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The Left Atrium

Brave new biotechnology

Alan S. Kahn
CMAJ April 15, 2003 168 (8) 1023-1024;
Alan S. Kahn
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Our posthuman future: consequences of the biotechnology revolution Francis Fukuyama New York: Farrar, Straus and Giroux; 2002 256 pp $41.50 ISBN 0-374-23643-7

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How is medical science promising or threatening to change our lives? One need look no further than Margaret Atwood's The Handmaid's Tale or recent films such as GATTACA and Brain Candy for some futuristic visions — or nightmares. Perhaps Aldous Huxley's classic novel, Brave New World, serves as the best guide to a future worth fighting to prevent. Similarly bleak is Francis Fukuyama's Our Posthuman Future: Consequences of the Biotechnology Revolution, an expansive journey through science, philosophy and politics that serves to warn us how current trends in medical science threaten to transform the very essence of what we are.

Fukuyama, a professor of social science at Johns Hopkins University, initiates his argument by asserting that there exists a unique and species- uniting human nature that consists of a capacity for language, rationality, art and feeling, and a miraculous spiritedness that may involve free will. Fukuyama finds company in his belief through a clear and thorough literature review in which he shows that most philosophies are grounded in a belief in the existence of core human traits. Less convincingly, he uses evolutionary and neuropsychological concepts such as kin selection and nonviolent sociability to further support the idea that we possess a set of ingrained human behaviours and characteristics.

It is the universality of our common human nature, Fukuyama argues, that provides the basis for a recognized equality under moral and legal codes. However, according to Fukuyama, if intrinsic and absolute differences between human beings are introduced via chemical or genetic means, the natural link that binds us all may be severed. Moreover, if Fukuyama's proposition is correct, the resulting societal stratification could deny many their right to human dignity. Master and slave, gene-rich and gene-poor, suprahuman and subhuman classes could result from our unregulated striving to manipulate medically our natural fate. Fukuyama argues that not only is this potential divide bad in itself, but it creates an inequality that could provoke rebellion and violent resistance against the ruling classes.

But how is our seem ingly benevolent modern medicine contributing to a “posthuman” future in which our very nature may be altered, tragically restricting the diversity of our thoughts, feelings and actions? By analyzing new developments in reproductive technology, life extending techniques and neuropsychopharmacology, Fukuyama illustrates how today's practices may lead to tomorrow's demise. For instance, with an ever-increasing array of prenatal screening tests and the ability to identify genetic markers for gender, disease predisposition, intelligence or criminality, there is ample reason to worry that the metaphor of manufactured “designer babies” is becoming a reality.

Just as the practice of expelling uncertainty from the beginning of life increases, so too grows the denial of inevitable death, Fukuyama says. With death-defying medicine, transplantation and cryogenics, some of us strive to fulfill a desire to live life to its longest. Fukuyama convincingly argues that gene-enhancing, life-extending techniques could lead to an upheaval in our population demographics, resources and long-entrenched ethical ideals.

His dark indictments continue with a furious attack on the psychiatric profession, which he alleges is leading the race to alter human nature. Without presenting credible statistical evidence, he portrays psychiatry as a pill-pushing enterprise that, for the most part, indiscriminately elevates mood or suppresses hyperactivity, with the goal of bringing all minds to the euthymic middle. He posits that if a perfect happiness - inducing pill such as Huxley's soma were developed, intrinsic human needs for recognition and feeling of self-worth (Socrates' thymos) would be artificially fulfilled. This would obliterate our innate drive to develop inter- and intrapersonal relationships.

Fukuyama argues that, as a result of this hypothetical eradication of hope, fear and struggle from human life, we will lose our ability to empathize. If, on the one hand, new biotechnologies are distributed equally, then suffering may be collectively rooted out — as may the concept of a soul. However, if only the privileged classes benefit from such intervention, they will fail to empathize with the suffering of the disenfranchised. Fukuyama warns that a potentially more horrifying scenario is the denigration of the “lesser class” without their awareness or consent through state-sponsored, physician-supported interventions that restrict emotion.

After painting this alarmist picture of our posthuman future, Fukuyama strikes a more positive tone in the last quarter of the book. He argues that the hazards he has presented can be averted by creating national and international regulation that limit the development and use of biotechnology.

Gazing into a biotechnological future that is very uncertain, this book provides a fascinating framework for exploring the possibilities that await us. Although many of Fukuyama's propositions are controversial — such as his often unrelenting attack on medicine and, more specifically, psychiatry — he should be applauded for attempting to move us beyond everyday talk of ethics to a deeper examination of human nature and its natural limits. Our Posthuman Future is an engaging, expansive and well referenced stimulus for discussion among health professionals, policy-makers and the general public. Fukuyama challenges the reader to follow Nietzsche's philosophical ideal by becoming aware of society's chosen goals and values, so that we may move forward with our eyes open.

Alan S. Kahn Third-year Medical Student, University of Western Ontario London, Ont.

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