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Beyond Therapy: Biotechnology and the Pursuit of Happiness

Beyond Therapy: Biotechnology and the Pursuit of Happiness

by Leon, MD, Kass MD, PhD., William Safire, Presidents Council on Bioethics

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ISBN-10: 0060734906

ISBN-13: 9780060734909

Pub. Date: 12/02/2003

Publisher: HarperCollins Publishers

A groundbreaking new exploration of the promises and perils of biotechnology — and the future of American society.

Biotechnology offers exciting prospects for healing the sick and relieving suffering. But because our growing powers also enable alterations in the workings of the body and mind, they are becoming attractive to healthy people who would just like


A groundbreaking new exploration of the promises and perils of biotechnology — and the future of American society.

Biotechnology offers exciting prospects for healing the sick and relieving suffering. But because our growing powers also enable alterations in the workings of the body and mind, they are becoming attractive to healthy people who would just like to look younger, perform better, feel happier, or become more "perfect."

This landmark book — the product of more than sixteen months of research and reflection by the members of the President's Council on Bioethics — explores the profound ethical and social consequences of today's biotechnical revolution. Almost every week brings news of novel methods for screening genes and testing embryos, choosing the sex and modifying the behavior of children, enhancing athletic performance, slowing aging, blunting painful memories, brightening mood, and altering basic temperaments. But we must not neglect the fundamental question: Should we be turning to biotechnology to fulfill our deepest human desires?

We want better children — but not by turning procreation into manufacture or by altering their brains to gain them an edge over their peers. We want to perform better in the activities of life — but not by becoming mere creatures of chemistry. We want longer lives — but not at the cost of becoming so obsessed with our own longevity that we care little about future generations. We want to be happy — but not by taking a drug that gives us happy feelings without the genuine loves, attachments, and achievements that are essential to true human flourishing. As we enjoy the benefits of biotechnology, members of the council contend, we need to hold fast to an account of the human being seen not in material or mechanistic or medical terms but in psychic, moral, and spiritual ones. By grasping the limits of our new powers, we can savor the fruits of the age of biotechnology without succumbing to its most dangerous temptations.

Beyond Therapy takes these issues out of the narrow circle of bioethics professionals and into the larger public arena, where matters of this importance rightly belong.

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HarperCollins Publishers
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6.00(w) x 9.00(h) x 0.88(d)

Table of Contents

Bioethics and Scientific Process: Cautions about debates involving ethics and sciencexi
About the Authors of the Foreword, Added Comments, and Introductionxviii
Letter of Transmittal to the Presidentxxiii
Members of the President's Council on Bioethicsxxvii
Council Staff and Consultantsxxix
1.Biotechnology and the Pursuit of Happiness1
IThe Golden Age: Enthusiasm and Concern5
IIThe Case for Public Attention8
IIIDefining the Topic11
IVEnds and Means13
VThe Limitations of the "Therapy vs. Enhancement" Distinction15
VIBeyond Natural Limits: Dreams of Perfection and Happiness19
VIIStructure of the Inquiry: The Primacy of Human Aspirations24
VIIIMethod and Spirit26
2.Better Children30
IImproving Native Powers: Genetic Knowledge and Technology34
AAn Overview34
BTechnical Possibilities36
1Prenatal Diagnosis and Screening Out39
2Genetic Engineering of Desired Traits ("Fixing Up")42
3Selecting Embryos for Desired Traits ("Choosing In")45
CEthical Analysis51
2Questions of Safety53
3Questions of Equality58
4Consequences for Families and Society60
IIChoosing Sex of Children65
AEnds and Means67
BPreliminary Ethical Analysis70
CThe Limits of Liberty76
DThe Meaning of Sexuality and Procreation78
IIIImproving Children's Behavior: Psychotropic Drugs82
ABehavior Modification in Children Using Stimulants85
1What Are Stimulant Drugs?89
2Behaviors Inviting Improvement Through Stimulant Drugs91
3The "Universal Enhancer"95
BEthical and Social Concerns98
1Safety First99
2Rearing Children: The Human Context100
3Social Control and Conformity101
4Moral Education and Medicalization104
5The Meaning of Performance106
IVConclusion: The Meaning of Childhood108
AppendixDiagnostic Criteria for Attention-Deficit/Hyperactivity Disorder109
3.Superior Performance115
IThe Meaning of "Superior Performance"116
IISport and the Superior Athlete121
AWhy Sport?121
BThe Superior Athlete122
CDifferent Ways of Enhancing Performance123
1Better Equipment124
2Better Training125
3Better Native Powers126
IIIMuscle Enhancement through Biotechnology127
AMuscles and Their Meanings127
BMuscle Cell Growth and Development130
COpportunities and Techniques for Muscle Enhancement132
IVEthical Analysis140
AHow Is Biotechnical Enhancement Different?140
BFairness and Equality150
CCoercion and Social Pressure153
DAdverse Side Effects: Health, Balance, and the Whole of Life156
EThe Dignity of Human Activity159
1The Meaning of Competition161
2The Relationship between Doer and Deed163
3Acts of Humans, Human Acts: Harmony of Mind and Body165
FSuperior Performance and the Good Society172
4.Ageless Bodies179
IThe Meaning of "Ageless Bodies"180
IIBasic Terms and Concepts184
IIIScientific Background189
ATargeting Specific Deficiencies of Old Age189
1Muscle Enhancement189
2Memory Enhancement190
BGeneral (Body-Wide) Age-Retardation194
1Caloric Restriction195
2Genetic Manipulations197
3Prevention of Oxidative Damage200
4Methods of Treating the Ailments of the Aged That Might Affect Age-Retardation201
aHormone treatments202
bTelomere research203
IVEthical Issues205
AEffects on the Individual208
1Greater Freedom from Constraints of Time211
2Commitment and Engagement211
3Aspiration and Urgency212
4Renewal and Children213
5Attitudes toward Death and Mortality215
6The Meaning of the Life Cycle216
BEffects on Society217
1Generations and Families219
2Innovation, Change, and Renewal220
3The Aging of Society222
5.Happy Souls230
IWhat Are "Happy Souls"?236
IIMemory and Happiness240
AGood Memories and Bad245
BBiotechnology and Memory Alteration249
CMemory-Blunting: Ethical Analysis253
1Remembering Fitly and Truly257
2The Obligation to Remember260
3Memory and Moral Responsibility261
4The Soul of Memory, The Remembering Soul262
IIIMood and Happiness264
AMood-Improvement through Drugs270
1Mood-Brightening Agents: An Overview271
2Biological and Experiential Effects of SSRIs274
BEthical Analysis283
1Living Truly284
2Fitting Sensibilities and Human Attachments288
3What Sorrow Teaches, What Discontent Provokes291
4Medicalization of Self-Understanding295
5The Roots of Human Flourishing298
6The Happy Self and the Good Society301
6."Beyond Therapy": General Reflections309
IThe Big Picture310
IIFamiliar Sources of Concern314
AHealth: Issues of Safety and Bodily Harm315
CEquality of Access316
DLiberty: Issues of Freedom and Coercion, Overt and Subtle318
IIIEssential Sources of Concern322
AHubris or Humility: Respect for "the Given"323
B"Unnatural" Means: The Dignity of Human Activity327
CIdentity and Individuality330
DPartial Ends, Full Flourishing332
IVBiotechnology and American Society340
ACommerce, Regulation, and the Manufacture of Desire342
BMedicine, Medicalization, and a Stance "Beyond Therapy"344
CBiotechnology and American Ideals348

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