Jan-Christoph Heilinger

Is it necessary to have an ideal of perfection in mind to identify and evaluate true biotechnological human “enhancements”, or can one do without? To answer this question we suggest employing the distinction between ideal and non-ideal theory, found in the debate in political philosophy about theories of justice: the distinctive views about whether one needs an idea of a perfectly just society or not when it comes to assessing the current situation and recommending steps to increase justice. In this paper we argue that evaluating human enhancements from a non-ideal perspective has some serious shortcomings, which can be avoided when endorsing an ideal approach. Our argument starts from a definition of human enhancement as improvement, which can be understood in two ways. The first approach is backward-looking and assesses improvements with regard to a status quo ante. The second, a forward-looking approach, evaluates improvements with regard to their proximity to a goal or according to an ideal. After outlining the limitations of an exclusively backward-looking view, we answer possible objections against a forward-looking view. Ultimately, we argue that the human enhancement debate would lack some important moral insights if a forward-looking view of improvement is not taken into consideration.

Both, bioconservatives and bioliberals, should seek a discussion about ideas of human perfection, making explicit their underlying assumptions about what makes for a good human life. This is relevant, because these basic, and often implicit ideas, inform and influence judgements and choices about human enhancement interventions. Both neglect, and polemical but inconsistent use of the complex ideas of perfection are leading to confusion within the ethical debate about human enhancement interventions, that can be avoided by tackling the notion of perfection directly. In the recent debates, bioconservatives have prominently argued against the ‘pursuit of perfection’ by biotechnological means. In the first part of this paper, we show that—paradoxically—bioconservatives themselves explicitly embrace specific conceptions of human perfection and perfectionist assumptions about the good human life in order to argue against the use of enhancement technologies. Yet, we argue that the bioconservative position contains an untenable ambiguity between criticising and endorsing ideas of human perfection. Hence, they stand in need of clarifying their stance on human perfection. In the second part of the paper, we ask whether bioliberals in fact (implicitly) advocate a particular conception of perfection, or whether they are right in holding that they do not, and that discussing perfection is obsolete anyway. We show that bioliberals also rely on a specific idea of human perfection, based on the idea of autonomy. Hence, their denial of the relevance of perfection in the debate is unconvincing and has to be revised

Die Frage des Menschen nach sich selbst beschäftigt Menschen zu allen Zeiten und an allen Orten, so auch in der Gegenwart. Die hier versammelten Wissenschaftler, Politiker, Theologen, Journalisten und Schriftsteller aus verschiedenen kulturellen Traditionen geben in über fünfzig prägnanten Beiträgen ihre persönliche Antwort auf die aufgeworfene Frage. Was ist davon zu erwarten? Sicherlich keine abschließende Lösung der Frage. Doch ist ein schillerndes Spektrum aktueller Positionen zum menschlichen Selbstverständnis entstanden - zugleich kritisch und konstruktiv, pointiert und tiefgründig. Eingeleitet und kommentiert wird die Sammlung mit Beiträgen von Volker Gerhardt, Julian Nida-Rümelin, Detlev Ganten und Jan-Christoph Heilinger.

Asgary and Smith (2013) identify an important challenge: the difficult position of physicians caught between the obligation to treat every human being with the same professional rigor, and their feelings of responsibility toward the state and its judicial decisions on asylum requests. The authors show that in some cases this conflict leads to a tendency to "sacrifice their medical responsibilities". The authors' core demand is that health care workers should be independent of the state and judiciary systems, and thus prioritize the interests of the patient. We agree entirely with the authors, that well-performed documenting is the only ethically justifiable option and should not be influenced by a feeling of responsibility for contributing to judicial decisions. However, the authors also address the more general, and ethically more challenging, issue of the responsibility of health care workers and the state toward asylum seekers and ask, how much health care provision is appropriate?