{"id":3032,"date":"2016-05-20T10:52:29","date_gmt":"2016-05-20T09:52:29","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=3032"},"modified":"2016-05-20T10:52:29","modified_gmt":"2016-05-20T09:52:29","slug":"enhancement-as-nothing-more-than-advantageous-bodily-and-mental-states","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2016\/05\/20\/enhancement-as-nothing-more-than-advantageous-bodily-and-mental-states\/","title":{"rendered":"Enhancement as Nothing More than Advantageous Bodily and Mental States"},"content":{"rendered":"<p><em><strong>Guest Post by Hazem Zohny<\/strong><\/em><\/p>\n<p>Some bodily and mental states are advantageous: a strong immune system, a sharp mind, strength. \u00a0These are advantageous precisely because, in most contexts, they are likely to increase your chances of leading a good life. \u00a0In contrast, disadvantageous states \u2013 e.g. the loss of a limb, a sense, or the ability to recall things \u2013 are likely to diminish those chances.<\/p>\n<p>One way to think about enhancement and disability is in such welfarist terms. \u00a0A disability is no more than a disadvantageous bodily or mental state, while to undergo an enhancement is to change that state into a more advantageous one \u2013 that is, one that is more conducive to your well-being. \u00a0This would hugely expand the scope of what is considered disabling or enhancing. \u00a0For instance, there may be all kinds of real and hypothetical things you could change about your body and mind that would (at least potentially) be advantageous: you could mend a broken arm or stop a tumour from spreading, but you could also vastly sharpen your senses, take a drug that makes you more likeable, stop your body from expiring before the age of 100, or even change the scent of your intestinal gases to a rosy fragrance.<\/p>\n<p>Would all such changes be instances of enhancement?<!--more--><\/p>\n<p>According to this welfarist approach, yes \u2013 at least to the extent that such changes are likely to improve your well-being. \u00a0The idea here is not to bog down the concepts of enhancement and disability with contestable boundaries tied to problematic concepts like normal and abnormal traits and functioning, along with unproductive attempts to distinguish treatment from enhancement. \u00a0For instance, imagine one person is extremely short due to an otherwise benign brain tumour stunting their growth, while another is equally short due to genes inherited from short parents. \u00a0Does one require treatment while the other can only hope for enhancement? \u00a0The welfarist account asks us to skip these fruitless questions and focus on whether their stature is disadvantageous \u2013 i.e. whether it is reducing their wellbeing. \u00a0If it is, the discussion can then move on to whether we ought to do something about it biomedically, or whether we should work to make society, for instance, more accommodating and non-judgemental towards the extremely short. \u00a0That is what should occupy our deliberation, not whether a person is within some \u2018normal\u2019 range that is typical of the species or that is expected by society. \u00a0The same holds for all other bodily and mental states, including intelligence, strength, life expectancy, appearance, and so on.<\/p>\n<p>It\u2019s an appealing approach to the extent that it reorients our attention to what most agree is of central value here: how bodily and mental states impact people\u2019s well-being, and what we should do about states that are disadvantageous. \u00a0But equally importantly, it divorces the concept of disability from the usual connotation that disabilities are unfortunate deficiencies that deviate from the norm and that require a medical fix \u2013 a connotation that is arguably at the root of much discrimination against people with various impairments.<\/p>\n<p>On the other hand, by broadening the scope of these concepts, the welfarist account hits a different snag: if our sole criterion for what makes a state enhanced or disabled is merely whether that state is advantageous or disadvantageous to a person, we may find ourselves labelling people as disabled because of their race or sexual orientation. \u00a0For instance, it can clearly be disadvantageous to be gay in a homophobic society. \u00a0It can similarly be disadvantageous to be a certain skin colour in a racist society. \u00a0Even being a woman can be disadvantageous in many societies. \u00a0But are gays, blacks and women \u201cdisabled\u201d in these contexts? \u00a0This seems to be stretching the use of the term a little too far beyond how we ordinarily use it. \u00a0There is also a degree of political incorrectness here, all the more so given that on this account, if, say, a black person in a racist society were to undergo an intervention to have paler skin, the welfarist account would deem them \u201cenhanced\u201d (presuming the intervention proved advantageous to them).<\/p>\n<p>This seems troublesome. \u00a0One way to avoid such seeming mislabels is to exclude things like social prejudice from what we consider advantageous or disadvantageous bodily or mental states. \u00a0That is, since being gay, black or a woman is only disadvantageous because of unjust discrimination, then this is a separate matter from enhancement and disability \u2013 it is a social issue of prejudice and should be tackled as such.<\/p>\n<p>And yet, this looks suspiciously arbitrary. \u00a0If the whole point of this approach is that it gets us to focus on what is advantageous or disadvantageous to an individual in terms of their bodily and mental states (without getting side-tracked with morally irrelevant boundaries like what is \u201cnormal\u201d or \u201cabnormal\u201d), then excluding social prejudice would seem like a distraction from that. \u00a0Surely we can say that, for instance, in a homophobic society it can be disadvantageous to be gay, but that it shouldn\u2019t be, or that it can be disadvantageous to be a women in a misogynistic society, but that it shouldn\u2019t be. \u00a0I argue that the controversy only arises if we use the label \u2018disabled\u2019 here with the kind of connotations this welfarist approach is aiming to undermine: connotations like \u201cdeficiency\u201d or \u201cmisfortune\u201d or the need for medical attention. \u00a0None of those is implied by the welfarist account.<\/p>\n<p>&nbsp;<\/p>\n<p><em>Follow this link for\u00a0the full paper:\u00a0<span style=\"color: #0000ff\"><a style=\"color: #0000ff\" href=\"http:\/\/jme.bmj.com\/content\/early\/2016\/05\/13\/medethics-2015-103229.abstract\" target=\"_blank\">Enhancement, Disability and the Riddle of the Relevant Circumstances<\/a><\/span><\/em>.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Guest Post by Hazem Zohny Some bodily and mental states are advantageous: a strong immune system, a sharp mind, strength. \u00a0These are advantageous precisely because, in most contexts, they are likely to increase your chances of leading a good life. \u00a0In contrast, disadvantageous states \u2013 e.g. the loss of a limb, a sense, or the [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2016\/05\/20\/enhancement-as-nothing-more-than-advantageous-bodily-and-mental-states\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2147,2153,443,563,328],"tags":[1856],"class_list":["post-3032","post","type-post","status-publish","format-standard","hentry","category-genetic-jiggerypokery","category-guest-post","category-jme","category-language","category-philosophy","tag-enhancement"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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