“The limits of our language are the limits of our world”
-Philosopher Ludwig Wittgenstein, 1921
Distinguishing the line between therapy and enhancement remains a contentious and difficult project. The debate revolves around a number of moral concerns, philosophical approaches, and practical safety issues as to the proper role of medicine, therapeutics, and values in society.
While most agree that a therapy can roughly defined as a treatment for a disorder or deficiency, which aims to bring an unhealthy person towards a healthier state of being, the term enhancement is so problematic that is has created grid-lock in ethical discussions of great practical importance.
No where was this more clear than in the keynote talks given by Leon Kass and Francis Fukayama at the American Society for Bioethics and Humanities conference in Philadelphia last week. The problem with these two terms is that they are not mutually exclusive, what might be considered healthy and normal for one person may not be for another.
So, what is normal? Clearly, every person enters the world with different natural endowments that fall along a distribution of emotional, cognitive and sensory capabilities. Those individuals with debilitating mental disorders or that exhibit extreme deficiencies in a particular capability relative to the general population are easily characterized into the therapy category.
Within the context of today’s terminology the use of neurotechnologies by “healthy” individuals for “non-medical” purposes is currently defined as enhancement. However, this does not capture the actual intention and belief of most. This is why I am proposing a new model ethical model based on the concept of neuroenablement.
Without neuroenablement we run the risk of medicalizing most of human behavior and increasing the stigmatization associated with improving one’s capabilities within one’s right to pursue their individual definition of life, liberty and happiness.
As I have mentioned previously, in the minds of many, “enhancement” evokes artificiality, denotes a lack of worthy achievement, is characterized as “a perversion of medicine”, or even maligned as an unnatural shortcut. On the other hand, enablement projects images of empowerment, lifting the bottom up, and even addresses issues of fairness and social equity. Neuroenablement empowers people: it provides a way for people to leverage better tools for mental health to achieve desired results
As I will explain in future posts, the neuroenablement model will clarify ethical discussions, allow regulators to develop effective policies with respect to advancing neurotechnologies, and in the end promote human dignity. If you have a keen interest in this subject please feel free to email me with your thoughts.