Beyond Therapy
Biotechnology and the Pursuit of Happiness

December 9, 2003

Unedited transcript prepared from a tape recording

 

3:45 p.m.	Registration
4:00	Panelists:	Gregg Easterbrook, New Republic
		Leon R. Kass, M.D., AEI and the President’s Council on Bioethics
		Peter Lawler, Berry College
		Diana Schaub, Loyola College of Maryland
	Moderator:	Christopher DeMuth, AEI
6:00	Adjournment

Proceedings:
MR. DeMUTH: Ladies and gentlemen, welcome, and good afternoon. Welcome to the American Enterprise Institute for this book discussion focusing on the recently published "Beyond Therapy: Biotechnology and the Pursuit of Happiness." My name is Chris DeMuth. I'm president of the American Enterprise Institute and I will be moderating this discussion--presentations by panelists and a general discussion with all who are gathered here.

I doubt that there is anyone whose life has not been profoundly improved, their health and also their happiness, by dramatic advances in medicine and, as we now say, biotechnology. I doubt that there is any one of us who has not been equally disturbed, unsettled by stories in the newspapers or by experiences in our personal lives of strange and disturbing uses of new technological possibilities. These are the issues. How to draw the line between the two of them, how to think about them as ethical matters, and how the government might appropriately cope with these profound dilemmas are the subjects of our discussions this afternoon.

I, for my sins, have read a lot of government reports in my time. I have never seen anything remotely like "Beyond Therapy: The Report of the President's Council on Bioethics" issued in October. It is, for one thing, extraordinarily lucid. It altogether avoids the usual risks of government, and especially government committee, documents of being bombastic on the one hand or mealy-mouthed and compromised beyond intelligibility on the other. It is powerfully written. It is--as the chairman says in the introduction, attempted first of all to be a book of education.

I have also read many, many books on cloning, on biotechnology issues and have occasionally sparred with the chairman of this council privately and in public forums on some of these very tricky puzzles, and of all that I've read, nothing comes close to being as illuminating and educational as this wonderful volume. It is no surprise at all that the volume would have been brought out by a commercial publisher. Reagan Books HarperCollins just published "Beyond Therapy."

And I want to congratulate my colleague and good friend Leon Kass, who is Hertog Fellow at AEI as well as being a distinguished professor and a member of the Committee on Social Thought at the University of Chicago, and of being the chairman of the President's Council on Bioethics, for pulling off this stupendous intellectual feat.

To discuss the report, we will hear first from Leon Kass. Margaret Talbot, who was advertised as being on the panel, has come down with the flu. I'm quite certain that Dr. Kass has lectured to her about neglecting to get her flu shot in October, and I'm very sorry that she could not be with us this afternoon. We do have, however, three thinkers on ethical and cultural issues who are unsurpassed in the quality of their work, and we're delighted that they came here to discuss specific chapters of the Council's report.

We will begin with Gregg Easterbrook, who is a fellow at the Brookings Institution, a contributing editor of the New Republic, and one of America's best known writers on science, economics, technology, many other issues. Two of his past books, one on the environment titled "A Moment On Earth," and one on religion in modern life called "Beside Still Waters," are well known to many people. His newest book--and I'm sure he will appreciate my pitching it, even if our other two panelists didn't have--don't have books of their own to wave around, is "The Progress Paradox: How Life Gets Better While People Feel Worse," just published by Random House. And Gregg will speak first on Chapter 3 of the Council's report, "Superior Performance."

He will be followed by Diana Schaub, who is a professor at Loyola Maryland. Professor Schaub has been a post-doctoral fellow at Harvard University. She has taught at Michigan, and served at the National Interest here in Washington. She is the author of the 1995 book, "Erotic Liberalism: Women and Revolution in Montesquieu's Persian Letters."

The final speaker will be Peter Lawler, who is chairman of the Department of Government and International Studies at Berry College. He is editor of the quarterly political science journal Perspectives on Political Science, and author of well over a hundred articles in professional journals and the general press on culture and politics. His most recent book is "Aliens in America: The Strange Truth About Our Souls."

Professor Schaub will be speaking second on Chapter 4 of the book, "Ageless Bodies," and Professor Lawler last on Chapter 5, "Happy Souls."

Without further introductions, biographies of all of these individuals are in the handout materials. I'm going to ask Dr. Kass to make initial remarks, and then our three panelists will speak in turn. We'll have some discussion up here at the front of the room and then open it to general remarks, questions, and discussions.

Leon Kass.

MR. KASS: Thanks to you, Chris, for very generous remarks. Thanks to my colleagues on the panel for taking the trouble to read and to offer comments. And thanks to a very sizable audience for coming out.

The purpose of this report, as Chris has pointed out, is, in the first instance, educational. We offer no recommendations. In Washington, I was told, that's the single best way to be utterly ignored. Your presence here today indicates that we're not altogether wrong in thinking that if we put something out that might contribute to people's reflections on these matters, people might pay at least some attention, even here. So thanks to all of you.

My task in the beginning is to set the table for the discussion by providing a brief overview of the report--what's in it and why. This is no easy task. Summarizing this highly complex and wide-ranging book is almost as difficult as it was for the Council and staff to produce it. Yet for present purposes, the following will have to suffice. And let me begin with the why.

