Thursday, January 16, 2003
Session 3: Beyond Therapy:
Biotechnology and the Pursuit of Human Improvement
Discussion of a Paper
Prepared by Leon R. Kass, M.D.
CHAIRMAN KASS: I think we're all here except
for Frank who's coming back from a Dean's meeting as soon
as he can. This afternoon we come to our topic on "Beyond
Therapy," sometimes known as our topic on enhancement.
We have two sessions. The first, sort of general reflections
and the second, the taking up of a particular case study,
the ethical aspects of sex control.
Council members will have seen this paper/lecture, more a
lecture than a finished paper, that is intended as a discussion
paper to continue the conversations that we've had a couple
of times, most recently the very excellent conversations stimulated
by Michael Sandel's wonderful discussion paper.
I don't want to say very much. The lacunae in the paper and
the notes that are invitations to the author for further development
are there, and the limitations, I think, are clear.
I do think I would call attention, I guess, to three things
of some importance, namely the three parts at the end. One,
the discussion of our attitude with respect to these Beyond
Therapeutic interventions, what I call the attitude of mastery,
and it's in that place where we explore several things and
try to discuss some things that were in Michael's paper.
Then sections on possibly questionable means and then some
discussion of the desirability of the ends, either the end
of indefinite agelessness of body or the pursuit of a certain
understanding of happy souls, part of which I argue, in fact,
is not happiness indeed.
I would prefer it, I think, if the conversation focused on
those last things, on the constructive, or the attempt to
say what issues I think are somehow most important, rather
than the ones that I've raised if only to set aside, though
I would say only one thing in addition.
By taking up this question mostly in terms of the choices
of individuals, I think I've blundered. I mean, in some way,
as Charles Krauthammer and Frank and others have argued in
the past, it might very well be that the major worries we
have about these technologies are not what you'd say to the
individual case, but only when you see these things in the
I have, for my own reasons, tried to argue the moral case
in the individual case, but the questions of liberty and its
constraint through technologies that what go to work on others,
and the Ritalin case that we took up last time is a perfectly
good example, means that to do this paper properly, the things
that have been set aside for the purposes of this analysis
would have to be brought in and emphasized.
But with that apologian introduction I would like to ask,
and Michael has kindly agreed, to ask Michael to serve as
Chair of this discussion and try to guide it, just so that
I won't have to try to keep order and also attend to the
what I trust will be the interesting criticisms and comments.
So thank you Michael.
PROF. SANDEL: The floor is open. Gil?
PROF. MEILAENDER: Leon, let me start with
I may have some other sorts of questions later, but
let me start with some questions that do not necessarily reflect
my considerable sympathy with where the paper's going, but
would just ask some questions to maybe get you to expand a
little more on the way you discuss the loss of agency in the
use of some of these techniques and the importance of that.
Let me just ask three questions about that general issue.
It comes up in pages 14 and 15 in the paper where you
I guess it's in the "Means" section and you move beyond some
kind of simple, natural-artificial thing to try to get at
what more deeply is going on and the issue of passivity and
playing no role and so forth.
The three questions would be these. What if it makes us happier?
If the use of one or another of these techniques makes us
happier, and I don't just want you to tell me that better
to be Socrates dissatisfied.
What I mean is, what if in some sense, you know, if you think
back to the stuff we read about Prozac, for instance, and
so forth. What if in some sense I think I've really gotten
a little more to myself here, this is something more to the
real me. What do you say about that?
Then the second matter, what if what if we really do
choose this? In what sense are we not exercising agency? You
want to say that we're not while, at the same time acknowledging
that the law might well hold us responsible in certain cases
and seem to back into the law being a fiction at that point.
I wonder if you might want to say a little more about that.
Then a third question, maybe not doesn't go quite so
directly out of anything you say in the paper, but with respect
to germ line alterations done before I had any agency, how
does the agency analysis that you give deal with that?
I mean, any agency that I have is built on whatever those
alterations might be, so I don't quite see how that analysis
works. Those would be sort of just for starters, three questions
about what I think is a fairly important move in your argument
CHAIRMAN KASS: No, those are very welcome
and good questions. Let me change the first one slightly.
I don't think it affects the point. What if the use of these
means doesn't necessarily make us happier, but makes us, in
fact, more able to function in the ways in which in the last
section of the paper, or even here I'm claiming are somehow
essential to our flourishing.
I do give some examples of things which are non-therapeutic,
which one would, I think, countenance. The use of agents to
keep pianists' hands from sweating, or a neurosurgeon's hands
from trembling, or let me make it even stronger.
What if it really is the case that part of the reason that
one is frustrated or unhappy or incapable, in fact, of pursuing
one's own activity is that there really is some kind of wiring
or chemical problem in the brain.
Why not treat this as in some way the restoration of some
kind of wholeness of equipment so that now that's not
exactly your question, but with respect to the way I've reformulated
it, I'd have to say I'd have a hard time making the case against
In other words, the fact that something is non-therapeutic
doesn't seem to me necessarily a violation of this in the
genuineness of our activities; that there are certain kinds
of things that we would take that would be aids to our functioning
well, humanly speaking.
Even if they were means to which we were passive and in some
ways functioned in us magically without our really understanding
how they proceeded. You're smiling so I should let you interrupt.
PROF. MEILAENDER: Well, I just want to
I wonder, and I may be missing something here, but if
we could stick a little more with my un-reformulated question.
You distinguish between a sort of mood that might be humanly
intelligible. I have joy at the arrival of a loved one, say.
You distinguish between that, which you call humanly intelligible
and the mood that isn't so intelligible.
I just have joy because I've been programmed to have it,
and I guess I still want to ask See, what's so bad about
having joy? Is there somewhere back in the kind of underpinnings
of your view the sense that really I ought to feel a little
alienated in some way in the universe, or just if you can
CHAIRMAN KASS: Unlike our visitors on the
Prozac discussion, I'm not a friend of deliberate alienation.
There's plenty of it in the world, thank you very much, without
having to go cultivating it.
No, I guess the argument is that leaving aside the very real
possibility that the basis of our moods are not only determined
by fit responses to the things we encounter, but in fact might
be determined by the intactness or fitness of our equipment
unbeknownst to us.
I mean, some people are in fact given a good gift by nature,
and then there's Eeyore and I think if one could do something
for Eeyore I wouldn't be averse to doing it.
But having said that, it does seem to me that on the whole,
we think we'd like to think that our feeling states
are somehow related to either our own activities or our own
relations to the world; that we feel joy
I mean, if somebody is medicated to, you know, feel joy at
the World Trade Center disaster, you'd say something is grotesque,
and therefore there's a certain sense of the fitness between
the way we feel and the things of our experience without being
doctrinaire about it and without saying, `I know in all cases
what the fitting response is.'
There's room for a lot of variation, but it does seem to
me that to begin to deal with the feeling state and the general
mood state in a way that is somehow unrelated to the events
of one's life is to sacrifice something of what it means to
be in relation, properly responsive to, appreciating and feeling
in the world and in relation to other people.
I think there's a lot of ambiguity there, I mean, I
PROF. MEILAENDER: Just one more. I don't
want to occupy too much time, but isn't if you think
of sort of completely pre-pharmacological era possibilities,
isn't in a certain sense a description of certain philosophical
attitudes toward life precisely that?
Doesn't the stoic, for instance, want to develop a certain
kind of, in this case it's really a kind of an almost non-emotional
response, regardless of what the events of life are?
CHAIRMAN KASS: That's a nice point, though.
