Continuing the conversation with Dr. James Hughes of Trinity College, founder of the Democratic Transhumanism movement.
Read Part I.
Democratic Transhumanism, despite its futuristic trappings, hearkens back to an earlier manifestation of the liberal tradition. In the 19th and early 20th century, scientific rationalism and technological utopianism went hand-in-hand with socialism, feminism, and progressivism. This changed in the post-WW2 era, as science and technology seemed to many to be increasingly the tools of military and corporate giants. The anti-technology perspective emerged most strongly in the environmental movement, which often linked ecological irresponsibility (industrial pollution, toxic waste dumps, unethical animal and human experimentation, etc.) with technological development. While many progressives and greens are more willing adopt cleaner, better technologies today, some of the anti-technology biases remain. From Dr. Hughes' essay on Democratic Transhumanism:
Today most bioethicists, informed by and contributing to the growing Luddite orientation in left-leaning arts and humanities faculties, start from the assumption that new biotechnologies are being developed in unethical ways by a rapacious medical-industrial complex, and will have myriad unpleasant consequences for society, especially for women and the powerless. Rather than emphasizing the liberty and autonomy of individuals who may want to adopt new technologies, or arguing for increased equitable access to new biotechnologies, balancing attention to the “right from” technology with attention to the “right to” technology, most bioethicists see it as their responsibility to slow the adoption of biotechnology altogether.
The tension between philosophies focused on for social justice and environmental responsibility and the transhumanist movement is strong, and the evident frustration and anger in Dr. Hughes' tone -- both in the article linked above and in today's section of the interview -- reflects his belief that the human enhancement movement should be considered an ally, not an opponent, of those who are trying to better the human condition. He and I don't see eye-to-eye on many of the topics discussed in today's section, but we do agree on an underlying value: responsible technological development is critical for building a better planet.
Cascio: A concern many technologically-literate environmentalists have about human bioengineering (and life extension, and the like) is that it will inevitably be asymmetrically distributed, with the already-rich and powerful getting the first shot at it.
Hughes: In first place there is no inevitability about the cost of transhuman technologies. Depending on the type of technology and the point in its innovation lifecycle, technologies can be cheap or expensive. Just look at anti-retroviral therapy. For a decade HIV-positive people in the affluent North were the guinea pigs and underwriters of the enormous costs of these therapies.
Then the developing world threatened to produce the drugs themselves and abrogate the intellectual property regime (and I wish they had). In response to the threat and the political pressure from the global public health lobby anti-retrovirals were licensed for less expensive production, and then alternative versions were developed which cut costs to less than a dollar day.
Now, less than a dollar a day is still more than a lot of HIV positive people in Africa make, so is the answer of leftist Greens that we should ban anti-retrovirals until everybody can afford them? Or do we try to get them to as many people as possible, year by year? The same logic will apply to every new technology, from those which save lives, to those which allow us to improve memory and mood, to those which enable radical body art. And some of these technologies will be cheap at the outset, such as a cancer vaccine that sensitizes the immune system to identify and destroy cancers.
Cascio: That's an interesting take -- that rather than thinking of the early adopting rich countries as getting the goodies first, we should think of them as being the guinea pigs (or beta testers) for the rest of the world.
Hughes: I don't want to sound like I think its good for the poor and developing world to wait a couple years for new tech. But there is a life cycle to most tech that the Luddite left ignores - if a technology develops a large enough market among the affluent they get then cheap enough so that they become available to the poor. There is a strong moral and practical case for using public monies to shorten that cycle for technologies that dramatically improve people's lives, as human enhancement technologies will. For Gameboys or McDonalds equitable access isn't so urgent.
Cascio: Many left-greens, including me, worry that transhuman technologies can result in conditions which would tend to further concentrate power and wealth in the hands of those who already possess it. Is that a legitimate concern?
Hughes: Yes, absolutely. There is probably a qualitative difference between the feedback loop between wealth inequality and differential access to cognitive enhancement, and the feedback loop between wealth inequality and differential access to the Internet. In other words, we do have to worry about the possible development of a widening gap between an accelerating "posthuman" aristocracy and a majority of the rest of the world moving ahead at a much slower pace. The best, and probably the only way, to effectively reduce the risk of GenRich/GenPoor bifurcation is the ensure broad as possible access to cognitive, health and ability enhancements. I think this will be perfectly obvious even to the most Luddite as these technologies arrive. The world's poor are going to want life extension and very few left Greens are going to campaign to save them from it.
The "forbid enhancement because it will only be available to the rich" argument does, however, provide one more brick for the bioconservative roadblock to funding research in human enhancement. So long as the public thinks life extension and cognitive enhancement is "science fiction," and will never happen, then the religious fundamentalist zealots and their secular and progressive allies can deep six the research programs which could bring them online all the sooner.
