Enhancement medicine and public health

Abstract

Biomedical progress in genetics, reproductive medicine and the neurosciences, have made it possible and tempting to modify biological characteristics of the human organism, beyond what is considered normal for the species, interfering with random biological processes, or selecting, improving and perfecting such traits as visual acuity, height, sex longevity, even programming behavior. It is anticipated, and feared by some, that irreversible biological modifications might modify anthropological attributes and eventually lead to the creation of cyborgs, transhumans, and extrahumans. There is general, though not unanimous, agreement that such practices might only be available to individuals, and that they should definitely be barred from ever being used in the public realm or for political ends. Even so, the issue has led to polemical discussions by philosophers, theologians, anthropologists and sociologists who have debated on the legitimacy of individual decisions, but failed to analyze possible cumulative consequences that singular irreversible biological modifications might exert at the population level. Public health usually studies individuals and groups in order to gain knowledge, suggest policies and develop programs at the general population level. In a similar vein, it should study and possibly anticipate regulating singular enhancement decisions that eventually will become more widespread, affecting the genetic pool, modifying behavior patterns, or destabilizing demographic distributions through the cumulative effect of individual decisions. Public health should remain alert to the possible general effects of individually chosen enhancement procedures and be aware that at some point regulative measures might be called for in protection of the common weal.