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Medicine, Health Care and Philosophy
Published in: Medicine, Health Care and Philosophy 4/2021

Open Access 01-12-2021 | Scientific Contribution

Enhancing the collectivist critique: accounts of the human enhancement debate

Author: Tess Johnson

Published in: Medicine, Health Care and Philosophy | Issue 4/2021

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Abstract

Individualist ethical analyses in the enhancement debate have often prioritised or only considered the interests and concerns of parents and the future child. The collectivist critique of the human enhancement debate argues that rather than pure individualism, a focus on collectivist, or group-level ethical considerations is needed for balanced ethical analysis of specific enhancement interventions. Here, I defend this argument for the insufficiency of pure individualism. However, existing collectivist analyses tend to take a negative approach that hinders them from adequately contributing to balanced ethical analysis, and often leads to a prohibitive stance. I argue this is due to two common problems with collectivist analyses: inappropriate acceptance of individualist assumptions, and failure to appropriately weigh individual vs collective ethical considerations. To further develop the collectivist critique in the enhancement debate, I suggest we may look to collectivism in public health ethics, which avoids these problems.
Footnotes
1
Each element of this definition is required in order for an intervention to count as an enhancement, thus excluding non-beneficial disease-unrelated modifications like, say, hair colour modifications (in some contexts). For further discussion, see Segers et al. (2019).
 
2
I acknowledge that collectivism can be understood in various ways. For example, in the case of religious groups, to refer to the interests or commitments of their own community, rather than the interests of a broader society. Thus, we can distinguish between broader collectivism, and what we might call this form of ‘community collectivism’. However, I use the former, broad understanding.
 
3
For further discussion of the “liberal dilemma” that states face concerning conflicts between individual and collective interests, see Nielsen et al. (2001).
 
4
That is, resources in a society that are accessible by anyone (non-exclusive) and that are not depleted by a number of individuals trying to access the good at once (non-rivalrous).
 
5
Insofar as my definition is concerned, this constitutes enhancement by virtue of its: 1) not eliminating a predisposition to a disease, 2) modifying a normal individual’s immune function, and 3) producing benefits. I acknowledge that to other definitions, this constitutes a grey area between enhancement and treatment.
 
6
Note that this approach aligns with a conceptual argument concerning the treatment-enhancement distinction. Adherents to the distinction hold that there is a descriptive and normative difference between treatment and enhancement. Whilst treatment-uses of genome editing are acceptable, enhancement uses are not, because treatments aim to correct for existing deficits, whereas enhancements do not. I do not engage with this or other, similar conceptual arguments surrounding therapy vs. betterment, discussions of naturalness, or definitions of disease. For further discussion of these, see Hofmann (2017).
 
7
Here, I examine collective-oriented public health ethics concepts, aligning with a collectivist critique. However, it should be noted that other areas of health justice are successfully grounded on more individualist, but non-libertarian concepts that similarly allow for balanced debate. The capabilities approach is one such method. Due to space limits I cannot explore the full scope of such approaches here.
 
Literature
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Metadata
Title
Enhancing the collectivist critique: accounts of the human enhancement debate
Author
Tess Johnson
Publication date
01-12-2021
Publisher
Springer Netherlands
Published in
Medicine, Health Care and Philosophy / Issue 4/2021
Print ISSN: 1386-7423
Electronic ISSN: 1572-8633
DOI
https://doi.org/10.1007/s11019-021-10030-7

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