I guess I would say that that's not so much an attempt to
produce a kind of apathy regardless of the events of life,
but it's an attempt to somehow bring one's feelings into an
alliance with what they take to be the deeper truth about
life, which is to say that the only things which
There are things which are in our power, and there are things
which are not in our power, and there's absolutely no point,
I think, in somehow wasting one's psychic energy on the things
which are not in our power.
It's not a philosophical view to which I'm attracted, but
I think they would claim that's precisely an attempt to move
one's self in a fitting direction, they just don't see the
world in the same way that other people do.
Very quickly on the other two points, what I meant by saying
that, you know, someone who loads themselves up with medication
and ceases to be in their right mind and we don't have
to go to drugs, we could start with alcohol is somehow
responsible for all of the things that happen as a result
for having put themselves in that condition, but when people
wake up the morning after, they say, "Gee, that wasn't me."
That people behave not in their right minds, or that there's
somehow a transformation of who they are, and what happens
to them is unbeknownst to them. Now, if you've done it enough
times, I suppose and you're one of these people who
sits on your own shoulder and watches yourself undergoing
these experiences, you can say, "Oh yes, I'm beginning to
feel high now, and my speech is getting a little slurred,
and now I can't really tell the difference between my friends
and my enemies."
But for the most part, people lose themselves as a result
of some of these agents, and that's partly what I meant by
saying one puts one's self in the condition where one allows
things to happen which are unintelligible, and that there
is I mean, granting there are occasions for joyous drink
and all of that, but as a chronic diet, it would seem to me
that one would have surrendered who one was to these things
that work on you.
Now, the last question about germ alteration, I would also
want to enlarge, because it makes trouble for the point of
view that I'm taking here. In a certain way, the equipment
with which we start in life is magically given to us. Right?
I mean, we didn't choose it, we don't really understand when
we're born the fact that we have sensation or what it means
that we see, that we smell. All these things are somehow part
of the given-ness of things.
As was pointed out, actually, by some staff response to this,
the given-ness would be a matter of indifference, whether
it was given to us by nature, by God or by genetic engineers.
We would acquire a kind of equipment to start with which
we would then exercise, and in a way without really understanding
what we're doing. That is, my paper abstracts altogether from
the kind of much of the mysteriousness of human experience,
and seems to talk more about its intelligibility and that
we somehow can figure out what we're doing.
I think that's a deficiency. The only reason I think I'd
stay with that is because I do think that, whether you believe
it's evolution or whether you believe it's divine plan or
nature, something like that, there is a way in which most
of the ways in which we encounter ourselves and encounter
the world around us and fellow human beings, the means and
the ends that we pursue are to a greater or lesser extent
accessible to us, granting that the original equipment might
To surrender even more of that to forces that just work on
us and that we don't understand is, I think, to lose at least
a partial grip on the kind of life that nature or God has
That's, I think So, I mean, the more I work on this
the harder it is to simply say there's a line here, but I
do think that the disruption of activity, the disruption of
normal activity is, I think, an important aspect of what it
is to worry about here.
PROF. SANDEL: Thank you. Paul, welcome.
DR. MCHUGH: Thank you very much. I had a
number of things I wanted to say, and perhaps will go on too
long, so you must cut me off, Michael. I found this article,
along with Michael's article before, very fascinating, important.
I have great sympathy for it, and then I get very discouraged.
I get discouraged, not because I disagree with any of these
things, but I'm concerned that we're talking about a growing
break between the higher culture and the common culture in
That's affecting medicine as well as everything else. I went
over this article very carefully and saw at least seven points
that you were talking about.
I only want to talk about a few of them. In relationship
to our hopes that the things which are common in our culture,
the good can be lifted and made even higher by their expression.
To some extent in reading your article, Leon, I looked for
examples of what are the problems seen here, and the problems
that come from this issue of enhancement.
It led me back to those things that are in which the
higher culture and the common culture interlock happily. I'd
like to draw a few examples of people, I think, that we recognize
take from the common culture but make it higher.
The two that I want to remind you of are Cal Ripken and Frank
Sinatra. Cal Ripken is different from Pete Rose, and Frank
Sinatra is different from Elvis Presley.
Why is that? We'll start with Sinatra first. For Sinatra,
Sinatra showed us Sinatra's part of the common world,
part of the common culture. He sings common songs, but he
shows us what those wonderful music can be, and that's why
we love him.
It's not just that Bobby Soxers screamed about him. I mean,
I'm not a Bobby Soxer and I still listen to Sinatra. Why do
I do that? I do it because he makes us aware just what the
music can do.
Elvis on the other hand, the music was to make Elvis. That's
why people say Elvis isn't dead, because he's an icon, okay?
Elvis lives because Sinatra is dead because he's a human
and made music what it could be.
Elvis is alive because he's an icon and tried to make music
make him. You don't sing many Elvis songs. You know, it's
the same thing. You could go on in the music area. Louis Armstrong
versus the Rolling Stones, Ella Fitzgerald versus the Supremes.
I mean, it's all the same. Why do we love them? They make
the higher culture from the common culture. The same thing
in baseball. What a wonderful game, and Michael and I spend
perhaps much too much time thinking about it.
But it's the same thing with Cal Ripken versus Pete Rose.
It was interesting, wasn't it, and problematic at the World
Series that although the American people, the majority said
that the greatest achievement was Ripken's achievement, the
people cheered loudest when Pete Rose was out there.
I suppose I can understand that. But the thing about Ripken
that I want the little story about Ripken I want to
tell you about. I shared it with Michael, but it's so telling,
and it came when Ripken's stretch of games had come to exactly
the point where it matched Lou Gehrig's.
People came to Ripken, lots of them, and said, "Cal. Stop
now. The record is yours with Gehrig and that's enough." Ripken,
you know, and to some extent you can see the sympathy of that.
I mean, the fact that Lou Gehrig had to stop because he had
amyotrophic lateral sclerosis. He stopped because disease
stopped him in his tracks. Ripken was going strong and could
have celebrated, in a sense, that.
But he said, no, that would be very wrong. That would imply
that I did this to reach this record. This record was the
outcome of my desire to play major league baseball play
baseball at the major league level every day.
That's what it was about. I don't care about this record.
I want to play every day. Showing us that the game is not
there to glorify me. I'm here to show what can be done with
the game, okay?
Now, the same thing now applies Rose is another, for
him, he could gamble, he could do anything, he could debase
the game for his purposes, for all that he was The game
was for him and to make him what he is.
I can go on a little further. Medicine is intended to help
us overcome an illness and to be what we are intended to be.
To use it in another way is to take what we've discovered
and misuse it.
But I'm not sure I could persuade anybody of this, because
this is talking about, you know, the higher culture, and we
live most of the time in the common culture.
We need to be sure that we're telling people what they're
losing, because the higher culture ultimately is to bring
us on we might have to give something up to be in the
higher culture, but it makes up for it in all kinds of ways.
The higher culture really tells us what can be done, and
I'm quite worried that people aren't going to hear that, even
as they hear what you have pointed out, things like family
despotism at the expense of childhood, conformity and courage,
the break with nature, the non-environmentalist aspect of
this intrusion, the hostility towards replacement and ultimately,
therefore, the hostility towards little children themselves,
that we see everywhere.
We still see it. You know, you can't fly on an airplane with
a crying child without the person sitting next to you squawk
and holler, and I remind them that's Social Security, buddy.
I mean, they're the people that's going to be working when
DR. MCHUGH: They always say, "Well, I hadn't
thought of that." I say, right, you know, they're going to
be working so for God's sakes, put up with their crying.
