Caplan does not defend medical enhancement so much as attack its critics. Or rather, he attacks a small group of conservative critics who want to preserve “human nature.” He dispatches those critics with admirable precision, but I am not sure why he believes that group of critics includes me. My worry about enhancement technologies has little to do with human nature. My worry is that we will ignore important human needs at the expense of frivolous human desires; that dominant social norms will crowd out those of the minority; that the self-improvement agenda will be set not by individuals, but by powerful corporate interests; and that in the pursuit of betterment, we will actually make ourselves worse off.
It's no secret that many Americans are deeply ashamed of their personal shortcomings and inadequacies. Nor is it any secret that these shortcomings and inadequacies can be exploited for commercial profit. But do we really want to submit our health-care system to the same forces that have made millionaires out of motivational speakers and diet book authors?
Skepticism about enhancement technologies is not equivalent to a wish to set back medical research and declare some applications off-limits. This is a debate about enhancing human traits, not curing human illness. To say that our medical research agenda will be set back if we restrict enhancement technologies makes no more sense than saying that cancer surgery will be set back if the American Broadcasting Corporation cancels its cosmetic surgery reality TV show Extreme Makeover.
We live in a country where 46 million uninsured people cannot get basic medical care, while the rest of us spend a billion dollars a year on baldness remedies. It is not just the inequity here that is so impressive. It is the fact that we have gotten so accustomed to the inequity that we do not see it as obscene.
Citation: Caplan A, Elliott C (2004) Is it ethical to use enhancement technologies to make us better than well? PLoS Med 1(3): e52.