The age of biotechnology has begun filled with hope and expectation. Advances in genetics, drug discovery, and regenerative medicine promise cures for dreaded diseases and relief from terrible suffering. Advances in neuroscience and psychopharmacology promise better treatments for the mentally ill. Techniques of assisted reproduction have already allowed more than a million infertile couples to have their own children. Without such advances--past, present, and future--many of us would lead diminished lives or not be here at all.

But our desires for a better life do not end with health, and the possibilities of biotechnology are not limited to therapy. Although most biomedical technologies have been developed for therapeutic purposes, once here, they are quickly available to serve many other ends, good ones and bad. In mischievous hands, they provide new possibilities for bioterrorism or for social control, possibilities we do not take up in this report. But for people with innocent hands, the powers biotechnologies provide to alter the workings of body and mind are attractive not only for healing the sick and comforting the suffering, but for satisfying widespread human desires to look younger, perform better, feel happier, or become more perfect.

Some of our most popular dreams and nightmares, such as a world of genetically engineered designer babies with parents ordering up their children's characteristics, are, as the report takes some pains to indicate, are scientifically unlikely. But other scenarios are more than plausible, and many desire-satisfying uses of biotechnology are already here: Embryo screening or sperm sorting to choose the sex of offspring; growth hormone to make children taller; Ritalin and similar drugs to control behavior or boost performance in the young; and Prozac or similar drugs to brighten moods or alter temperaments; not to speak of Botox, Viagra, or anabolic steroids.

Many of these technologies are used mostly for good medical reasons, but not simply and not always. And I should point out that the cosmetic uses of biotechnology are spiraling even before some of these new powers are available. In 2002, Americans spent over $1 billion to treat baldness, about 10 times as much as what was spent worldwide seeking a cure for malaria. And in 2002, $7.7 billion were spent on 6.9 million cosmetic procedures in the United States, more than triple the number just five years earlier.

Looking ahead, other biotechnical are already visible on the horizon: Drugs to erase or at least flatten the emotional tone of painful or shameful memories; gene inserts to increase the size and strength of muscles; nanomechanical implants to enhance sensation or motor skills; and perhaps techniques to slow the entire process of biological aging and to increase the maximum human life span.

All this leaves us wondering: Where's the problem? What could be wrong with seeking better children, superior performance, ageless bodies, or happy souls? These are, after all, old and often worthy human desires which biotechnology promises to help us satisfy more easily. Moreover, in free societies like ours, choices about using technical enhancers of this kind are not made by central planners pursuing some vision of a perfect future society. They are made largely by private individuals pursuing their personal dream of happiness for themselves and for their children. Why worry, then, about letting people decide for themselves which uses of drugs or devices serving which goals are right for them?

There are, to be sure, questions about safety of the new biotechnologies and about the equality of access to their use. But these familiar concerns do not reach either the true promise or the deeper perils of the biotechnology revolution. Our hopes for self-improvement and our disquiet about a possibly post-human future are much more profound. At stake are the kind of human being and the sort of society we will be creating age of biotechnology.

Relative to its potential importance, the subject of this report, "Beyond Therapy," is one of the most neglected topics in public bioethics. No previous council has taken it up, not even in part. It speaks, in fact, to the major sources of public disquiet about the biological revolution. It raises some of its most weighty questions. It touches on the ends and goals to be served by the acquisition of biotechnical power, not just on the safety, efficacy, and the morality of the means we use to pursue them. It bears on the nature and the meaning of human freedom and human flourishing and it faces squarely the alleged threat of dehumanization as well as the alleged promise of super-humanization. It compels attention to what it means to be a human being and to be active humanly as a human being.

The Council spent 16 months looking into this subject, learning about the science and technologies, present and projected, from the experts in the field, and discussing among ourselves the likely human and social significance of the "Beyond Therapy" usage of these technologies.

Two important decisions governed our approach. First, we decided to consider all of these uses together. Rather than look piecemeal at, say, genetic engineering or anti-aging technologies or psychotropic drugs, we saw them as aspects of one big picture--human life in the age of biotechnology. Second, in organizing our reflections, we decided that the big picture of the age of biotechnology is not in fact about biotechnology itself, but rather about human beings empowered by biotechnology. Accordingly, we have organized our report not around the specific technologies or even around the powers they place in human hands, but rather around the human desires that they may serve--desires for better children, desires for superior performance, desires for ageless and youthful bodies, desires for happy souls.

Proceeding in this way enables us to see how these new technological possibilities for going beyond therapy fit with previous and present human pursuits and aspirations, including those well represented in the goals of modern medicine. They enable us also critically to assess the desirability of these goals and the significance of any successes in attaining them. What might the successful pursuit of these goals--longer life, stronger bodies, happier souls, superior performance, better children--using biotechnolgical means do both to the users and to the rest of the societies, and indeed to the desires themselves? And why might these consequences matter?

