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Defeaters to best interests reasoning in genetic enhancement

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Abstract

Pre-natal genetic enhancement affords us unprecedented capacity to shape our skills, talents, appearance and perhaps subsequently the quality of our lives in terms of overall happiness, success and wellbeing. Despite its powerful appeal, some have raised important and equally persuasive concerns against genetic enhancement. Sandel has argued that compassion and humility, themselves grounded in the unpredictability of talents and skills, would be lost. Habermas has argued that genetically altered individuals will see their lives as dictated by their parents’ design and therefore will not acquire an appropriate self-understanding. How should we view enhancement efforts in light of these concerns? I propose that we begin by adopting a defeasibility stance. That is, I ask whether our belief that genetic enhancements serve in the best interests of the child is reason to genetically enhance, underscoring a sort of epistemic vulnerability. I utilize the epistemological notions of defeasible reasons, undercutting (also called undermining) and overriding (or rebutting) defeaters in order to better understand and systematically evaluate the force of such concerns. I argue that close examination of both objections using this framework shows that we have reason to enhance, a reason that is defeasible but as yet, undefeated.

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Notes

  1. A different application of defeasible reasons, undermining and overriding defeaters can be found in Alvin Plantinga’s (2000) Warranted Christian Belief.

  2. Gazzinga (2005, 41).

  3. Savulescu and Kahane (2009), 275.

  4. Buchanan et al. (2000), 6.

  5. See Brock (2009) for discussion on positive and negative selection.

  6. The boundary between treatment and enhancement is not uncontroversial. See Parens (1998), particularly contributions by Juengst, Brock and Frankford.

  7. Treatment-oriented intervention is not without its critics. Some have argued that selection against embryos carrying genetic disease or predispositions to disability sends the wrong message to those living with illness, communicating that life is valued or desirable only in the absence of genetic disease. See Asch and David (2012).

  8. An earlier version of this principle appears in Savulescu (2001).

  9. While Savulescu and Kahane and Buchanan et al. agree on the acceptability of enhancement, the latter support the permissibility of enhancement in the absence of competing considerations and the former insist on an obligation to enhance in the absence of overriding reasons.

  10. Feinberg’s discussion of rights takes place within a legal context, specifically, to determine whether or not the state should prevent parents from foreclosing on children’s futures in some way, say, whether families can, due to religious conviction or cultural tradition, prevent their children from attending school or receiving blood transfusions. Feinberg’s distinction has, however, also proved useful and relevant to the ethical boundaries between parent involvement and a child’s autonomy, and has been utilized by Dena Davis, Michael Sandel, William Buchanan and Norman Daniels.

  11. See Rothenfluch (2016).

  12. See Little (1998).

  13. I’m assuming that this is a justified belief based on the right sorts of empirical evidence. Some have raised concerns about the permissibility of carrying out such experiments on human subjects (Daniels 2009 and in conversation). I take it, however, that the risks here will be analogous to the risks we undertake in other interventions. That is, we cannot clairvoyantly know that enrolling our children in prestigious institutions and encouraging participation in competitive sports will not cause them to become arrogant, induce an unhealthy competitiveness, or even develop an anxiety disorder. The best we can do is go by the best empirical evidence we have, and when we feel confident, experiment on human subjects.

  14. Thanks to Miriam McCormick for pressing for clarification.

  15. Pollock widens the set of defeaters and reasons to include other mental states, but beliefs seem to be most relevant here.

  16. My use of defeaters corresponds perhaps more precisely to rationality or justification defeaters (Plantinga 2000, 358–359; Steup 1996, 14), rather than warrant or propositional defeaters. The former characterizes defeaters on the basis of the subject’s beliefs and experiences, while the latter does not.

  17. Thanks to Jennifer Hawkins for highlighting this possibility.

  18. A possibility that Sandel himself entertains (95).

  19. In contrast, improvements sought through other means such as teaching a child how to play the piano or inculcating virtues through modeling and explanation do not fuel this sense of control as parents acknowledge that things might not work out as planned. To be clear, it is not that parents have to be committed to genetic determinism. It is sufficient that parents think it highly likely that their involvement will result in the traits and capacities they favor, whereas such a high degree of confidence is not available when it comes to environmental intervention. It is this sentiment that generates a loss of susceptibility, humility and compassion. Thanks to Norman Daniels for pushing me to clarify how genetic interventions are distinct from environmental interventions.

  20. To be clear, these proponents allow that certain circumstances might outweigh a parent’s permission or obligation to enhance, such as the compromised wellbeing of their other children, but even in this situation there remains at least initial reason to enhance.

  21. Brock also maintains that positive selection occurs at an embryonic-stage or pre-implantation stage, which then allows the normal processes of pregnancy, infancy and early childhood to build strong relationships between parent and child. Given the biological foundations of intimacy, loss of sympathy and unconditional love and acceptance do not seem to be likely consequences of genetic intervention (2009, 269). However, these claims are unsustainable. While a biological basis for parent–child relationships seems plausible and supportable, this does not seem to constitute a necessary or sufficient condition for the development of such a relationship, as evidenced by the vast number of unhappy, unhealthy relationships parents and their biological children, and the successful relationships between parents and adopted children. Thus the presences of these processes, post-intervention, do not secure unconditional love and acceptance between parents and child. Furthermore, these claims do not speak to Sandel’s more general worry that such technology might generate a degree of indifference towards others’ misfortune.

