSES

Other Categories
  • All Purpose Goods
  • Intelligence
  • Memory
  • Self- discipline
  • Foresight
  • Patience
  • Sense of humour
  • Optimism

Anti-Social Personality Disorder
  • Antisocial Personality Disorder is five times
    more common among first-degree biological
    relatives of males with the disorder than among
    the general population
  • The risk to first-degree biologic relatives of
    females with the disorder is nearly ten times
    that of the general population.
  • Adoption studies show that both genetic and
    environmental factors contribute to the risk of
    this group of disorders, because parents with
    Antisocial Personality Disorder increase the risk
    of Antisocial Personality Disorder in both their
    adopted and biologic children.

Empathy and Mirror Neurons
  • People with an antisocial personality have a
    limited range of human emotions and in
    particular, lack empathy for the suffering of
  • Empathy, or the capacity to understand and
    recognise and actions and emotions of others may
    be provided by neurons located in the inferior
    frontal cortex and the anterior part of the
    inferior parietal lobule of the brain
  • These nerve cells are active when specific action
    are such as picking an object of food and eating
    are performed
  • but what makes them remarkable is that they also
    fire when another animal, the experimenter or
    even a robot perform the same action.
  • mirror neuron fires as though the observer were
    itself performing the action.
  • Mal Horne

Empathy and Mirror Neurones
  • Evidence is mounting that the region of the brain
    known as the insula, provides the substrate for
    our understanding of the emotions of others
  • activity of insula neurones underpins the emotion
    of disgust.

  • mirror system for hand actions and the mirror
    system for emotions are more active in people who
    are empathic as judged by questionnaires
  • in children, the degree of activity of mirror
    neurons induced by observations and imitation of
    facial expression correlated with empathic
    concern and interpersonal competence
  • children with the autism spectrum disorders who
    are social isolated and have difficulty
    demonstrating warmth and interpersonal
    connectivity also have disturbed activation of
    the mirror neurons

  • The Genetics of Criminality/Aggression
  • Twin studies and adoption studies
  • E.g. Cloninger Grottesman (1987) correlation
    in criminality 0.74 for MZ twins and 0.47 for DZ
  • MAOA gene polymorphisms
  • Brunner study in the Netherlands
  • Mutation on MAOA gene

The Neuroscience of Criminality/ Aggression
  • Caspi et al. (2002) investigated the relationship
    between the presence of a change in the gene
    encoding for monoamine oxidase A (MAOA), a
    neurotransmitter metabolising enzyme, and
    tendency towards antisocial behaviour in a cohort
    of New Zealand males.
  • They found that men who had been mistreated as
    children and were positive for the polymorphism
    conferring low levels of MAOA were significantly
    more likely to exhibit antisocial behaviour than
    those who had mistreated but lacked the change.
  • Both groups were more likely to exhibit
    antisocial behaviour than those who were not
  • This suggests a possible interaction between
    mistreatment and MAOA deficiency in causing
    antisocial behaviour and raises the possibility
    that pharmacological manipulation of MAOA may
    influence the development of such behaviour.

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  • lower than normal levels of CSF 5-HIAA (a
    serotonin metabolite) in persons who behave
  • inverse relationship between indicies of
    serotenergic function and impulsive aggressive
  • depleting serotonin leads to more aggressive
    behaviour SSRI increase co-operation/reduced

Oxytocin and Trust
  • Oxytocin shown to influence ability to infer
    anothers mental state
  • Oxytocin increases willingness to trust, but this
    does not extend to all risk taking, only social
  • decrease of trust after betrayal even after
    several betrayals. Reduces fear of social

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Hypothalamus, sex hormones
Corticolimbic, dopamine
Oxytocin, vasopressin, CRH?
Right to Enhancement
  • Significant enhancements for worst off to bring
    about sufficient levels of well being
  • Derivative right from existing rights
  • Intrinsic right to a decent level of well-being
    right to a minimally decent life

Derivative Right
  • Derived from Basic Human Rights

UN Universal Declaration of Human Rights
  • Article 3.
  • Everyone has the right to life, liberty and
    security of person.
  • Article 18.
  • Everyone has the right to freedom of thought,
    conscience and religion this right includes
    freedom to change his religion or belief
  • Article 19.
  • Everyone has the right to freedom of opinion and
    expression this right includes freedom to hold
    opinions without interference and to seek,
    receive and impart information and ideas through
    any media and regardless of frontiers.