And just very briefly, in Chapter 2, we consider the pursuit of better children using techniques of genetic screening and selection to improve their native endowments, or drugs that might make them more accomplished, attentive, or docile. In the third chapter, we consider the pursuit of superior performance using genetic or pharmacological enhancement, taking the domain of athletics as a specially revealing instance. In the 4th chapter, we consider the pursuit of ageless bodies, both modest and bold, using either soon-to-be-available genetic interventions to increase the strength and vigor of muscles, or various efforts, somewhat more futuristic, to retard the entire process of biological senescence. And in the 5th case study chapter, we consider the pursuit of happy or satisfied souls using pharmacological agents that dull painful memories or that brighten mood.

In a final chapter, we try to put all of this together, what we have learned from the various case studies. While each of the separate instances will make the concerns concrete, the full value of the inquiry requires considering all of these instances together and seeing them as a part of a larger human project toward perfection and happiness.

Let me just close, I think, by posing the dilemma. We are not criticizing the uses of biotechnology, nor are we troubled particularly by these human desires. These human desires are in fact the source of much that is good about us. The question is, what happens when these natural human desires become empowered by these technological means?

And one could put the dilemma in this following way: To be sure, we want better children. But do we want better children if it means turning procreation into manufacture or it means altering their brains to gain them an edge over their peers?

We want to perform better in the activities of life. But do we want to accomplish this by becoming mere creatures of our chemists or by turning ourselves into bionic tools designed to win and achieve in inhuman ways?

We want longer lives. But do we want it at the cost of living carelessly or shallowly with diminished aspiration for living well or by becoming people so obsessed with our own longevity that we care less and less about the next generation's?

We want, of course, to be happier. But do we want it by means of drugs that give us happy feelings without the real loves, attachments, and the achievements that are essential for human flourishing?

In the last chapter of the report we try to look at some of the human goods that are most in need of defense. To be sure, we are concerned about health and safety. We are concerned about equal access to the benefits of technology. We are concerned about freedom and coercion and subtle social pressures of conformity.

But we also deal with things that are not all that popular in American discourse: The question about the dangers of hubris and humility before they're naturally given; the importance of the dignity of human activity in which our deeds flow immediately from body and soul united in pursuit of their activities; questions of identity and individuality and the risks of turning ourselves into something other than ourselves as we pursue these forms of perfection; and then the question, really, of whether, in pursuing some of these partial ends, we don't jeopardize what true human flourishing might be.

The document finishes with a brief look at biotechnology and the American ideals. And there we deal with three things that are really quite challenging: The question of commerce and the manufacture of new desires; the question of the growing medicalization of human life and what it means to try to understand more and more of human life in biomedical terms; and finally, the question of how the American ideas of life, liberty, and the pursuit of happiness are both friendly to the growth of these new biotechnologies beyond therapy--how they might, in a way, serve to moderate some of the extreme possibilities--but also how we have to somehow remind ourselves of what these ideals are for if we are to have the benefits of these technologies without walking down the road voluntarily to our own degradation.

Thank you.

MR. DeMUTH: Thank you very much, Leon. Next, Gregg Easterbrook. Gregg?

MR. EASTERBROOK: Thank you, Chris.

Some of biotech is about curing disease, and nobody's against that. But some of it is about deciding that we're unhappy with what God gave us. And I have a joke about that. I heard this, actually, last night in New York from Jeff Greenfield of CNN.

A grandmother is walking along an ocean beach with her grandchild, and a huge storm comes up. And a giant wave sweeps the poor child out to sea and he disappears from sight. And the grandmother throws herself on the ground prostate. She raises her hands to the heavens and says, "God, I cry out to you. Save my only grandchild. If you return him to me, I promise I will keep the commandments and for the rest of my life I will do nothing but serve you." And suddenly a huge wind comes out of nowhere, and the sea roils, and a giant wave comes back toward the shore and the child is deposited completely unharmed at the woman's feet. And the woman breathes a sigh of relief and then looks up at heaven and says, "You know, when he was swept away, he was wearing a hat."

Well, some of our biotech work reminds me of that joke. I'm in the process of reviewing the commission's report for a major publication, so I can tell you I'm not supposed to have any opinions on it. But I will tell you it's a magnificent piece of work both as thinking and writing. And it is--as Chris says, if you read government reports, it is a great punishment for your sins. You could probably crack espionage suspects that we are trying to get to crack if we just locked them in a room and made them read government reports. They'd tell us anything.

But this is not only a well written report and very thoughtful, but you just don't find many presidential commission reports that talk about the quality of a person's soul and human dignity and other issues like that. So I urge you all, if some of you have bought the report--there's now a beautiful trade version of it--actually read the report. You'll find it very enlightening.

Most of us when we think about biotechnology, and certainly when you see it on the evening news or in the sci-fi version that appears in movies, the main concern is the big mistake, that there's going to be one big horrifying moment where a human-gorilla cross is created or mind control comes into existence or some other horrifying calamity. While you can't rule this out, I would say the odds of the big mistake are fairly small if only because natural selection has conditioned all living things to resist the big mistake. As far as we can tell, in natural history there's been no runaway genetic material, there's been no supergene that the rest of the biosphere has been unable to resist. And if you think about how immune systems work and how evolutions work, this makes sense. You wouldn't expect to find supergenes in nature; we do not. So it's reasonable to suppose that people won't be able to create supergenes, either. Although, of course, we could be wrong about that--200 years ago we would have said it was reasonable to suppose there'd never be a 747, and there it is. However, I think for our lifetimes, at least, the big mistake is not something that need concern us very much.

