The Pursuit of Perfection: The Promise and Perils of Medical Enhancement
http://www.100md.com
《新英格兰医药杂志》
Many new medical interventions raise important questions about the goals of medicine and the moral legitimacy of medical enhancement. Most interventions that cure, treat, or prevent diseases can also enhance or change human beings. Plastic surgery can repair a child's cleft palate and reduce the size of a person's nose. Viagra can help a man overcome sexual dysfunction and allow a man with normal sexual function to improve his sexual performance. Preimplantation genetic diagnosis can help a couple prevent the birth of a child with a devastating genetic disease and help a couple choose the sex of their child.
Even if we could agree that one should not use medical technology to enhance human beings, we would still need to find a way to distinguish between enhancement and therapy. The difference, according to many people, depends on the definition of disease. Medical therapies cure, prevent, or treat diseases, whereas medical enhancements do something different. According to a common theory, a disease is a harmful deviation from the normal range of human variation with respect to a particular trait. For example, a person with congestive heart failure cannot pump blood normally, and a person with type 1 diabetes cannot produce insulin.
What is considered normal in one society or culture, however, may be considered abnormal in another. An 11-year-old who is 4 ft tall might be considered a dwarf in the United States but normal in another country. In ancient Rome or Palestine, a person who heard voices inside his head might have been regarded as a prophet. Today, schizophrenia might be diagnosed in someone with that trait.
The Pursuit of Perfection, by Sheila Rothman and David Rothman, provides valuable insights into the debate about medical enhancement by exploring the recent history of medicine, including hormone-replacement therapy for women and men, plastic surgery, liposuction, the use of human growth hormone for short children, and research to promote longevity and prevent aging. The authors examine the social, economic, and cultural factors that have contributed to the debate about enhancement. They show that pharmaceutical companies, physicians, and surgeons have profited from selling patients medical products and services that are designed to enhance normal functioning, and that patients have sought and demanded these medical interventions in their pursuit of youthful vigor, femininity, virility, beauty, or happiness.
The authors also provide some useful insight into the conflicting attitudes of the medical profession toward enhancement by showing that some physicians have condemned various forms of enhancement as contrary to the goals of medicine, whereas others have promoted enhancement as a way of helping patients realize their goals and achieve happiness. The book is an important contribution to the debate about medical enhancement and should interest clinicians, scientists, policy analysts, and scholars. The book's most important message is that it will be very difficult for society to set boundaries between therapy and enhancement and to regulate enhancement.
David B. Resnik, J.D., Ph.D.
East Carolina University Brody School of Medicine
Greenville, NC 27858
resnikd@mail.ecu.edu(By Sheila M. Rothman and )
Even if we could agree that one should not use medical technology to enhance human beings, we would still need to find a way to distinguish between enhancement and therapy. The difference, according to many people, depends on the definition of disease. Medical therapies cure, prevent, or treat diseases, whereas medical enhancements do something different. According to a common theory, a disease is a harmful deviation from the normal range of human variation with respect to a particular trait. For example, a person with congestive heart failure cannot pump blood normally, and a person with type 1 diabetes cannot produce insulin.
What is considered normal in one society or culture, however, may be considered abnormal in another. An 11-year-old who is 4 ft tall might be considered a dwarf in the United States but normal in another country. In ancient Rome or Palestine, a person who heard voices inside his head might have been regarded as a prophet. Today, schizophrenia might be diagnosed in someone with that trait.
The Pursuit of Perfection, by Sheila Rothman and David Rothman, provides valuable insights into the debate about medical enhancement by exploring the recent history of medicine, including hormone-replacement therapy for women and men, plastic surgery, liposuction, the use of human growth hormone for short children, and research to promote longevity and prevent aging. The authors examine the social, economic, and cultural factors that have contributed to the debate about enhancement. They show that pharmaceutical companies, physicians, and surgeons have profited from selling patients medical products and services that are designed to enhance normal functioning, and that patients have sought and demanded these medical interventions in their pursuit of youthful vigor, femininity, virility, beauty, or happiness.
The authors also provide some useful insight into the conflicting attitudes of the medical profession toward enhancement by showing that some physicians have condemned various forms of enhancement as contrary to the goals of medicine, whereas others have promoted enhancement as a way of helping patients realize their goals and achieve happiness. The book is an important contribution to the debate about medical enhancement and should interest clinicians, scientists, policy analysts, and scholars. The book's most important message is that it will be very difficult for society to set boundaries between therapy and enhancement and to regulate enhancement.
David B. Resnik, J.D., Ph.D.
East Carolina University Brody School of Medicine
Greenville, NC 27858
resnikd@mail.ecu.edu(By Sheila M. Rothman and )