I think I'm rambling a bit here, but just recently, for example,
in relationship even to our other enterprises, look, we're
at war now, and it's a terrible war, but now a couple of our
pilots were given amphetamines to let them be more strong
in some way, and they probably killed those it may well
have led to their killing the Canadian soldiers, which was
So, I end by saying I read both of the things you say, but
this theme that maybe we're talking and could accept what
was individual, then we begin to get disturbed when it becomes
I think that's another expression of the fact that we lose
in the higher culture when the common culture is not inspired.
CHAIRMAN KASS: Paul, thank you very much.
You provide a much larger context. Whether people agree with
you in the details of the choices is beside the point, is
to recognize that to talk about this subject without paying
attention to the larger cultural context is a mistake.
However, I think one should take some heart, for example,
in let's say the concern about the steroid use in athletics.
If one thought, and by the way it's somewhat surprising, because
on the one hand one could say that there is a common over-emphasis
on the mere achievement, regardless of how it's achieved.
There are certain tendencies in the culture, not only in
sports but all kinds of places, where the accomplishment separate
from the activity is all that matters. Granted.
Yet, lots of people are, in effect, bothered by the use.
Maybe it's because, as Charles says, these people are cheating
or that it's somehow unfair. But there's also the sense that,
you know, this isn't quite the same activity, or may not be
the same activity.
Sport, in fact, if I thought it wouldn't somehow embarrass
us here to be giving more time to that topic, its seeming
to be too trivial for our work, it would seem to me it would
be a very good example, because that's one of the places in
the culture where there really is a respect for genuine excellence
and where you can often tell which it is, and not just by
who wins, not only, and where there is a link between what's
common and what's excellent.
On the one hand, the athletic heroes that one admires most
seem to do things that are just superhuman. At the same time,
they're doing the things that the rest of us can do slightly,
if badly, and therefore we understand that there's a continuity
between what is ordinary and what is extremely fine in the
performance of ordinary things.
So, and I think that there's a certain way in which even
the people who play sports in an ordinary way somehow understand
that the pleasure of it is in the activity, and is in somehow
the pursuit of some kind of excellence, and I wouldn't say
that we're simply corrupt on this altogether.
The question is whether or not one can take advantage of
those kinds of sentiments and, in a certain sense, some kind
of worry that the ultimate uses of these technologies will
be degrading in the sense that activity will be distorted
and excellence will be lost.
That's just part of this.
DR. MCHUGH: Well, I agree with that, and
agree strongly. I happen to think that sport is a very important
part of human life, because it's a place where you can see
human challenge without bloodshed.
It's the issue of you can see the hero and the emerging of
human possibility in an arena that costs, ultimately, if you
like certain games, costs people no injury, and therefore
can show human capacity in this way.
I agree with you on the steroids very much, and it's discouraging.
Although, you know, there's something to be said for the fact
that there is a bit of turn-off about the home runs, for example,
in baseball, you know, the old line, if you think it's a hopped-up
ball, you haven't looked at the hopped-up ball players.
I mean, here we have a record of 60 home runs that lasted
for multiple decades, and then suddenly we smash it again
and again and again, and there's something, you know, very
It takes away from that, and so I think that I very
much want to use the model and imagery and symbolism of sport
to talk to other people about the way we live other aspects
of our life and see our excellence there and how we are cheating.
I agree completely with Charles that it's cheating to have
these guys bulk themselves up.
PROF. SANDEL: Okay. There are a few people
waiting, but I want to see if just on this thread, Janet,
was yours on this thread?
DR. ROWLEY: Mine was on that thread.
PROF. SANDEL: Go ahead.
DR. ROWLEY: I guess the concern I have
with the emphasis on the steroids is that my own assessment
of academic, really, superior playing is that it's more than
So it's really coordination. You know, an outstanding tennis
player, a Michael Jordan, for example and I don't know
whether he's an appropriate example or not, but coming from
Chicago it's important that I at least mention him that
sports, ice skating, hockey, these do require strength, and
if you don't have it you're at a substantial disadvantage,
but that doesn't make you an outstanding player.
It's coordination and other aspects. A lot of it is skill
and practice. So you just don't get it from the bottle, and
so I'm concerned that we, in the focus on the steroids, we
don't lose sight of the fact that there's a great deal of
human values and skills still present in this.
PROF. SANDEL: I wonder if before calling
on the others, just following on Janet's point, Leon, that
I could just ask you about two specific examples that you
mentioned in your paper.
I wasn't clear what you thought about them. Drugs to steady
the hand of a neurosurgeon, or to prevent sweaty palms in
a concert pianist cannot be regarded as cheating, but they
are not the source of the excellent activity or achievement.
They may not be cheating, but are those objectionable, or
CHAIRMAN KASS: Well, if I'm forced to say
objectionable or okay I'm going to say okay. I'm not sure
that the things should be
PROF. SANDEL: Well, the reason I ask is
do they violate the norm that you emphasize about human activity
intelligible and transparent and working with one's
initial equipment and not being mysterious and magical and
CHAIRMAN KASS: No, I partly said that
I don't have the place exactly, page what?
PROF. SANDEL: Thirteen.
CHAIRMAN KASS: These are side matters that
somehow get in the way of the fundamental character of the
activity. It's not somehow intrinsic to being a neurosurgeon
that you've got shaky hands or that a pianist would necessarily
These are things which are adventitious. They occur in some
individuals, and here's an opportunity, in fact, to blunt
the noise and let the activity flourish.
I don't think one has fundamentally altered the activity
that one has engaged in, or the satisfaction that comes from
it just because one has blocked out these distractions or
these things which get in the way.
PROF. SANDEL: So the shaky hand of the
surgeon is a distraction. What about a drug not to steady
the shaky hand, but to make the hand somewhat more dexterous?
CHAIRMAN KASS: Well, this, I mean, here
Janet's admonition is somehow valuable, that almost all of
these activities that we value are not unidimensional.
They're not just the function of body parts. There's the
question of desire and attention and if we're going to do
a kind of analysis of all of these things and find out, well,
there's this piece which you could enhance slightly and you
can take me to the next one, and before you know it I've given
away the entire activity and we've got some kind of
the equivalent of some kind of little demon who's inside of
me who's doing this.
At some point maybe I'll say, you know, I've gone too far
with this agreement, but let me concede that there will be
a whole series of such intermediate cases that I'm going to
be able to justify and say you haven't yet, somehow, corrupted
or perverted the activity or taken it away from the agent
whose activity it is.
But I think you'll cross the twilight and at a certain point
you're going to be in darkness, and it will be a very different
kind of thing. This is not an area, I think all of us would
agree this is not an area that comes with bright lines and
"thou shalt's" and "thou shalt not's" and "this is degrading"
and "that's improving."
A casuistry is needed, and yet if this paper has any value
in it, at least it would be to call attention to the kind
of thing about which we should be thinking when we think about
the continuity of the continuum.
PROF. SANDEL: Right. Just on this issue
of the continuum or the range of examples, Charles, is it
DR. KRAUTHAMMER: Yes, it is, if I could
just pick up. In the example that Michael brought up, it seemed
that to me the distinction between the steadying of the shaking
hands and the increase in dexterity would be a distinction
between what you might want to call therapy on the one hand
and enhancement on the other; suppressing a defect as opposed
to creating a capacity.
Now, what was most interesting to me in your paper was your
rejection of that notion, that bright line between distinguishing
between therapy and enhancement, and you pointed out all of
the difficulties in doing it.
But I wonder, since intuitively we might say, keeping the
surgeon's hand from shaking, that sounds okay. Making a surgeon
of Rank A into a surgeon of Rank A+ with a drug, that sounds
a little bit like what we're deploring.