The little mistake, on the other hand, and the accumulation of little mistakes, is a very relevant concern. When you read "Beyond Therapy" as a report, you'll see it is mainly concerned with what would happen if there was an accumulation of small mistakes. Decisions about biological technology, each one in and of themselves that seem to be justifiable, that are rationalized by people as, well, this won't cause that much harm and it will give us benefit X, each decision individually seeming perfectly well justified leading up to a future in which some things may be better than they are today--people may be less grumpier or better looking or taller or faster or have better memories--but we won't necessarily recognize human dignity as we perceive it today.

So I would urge you, as you think about this issue, to worry about the accumulation of little mistakes. The chance of the nine-foot-tall invincible superhuman big mistake, I think, is fairly small.

On the question of biotechnology will affect performance, the first part of it we have today--and I'm not sure this is really even quite biotech--but drugs such as Zoloft and Prozac and Ritalin that everybody has on their minds that have some psychotropic effect or alter our behavior in some ways. It's hard to think about medicines of this nature because it's so hard to say how you could be opposed to an unhappy person becoming happy or a student who's doing poorly in school doing better. And as I think about these issues, I find some difficulty in determining how you can be opposed to an unhappy person becoming happy and so on. Certainly, if there were a drug with no side effects that would counteract grumpiness, my wife would make me take it. And what would be wrong with my wife making me take it if it had no side effects?

Now, the short-term question that we face with a lot of these issues is "if it had no side effects." A lot of popular psychotropic compounds may have side effects or their long-term side effects are not yet known. However, given the pace of technology, it's reasonable to assume that with the passage of time the side effects of drugs like Prozac and everything in that category will decline, that there will be less harm associated with them and more benefits. And it's going to be hard to see, at some level, what's wrong with that.

Now, when we look farther into the future, when we imagine drugs that will alter people's personalities--not just make a grumpy person cheerful, but they will alter or in some way change what's in our minds--there, I think, you--there, you start to get nervous. But in the early phase of this, which is what we're in, boy, if somebody's got a clinical diagnosis that Prozac could change in some positive way, it's hard to see what's wrong with that.

Now, there's pressure in society to use drugs where drugs are not called for, and Ritalin with children is the most obvious example, although there are some children who genuinely require it. Many parents--and I'm an example--have found happiness in resisting it for our kids. But as drugs get better and the side effects decline, the arguments against them are going to be diluted, and I think we just have to prepare ourselves for that. That's what's going to happen.

As regards performance-enhancing physical drugs in, especially, athletics-the report uses athletics as an example--clearly, some of them are around us already. The steroid class of drugs that are used especially in major league baseball are around us today. If you look at pictures of baseball games from the 1960s, the players look like stick figures compared to the players of the present. Today even the shortstops of major league baseball teams look like these hulking muscular guys who should be working as male strippers for a living. And in the '60s, the baseball players were skinny, fast sort of wiry people, and they're now all incredibly muscular. And it's not because they've been hitting the Nautilus machines, although that's part of what's going on.

The report points out that, from the standpoint of public appreciation of sports, the cross-check here against baseball is that baseball fans are upset and maybe the public will just never be interested in the performance of genetically enhanced athletes because it won't seem human, it won't seem interesting and engaging in the way the Olympics and similar events seem to us today. And I would point out the NFL, which elaborately bans steroid and other sorts of drugs and test for them constantly, is much more popular today than major league baseball, which allows such drugs. And I think there's a relationship between those things.

Now, it is true that if you watch late-night cable TV, there are already basically robot athletic events. You can tune in these channels where robots are smashing each other and things like that. And there may be some future market for that, but I would think that most sports fans and Olympics fans are going to strongly resist performance-altering drugs, even if they're widely available inexpensively to everybody, because it will change the nature of the competition. It won't be a human competition anymore.

And the one--this is a small example from the present day, but there may be some tellingness to this, and that is there is already in the car-racing scene, there is what's essentially robot competition. That's drag racing, if you know anything about this. Professional drag racing, those cars are incredibly fast, but there's almost

no skill involved in drag racing and it's not--it's just a machine and it's not particularly popular, whereas NASCAR racing, as you know, has become wildly popular in the last 20 years. And NASCAR racing is a very difficult human pursuit, dangerous too. I don't like it for that reason. But it requires incredible reflexes and courage and timing and so on. And it's the human pursuit that's popular, so I'd take some consolation from that.

Let me poach briefly on what Margaret Talbot's topic was going to be, since Margaret's not here, and think about the childhood question. The kind of futuristic, brave new world, dial-up properties for your children, genetics, that people talk about especially in science fiction movies do not seem probable based on current technology. Now, again, that could change. There was a time when the 747 would have seemed impossible. For our lifetimes, at least, these things do not seem probable.

What does seem probable for our lifetime is what the report calls negative eugencics, and that's ever-improving tests similar to amniocentesis, that's currently available, where you can not insert the properties that you want in a child, but find defects or worrisome properties. Right now, amnio looks for properties having to do with severe mental problems and a few physical ones. But it is vaguely possible to imagine within our lifetimes that tests that are somewhat similar to amnio or maybe even easier to take and less invasive could test for clumsiness and baldness and shortness and so on. And the report calls this possibility, which worries me a lot, negative eugenics--that you wouldn't be altering your embryo selection, you'd just be trying again and again until you got one that didn't have any negative markers.