One hundred and fifty thousand people die every day, and if you are a transhumanist, you see a day when they would not have to have died. The profound immorality of the bioLuddite position is not that they will be able to stop human enhancement technologies, but that they will be able to delay them and kill many people who could otherwise have lived. Yes, fresh water and more food and income could save people as well. That's why I'm a democratic transhumanist.
Cascio: What do you think of the "precautionary principle?"
Hughes: The precautionary principle is a Luddite Trojan Horse. It starts with the uncontroversial principle that technologies should be assessed for their risks before they are deployed. That's no problem, and we can argue about what kinds of approval processes and regulatory agencies are adequate, and when we have sufficient information of the risk/benefit ratios. But when the principle is applied by the technophobic, to things like human genetic engineering, the precautionary principle becomes a rationale for permanent bans. The first thing the technophobic do is systematically rubbish the potential benefits, and take seriously every hypothetical harm from now until the end of time. Their second argument appeals to the virtue of the known and the supposed inevitability that human efforts to engineer the delicate, evolved mechanisms of nature are doomed to disaster. On those grounds, no clinical trial or EPA assessment could ever capture the real long-term risks of genetic engineering.
Nick Bostrom has just written a brilliant paper about the "status quo bias" in everyday heuristics, and how it is expressed in bioethics. Once we take account of real, proximate risks and benefits of human enhancement technologies in a balanced way there certainly will be a case for banning some until they are safer. For instance, the World Transhumanist Association has taken the position that experiments with human reproductive cloning are currently unethical since the animal research suggests a very high risk of birth defects. Once the animal research has got the success rate up and birth defects low, then there the risk-benefit would pass the threshold for permitting the technique for parents who have genetic or infertility problems and want a child related to one of the parents. Then, when the risk of birth defects in these first clones has been assessed, and the technique demonstrated to be safe, we should permit all would be parents to use it.
This process suggests the other huge problem with applying the precautionary principle to human enhancement. Banning a new industrial chemical on precautionary principle grounds doesn't step on an individual's self-determination, but stopping them from exercising control over their own body, brain and reproduction does. For instance, Western feminists are delighted to encourage India and China to restrict women's access to ultrasound and abortion, restrictions most American women would never accept, all to prevent largely hypothetical future social consequences of imbalanced gender ratios from sex selection. As a consequence these laws not only harm the women who lose some of their reproductive choices, but also the girls born into families that don't want them, and who at best are given up for adoption. The way people use the precautionary principle is to argue that the difficulties that boys in the class of 2020 will have in getting a date to the prom trump all other concerns. I don't think so.
Cascio: Our *current* understanding of biological and environmental systems is more limited than we often like to admit, particularly regarding subtle cross-system interactions. It seems to me that some degree of a precautionary structure, one designed to consider very carefully the implications (both biological and social) would be a useful tool for making certain that the enhancements end up being that and not long-term degradations.
Hughes: Anything involving the release of genetically modified organisms in the environment and I completely agree. But in regards human genetic enhancement I think the right to self-determination trumps a lot of those vaguer, long-term concerns. What would the approval process have looked like for the precautionary approval of organ transplantation back in the 1970s? We might be getting around to trying some transplants about now, and untold hundreds of thousands of people would have died unnecessarily.
Cascio: But don't some self-determination choices have broader results for society at large? As a simplistic example, wouldn't a society already near the breaking point for pension support have a legitimate say in the implementation of life-extension technologies?
Hughes: You want to live in a society that tells people they have to die because we can't figure out how to keep them housed and fed? We are already living well-beyond the average 65 years that Social Security and Medicare estimated at their founding, and they are facing crisis as a consequence; so should we now deny medical treatment to everybody over 70? Yes, every society has to set priorities, and pensions and medical research and treatments can't be allowed to consume everything. But my preference is that we try to keep everyone healthy and alive first, and then figure out how to adjust.
Cascio: At the same time, as the recent Vioxx situation demonstrates, the current mechanism for assessment (in this case, FDA) isn't nearly as effective as one would hope it to be. One could easily imagine thousands (millions?) of people adopting an enhancement technology that looked good in computer models and fast-tracked trials, only to discover a decade or two down the road that it has some pretty unpleasant long-term side-effects, perhaps even shortening lives that they had expected to be lengthened. How long of a test would you consider appropriate for human enhancement biotech?
Hughes: I don't think enhancement medicine should be subject to a more stringent approval process than medical therapies. The calculations will be the same. Every medical treatment is a rapidly evolving mix of information and unknowns about risks, side-effects and benefits. When the FDA approved the weight loss drug Meridia it was controversial, and continues to be, because there were minor benefits and occasionally serious cardiac side effects. But then morbid obesity is a much bigger killer. Why not let people make that calculation with their doctor? If we were to come up with a gene tweak that doubles the life span of mice, but it had a 1% risk of earlier mortality, I think we would want to make it available to the public and let them decide. The question is when the possible risks outweigh the possible benefits so far that no one should be using it.