From Bench to Bedside, to Track and Field: The Context of Enhancement and Its Ethical Relevance

By Dr Silvia Camporesi

Published by University of California Medical Humanities Press

ISBN-10: 098898654X, ISBN-13: 978-0988986541

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The image of eugenics often portrayed in the media is reminiscent of the horrors of the early to middle 20th century. Legions of identical blond-haired, blue-eyed ubermenschen, backed by an authoritarian state with no room for diversity or difference. In 'From Bench to Bedside, to Track and Field: the context of enhancement and its ethical relevance', Silvia Camporesi demolishes that image. Instead she argues that we are entering a period of democratic eugenics, albeit fraught with its own ethical considerations.

Guiding us through the mass sterilisations of the classical eugenics period that began in the late 19th century and ended with the horrors of the Third Reich, Camporesi explores the historical context of the quest for human enhancement and the backlash against it. Drawing on areas ranging from current genetic technology to social constructions of disability, Camporesi then builds the argument for an idea I found intriguing. Long dead is the authoritarian idea of eugenics, she claims. Instead we are now entering the age of 'eligogenics', defined by individual and family choice over enhancement.

I particularly enjoyed the philosophical exploration of the questions surrounding the enhancement of children. For example, is it unethical to select for perfect pitch but acceptable to force a child into piano lessons? And when it comes to disability, what is or is not considered a defect in need of correcting? Here she offers the particularly striking example of deaf parents using PGD (preimplantation genetic diagnosis) to select for an embryo carrying 'genes for deafness'. Camporesi carefully lays out the arguments that our concept of disability is socially created and references the vibrancy of deaf culture.

Also caught up in the midst of these debates are regulatory agencies like the UK's Human Fertilisation and Embryology Authority (HFEA). The HFEA is mentioned several times, walking the delicate line between the unregulated market-driven American model and the restrictive approach of many continental European countries. Ultimately, Camporesi comes down against the rampant use of genetic diagnostic choice with the elegant argument that choices made by the parents could end up limiting the future freedoms of the child.

The second half of the book is focused on human enhancement in a sports context. Sport, argues Camporesi, is torn between an ethos of the human body excelling in its natural glory, and a practical culture that already embraces enhancement through extreme training and illicit pharmaceuticals. Where does the burden of responsibility to ensure sport is true to its nature fall - on the atheletes, the trainers, the sponsors or the anti-doping regulatory agencies? Here she used the infamous examples of Lance Armstrong, who after admitting to doping now faces lawsuits over his 'false advertising'.

Camporesi makes the argument for a strong deliberative democracy and adopting the precautionary principle from ecological management - the burden of responsibility being placed on the organisation and not the individual. She makes a strong case for a greater role of the philosopher to help shape this debate. Although sport is a useful microcosm of society, where the pressure to go above the human norm is strong, this attention does make it feel almost like two separate books. The focus shifts from society-level problems and solutions in the first half to ones that focus on a small subset of those issues in the second.

'From Bench to Bedside, to Track and Field' explores the shifting idea of eugenics and, while I found the track and field aspect took up too much space despite its narrow focus, the book primes the reader for an exploration of our emerging world of self-chosen enhancement.

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