The pressure on parents, I suspect, to do it as soon as that stuff becomes available, the pressure on parents to use it will be intense, because parents have a responsibility to bring their children--present their children with the best possible world. Today, that's environmental. You can get cello lessons for your children and take them to the best schools and so on. If it becomes possible to present your children with the best possible genetics coming into the world, even if it's only in a negative sense by eliminating the presence of flaws, a lot of parents are going to find incredible pressure on them--self-imposed or social--to do it.

And although at the early stages it will probably be expensive and only available to the rich--this brief period where we worry that the rich have some sort of genetic advantage--the history of technology is that for the first couple of decades it's only available to the rich and then the price falls and it's available to everybody. So I would assume that if such technology becomes practical and reliable, that in a relatively short time--one generation, say--it will be widely available to everybody.

And then you'll really have a question about what happens to kids and how we bring children into the world. If you just think for a minute, well, you know, if you could have a kid and you had a choice between a short, clumsy kid who was going to become prematurely bald and a tall, athletic, handsome kid with a full head of hair, every parent would choose kid number 2. You'd almost have some sort of weird fiduciary to choose kid number 2. And yet, think of the great contributions that have been made to the world by short, clumsy, bald people. Think more importantly in your own lives, think of the short, clumsy, bald people whom you personally have loved, the people who have obvious things about them that would show up as a genetic defect in some advanced future marker test, and yet have turned out to be wonderful people. When I read that report on this, negative eugenics was what scared me because it feels like something that's going to be practical and for sale sometime in the next 10, 20 years.

Finally, the last thought I would give you to keep in your minds is we tend to assume that all technological developments are inevitable. And one of the things this report is about is asking whether, just because these things are inevitable, do we really want them. But we also have to ask ourselves the evolutionary inevitability of this as well. This is a thought that doesn't give me much comfort, although it may not matter all that much to future generations. Things that seem strange or even grotesque to us about bioengineering, to our generation, may seem from the perspective of future generations merely to be adaptations. Future generations may consider it part of the natural scheme, that first there was undirected evolution and then there was directed evolution under our control. And they may consider it totally obvious that this was what was going to happen all along and why were we, in the early 21st century, fighting it?

I think there are some good reasons that we should, or at least regulate this technology very closely. The report lays most of those reasons out. But as we do so, I think we must bear in mind constantly that future generations are likely to take biotechnology for granted and wonder why we resisted it--which makes it all the more important that we elucidate very clearly the moral reasons for doing so.

Thanks.

MR. DeMUTH: Next we will hear from Diana Schaub. Diana.

MS. SCHAUB: "Beyond Therapy" is the second report of the President's Council on Bioethics. While similar to the first in its spirit of inquiry and moral seriousness, it differs in that it doesn't offer any policy prescriptions. It's more purely speculative and educational. The report's subtitle, "Biotechnology and the Pursuit of Happiness," reminds us that Americans believe it to be self-evidently true that each individual has a right to the pursuit of happiness. The report does not challenge that right or even its prevailing libertarian, subjectivist interpretation, according to which it is not only the pursuit that is left up to the individual, but the definition of happiness as well.

What the report does do is aim to make us more thoughtful in the exercise of our right to the pursuit of happiness by getting us to reflect on the question, What is happiness? In the course of deepening our understanding our own desires and of the goods we seek, the report leads us to doubt whether the sorts of biotechnologies that are likely to be developed will really satisfy us, despite the fact that they're being offered to us as answering certain deeply felt and widely shared human desires and aspirations.

The four main divisions of the inquiry take up four dreams of human improvement or perfection: the quest for better children, the quest for superior performance, the quest for ageless bodies, and the quest for happy souls. My assignment is to talk about the ageless bodies chapter. I've concluded that mine is the most difficult assignment, particularly if one wants to follow the report in arguing that these quests are questionable.

One can reject performance-enhancing drugs and devices in the name of true human excellence. One can decline feel-good pills in the name of true human happiness. One can refuse to select and design or de-select and re-design one's children in the name of true human love. To make the case against ageless bodies, however--to say no thanks to the prolongation of one's life--one has to make an argument for human mortality. Love, excellence, and happiness all sound a whole lot better and more likely to be part of a persuasive speech than does death. One could try to make the Grim Reaper sound less grim by speaking of the natural human life span or employing poetic language like three score and ten, but one still comes up pretty hard against our desire for self-preservation, our love of life and our loved ones, our dread of decline, and our fear of death.

In Shakespeare's "As You Like It," the melancholic Jaques recounts the following of the motley fool Touchstone. "It is ten o'clock. Thus we may see, quoth he, how the world wags. 'Tis but an hour ago since it was nine, and after one hour more, 'twill be eleven; and so, from hour to hour, we ripe and ripe, and then, from hour to hour, we rot and rot; and thereby hangs a tale."

Shakespeare tells us that the human story is one of inexorable ripening and rotting. But what if biotechnology allowed us to alter the effects of time, to suspend aging or to disentangle the desired effects of aging from the undesired? What if we could ripen without rotting? What if we could arrest not the maturation of our minds and spirits, but the senescence of our bodies? How would the human tale change, and would it change for the better?