It would seem to me that the reason that we intuitively say
yes to A and no to B is that one is what we would think of
as therapy, correcting a defect, and the other is enhancement,
creating something new.
It seems to me that if you take away that notion of the distinction
between therapy and enhancement, between disease on the one
hand and sort of superhumanity on the other, you have kind
of disarmed yourself intellectually in this discussion.
I'm not sure you could carry it through without that distinction,
given all of its problems.
PROF. SANDEL: Do you want to take that
on now or after you hear some other?
CHAIRMAN KASS: Let's go with some more.
PROF. SANDEL: Okay. Robby?
PROF. GEORGE: While I'm having trouble
resisting just getting involved in the casuistry with you
guys, but let me see if I can force myself, too, to raise
the point that I had actually raised my hand about.
Although it will take us away, Michael, I was going to raise
a completely different and a lot mushier issue, so if you
PROF. SANDEL: All right, well is there
anyone else who wants to pitch in on the casuistry? Go ahead,
PROF. GEORGE: Okay. Leon, as I was reading
sections three and four of the paper, an issue occupied my
mind that's completely different from anything we've raised
heretofore on the Council, but I wonder if you've given it
any thought and if you have anything to say about it.
As I say, it's somewhat mushy. It's this. There seem to be
some values and virtues, and perhaps what even might be called
attitudes, that individual people, or at least families or
units of society, as distinct from the larger society as a
whole, are capable of understanding, seeing the point of,
practicing, even if sometimes with difficulty.
Virtues and values aren't always easy to live up to or to
exercise, in the case of virtues. But there seem to be other
values and virtues, and I should think attitudes, and perhaps
the attitudes that you're commending, sometimes, as the opposites
of those that should be rejected, like the attitude we take
when we regard our lives and aspects of our lives as gifts,
which it's extremely difficult for an individual or even families
to get hold of, to understand, to see the point of and to
practice in the absence of a larger culture which formally
through its institutions and informally through its public
opinion and habits and so forth, is supporting.
The example that I'll borrow I hope it's useful
I borrow from Joseph Raz, the Oxford legal philosopher who
talked about this issue in his 1986 book, which was called
The Morality of Freedom.
His example was monogamous marriage. He said monogamous marriage,
assuming for the sake of argument that it's the uniquely valuable
form of marriage; that it's the morally best and right form
of marriage, Raz says that monogamous marriage can't be practiced
by an individual or by individual couples.
No, he says, rather, it requires a larger cultural structure
that supports it through its public laws and policies and
even more importantly, perhaps, by its informal attitudes.
Now, I take Raz to mean there not that a society that does
not value and practice a widely practice monogamy, it would
be impossible for a man to confine himself to a single wife,
or a wife to a single husband.
It doesn't mean that. Obviously, that would be possible.
He's not supposing that it would be made against the law to
take only one spouse. I think what he means is that individuals
would just have an extremely difficult time working from scratch
seeing the point and value of monogamous marriage in the absence
of a culture that gives them a sense of that value and of
the virtues associated with it and needed for it to flourish.
If you're trying to just reinvent the wheel it's not
as if you can't actually construct a pretty rigorous argument
in Aristotelian fashion, perhaps, for monogamous marriage,
but it will simply seem a kind of sterile argument, a kind
of casuistry that people will, whether they can find some
logical flaw in it or not, not really be able to make use
of in getting a grip on this good, valuable thing.
In reading parts three and four of the paper, I was thinking,
you know, the attitude that you're here holding up, and the
attitude that Michael held up in his paper at the last meeting,
might be just that sort of thing, that this is not a matter
really of individual choice exclusively, but the kind of thing
that's inherently a gift.
The attitude itself, a gift, made possible, not made certain,
but made possible by a culture that provides the resources
for it by that kind of formal and informal support.
CHAIRMAN KASS: This is a continuation of
Paul's comment in, not speaking about the higher and common
culture, but speaking about the world understanding of the
culture as a whole.
I think one of the although I found that Michael's
analysis, though welcome, thought it didn't go far enough.
He did go in a way to the extent to which these more philosophical
questions of goals and means can be dealt with at all, it
might only be possible if one has a culture that shares a
certain kind of attitude with respect, for example, to the
issue of appreciating and savoring as opposed to trying to
master and the like, which is why I think beginning with attitude
is not just to be set aside, but there's something primary
Michael, at the end of his little paper, hinted that the
roots of this matter might, in fact, be with a certain turn
in Western thought, both about the nature of nature and about
what our attitude toward it should be, and that perhaps we
need to rethink that.
I wish him lots of luck. I would like to do it too, and to
do it without sacrificing all the great benefits that all
of us have as a result of this turn. But, no, I think you're
absolutely right, and there are lots of things in the culture
that stand in the way of getting to these kinds of questions,
even if one wanted, even if one could do it intellectually.
On the other hand, and I really do mean this, I do think
that when people look at some of these biotechnological developments
and the world that they might be producing for our descendants,
yes, some people are worried about the ethics of the means
and the questions of the sanctity of embryonic life, but some
of them are really worried about the question of what would
human activity be like and what would human institutions be
The power of the novel like Brave New World is that
it at least it evokes those kinds, still evokes those
kinds of concerns. So, I'm, at least for myself, not willing
to turn my back on this culture and declare it as being incapable
of resonating to these sorts of things, because I sense the
people's worries about those matters.
I mean, sure, there are prophets who say, look, the post-human
future will be wonderful, we should go there. Evolution has
in fact made it possible for us to take the reins of our own
destiny and to produce something better than human beings.
But I think that the people as a whole are concerned about
this, and public bioethics has yet, I think, to give voice
to that concern. That's part of the justification for working
at this difficult project, because I do think it touches some
of the really deepest questions.
What kind of a world will these technologies produce if they
were allowed to develop in their own way?
PROF. GEORGE: A brief follow-up Michael?
PROF. SANDEL: Yes, go ahead.
PROF. GEORGE: Leon, I certainly agree with
that. I wonder if the strong libertarian streak that we Americans
do pride ourselves on and which has served us very well in
very many respects, and which foreigners often comment on,
does provide, though, a particular challenge to seeing the
problem, because we're always tempted to believe that we can
solve these things, handle these issues as a matter of individual
choice and sometimes, then, fail to see the respects in which
they are inherently and profoundly social.
Still matters of choice, there's still choosing that needs
to be done, but social and not entirely individual.
PROF. SANDEL: While we're still in
I have Bill and Frank waiting and then Gil on the issue of
shaping attitudes and the moral culture. Were there people
who wanted to speak to that before we moved on to others?
Was yours on that, Gil? No. Okay, in that case, Frank and
then Bill. Oh, Bill, I'm sorry.
DR. MAY: Well, several comments now. First,
you give us directly the quote from Montaigne, "The Hymn to
Aging," and the benefits of that, "led by nature's hand down
a gentle and virtually imperceptible slope towards the grave."
You quoted this at an earlier meeting, and I'll repeat a
comment I think I made at that point. There's certainly a
truth to that, but I guess I've had more powerful sense of
readiness for the grave with a sense of work completed.
I'm acutely unready for it when that book is not yet written
or almost finished or something like that, and I think more
generally in life people sense when they've got those children
grown and they're no longer taking in water out in the harbor,
but they're rolling along in the seas, a sense that their
work is done.
Yes, I suppose signs that the castle is crumbling also prepares
us, but it's not the indispensable way that we are prepared
for our mortality, it seems to me. That's the first point.
The second relates to what Frank has said. I mean, there
are stretches of this paper that is perfectly beautiful. The
closing coda is a very beautiful paragraph indeed.
