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Beyond Therapy: Biotechnology and the Pursuit of Happiness

The President's Council on Bioethics
Washington, D.C., October 2003



Letter of Transmittal

October 15, 2003

The President
The White House
Washington, D.C.

Dear Mr. President:

I am pleased to present to you Beyond Therapy: Biotechnology and the Pursuit of Happiness, a report of the President's Council on Bioethics.

The product of more than sixteen months of research, reflection, and deliberation, we hope this report will prove a worthy contribution to public understanding of the important questions it considers. In it, we have sought to live up to the charge you gave us when you created this Council, namely, "to undertake fundamental inquiry into the human and moral significance of developments in biomedical and behavioral science and technology" and "to facilitate a greater understanding of bioethical issues."

Biotechnology offers exciting and promising prospects for healing the sick and relieving the suffering. But exactly because of their impressive powers to alter the workings of body and mind, the "dual uses" of the same technologies make them attractive also to people who are not sick but who would use them to look younger, perform better, feel happier, or become more "perfect." These applications of biotechnology are already presenting us with some unfamiliar and very difficult challenges. In this report, we consider such possible "beyond therapy" uses, and explore both their scientific basis and the ethical and social issues they are likely to raise.

We have structured our inquiry around the desires and goals of human beings, rather than around the technologies they employ, the better to keep the important ethical questions before us. In a quartet of four central chapters, we consider how pursuing the goals of better children, superior performance, ageless bodies, or happy souls might be aided or hindered, elevated or degraded, by seeking them through a wide variety of technological means.

Among the biotechnical powers considered are techniques for screening genes and testing embryos, choosing sex of children, modifying the behavior of children, augmenting muscle size and strength, enhancing athletic performance, slowing senescence, blunting painful memories, brightening mood, and altering basic temperaments. In a concluding chapter, we consider together the several "beyond therapy" uses of these technologies, in order to ask what kinds of human beings and what sort of society we might be creating in the coming age of biotechnology.

On the optimistic view, the emerging picture is one of unmitigated progress and improvement. It envisions a society in which more and more people are able to realize the American dream of liberty, prosperity, and justice for all. It is a nation whose citizens are longer-lived, more competent, better accomplished, more productive, and happier than human beings have ever been before. It is a world in which many more human beings-biologically better-equipped, aided by performance-enhancers, liberated from the constraints of nature and fortune-can live lives of achievement, contentment, and high self-esteem, come what may.

But there are reasons to wonder whether life will really be better if we turn to biotechnology to fulfill our deepest human desires. There is an old expression: to a man armed with a hammer, everything looks like a nail. To a society armed with biotechnology, the activities of human life may seem more amenable to improvement than they really are. Or we may imagine ourselves wiser than we really are. Or we may get more easily what we asked for only to realize it is much less than what we really wanted.

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 our chemists or by turning ourselves into tools designed to win or achieve in inhuman ways. We want longer lives-but not at the cost of living carelessly or shallowly with diminished aspiration for living well, and not by becoming people so obsessed with our own longevity that we care little about the next generations. We want to be happy-but not because of a drug that gives us happy feelings without the real loves, attachments, and achievements that are essential for true human flourishing.

I believe the report breaks new ground in public bioethics, by dealing with a topic not treated by previous national bioethics commissions. And it approaches the topics not on a piecemeal basis, but as elements of one large picture: life in the age of biotechnology. Beginning to paint that picture is the aim of this report. We hope, through this document, to advance the nation's awareness and understanding of a critical set of bioethical issues and to bring them beyond the narrow circle of bioethics professionals into the larger public arena, where matters of such moment rightly belong.

In enjoying the benefits of biotechnology, we will need to hold fast to an account of the human being, seen not in material or mechanistic or medical terms but in psychic and moral and spiritual ones. As we note in the Conclusion, we need to see the human person in more than therapeutic terms:

as a creature "in-between," neither god nor beast, neither dumb body nor disembodied soul, but as a puzzling, upward-pointing unity of psyche and soma whose precise limitations are the source of its-our-loftiest aspirations, whose weaknesses are the source of its-our-keenest attachments, and whose natural gifts may be, if we do not squander or destroy them, exactly what we need to flourish and perfect ourselves-as human beings.

We close the inquiry with a lingering sense that tremendous new biotechnical powers may blind us to the larger meaning of our own American ideals and may narrow our sense of what it is, after all, to live, to be free, and to pursue happiness.

But we are also hopeful that, by informing and moderating our desires, and by grasping the limits of our new powers, we can keep in mind the true meaning of our founding ideals-and thus find the means to savor the fruits of the age of biotechnology, without succumbing to its most dangerous temptations.

Mr. President, allow me to join my Council colleagues and our fine staff in thanking you for this opportunity to set down on paper, for your consideration and that of the American public, some (we hope useful) thoughts and reflections on these important subjects.

Leon R. Kass, M.D.

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