Friday, January 9, 2015

Enhancement and authenticity: Is it all about being true to our selves?

I’ve met Erik Parens twice; he seems like a thoroughly nice fellow. I say this because I’ve just been reading his latest book Shaping Our Selves: On Technology, Flourishing and a Habit of Thinking, and it is noticeable how much of his personality shines through in the book. Indeed, the book opens with a revealing memoir of Parens’s personal life and experiences in bioethics, specifically in the enhancement debate. What’s more, Parens’s frustrations with the limiting and binary nature of much philosophical debate is apparent throughout his book. The result is an interesting blend of meta-philosophical and personal reflections, with particular arguments about aspects of the enhancement debate.

This isn’t to criticise the book. Far from it. I found it an enjoyable and thought-provoking read. Parens and I certainly come from different starting points: he is far more inclined to resist the use of biotechnological enhancements than I, and has written about the phenomenon negatively in the past. But it would be silly for me to dwell on this difference here. Parens’s book is explicitly designed to offer a corrective to this “pro” or “con” mentality. His central argument is that those who care about how technology is used to shape our lives should embrace binocularity. That is: they should be willing to oscillate between competing perspectives. For example, they should acknowledge that humans are both biological machines, capable of being tinkered with and adjusted, as well as subjects and agents, capable of dreaming, desiring, willing and experiencing.

The binocularity thesis is an interesting one, and one that Parens explores in several different ways. I want to focus on one of them in the remainder of this post. In chapter 3 of the book, Parens makes the claim that there is something that unites both the “knockers” and “boosters” of human enhancement, namely: they are each committed to a certain ideal of human authenticity. This is interesting since that ideal is more typically associated with the knockers of human enhancement, not the boosters. What’s more, Parens actually presents some evidence for this claim. Is this evidence any good? What are its implications? Let’s find out.

1. The Moral Ideal of Authenticity
We have to start with a closer look at the concept of authenticity. There is no sense in evaluating Parens’s evidence if we don’t know what he is talking about. We all have a vague sense of what authenticity is. It is about being true to something, to some ideal, principle, concept, or person. An authentic expression of one’s opinion is one that is pure, uncontaminated by the desire to be duplicitous or deceptive. That much is straightforward. But obviously philosophers would like a more precise and refined concept. So, unsurprisingly, Parens obliges. In his analysis, he focuses on the moral ideal of authenticity. What does he mean by this?

The answer lies in the work of Charles Taylor, a Canadian philosopher, communitarian and critic of secularism. Taylor does not write about the enhancement debate itself, but he does write about the related debated between the knockers and boosters of modernity. By “modernity” Taylor means to refer to the philosophical, political and scientific ideals that emerged from the enlightenment era. One of those ideals was the ideal of authenticity. This ideal can be understood in the following way:

Moral Ideal of Authenticity: In living your life, you must be true to your own way of being, i.e. your own path to self-fulfillment. If you are not true to this, you miss the point of life, you miss what being human is really all about. Being true to oneself means overcoming impediments to self-understanding, and knowing what is important to one’s sense of self.

In short, you must to true to yourself, to your sense of what your life is about. When Taylor and Parens speak of this being a moral ideal, I do not think they mean for it to be an ideal related to obligation or duty; rather, I think they mean for it to be a statement of prudential axiology, i.e. as a claim about how to live the good life.

One of Taylor’s most important arguments is that this ideal of authenticity has been misunderstood in the debate between the knockers and boosters of modernity. Critics of modernity think of the ideal in terms of selfishness, self-indulgence and the egotistical desire to get what you want from life, without any real concern for others. The critics propose, in lieu of this, the ideal of the virtuous life, one that involves the cultivation and sustenance of certain forms of excellence. Taylor argues that the critics miss the fact that both they and the boosters share the ideal of authenticity. They both have a particular conception of what it means to live a human and fulfilling existence — one that is true to the self. Where they differ is in how they cash out that ideal.