Excuse me, Paul's comment about the distinction between the
high culture and the common culture, the low culture, and
one begins to wonder whether we're talking about stuff that
is susceptible to policy-making and legislating or we're talking
about things where the appropriate mode of relationship is
I'm a little bit hesitant about the distinction high and
low, because its fineness and crudeness or sensitivity that
doesn't necessarily relate to what we think of when we talk
about high and low.
Last comment you offer is on a very previous and appreciative
conversation with Michael Sandel on the question of mastery
and giftedness. I simply would be very interested in hearing
from our temporary Chair what his response might be to those
sections of your paper that refer to Michael Sandel's comments.
CHAIRMAN KASS: Could I do something quickly
on the first and then? I'm very eager to hear, also, I'll
only deal with the first comment. It's very interesting, it
was interesting when we had our people on aging research present
at the last meeting.
I had occasion with Dr. Austad over dinner to pursue the
question with him further. The degree to which they regard
life sort of like a time line having no shape, but you could
add increments to it as if it had no form of its own; that
it was either going to be more of it or less of it or a lot
more of it, or something like that.
What I was in a way arguing for here, are a number of things,
that to really think that to take seriously finitude
not as just a curse, but as and none of us will ever
know exactly in advance what the shape will be like, and I
certainly don't want to romanticize the end of life the way
many people now have to go through it. That should be said.
But to perceive one's life as time, the extension of which
is to be regarded homogenously, as if it were just a variable
in physics, rather than to see it as part of something that
has a shape and a trajectory and a form, I think, is a kind
of distortion of what the truth about things is.
Partly in the quotation from Montaigne, one does begin to
see, you know, as my friend Joseph Epstein said, "I look in
the mirror and I say to myself, where did I ever get such
a turkey neck?"
You know, and he's beginning to see that there are certain
kinds of intimations. That's not the whole story. The other
thing has to do with the perception of time future, and whether
or not you think that there is always going to be tomorrow,
which one is going to be encouraged to do if there are no
intimations that things are slowing down, then it seems to
me one also misperceives the shape of a life and may not even
have the same kind of attitude toward having a project, finding
something to complete, having a family, doing these various
kinds of things that are somehow tied to the trajectory of
So I didn't want the Montaigne thing to stand alone. I think
one wants to talk about both readiness for finitude, as well
as the perception and uses of time in the early part of life,
which is a lot we'd look upon it very differently if
you thought it was extendable indefinitely, than if you thought
you were on the way up, or that you were at your peak, or
that you were now part of the generation that was supposed
to make way.
PROF. SANDEL: My response to Leon's response.
As I understand it, Leon's reply on the point about mastery,
leaning against mastery and cultivating and appreciation of
As I take it, Leon accepts the critique of a certain Promethean
aspiration to mastery, but goes on to make the point that
simply to assert as the rival norm giftedness or an appreciation
for the given is indeterminate.
It's indeterminate in the sense that it doesn't tell us by
itself which things can be fiddled with and which should be
left inviolable. He gives the example of smallpox being among
the things that are given, and simply because it's given doesn't
mean we should acquiesce in it and not intervene to confront
it or even to eradicate it.
I certainly agree with that. I agree that the notion of giftedness
or restraining the drive to mastery is indeterminate in the
sense that it doesn't by itself specify what things we should
try to alter and what things we should stand back and simply
appreciate or savor.
Though I'm not sure that any norms at this level of abstraction,
no norm in this range would be determinate, I think. But then
the question arises, well, then, how do we go about deciding.
Here I think I would agree with Leon, that we have to assess
the worthiness of the ends, the goodness or badness of the
givens that we step back to contemplate or to reflect on,
possibly to appreciate, maybe to try to eradicate.
So then the question is, well, all right, if we agreed that
we have to reflect on the goodness of the gifts, not all gifts
are ones that we would want to simply affirm or leave in place,
what's the source of those moral judgments?
I agree the source can't just be an invocation of the idea
of the gift. I think there is a certain conception of a good
life for a human being implicit in the general account.
It's one that Bill May brought out last time when he was
giving what I took as a sympathetic elaboration that there's
a tension between the molding and beholding, Bill's language,
between the shaping, the intervening and the savoring, and
it seems to me the account of the good life that this gestures
toward is one that says we have to hold in tension these two
stances toward the natural world and toward ourselves.
It's not easy to hold them in tension, especially when we
live in a culture where the drive to mastery is so predominant
that it crowds out the other sorts of attitudes and appreciations.
So there is a kind of norm there. It's a norm of a certain
kind of life, a certain kind of goof life. It's not, though,
one just specified in those general ways that will help us
say, well, what should we alter and what should we accept.
But here I think we have to look case by case. Here's where
I don't think we can expect a global answer. So, for example,
we could look at smallpox, and we have to investigate whether
smallpox, despite the great damage it does to human life,
is there some, nonetheless some very important end that we
should respect in preserving it, and if there isn't then we
should eradicate it.
We have to have a local examination of each case. When we
come to sex selection, we have to say, well, here's a case
where the drive to mastery seems to be getting the better
of us, but is there some important human end that's served
by specifying the sex of our children.
If we can't give a good answer to that question, then that
would be a case where that would be a good reason to restrain
the drive to mastery. Is some important, crucially important
end served here?
Whereas in pre-implantation genetic diagnosis to screen out
dread diseases, there we might say, yes, some very important
human end is served here. So we have to go case by case. There
has to be, it seems to me, a local, particularized moral inquiry
in order to make determinate this general account of where
the culture seems to be going wrong in the drive toward mastery.
I don't and here I have some questions maybe for later
about what I take to be the other account, the other normative
account, Leon, in your paper, which emphasizes this kind of
undivided, transparent, unmediated relation to one's own activity.
Insofar as that's attractive, I don't know that it's more
determinate than the other kind of standard, and I'm not sure
I fully understand the moral weight of it, so I'd like to
ask about that.
But this, maybe we should put that off. I think we do have
to assess the good of the given. I agree with that, but I
don't think we can fully specify the good of the given just
I think we have to deliberate and engage in moral reasoning
case by case with respect to each practice or given that we
DR. MAY: May I add a word on the question
of gift which you talked about. In my limited experience with
actors and singers and so forth, I so often realize that there's
really a double gift.
One is the gift of the talent, and the second is the gift
of the psyche to support it, and oftentimes you have an immensely
talented person, but the psyche to support that, in performance
particularly, and all the acute anxieties that can go with
Now you face an interesting problem with regard to range
of normal and so forth. That person's psyche could cope with
normal functioning in life. It's in the setting of the stage
that there are demands upon it that they're not able to support.
Now you've got an interesting problem. Do you offer medical
treatment to sustain the psyche in this particular task, when
in fact, in so many ways, the alternative would be to walk
away from it?
But in walking away from that second gift, the gift of the
talent, then, yes, they can function, and it's within a range
of normality, but there is also an enormous loss associated
with that walking away from something that you've been given.
It seems to me this is a range of complication in that discussion.
PROF. SANDEL: Just on this, Paul?
DR. MCHUGH: Just to finish off your comments,
Bill. I just wanted to make the point that I didn't use the
word "low culture." I used the word "common culture," and
I'm in favor of common culture because we're a part of it.
I want the higher culture to lift it, and my problem now
with what we're talking about in the examples I gave to you
is that I think that music deteriorates in the common culture
into Elvis. Okay?
I don't want to see medicine deteriorate into Dr. Feelgood
with his shadowy cousin Dr. Kevorkian, because that's the
way it will go.
PROF. SANDEL: Frank?