The authors acknowledge that this may be the most radical of the subjects addressed in the report. The desire for a deathless existence challenges the most fundamental of human limits. Even if the most that might be attained is a doubling of the maximum human life span, the quest for more life is in principle indistinguishable from the quest from the quest for immortality.

Now, by no means does the report set itself altogether against the notion of longer and more vigorous human lives. It admits that the moral case for living longer is very strong. And of the three possible avenues for extending life, it heartily approves of two of them.

The past century saw tremendous gains in average life expectancy as the result of reductions in infant mortality and premature death in the young and middle-aged. In the United States, average life expectancy has gone from 48 to 78 years since 1900. The same gains in nutrition, health, and safety are surely to be sought and welcomed in less-developed nations.

Attention is also being directed toward improved prospects for the elderly, with treatments for specific illnesses and causes of death. Again, much of this is welcome. However, the gains to be expected from this approach are modest. The report notes that even if diabetes, all cardiovascular diseases, and all forms of cancer were eliminated today, life expectancy at birth in the United States would rise to about 90 years from the present 78. That would be significant, but it would not fundamentally alter the shape of the human life cycle. There is also the possibility that such increases would not be an unalloyed improvement since cures for a handful of disease would just leave one subject to others and subject to the more general ravages of time. Moving into our eighth and ninth decades, we might face the prospect of a much prolonged dotage and second childishness, debilitated and dependent but still lingering on.

Accordingly, it's only the third avenue, direct and general age retardation, that holds out the truly radical promise of combatting senescence and extending the maximum human life span now fixed at 122 years. According to the report, it's only this last approach that raises the most significant physical, social, and moral consequences. Now, the whole business is not as science-fictiony as it sounds. Age retardation is already being pursued with quite remarkable results in animals. Through genetic manipulations, researchers have achieved a sixfold increase in the life span of worms. Genetic manipulations coupled with caloric reduction have produced a 75 percent increase in the life span of mice.

So now would be the time, before a dramatically extended human life span is on the horizon, to conduct some thought experiments aimed at ascertaining whether longer life holds promise or peril for us. The report does this by speculating about possible transformations in our outlook on life and death, our level of commitment and aspiration, and our familial and societal relations. It struck me while reading the report that science fiction has always been a good source of these sorts of thought experiments, and perhaps also that science fiction could help informing the sort of public opinion that will be necessary to stave off some of these developments.

So, to anyone interested in these issues, I strongly recommend Star Trek, the original series, of course, not any of the second-rate sequels. Given the scientific mission of the U.S.S. Enterprise ("to explore strange new worlds, to seek out new life and new civilizations¾to boldly go where no man has gone before"), you might expect that the show would be gung-ho for the conquest of nature, including pushing the envelope of our human nature. In fact, however, episodes of Star Trek repeatedly confirm the needfulness of human limitations and, indeed, revel in the self-imposed acceptance of those limitations. Interestingly, this attitude is embodied most in the ship’s Chief Medical Officer, Doctor McCoy, whose nickname is "Bones," a nickname that forcibly reminds us of the limitations of the medical art-the bodies doctors attend upon will die.

Many episodes of the show dealt with issues of mortality and immortality. Let me mention just two, an episode entitled "Miri" (a name intentionally reminiscent of Shakespeare’s Miranda who delivers the famous line "O brave new world that has such people in’t!") and an episode entitled "Requiem for Methuselah" (Methuselah being the longest-lived of the Biblical figures; the Bible says he lived 969 years.) In the first episode, the Enterprise answers a centuries-old distress call from a parallel planet Earth. There, the crew happens upon the results of a Life Prolongation Project that went disastrously awry in the 1960s. All the adults on the planet are dead, victims of a manmade virus that afflicts individuals at the onset of puberty. The planet is populated entirely by children, who are hundreds of years old, living a Lord-of-the-Flies-type existence. As a result of the Life Prolongation Project, they age one month for every one hundred years of real time, until reaching puberty at which point the virus causes them to age rapidly and horribly. We see before us the dystopia of an almost eternal childhood.

The show raises some important considerations: in any project to lengthen life, what stage of life do we want to lengthen, all of them equally, or some more than others? Perhaps most fascinatingly, the episode is premised on the connection between mortality and fertility-a connection highlighted by the Council’s report. Apparently, in the research conducted thus far, the most common side-effect of age retardation is sterility or reduced fertility. It seems as if, in pursuing an ageless body, the balance between the individual and the species is altered. When we choose vastly longer life for the individual, the propagation of the species is sacrificed. The society in the Star Trek episode is a drastic rendition of the trade-off. In pursuing immortality for themselves, the residents of the planet made clear their hostility to the succession of the generations. They sought to make themselves irreplaceable. In a sense, the virus is the internal truth of their project, for the virus makes impossible the succession of the generations. Fertility brings with it an immediate sentence of death, so immediate that fertility cannot achieve its purpose. Without any power of regeneration, this society of perennial youngsters is slowly dying. "Miri," for whom the episode is named, is a girl on the cusp of adolescence, fearful of growing up, but also drawn to the adult world and especially Captain Kirk with whom she falls in love. Fittingly, it is her love for him that eventually allows the crew to intervene and reverse the effects of the Life Prolongation Project.

