Tenth International Conference on Health, Wellness & Society

Abstract

This paper articulates an approach to the politics of human biomedical enhancement from the perspective of public health ethics. A public health approach to the enhancement debate makes population rather than individual characteristics the focal object of inquiry and draws attention to the role of interventions by collective institutions like the state. In the first respect, a public health approach makes salient the spillover effects from individual enhancement choices, as well as the interaction between enhancement technologies and other modes of disadvantage. In the second, it highlights the importance of legitimacy considerations for the enhancement debate. These two features of a public health approach have practical implications for the enhancement debate. A change in focus from individuals to populations can offer a principled account of when biomedical interventions to achieve positional goods are justified. This is through the criterion of population well-being. A public health approach to human biomedical enhancement makes salient the interaction between new biomedical technologies and the ecological and social determinants of well-being. Interaction effects emphasize the importance of technologies that de-cluster rather than amplify disadvantage. This approach is also consistent with evidence from developmental systems theory and evolutionary developmental biology that genes do not have a fundamental explanatory role in the development of phenotype, and which instead emphasizes interactive dynamics between environment, organism, and genetics. Finally, the approach emphasizes the importance of democratic legitimacy for the structure of both formal and informal institutions governing emerging technologies.