PROF. FUKUYAMA: Well, Leon, you mentioned
that there's a whole social dimension to enhancement that
you don't really deal with in the paper. I thought I might
say a little bit about that, because actually, to me, that's
in a way the most threatening aspect of enhancement.
I think that it's actually an argument that you can present
in a straightforward way that is fairly clear to people, although
I really like the paper and I think the discussion it stimulated
indicates how useful the paper is.
But let me just lay out a framework for thinking about when
you scale this up to the level of societies, what's wrong
with enhancement. One obvious problem has to do with so-called
positional goods, or goods that have to do with status, in
which you're basically involved in a zero-sum game with other
members of society where a gain for you is a loss for others
and vice versa.
Now it seems to me many potential objects of enhancement
involve these kinds of zero-sum games. Height is a perfect
example. Being of shorter than average stature, I know perfectly
well that there are lots of disadvantages to that, and all
sorts of opportunities that I haven't had that I would have
had if I were, you know, six foot three.
But that's not an absolute good. If I had been born in the
year 1500, or you know if I had been born in Japan or some
other place, that disadvantage wouldn't have accrued to me.
Robert Frank actually, the economist Robert Frank has this
wonderful book called Choosing the Right Pond, where
he points out that actually many economic goods that we think
of as absolute goods are in fact positional goods, or some
of them are actually mixed, so that you may want that Masarati
because even on a desert island you just love the look of
the carburetors, but you know, many people also like the fact
that their neighbor has a Jaguar and they can one-up them.
So the motives are fairly complicated, but there is definitely
going to be one class of enhancements that will be positional
goods, and the typical solution to this kind of arms race
situation is actually for a public authority to intervene
and simply say, look, you just don't compete along this dimension
because in the aggregate, although you can have individual
winners and losers, in the aggregate nobody can win this kind
So that, I think, is fairly straightforward. A second category
of issues has to do with public bads, or negative externalities,
or, you know, we've dealt with this already.
I would think that actually much of life extension falls
in this category. It's of obvious benefit to an individual
to have another ten years of life, even ten healthy years,
but it seems to me, on the whole, it's not good for society
as a whole.
I mean, there are a number of reasons why this might be true.
I think actually things like innovation, change, adaptation
to new circumstances actually goes on generational cycles,
and if you lengthen the length of generations, I mean, you
wait for Franco or Castro to die or you wait for the Depression
generation to get out of the way so that you can actually
spend money instead of putting it in bank accounts.
This sort of thing. I mean, all of these things slow down
dramatically, which imposes a cost on society as a whole,
even though every individual in the society would individually
want that extra ten years of life.
So I think that that's one appropriate way of thinking of
that. Now, the final problem, I think, has to do with the
problem of social control and social engineering where one
group of people will attempt to use enhancement technology
to shape the behavior of other members of the society.
Now, and this has already come up in our discussion of Ritalin,
which it seems to me, if Dr. Diller is right, that seven out
of eight children being prescribed Ritalin actually don't
have aren't being prescribed it for therapeutic uses.
Then in fact, most of the use of that drug is really as an
agent of social control. This actually then gets back to I
think the issues that you raise in your paper.
What's wrong with social control? Well, the answer is nothing
in itself. Parents try to socially control the behavior of
their children. It's called education, socialization, so forth.
You don't want them to grow up as criminals. You want them
to put off short-term gratifications for long-term ends, and
all of that. So we do that all the time.
What is wrong with this class, this potential class of technologies
that may permit new types of social control that we haven't
seen? Here I think you end up bringing back a lot of the considerations
that are in your paper that have to do with wholeness and
integrity and in a certain way the complexity of a whole human
being, because I would say that the biggest problem with most
attempts at social control and social engineering are that
they are based on an oversimplified model or understanding
of human behavior that does not understand the complexities
of human motivation, and therefore when they try to push on
this one lever thinking they're going to solve one problem,
it comes out somewhere else because they don't understand
that actually all the levers are connected to one another.
This, in fact, is actually one of the would be part
of I asked you the other night. I was asking you what
your answer would be to the Darwinian, you know, talking about
giftedness and if you don't believe that God gave you all
these characteristics as a gift, then presumably the other
big alternative is that evolution gave it to you.
You can say, well, if that's just a snapshot in evolutionary
time what's so great about that gift and why do we have to
defend it. I guess my answer to that question would be that
actually evolution created a whole human being whose
and the interworking of the different parts make an adaptive
sense that's extremely complex and that we don't perceive
So that, for example, many targets of enhancement like hatred,
competitiveness, violent aggression, all sorts of propensities
that we don't like actually are there for good evolutionary
reasons, and they're linked to things that are very positive.
We deplore our group-mindedness. We always divide human societies
into insides and outsides, but if you think about it in evolutionary
time, if we didn't do this, we wouldn't be the social species
that we were, and it's very hard to separate the good aspects
from the bad aspects.
Some of those are simply unsolvable, I think, dilemmas of
social organization. There's actually a lot of game theory
that's quite interesting in this regard.
There's this game in evolutionary game theory, hawk and dove,
where you have a population of hawks that are predators and
doves that are peaceful minded, so forth.
It turns out that given I mean, it depends on the starting
behaviors of the populations, but the doves who cooperate
but are very passive don't win, but the hawks don't win either
because in a way both the hawkishness and the dovishness,
when scaled up to a social level, have kind of off-setting
So as the game is played, you actually get a mixed population
of hawks and doves, and so both of those characteristics are
actually adaptive in a certain sense.
It seems many human characteristics are like that. What I
see as the single most threatening thing about enhancement
technology is that somebody is going to say, `Hey, great,
we can change this particular obnoxious characteristic of
human beings that we don't like.'
If it's not totalitarian states doing it, it'll be some school
district or some group of parents that gets it in their head
that girls should be less feminine or boys should be some
other way, or some other thing.
Maybe it's just the opposite. Maybe in some point they'll
want more feminine girls and more aggressive boys. Whatever,
but it seems to me that it's almost inevitably the case that
if, in fact, all of these human characteristics are bound
up in these extremely complex wholes, where the good things
are inevitably linked to the bad things, that virtually any
intervention like this, using these new, more powerful technologies
is almost always going to lead to unforeseen consequences.
I really think that that's the issue of hubris, when people
it's not the hubris of the method bringing modern science
to bear to try to achieve these ends, because we do that all
the time through all of our other technology.
It is the hubris of thinking that we understand this, you
know, especially the interrelationship of human emotions into
a whole human being, and that we understand how those interrelate
and how the good emotions relate to the bad emotions well
enough that we can intervene and manipulate to make people
So I guess that's my overall sense of the lay of the land
on the social side of this, what's wrong with this stuff.
PROF. SANDEL: Could I just make a comment
to Frank, and Leon, you can feel free to react or to leave
it till your full reaction. What you're doing in explaining
what's wrong with enhancement essentially is translating all
this talk about the moral objection, trying to locate the
moral objection, to translate it into problems of social organization
or evolutionary complexity.
In a way, what you're and maybe you're right, but you're
making a radical suggestion that the whole moral inquiry is
misplaced or misdirected. You are really, because all of the,
as I listened, tell me if I'm wrong, as I listened to each
of those four reasons to worry about enhancement, all of them
none of them has to do with identifying anything intrinsically
morally objectionable in the enhancement.
It all has to do with adverse effects on social organization
or misunderstanding evolutionary complexity and therefore
giving rise to unforeseen consequences.
Do I have that right?
CHAIRMAN KASS: Don't agree. Look, this goes
back to an exchange that we had at the last meeting where
you listed a number of things and, you know, deformed human
life, it would do this, that and the but where's the
As if the moral problem was simply is it objectionable in
itself, is it good or is it evil. Frank is talking about things
that would transform the character of human life for the worse.