  22. While Savulescu uses “treat”, he is defending genetic intervention (including enhancement) more broadly in this piece.

  23. Habermas’s worry is distinct from concerns of autonomy found in biomedical ethics more generally, and enhancement in particular. Habermas argues that if one’s dispositions are, from the very start, molded according to parents’ desires and societal values, it will be difficult, if not impossible, for the child to distinguish herself as separate from, and independent of, third-party intentions. She might, in a sense, be able to carry out what she wants to do, but the problem for Habermas is that she will not regard her desires as truly her own.

  24. Habermas motivates the worry by discussing the role of self-understanding in the context of membership to a moral community, one which “requires all its members to show equal respect of every other member and to be responsible in their solidarity with all of them” (73). Habermas connects at times to Kant’s principles of humanity and universalizability and even draws support from diverse religious and metaphysical doctrines which too seem to agree that “a minimal ethical self-understanding of the species [sustains]…this kind of morality” (40). While Habarmas situates self-understanding within a picture of moral agency and human dignity, it will go beyond the aim of this paper to present and examine these connections. I will, instead, take it for granted (I think uncontroversially) that perceiving one’s authenticity is in itself valuable. My discussion, then, will center on whether or not genetic enhancement deprives us of such understanding, and remain neutral about the impact of such understanding on moral reasoning, or being members of the relevant type of moral community.

  25. Habermas distinguishes here between positive enhancement and therapeutic intervention. He writes that as long as “intervention is guided by the clinical goal of healing a disease or of making provisions for a healthy life, the person carrying out the treatment may assume that he has the consent of the patient preventively treated” (52). The idea here seems to be that we can unproblematically assume patient consent for preventative or therapeutic measures, whereas the same sort of confidence cannot be garnered for positive enhancements. Habermas further points out that even in cases of therapeutic intervention, a sort of “instrumentalization” of human nature is possible in cases where the patient’s virtual consent is not considered. (52).

  26. A similar line of reasoning can be found in Parens (2004), where he argues that acknowledging genetic influence on behavior, far from minimizing or erasing a sense of authorship and responsibility for one’s behavior, it “could give individuals an increased sense that they are responsible to alter those imperfections, to change their temperaments by whatever means possible (exercise, drugs, cognitive therapy, and so on)” (S24). Again, the worry is that for the recipient, it is unclear whether the drive for change stems from authentic desires or is again rooted in her parents’ intervention.

  27. It is important to note that Habermas, like Sandel, does not assume genetic determinism. He explicitly maintains that “irrespective of how far genetic programming could actually go in fixing properties, dispositions and skills, as well as in determining the behavior of the future person, post factum knowledge of this circumstance may intervene in the self-relation of the person….The change would take place in the mind” (53).

  28. Sandel is here refuting the view that genetic engineering would impair the child’s autonomy by infringing on her right to choose her own life. This is related to, but not the same as, Habermas’s concern that genetic engineering will distort self-understanding. However, Sandel’s claims here are relevant because it points to a potentially mistaken assumption on Habermas’s part that absent genetic engineering, we can justifiably view ourselves as full authors of our lives.

  29. He relies here on Hannah Arendt’s notion of natality, which views birth as an entirely new beginning, detached from existing persons and societies.

  30. It might be argued that children are never entirely detached from parental intentions since parents have deliberately selected one another. I take it that the unenhanced child can still be viewed as a new and independent beginning in that mate selection does not establish or control which genes or traits will be transmitted to offspring.

  31. We may also view the tension between best interests and Habermas’s self-understanding argument as a tension between competing biomedical principles (Childress and Beauchamp 2013). According to their principled approach, we are to weigh and balance different moral norms relevant to the situation. While this method parallels and helpfully illuminates the rebutting nature of Habermas’s argument against best-interests reasoning, the framework isn’t appropriate for the paper as I make no assumptions about fixed values, and it is unclear that Habermas’s argument conforms to the demands of any of the principles.

  32. Melis (2014) explains that an overriding defeater to one’s belief is “perfectly compatible with the justificatory process having been executed impeccably, and having being delivered by a reliable source working in good circumstances” (437). Epistemological overriding defeaters operate by preventing reasons from leading to truth, whereas underminers suggest a mistake in the process. The situation is of course slightly different in the practical case: as suggested above an overriding defeater leaves intact the reason-giving force of the original reason (best interests in our case) to perform the act.

  33. While Brock discusses the role of environment in shaping the child’s identity, he does not show that environmental impact may be variable and will allow the child to retain the newness Habermas thinks essential for self-understanding.

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Rothenfluch, S. Defeaters to best interests reasoning in genetic enhancement. Philos Stud 174, 2845–2869 (2017). https://doi.org/10.1007/s11098-016-0813-1

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