The other episode, "Requiem for Methusaleh," examines another sort of immortality, lest we think that perpetual maturity would be better than perpetual youth. The Enterprise encounters Flint, a 6000 year old man, who has retreated from the human world to his own private planet. He was born in 3834 BC, inexplicably endowed with the capacity for instant tissue regeneration. He has lived a thousand different lives, many of them notable. He was, for instance, Leonardo da Vinci and Brahms. Over the centuries, he has amassed wealth and knowledge. And yet, he is now as cold and unyielding as his name, Flint. He is quite prepared to kill the whole crew of the Enterprise in order to protect his privacy. Doctor McCoy is astonished at his cruelty: "You have been such men, you have known such beauty …" But as Flint explains: "I have seen a 100 billion fall." His longevity has rendered him misanthropic.

He is not, however, a misogynist. He is at work manufacturing the perfect female android, an immortal mate for himself and a remedy for his solitude and boredom. Star Trek almost always portrayed those beings who go beyond the normal limits of an embodied existence to be cruel, controlling, and intolerably lonely. Often they feel their longevity to be a curse. Of course, Captain Kirk and company manage to escape Flint’s clutches, and again it is love that provides the corrective, in this case the android’s rebellious love for the Captain. When Flint’s creation self-destructs, he relents. In the end, Flint learns that in leaving Earth’s atmosphere, his immortality has been compromised. From now on he will live out a natural lifespan. This knowledge of his mortality immediately improves his character, as he resolves to devote the remainder of his now precious days to helping his fellow man.

My years watching Star Trek have left me receptive to the view that mortality is, if not precisely a good thing, then at least the necessary foundation of other very good things, and that there is something misguided about the attempt to overcome mortality. Still, one can’t help but wonder "what if…?" Knowing that Mr. Kass has recently published a book on Genesis, I have just one question. We are told in Genesis that the earliest generations of men, through Noah, had lifespans closer to a millenium than a century. We also know that things ended rather badly for them. While Star Trek’s "Methuselah" reforms, the Biblical Methuselah was done away with in the Flood. Would greater longevity for modern man result in the same incorrigibility? Or do we have more resources now-psychological, political, religious-for dealing with the consequences of longer life? Antediluvian man was unfamiliar with death. Perhaps our sense of mortality is sufficiently well-established to allow us to delay the actual blow. So long as we still die, and we know we still die, no matter how far in the future that date is, won’t we still have the experience the poet speaks of: "But at my back I always hear / Time’s winged chariot hurrying near"? And if so, if time still presses us, won’t the salutary human responses to death perdure? Wouldn’t even long-lived men walk the now well-worn paths of transcendence: procreation and poetry, philosophy and faith? Since the quest for immortality will never be satisfied through an ageless body, won’t human beings still seek participation in the eternal?

MR. LAWLER: It makes good sense for this Commission to turn its attention to the prospect of happy souls right after considering the prospect of ageless bodies. We want ageless bodies not for their own sake but to be happy. But according to John Locke, the philosopher who is the key to America, what distinguishes us human beings from, say, the chimps and the dolphins is not happiness itself, but our pursuit of happiness. We might even say that Locke makes the strange suggestion that the happy soul is an oxymoron.

Ageless or fairly ageless bodies will not make us happy because biotechnology will never be able to eradicate the possibility of accidental death. Those blown up in an explosion or flattened by an asteroid will be gone forever. Seemingly largely freed from the necessity of natural death, but still having to face the prospect of accidental death, we will perceive our lives as being more accidental and contingent than ever. So this report quite reasonably speculates that anxiety about accidents will continue to grow.

We already see that as high technology increasingly makes our lives objectively more secure and long we become in many ways more anxious and risk-averse than ever. We live in a time when well-educated and prosperous Americans are nonjudgmental about everything but health and safety-about those we are increasingly paranoid, prohibitionist, and puritanical.

If perfect or more perfect bodies will not make us happy, we might as well try to perfect our souls. According to Aristotle, we do that through the practice of moral virtue. But one of the downsides of living in an increasingly high-tech society is that both virtue and opportunities to act virtuously seem to be in particularly short supply. So for us perfecting our soul has come to mean employing psychotherapy of various kinds to feel good without having to be good. We can now hope to use biotechnology to bring our memories and moods under our conscious control. And mood control is more fundamental than memory control: we need not fear our memories if we can keep them from making us feel bad.

The main fear of this chapter on happy souls is that some kind of super-Prozac might rob us of our distinctive humanity, that we might end up living relatively content in the present-unmoved by past and future, by love, shame, guilt, grief, or death. That solitary contentment is far inferior to the splendid social flourishing rightly called human happiness. But this report also shows that intense human happiness is inseparable from intense human misery. We human beings seem to lack the moderation that the other animals naturally enjoy.

So we can’t help but ask why we shouldn’t use biotechnology to make ourselves as at home in the world as our fellow animals naturally are. This report makes the case for biotechnological mood control seem pretty powerful. Let me make that case as strongly as I can.