I take that to be a moral comment, and not merely an operational
one. It's not a moral objection in terms of thou shalt and
thou shalt not. It's a moral objection in terms of the greater
good and the lesser good, if I'm
PROF. GEORGE: Well, but I think Michael's
entirely right to notice that lurking there in the background,
behind the considerations that Frank raised is some judgment
that Frank must have in his mind that enables us to distinguish
the good from the bad or the greater good from the lesser
It's the kind of thing that I think just has to be teased
out. It's not that there's something wrong with Frank's analysis
necessarily, it's just incomplete until we get to those considerations
which are plainly there in the background, but are hovering
in the background and naturally they interlock, you know,
what are they.
DR. KRAUTHAMMER: Or to put it another way,
perhaps to harmonize it with your analysis, Leon, which is
very individually based. I think what Frank is saying is that
if you it's rather difficult to see what's essentially
wrong with enhancement in an individual.
You try to tease it out, because intuitively it seems like
a good idea. What Frank is saying is that when you aggregate
it, then you can see it much more clearly.
I'm not sure that there is a contradiction between the social
analysis and the individual moral analysis. I think the social
analysis helps to illuminate the moral analysis by saying
that if you do it on a societal basis then it jumps out at
you how distorting and dehumanizing these activities are.
PROF. GEORGE: Distorting and dehumanizing
will be concepts that are intelligible only against an understanding
of the human. The understory of human flourish
DR. KRAUTHAMMER: No one is denying that.
CHAIRMAN KASS: Everybody who's spoken I
think agrees to that.
PROF. GEORGE: Well, I think Michael was
saying to Frank Michael, you can speak for yourself,
but I think what he was saying to Frank is not that he was
denying it, but it was just left untreated.
CHAIRMAN KASS: Unspecified.
PROF. GEORGE: Right.
CHAIRMAN KASS: Right, okay. Yes, well, in
fact, in the paper, I mean, in terms of the ends, which I've
lifted up to view as the ends that seem to me to be most likely
candidates, attractive candidates for personal use, namely
ageless bodies and a certain understanding of happy souls
or at least not unhappy souls.
When I came to try to make the case against what might be
wrong with the pursuit of ageless bodies, I thought the only
way you could begin to show that, in fact, was to aggregate
the consequences and have a look at what it would like if
that were the practice of a population as a whole, in the
mirror of which we might be able to see how it might be deforming
for any given life to live in a world like that, and that
only by somehow aggregating the multiple choices and picturing
what that means, both with respect to the perception of time,
the shape of a life, and various other things that do touch.
I did admittedly, not with much precision, listed a number
of things that I thought to be fundamental human goods that
were at risk here. I mean, I don't think, having read some
things of Frank's, I think there are things I think
he could, if we stopped speaking, let him speak, he could
sort of fill in that content for himself.
I mean, there is some sense of human nature, not something
absolutely inflexible, but nevertheless the activity of which
and the flourishing of which is what one is trying to defend
here, and the attempt to somehow improve it by piecemeal intervention
without regard for the complexity of the whole of it is to
run the risk of degrading ourselves, not just getting things
to go wrong.
PROF. SANDEL: I've got Now, we're
going to end at 3:30 or after? We started late.
CHAIRMAN KASS: Take five extra.
PROF. SANDEL: All right, because I still
have, I've got Bill and Gil and I was tempted to take one
more crack at this issue, but maybe put that aside? No.
CHAIRMAN KASS: Go ahead.
PROF. SANDEL: It seems to me there are
two different ways in which aggregating consequences can help
us better understand the effect of some of these practices
The way that I understood, Leon, you to be aggregating consequences
in order better to see the moral defect was if we imagine,
when you invite us to imagine what would happen if people
didn't age, but just suddenly died, and wouldn't this have
the effect, if you imagine it aggregated across a society,
of changing certain important practices and understandings
that we have.
So that's aggregating consequences in a way that highlights
the moral defect of the practice. It transforms our relation
to one another, the relation between the generations deforms,
relations of parents to children and one's own self-understanding.
There's a second way of aggregating consequences to show
what's wrong with enhancement that doesn't aggregate in order
to show here how morally we would transform ourselves, but
instead shows here if you imagine the arms race, it wouldn't
work, morality aside.
The example here is Frank's first example about enhancement
to increase height, where parents could go and get growth
hormone to have their less than average child lifted up.
But then if we aggregate that, Frank points out, and imagine
everyone doing that, why then it wouldn't work. There'd be
an endless arms race. People would have to go back again and
again just to try to stay ahead as the average height increased.
Now, that's an argument against enhancement that appeals
to aggregated consequences, but at no point did those aggregated
consequences highlight the moral objection to the enhancement.
They have all to do this is what I meant by emphasizing
the social coordination problem of the endless arms race
it simply wouldn't work to achieve the individual aim.
PROF. FUKUYAMA: My first two examples are
completely utilitarian. That's right.
PROF. SANDEL: Rebecca, quickly on this
and then we'll go.
PROF. DRESSER: One methodological point.
It seems to me as a public bioethics counsel, our strategy
is best to bring in all these different considerations, because
we have this problem of convincing others, including the common
culture and physicians and so forth.
So I would rather use these in an additive way and that's
one thing I liked about our cloning report.
CHAIRMAN KASS: We agree completely.
PROF. SANDEL: Okay. I have Bill and then
DR. HURLBUT: When I read this essay, I
was I wholeheartedly agree with the central insights
of the essay, but as I was reading it, I was asking myself
what is this happiness going to be like that you're hypothesizing?
Indeed, what would agelessness be like? Well, starting with
agelessness, it certainly isn't going to be the overcoming
of death, because there would always be the possibility of
death from accidents or homicide.
So that's going to linger over us like a shadow for sure.
Then, what would this happiness be like? Well, the happiness
can't be a static state of comfort, because creatures as complicated
as human beings are made happy by something that is dynamic
in the ability to meet an ongoing series of possibilities.
It's an open phenomenon. So I was asking myself what enhancements
could lead to such states? Even if you hypothesized they were
possible, what would these enhancements be like?
It all came back down to me to a little bit what Frank was
talking about. Well, where did we come from, what are we for,
and the question of what does happiness mean at all.
Looked at from one perspective, happiness is an agency of
evolution. It's related to drawing us into that which is good
for us as organisms and for evolutionary process.
Looked at another way, happiness is that blessed possibility
given to us by whatever it be, God or evolution. In that sense,
what it seems to me is at stake here in the very center of
the core of this is the question of the meaning of the natural.
How does happiness relate to the given world? Its human dynamics,
its dependencies, its modes of creative extension and so forth.
You defend very well in your essay and you illuminate the
notion that being at work in the world as we find it could
be very crucial to our happiness; that it's not just as we
find it, but as we could be perfected without ceasing to be
ourselves in the process of it.
So, when I started looking at all that together, I don't
know if this connects easily, because it's a hard thought
to get at, but why are we as we are and what makes for happiness?
It struck me that we are as a creature a general purpose
organism, a best balance of body, mind and the real world
such that we have certain qualities of freedom and open-endedness,
and that all of these enhancements are in some ways self-limiting.
They are taking us off not up higher, but taking us
beyond the top of that which is our most central quality of
human nature. This is a hard thought.
I don't know how to say it easily, but when I think of what
would you do these enhancement projects for, I ask myself,
well, why would you do these interventions against given nature,
and even when you consider there's a risk involved.
The first one that comes to my mind is the trivial uses of
them. The sort of indulgent pleasures or whatever it might
be, what's been called "free play", a kind of indulgence in
aesthetics of the body or some superficial contentment, which
is sort of like what Nietzsche called pitiable comfort, that
trivializes human life.