Parens claims that a similar misunderstanding plagues the debate between the knockers and boosters of bio-enhancement. What is this misunderstanding? (Note: throughout what follows I will be assuming no major difference between what is referred to as “enhancement” and what is referred to as “treatment”. This is somewhat in keeping with Parens’s own approach, since he prefers to conceive of the debate in terms of technology that is used to shape the self, and prefers not to prejudge whether it is actually an enhancement. No doubt, I should have switched to Parens’s terminology, but I persevere with the term “enhancement” on the grounds that the term is so prevalent and can reasonably cover the types of biotechnology discussed in the following examples.)

2. Authenticity and the Enhancement Debate
Parens argues that the misunderstanding between the knockers and boosters of enhancement hinges on the attachment people have to certain aspects of their characters and abilities. The knockers of enhancement are grateful for certain fixed characteristics and feel that those characteristics are essential to who they are (their authentic selves). Likewise, the boosters of enhancement are impressed by the human ability to create identity, to act to fulfill certain projects, plans and aspirations. They feel that following that model of self-creation is being true to their authentic selves.

But this is just a general characterisation of the competing conceptions. As I said in the introduction, one of the more compelling aspects of Parens’s argument is the evidence he amasses in support of the claim that these conceptions share a commitment to authenticity. It is really this evidence that I want to focus on. That evidence comes from two main sources. First, from academic commentators — members of the knocker or booster brigades — and second, from statements by people who have used or rejected the use of bio-enhancements. In the interests of clarity, I will simply list this evidence, coding it as E1, E2…En as I go along. I will also provide links to the original sources after each description:

E1 - Elliot’s Discussion of Medical Enhancement: The first bit of evidence comes from Carl Elliot’s book Better than Well, which is a critique of how Americans engage with certain types of medical treatment. Elliot has two major concerns about how certain drugs — e.g. anti-depressants — are promoted and used. He worries in the first instance that the drugs will alienate people from who they really are, and in the second instance that they will alienate us from how the world really is. For example, an anti-depressant might cure us of our melancholy, but also lead us to ignore problems with our personal and social environments. Maybe we are depressed by our unfulfilling jobs or by the degree of social injustice we experience, and maybe the drugs mask what is a proportionate response to our predicament. In other words, maybe the drugs prevent us from living a truly authentic life. (Source: Elliot)
E2 - Kramer and DeGrazia’s Support of Anti-Depressants: The second bit of evidence comes from the work of Peter Kramer and David DeGrazia. They both make arguments for the use of drugs like Prozac that appeal to the ability of the drugs to remove certain impediments to self-fulfillment. A person could be crippled by depression and unable to achieve some goal or project that is an important part of their self-conception. By using the drugs, they free themselves to be true to their own ideals of self-fulfillment. Again, that seems to be an appeal to the ability to live an authentic life.(Sources: Kramer, DeGrazia)
E3 - The Paxil Ad: Paxil is an anti-depressant drug, similar in chemical operation to Prozac (i.e. it’s an SSRI). An ad appeared for Paxil in a medical journal many years ago which spoke of the “imprisoned patient” and then showed an image of an unfinished sculpture. The message was clear: the patient suffering from depression was like the unfinished sculpture. They were trapped in a block of marble, waiting to be freed. Paxil would enable them to do this. It would free the true self that was being masked by the illness. (Source: Could not find a copy of the ad)
E4 - Debate about Cochlear Implants: The fourth bit of evidence comes from the debate between those who use and those who reject the use of cochlear implants. As Parens points out, some members of the Deaf community reject the use of such implants on the grounds that deafness is an essential aspect of their self-identity (partly constitutive of their authentic selves). Contrariwise, there are those who embrace the use of cochlear implants because they allow them to be more truly human. For example, Michael Chorost, who wrote a book entitled Rebuilt: How Becoming Part Computer Made me More Human, claims that the cochlear implant allowed him to experience the world more fully — almost the opposite of Elliot’s concern about anti-depressants alienating us from reality. (Sources: Crouch, Chorost)
E5 - Women who get Cosmetic Surgery: The fifth bit of evidence comes from the work of Kathy Davis, a sociologist who interviewed women who received cosmetic surgery (e.g. breast enlargements or reductions). She was struck by how these women tended to report a similar motivation for seeking the surgery. They claimed to have a body part that didn’t belong — that didn’t fit with their true identity — and they needed to have it altered to express their true selves. (Source: Davis)
E6 - Debate about Treatment for ADHD: The sixth bit of evidence is drawn from ethnographic work by Ilina Singh on children diagnosed with ADHD. Again, Parens notes how the language of authenticity permeates the views of those who embrace and those who reject pharmacological treatment for their condition. Those who embrace it think the drugs enable their moral agency (their ability to express themselves through action), while those who reject it think the drugs change who they really are. (Note: the majority of Singh’s subjects seemed to think they benefited from treatment). (Source: Singh)
E7 - Poets using Anti-Depressants: The seventh bit of evidence comes from the experiences of poets using anti-depressants. Some poets think the drugs remove a barrier to doing their work, while others think the drugs separates them from a crucial aspect of their identities (Source: Berlin (ed)).
E8 - Debate about Transgender Surgery: The final bit of evidence comes from the debate about gender reassignment surgery (another example of using technology to shape ourselves). There are those that reject such surgeries on the grounds that it amounts to a denial of one’s true, genderqueer, norm-challenging self. On other hand, there are those that embrace such surgeries on the grounds that they allow people to become who they truly are. Once again, we have a debate about the ideal of authenticity (Sources: Raymond, Green).

