Medical Ethics:The Moral Significance of the Therapy/Enhancement Distinction

Introduction: A common concern with genetic engineering is that there is something unethical about attempting to modify the human genome so that humans with "better than normal" characterists (e.g. strength, I.Q., etc.) are produced. In comparison, genetic therapy for the purpose of treating, disease, illness, and various dysfunctions and disorders is considered to be morally legitimate. This article begins with an examination of the difficulties that are involved in making the therapy/enhancement distinction due to the difficulties that surround the project of defining an illness. The author (David Resnik) then questions the view that enhancement is unethical. Answer these questions and mail them to my inbox by Monday the 7th.

1. On page 210 in the section entitled, "The Concepts of Health and Disease" Resnik discusses several approaches to defining what is normal and healthy and what is diseased, abnormal, or unhealthy. In the paragraph that begins "The bioethics literature...." two definitions of normal are given. (a) Describe each of these views. Also, try and provide an example that illustrates each definition. (b) In the following paragraph a further approach to defining "normal" is described. Try and put this view in your own words. The rest of this section offers criticisms of these three definitions. We will look at some of these objections in class.

2. In the section entitled, "The Goals of Medicine", Resnik looks at attempts to argue that enhancement is unethical because it violates the goals of medicine. Several goals of medicine are listed. (a) What are some of these goals? (b) Can various forms of enhancement fit under of these goals? If yes, provide examples.

3. In the section entitled, "Our Humanness" Resnik looks at several ethical theories and concludes that none of them entail that it is wrong to tamper with human nature as it is presently constructed. In the last paragraph of the first column of p. 213 Resnik argues that both a utilitarian ethic and a Kantian ethic allow for at least some genetic enhancements. (a) How is utilitarianism defined in the text? (We have discussed this theory twice in class) (b) Why would a utilitarian be in favor of at least some genetic enhancements? (c) What is a Kantian concerned with violating according to this paragraph? (d) What are some alterations that a Kantian would object to?

4. In the last paragraph of p. 213 another argument is given against tampering with the human genetic code. (a) What is this argument? (b) How does Resnik respond to this argument? On page 214 Resnik states a common religious or theological objection to tampering with the human genetic code. (c) What is the argument? (d) How does Resnik respond to it?