One can see right away why that's wrong. The other one would
be competition. That seems to me to be that has a little
more bite. It is a giving over to another natural impulse,
so we're losing ourselves in a way that way too.
But the third one that struck me is noble purposes. When
you look at what happiness is, you clearly aren't going to
get happiness by taking a drug.
The whole of the unfolding of life is a process of removing
us from the level of the basic molecules of determinism into
an arena of agency where there's a rising scale of indeterminacy,
of freedom that's emerging.
So there's no magic carpet to happiness or contentment. Contentment
actually relates in some strange way to the process of life.
It's like, maybe you could change the dye a little bit, but
that wouldn't change the it's like, if life is a Persian
carpet, you might be able to change the dye temporarily, but
life's happinesses are actually the pattern put in one knot
at a time through living.
In that sense our happiness is related to ideas, concepts,
cosmology, not to the color but the pattern of life. So what
pattern of life would give us the meaning that would, in fact,
I don't think the self-limiting that would be involved in
the trivial or the competitive would do that, because I just
don't think they would. I don't think there's any way to engineer
those kinds of things.
But what struck me in this is that there is a way where
there's an amazingly interesting thing about all this where
the meaning of agency is also connected to the deepest happiness.
Where and this is where the triviality of the individual
or the competitive quality actually are solved. Where the
individual and the community meet. This brought me back to
Hans Jonas' essay that we read at the beginning of this project
It struck me that there was something profoundly beautiful
and true that, as he spoke about the meaning of human experimentation,
and he spoke about that devotion, that dedication, that sense
of true sacrifice from the highest devotion, and how it's
The sublime solitude of dedication and ultimate commitment
away from all reckoning and rule into a whole different sphere.
That struck me as the thing that's the highest extension of
this quality that Leon speaks of as being at work in the world
and being perfected through an agency that keeps us
that moves us toward perfection, but also keeps us, preserves
that inner essence of what we are.
That struck me as the one place where enhancement meets.
This is a very hard thought. I'm not sure I'm getting it across,
but it struck me, that's where enhancement meets and coordinates
with this true human meaning.
It's You can see how you could use enhancement as a
surgeon, or maybe for some explorer, exploration or artist.
All these involve that dedicated devotion, but they engage
the full human faculties, and they increase dignity.
They all have an element of giving, of being used up, and
this is where the meaning of the natural seems consistent
and the other uses of enhancement seem inconsistent.
That was a very hard thought. I'm sorry if that was so wordy,
but I think there's something in there.
PROF. SANDEL: Gil? We're running close.
Why don't, Gil, you make your comment and then Leon can respond
PROF. MEILAENDER: Okay. I had two points.
The one is just a very minor quibble, the other Frank's having
rubbed your nose in social realities, I want to get you to
think about something very ethereal.
The very minor quibble, I want to make it, even though you
understand that I think this is a great paper. But very near
the start, on page two, you contrast what you're going to
take up or you say it will get us beyond our narrow
preoccupation with the life issues.
I'd just like to encourage you to find a different formulation.
It's a different preoccupation, but there's nothing narrow
about seeking to honor the time and the place that every human
DR. KRAUTHAMMER: He meant endless, not
PROF. MEILAENDER: Oh, well.
PROF. MEILAENDER: He may have meant narrow,
but this is an old conversation, but I wanted to encourage
you. Now the other point. I want to see if I can get you to
think about heaven, because in your wonderful last section
on dubious ends, you make various kinds of claims that we
need our finitude to make possible the best things; that the
very prospect for human happiness requires the possibility
of deep unhappiness.
You say things like that, and that might not make too much
difference if you didn't say in your last paragraph that the
life that you've described is a life that stretches towards
some fulfillment to which our soul has been oriented.
The question would therefore be whether what one would
mean by such fulfillment, whether we can conceive of fulfillment
that is only destructive of the best life, as you've described
it, or whether we can conceive of fulfillment that would somehow
complete it and be fulfillment in that sense.
PROF. SANDEL: Gil doesn't like the Greek
flavor of this, Leon.
CHAIRMAN KASS: Or Hebraic.
DR. MCHUGH: Can I just finish up one other
thing before? I just for 30 seconds want to remind you that
what we're doing in a sense is some people would say reinventing
the wheel as we look at the problem of beholding and the tension
with it that you make with transforming, because there was
a person in education that saw those two things and brought
them together, and that person is Maria Montessori who you
remember had as her theme the biological concept of liberty
She said that the child must be free to act spontaneously,
but should fit an environment that's ready for his spontaneous
action, what she called auto-education that we need to work
with, with the idea that growth should be enjoyed, beheld,
but at the same time helped in ways that speak to liberty.
Her work is something that we should remind ourselves of
whenever we are thinking that maybe no one ever thought of
these two things and bringing them together successfully.
PROF. SANDEL: Thank you. We'll give Leon
the last word.
CHAIRMAN KASS: I should be brief. First
of all, thank you all for taking the paper so seriously and
offering helpful comments, and there's lots more to think
Bill Hurlbut, we should talk further, but I got something
from that. It seems that to talk somehow about the natural
or the natural and fulfilled or the natural and improved without
ceasing to be what we are, and then to try to give it some
specificity, whether it's in terms of open-endedness and freedom
as you and Paul were saying, or whether other kinds of qualities
don't have to enter into this, that's the hard task.
I mean, the natural of the squirrel is a lot simpler than
the natural of the human, especially because of the indeterminacy
and how much is filled in by culture and the like and we're
not going to
It seems to me one might be able to make a case for not squashing
certain kinds of human capacities without having to settle
the differences amongst the various cultures as to how they
try to fill in that view of the perfection.
I mean, there is a way in which we can read one another's
culture and recognize them as human, even as we continue to
fight about who might have the clearer understanding.
So it's a matter of not letting the human floor fall below
the possibility of reaching for whatever account of the fulfillment
that we have. I thought it was probably as far as we were
going to get in this Council when Robby George last time tried
to get Michael Sandel to see whether he was willing to take
on the proof of the existence of God, but now you give me
heaven that I have to deal with.
PROF. GEORGE: By the way, I think we should
hold any discussion of heaven until Michael Gazzaniga is here.
CHAIRMAN KASS: I am at best an agnostic
on heaven. At best, and it doesn't enter into my
PROF. GEORGE: How about hell?
CHAIRMAN KASS: More likely. No, it seems
to me that to give a kind of anthropological answer is to
say that part of the reason why so many different cultures
have somehow postulated a life hereafter, and I don't mean
to say that they've postulated it because they haven't divinized
that there must be such a thing, but why it shows up in so
many different places is partly to give a hopeful answer to
the fact that there seems to be a gap between the aspirations
to which we are pointed here in earthly life and the fact
that we don't get there.
Therefore, there is a hope that there might be a different
and a better life in which those aspirations could be realized.
For myself, I'm content to be aspiring. I don't insist on
That may be shallowness on my part, but I take this direction
as a gift. Whether or not there's a giver, and whether or
not there is a better place in which you and people of your
ilk might someday go, I'm probably going somewhere else if
there is such a place.
DR. FOSTER: Well, Leon, there was a famous
rabbi who once said, "What I aspired to be and was not comforts
PROF. SANDEL: Well, those are two graceful
notes on which we can end by thanking Leon for a very stimulating
paper. Thank you.
CHAIRMAN KASS: Let's take ten minutes this
time. We're, as usual, behind.
(Whereupon, the foregoing matter went
off the record at 3:46 p.m. and went back on the record at