UN Declaration of Human Rights
  • Article 23.
  • (1) Everyone has the right to work, to free
    choice of employment, to just and favourable
    conditions of work and to protection against
  • Article 25.
  • (1) Everyone has the right to a standard of
    living adequate for the health and well-being of
    himself and of his family, including food,
    clothing, housing and medical care and necessary
    social services, and the right to security in the
    event of unemployment, sickness, disability,
    widowhood, old age or other lack of livelihood in
    circumstances beyond his control.
  • Article 26.
  • (1) Everyone has the right to education.
    Education shall be free, at least in the
    elementary and fundamental stages. Elementary
    education shall be compulsory. Technical and
    professional education shall be made generally
    available and higher education shall be equally
    accessible to all on the basis of merit.
  • (2) Education shall be directed to the full
    development of the human personality and to the
    strengthening of respect for human rights and
    fundamental freedoms. It shall promote
    understanding, tolerance and friendship among all
    nations, racial or religious groups, and shall
    further the activities of the United Nations for
    the maintenance of peace.

International Covenant on Economic, Social and
Cultural Rights (ICESR)
  • Article 1
  • All peoples have the right of self-determination,
    including the right to determine their political
    status and freely pursue their economic, social
    and cultural development.
  • Article 11
  • Everyone has the right to an adequate standard of
    living for himself and his family, including
    adequate food, clothing and housing...
  • Article 12
  • Everyone has the right to the enjoyment of the
    highest attainable standard of physical and
    mental health.
  • Article 13
  • Everyone has the right to education. Primary
    education should be compulsory and free to all.
  • Article 15
  • Everyone has the right to take part in cultural
    life enjoy the benefits of scientific progress.

Basic right
  • Right to a sufficient level of well-being

Biopsychosocial nature of well-being/disability
  • The basic argument
  • Social impediments to a good life
  • Biological and psychological impediments to a
    good life
  • Capabilities and disabilities are partly
    determined by psychology and biology
  • Capabilities and disabilities are unequally
  • Some normal people are so disabled by their
    biology or psychology that they face significant
    or insurmountable obstacles to achieving a good
  • These people have a right to have these obstacles

Negative or Positive Right
  • Is this a negative or positive right?
  • In so far as we have positive rights to anything
  • Right to a sufficient level of well-being right
    to enhancements to achieve this
  • Not a right any enhancement but a right to
    significant enhancements
  • Political as well as moral right

Positive Right
  • Basic right, at least for the worst off
  • Stronger claim
  • those above the level of sufficient well being
    still have claim on significant enhancement
  • Modafenil for worst off or Modafenil for

First Argument for Enhancement
  • 1. Choosing not to enhance is wrong
  • Dietary neglect results in a child with an IQ of
    110 dropping to 85 (normal)
  • Wrong
  • Failure to institute some diet means a child with
    an IQ of 85 fails to achieve an IQ of 110
  • Equally wrong
  • Substitute biological intervention for diet

Second Argument Consistency
  • We accept environmental interventions
  • Education
  • Computing and information technology

  • There is no difference between environmental and
    biological intervention
  • Rats given stimulating environment vs prozac
  • Environmental manipulations affect biology rats
    who were mothered showed genetic changes
    (heritable changes in methylation)

  • Environmental manipulations affect biology
  • Maternal care and stress
  • hippocampal development
  • cognitive, psychological and immune deficits
    later in life
  • Early experience can actually modify protein-DNA
    interactions that regulate gene expression,
    (changes in methylation id DNA) Michael Meaney

  • Education
  • Internal cognitive enhancement
  • altering biology
  • External cognitive enhancement
  • computers, internet

Third Argument No difference to disease
  • If we accept the right to treatment and
    prevention of disease, we should accept right to
  • Goodness of health is what drives a moral
    obligation to treat or prevent disease

No difference to disease
  • Health is not what matters health enables us to
    live disease prevents us from doing what we want
    and what is good
  • But how well our lives goes
  • People trade health for well-being when engage in
    risky activities
  • Well-being drives a moral obligation to enhance
  • Disability not disease matters
  • Psychology and biology can be disability

  • Enhancement is not just a good thing but a basic
    human right pressure, provision
  • Just like education
  • Significant improvements to those falling below
    the threshold should be treated like basic
  • Raising IQ from 85 to 100

Too Expensive?
  • US Military
  • "The world contains approximately 4.2 billion
    people over the age of twenty. Even a small
    enhancement of cognitive capacity in these
    individuals would probably have an impact on the
    world economy rivaling that of the internet."
  • 3 IQ points
  • 150 billion per year to the US economy
  • 1.5 increase in GDP

Basic Human Right to Enhancement
  • There is a basic and derivative right to human
    enhancements which significantly increase
  • At least in those whose level of well-being falls
    below a sufficient level
  • This right is on a par with the right to
    education, health care and life
  • The most basic human interest is in a good life
  • Our own biology and psychology may be an obstacle
    to a minimally decent life
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