‘Beyond’ Human Enhancement — Taking the Developing Country’s Perspective Seriously

Asian Bioethics Review https://doi.org/10.1007/s41649-021-00193-z ORIGINAL PAPER ‘Beyond’ Human Enhancement — Taking the Developing Country’s Perspective Seriously Vorathep Sachdev1 Received: 9 August 2021 / Revised: 23 September 2021 / Accepted: 24 September 2021 © The Author(s) 2021 Abstract Bioethicists and philosophers dominate the on-going debate on human enhancement. They have debated the definition of human enhancement as well as the potential impacts of human enhancement technologies (such as pharmaceutical enhancements or pre-natal selection). These discussions have percolated, through bioethics bodies and bioethics recommendations, policy makers and have eventually been translated into policy. While some suggestions have been based largely in Western liberal democracies, others have deliberated the geopolitical consequences of human enhancement technologies. This paper argues that the present debate currently lacks perspectives from developing countries. It begins by introducing the current debate on human enhancement and recognizes Allen Buchanan’s well-raised concerns on how these technologies may potentially cause new injustices for low- and middleincome countries (‘developing countries’). It then provides two arguments calling for further research into human enhancement from the perspective of developing countries. First, this paper will argue that the current frames with which enhancement technologies are viewed are inherently neoliberal and require change. The second argument shows how the potential impacts of human enhancement technologies in developing countries have not been fully realized by analyzing how human enhancement technologies will impact Thailand, a developing country. Keywords Human enhancement · Buchanan · Development · Neoliberalism · Medical tourism * Vorathep Sachdev 1 The University of Edinburgh, Edinburgh, UK 13 Vol.:(0123456789) Asian Bioethics Review Introduction There is significant evidence that bioethical recommendations are considered by policymakers while creating policy (Cabrera 2015), making the deliberations of bioethicists important for the general public and the world’s geopolitical climate. Human enhancement (‘enhancement’) and human enhancement technologies (‘enhancement technologies’) have been subject to great debate in the bioethical arena, what was merely speculative and science fiction at first is now almost reality (Quigley and Ayihongbe 2018). While the definition of enhancement is by far an unsettled one, this paper does not intend to debate several meanings of enhancement. As such, it adopts the Welfarist account of enhancement that is almost synonymous with the dictionary definition of the word ‘enhancement’: “an intervention which increases the chance of a person having a good life” (Savulescu 2006). Setting out a simple definition allows us to move past debates on the distinction between enhancement and therapy and focus on bioethical debates regarding the possible consequences of enhancement, and enhancement technologies (means or interventions by which enhancement is achieved) (Buchanan 2011). Enhancement technologies include cognition-enhancing pharmaceuticals like Adderall or more invasive interventions such as the genetic modification of embryos (Ricci 2020). These enhancement technologies have the potential to impact the whole world (Bess 2007), yet much of the debate has been dominated by bioethicists and has primarily been conducted in the West, both the positive spin on enhancement as well as the egalitarian concerns have primarily been based in Western liberal democracies (Hogle 2005). In 2005, anthropologist and bioethicist Linda Hogle recognized the insufficient focus on developing societies and political consequences of enhancement in bioethical literature when she stated: Yet the overriding bioethics focus on Western notions of fairness and equity, risk, and prescriptive judgments for policy purposes excludes analysis of social disparities, differences in local political, economic, and health conditions, and differing value systems that are central to anthropological understandings of health and medicine. What might enhancement mean in a poor society where an artificial limb specially designed for working in rice fields or a bicycle designed to provide mobility means the difference in a person’s ability to make a living? Following this, the debate remained largely as a Western phenomenon (Morrison 2015) and when it has addressed the impact that these technologies may have on developing countries, for instance in Allen Buchanan’s book, ‘Beyond Humanity’ it has misunderstood these countries. Thus, this paper argues that these misunderstandings be corrected and calls for more research that suitably represents the perspectives of developing countries through two key arguments. Argument 1 puts forth that the current framework and mindset used to study human enhancement in relation to developing countries needs to be reconsidered. It challenges the neoliberal nature of how human enhancement is currently 13 Asian Bioethics Review viewed and then requires that the cultural and political notions shaping developing countries to be the starting point with which we view human enhancement for the purpose of developing countries. Philosopher Julian Baggini (2018) aptly put why it is important to do so by stating: If we forget when and where they wrote [non-Western philosophers], we are doomed to misunderstand them. But if we fail to see how what they say applies to here and now, we are doomed to waste or misuse them. Argument 2, on the other hand, posits that there are several unconsidered consequences that may occur from the application of enhancement technologies in developing countries. By using Thailand as a case study, it analyzes how one such unintended consequence is human enhancement tourism, and concludes that the potential impacts of human enhancement technologies will differ considerably from each other. Such unintended consequences are yet to be realized in the current literature. Notably, this paper should be viewed as a nyumon. A nyumon is a Japanese term for defining a physical space but also for inviting visitors in, Japanese writers translate it to the word ‘introduction’, where one is not told everything about another but given the opportunity to learn more about them and begin an acquaintanceship (Baggini 2018). Similarly, this paper invites the reader to understand the possible frames with which enhancement technologies should be considered and the possible consequences they may have on a developing country while still leaving the opportunity for more research to be conducted in the hopes that a fruitful acquaintanceship may begin. State of the (Inadequate) Debate While this paper will not expound upon all the important arguments raised along the bioethical spectrum, it provides a brief introduction to the enhancement debate here. It is an attempt to engage with the argu (...truncated)