We human beings will be better off using biotechnology to change the perverse features of our natures to achieve a shallower, but more pure, form of happiness. The cost in soaring greatness will be worth the gain in ordinary happiness. We won’t need to be as great-because we won’t need to be as miserable-anymore.

Thinkers such as Walker Percy say that we have good reasons to be anxious and depressed. We really do live in a crazy society and we really are mysteriously displaced or lost in the cosmos. But today such social and existential accounts of anxiety and depression are called into question by the possibility of their chemical cure.

Moods, we are now told, are really nothing more than the result of certain chemical reactions. And who’s to say which mix of chemicals tells us the truth about ourselves? We seem to have no reason not to prefer comfort and productivity to the truth, no reason not to follow Richard Rorty’s pragmatic advice and call true whatever mood makes us comfortable.

But if our moods got too good, our demand for biotechnological advances that really would improve our bodies would wither away. And because we would be too happy to worry about terrorism, the terrorists would surely win. So the soundest judgment is that our anxious, obsessive individualism needs to be curbed somewhat but not eliminated altogether.

Fortunately, our drugs seem ready to deliver exactly this result. Those who take selective serotonin reuptake inhibitors (SSRIs) such as Prozac or Paxil remain moved to some extent by anxiety, melancholy, and so forth, but not to the point of brooding over them or being overwhelmed by crippling social inhibitions.

This sort of "designer" mood brightening or balancing will certainly become more precise and effective. It will assist the bourgeois bohemian project of sophisticated Americans to reconcile a meritocratic work ethic with a life of easygoing enjoyment. To be too bourgeois or too bohemian-to be all work or all play-is self-destructive. So what we need to flourish in our time-and SSRIs might deliver-is a moderate or fairly calm form of uneasiness or restlessness. We need just the right mixture of the pursuit and the enjoyment of happiness.

I now have to say what I hope you already know. The case I just gave for conscious, biotechnological mood control is only makes sense to those who really believe that we do or will be able to completely understand human consciousness or the human soul. So it doesn’t make much sense to me. And I think this penetrating report would be even more powerful if it were more consistently confident that the mood control project is finally mission impossible-in fact, finally nuts.

Every modern or technological attempt to make us more at home in this world has had the main effect of making us more homeless. This one will be no different. I don’t think that there’s any reason to fear that we are capable of producing Nietzsche’s flat-souled last man or Huxley’s Brave New World.

We may soon enough believe that there is nothing we can do, except pop the right mix of pills, to make ourselves happy. This new and quite fundamental dependence on technological manipulation will make our existences more contingent than ever, and just beneath the surface of our new good feelings will be a new form of anxiety, a really bad mood. Our pursuit of happiness will be more fanatical and more futile than ever. But the good news is that there will be in some ways more evidence than ever from Locke’s or even Pascal’s view that we have souls.

So this report, in my view, is in some ways incoherent because it provides plenty of evidence that what it sometimes to seems to fear-that we will manipulate our chemical make-ups to withdraw into private fantasies-could not really happen. We will still be stuck with all the tough demands of living in a very high-tech, very meritocratic, very competitive society.

Because we will be able to, this report astutely speculates, we will be expected to brighten our moods to maximize our productivity and to be a source of constant pleasure to others. We will have to not only dress but feel for success. Being alienated, depressed, sad, shy, or just introspective will be regarded as problems that we have the duty solve by a quick trip to the drug store.

Contrary to what our silly libertarians think, designer mood control will be an unprecedented constraint on individual freedom. As Percy feared, we will no longer have a right to our anxiety, but that will make us more anxious and, I think, in some ways more angry than ever. Our anger will be directed, whether we know it or not, against an attempt to deprive us of part of the truth about our human being.

So this report is strongest when it is clearest that our pharmacological attempts at mood control will be yet another failed escapist solution to the problem of our obsessive individualism. Our biotechnological efforts will do nothing to solve any of the problems that come with the contemporary denials of the goodness of the limits and directions imposed on us by nature as the beings open to the truth. Despite their huge and undeniable benefits, our successes will actually tend to make us more unhappy by exaggerating even more certain features of our existence as individuals.

Our futile biotechnological pursuit of happy souls will erode still further our experiences of continuity, permanence, love, and friendship- our genuine connections with the world and the human beings around us-that really do moderate our genuinely human experiences of homelessness in this world.

So all honor to and God bless Leon Kass for getting government to venture a bit into thinking about the soul. The biggest news this report gives us is that there is no substitute for the practice of virtue, for really being good, if we really want to be as happy as we can be, and we need to think about what sort of virtue will be required to live well in the strange new biotech world, one in which there will be widespread experimentation on and by ordinary, reasonably healthy people with pharmacological mood control.

The secret to enjoying real human happiness always lies in our willingness to renounce our right to happy. It lies in fulfilling the demanding moral responsibilities given to us self-conscious mortals in a grateful and dignified way. That’s why Dr. Kass, in the book he wrote on his own, emphatically urged we Americans today, first of all, not to pursue happiness but to defend our dignity against the excesses of technology.

Contrary to John Locke or even Pascal, I do not believe that happy soul is an oxymoron. We can be humanly happy-and so not perfectly happy-when we think and act with the dignity given only to beings with souls.

[End of segment]