Parens also comments on similar disagreements among anorexics and those with body dysmorphia, but I’ve decided to skip over those since it is more of the same thing (with respect to the language and concepts used, not with respect to the nature of the different conditions). I think, taken together, these eight bits of evidence do provide some reasonable support for Parens’s claim about the pervasiveness of authenticity in the enhancement debate. Of course, Parens’s argument isn’t intended to be a true scientific or empirical argument. It is, rather, an interpretation of a range of different textual sources. It provides some initial support for a hypothesis that could (if the interest was there) be taken up by psychologists and other researchers in the future. Further experiments could be used to determine whether people really do conceive of the pros and cons of enhancement in terms of the ideal of authenticity.

3. What are the implications of this?
But assume for the moment that Parens is correct. What follows from this? Does it matter for the enhancement debate? Or should that debate continue as it has done? Does the pervasiveness of authenticity have any practical implications for how we approach the use of enhancement? I think some things do follow (weakly), and I want to close with three examples.

The first, which maps with what Parens himself seems to think, is that it may encourage a less divisive approach to the issue. The ideal of authenticity is about remaining true to some characteristic or aspect of yourself and your situation in the world. If Parens is right, then the knockers of enhancement prioritise some characteristics (e.g. their ADHD, depression or deafness), whereas the boosters prioritise others (e.g. their desire to pursue certain goals, to free certain aspects of their selves that they feel are hindered by a condition or disability). Within certain limitations, there is no reason why these different ideals cannot live side by side. Indeed, this is something that disability theorists often claim. They say we should not view one mode of living as being intrinsically better or worse than another; rather, we should accept that there are simply many different modes of living, each with their own value. There is no reason why the knockers and boosters can’t embrace this pluralism.

The second observation is that there is some reason to retreat from this pluralism, at least if it is understood in an extreme way. Although it is no doubt true that several different ideals of authenticity can live side-by-side, it is also true that certain ideals have implications beyond the implications to the one living the authentic life. For example, should a paedophile or serial rapist be encouraged to reject chemical castration on the grounds that their sexual preferences are an essential part of their authentic selves? The proposition seems troubling. Surely there are some conceptions of an “authentic life” that cannot be wholly tolerated and which people should be encouraged to reject? If that’s right, then we can only have pluralism up to a point. (Note: I speak here of “encouragement” not of “compulsion”).

The final observation is of a more personal nature. By this, I don’t mean that the observation is about me and the way I live my life, but rather that it is about the kinds of decisions we all make about our lives. By drawing attention to how different ideals of authenticity operate within the enhancement debate, Parens’s argument also encourages us to think more seriously about what is important to us in our own lives. What characteristics and attributes are of value? Which of them would we like to preserve? Which would we like to modify? Maybe our melancholic moods are integral to our creativity and self-expression, maybe they are not. Either way, maybe we should take a more reflective and considered approach to the use of particular enhancement technologies. In doing so, we could avoid falling into the trap of being a knee-jerk knocker (as Parens once was) or a knee-jerk booster (as I tend to be).

That might be the most important lesson to draw from Parens’s book.

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