The Brainy Bunch

I realized today that we only have 6 class discussion periods left. 6! After writing 20 blog posts (including this one), 6 seems like a pretty small number. The end of the semester is rapidly approaching, and I have mixed feelings about upcoming finals.

This section in the textbook is on ethical issues in medical enhancement, including their effect on people with disabilities (Chapter 18). Medical advancement is an interesting topic, and one that seems to be highly contested in some sports. Is it smart/ethical to treat people who operate at less than "normal" (therapy) and/or give advancements to people who are functioning at a normal level so that they can be a step above that (enhancements)? Or is it a more intelligent decision to not provide this type of treatment to anyone? 

A relevant application of this question is found in the mass use of Ritalin and Adderall, highly addictive amphetamine salts that improve function for people with attention deficit/hyperactivity disorder (ADHD). For those who need the drugs to function, access to one of them is important. But what about the medical and law students who already have "normal" function but take Ritalin, Adderall, or modafinil (narcolepsy-countering stimulant) to gain an advantage and perform well under extremely stressful and demanding circumstances (Pence 447)? Is it ethical for them to fake the symptoms of ADHD and/or sleep disorders in order to gain access to stimulants that will improve their academic ability, or is it considered "cheating" like doping is in athletics?

The author of the text defines cheating as, "when the rules say competitors can't do X and someone secretly does X" (Pence 451). It is also discussed as a way of breaking the moral character in sporting and athletic events. So, for example, when athletes use growth hormones or blood with a higher red blood cell count as a way to gain an advantage in a competition, even though it is illegal to do so, it is considered cheating. It makes sense that competitors would want to do everything that they can do excel in their sport, but at what point is it no longer ethical? The Olympics used to ban the use of coaches, and advantages definitely still exist in wealthy athletes who don't have to work and can spend all of their time training, so are hormones just another advantage like these? Or are they somehow fundamentally worse? The chapter compares doping to an arms race, in that when athletes suspect that others are taking steroids they realize they are at a disadvantage and then also participate in doping (Pence 448). They do this to jostle for a positional advantage, putting them ahead of others who do not have the same assets in a competition. But, if everyone has access to the same advantage, it no longer puts them a step ahead. Justifying the use of steroids by saying that "everyone else does it" is using the ad populum argument, and is not a valid justification. Unfortunately, past research and surveys have shown that this mentality is dominating in some sports.

We know from experiences legalizing marijuana and prescription opioids that legalizing certain drugs does not decrease the number of people taking them, and would not help the current situation of doping in athletics. Legalizing steroids would only increase the arms race (Pence 454). Instead, we should be emphasizing that using steroids or doping with blood or other substances is cheating. The casual acceptance of cheating through doping and use of steroids is blatantly undermining fair competitions, and moves the focus from competing as you are to a mentality of "winning is everything"; which it is not. 

Therapeutic treatments, like growth hormones for those who need them and/or medications that restore a normal level of function (like Adderall or antidepressants), are not cheating. Therapy isn't cheating. Enhancements beyond normal functioning are. I agree with the author of the text on this one, that there are enhancements that are less harmful, like breast augmentation and botox injections, that fall into a category of their own because of a different intent. "Enhancements" like these are more for personal preference and do not directly give a substantial positional advantage to those who utilize them. 

The last section of this chapter mentions the effects of enhancements on people with disabilities and brings back up the question of, "What is normal and who defines it?" (Pence 455). Medical advancements have allowed people to overcome other obstacles previously defined as disabilities, like infertility or deafness. In the case of deafness, many Deaf parents (and others) advocate against the use of cochlear implants in children because it deprives them of access to the Deaf culture and introduces them solely into a Hearing world. This is interesting because those who argue for the use of implants claim that this argument contradicts the good of the family in a world that is more conducive to people who can hear. There are two gradients that apply here, that of a spectrum from lack of function to heightened function and one consisting of superficial defects to advantages in a person's life (Pence 456). There is a lot to consider when thinking about enhancements as they are related to people with disabilities. 

There are many things to consider in the general discussion on medical enhancements as well. However, the arguments against doping/using steroids, including using other drugs as stimulants when they're not needed for normal function, seem to be much clearer. As a bit of a side-note, the concept of "super-humans" has also been covered to a great extent in science fiction, especially in dystopian media. Are these advancements, whether in a singular person or in societies, considered ethical or even true enhancements? Will our society ever progress to a point where consistently taking enhancing drugs is the norm? 

Overall, many of the questions in this topic boil down to a sense of fairness and the importance of maintaining good, honest, moral character. And that's where I'm going to leave this discussion, at least for today. Leave a comment though, and let's chat about it! What are your thoughts/where do you stand?

Textbook reference:

Pence, Gregory. Medical Ethics: Accounts of Ground-Breaking Cases. 9th ed., McGraw Hill, 2021.