Melinda C. Hall

In a critical intervention into the bioethics debate over human enhancement, philosopher Melinda Hall tackles the claim that the expansion and development of human capacities is a moral obligation. Hall draws on French philosopher Michel Foucault to reveal and challenge the ways disability is central to the conversation. The Bioethics of Enhancement includes a close reading and analysis of the last century of enhancement thinking and contemporary transhumanist thinkers, the strongest promoters of the obligation to pursue enhancement technology. With specific attention to the work of bioethicists Nick Bostrom and Julian Savulescu, the book challenges the rhetoric and strategies of enhancement thinking. These include the desire to transcend the body and decide who should live in future generations through emerging technologies such as genetic selection. Hall provides new analyses rethinking both the philosophy of enhancement and disability, arguing that enhancement should be a matter of social and political interventions, not genetic and biological interventions. Hall concludes that human vulnerability and difference should be cherished rather than extinguished. This book will be of interest to academics working in bioethics and disability studies, along with those working in Continental philosophy (especially on Foucault).

The following is dedicated to promoting a version of the disability critique of negative genetic selection while navigating claims that launching such a critique threatens reproductive liberty or is unavoidably antichoice. I highlight problematic conceptual assumptions regarding genetics and choice made by proponents and opponents of selection alike and bring out the underlying ableist values of the prevailing conversation. Ableism is discrimination against persons on the basis of perceived disability. I conclude that the existing social and institutional milieu surrounding genetic selection threatens persons who experience difference with stigma and its accompanying political and social disadvantages. My ..

Bioethics influences public policy, scientific research, and clinical practice. Thinkers in Continental traditions have increasingly contributed scholarship to this field, and their approaches allow new insights and alternative normative guidance. In this essay, examples of the following Continental approaches in bioethics are presented and considered: phenomenology and existentialism; deconstruction; Foucauldian methodologies; and biopolitical analyses. Also highlighted are Continental feminisms and the philosophy of disability. Continental approaches are importantly diverse, but those I focus upon here reveal embedded models of individualized autonomy in medical discourses and encourage awareness of medicine's normalizing edges, thereby drawing attention to lacunae in traditional bioethical frameworks

Understanding disability requires understanding its social construction, and social construction can be read in cultural products. In this essay, I look to one major locus for images of persons with disabilities—horror. Horror films and fiction use disability imagery to create and augment horror. I first situate my understanding of disability imagery in the horror genre using a case study read through the work of Julia Kristeva. But, I go on to argue that trademark moves in the horror genre, which typically support ableist assumptions, can be used to subvert ableism and open space for alternative social and political thinking about disability. I point to the work of Tim Burton and Stephen King to demonstrate these possibilities in horror.

The disability critique of negative genetic selection is frequently accused of threatening reproductive liberty. This paper describes the disability critique and defends it against that objection. It also contends that the critique can work to deflate belief in genetic determinism. Recognizing the influence of genetic determinism helps advocate for existing persons in the disability community and protects reproductive liberty. The disability critique can point to genetic determinism but does not suggest a ban or obstacles to the choice of negative genetic selection; therefore, it is not antithetical to reproductive liberty, as has been charged.

In this paper, I critically assess transhumanist philosophy and its influence in bioethics by turning to resources in the work of Michel Foucault. I begin by outlining transhumanism and drawing out some of the primary goals of transhumanist philosophy. In order to do so, I focus on the work of Nick Bostrom and Julian Savulescu, two prominent contributors to this thinking. I then move to explicate Foucault’s work, in the early iterations of the Abnormal lecture series, on the concept of vile sovereignty. Foucault used the concept of vile sovereignty to critique psychiatric witnesses that had been utilized in mid twentieth-century French courts of law. Turning back to transhumanism, I analyze transhumanist discourse on the basis of Foucault’s vile sovereignty. Transhumanists promote human enhancement in a way that rejects the body—especially the disabled body—and pose the question of what lives are worth living, as well as attempt to answer it. I conclude that because of the undeserved influence and ableism of transhumanism, it is important for feminist philosophers, philosophers of disability, and other disability scholars, who collide at the nexus of bioethical debate (especially with regard to reproductive technology and the body), to work together to intervene upon transhumanist discourse.

This paper calls fresh attention to ethical problems surrounding prenatal testing by focusing on genetic knowledge gained through evolving testing procedures. Advances in reproductive and prenatal genetic testing include non-invasive tests, such as Verifi and Materniti21, designed to gather detailed information regarding fetal DNA as early as 10 weeks. Meanwhile, a new method of chromosomal microarray has proved more reliable than karyotyping in detecting fetal abnormality. This method detects abnormalities in 1 out of every 60 pregnancies in which karyotyping identified the fetus as “normal.” Chromosomal microarray directly compares fetal DNA to DNA from a presumptively “healthy person” to identify genetic deviations. The chromosomal microarray method thus assumes a human genetic blueprint—that is, a normal genotype, deviance from which is risky and open to medical diagnosis. But, according to philosopher and geneticist Jackie Leach Scully, there is no genetic blueprint for human beings. Rather, genetic variation is constant. Thus, notes Scully, genetic discourse could free medical discourse from the dictates of the binary between normal and abnormal, although mistaken belief in a genetic blueprint can foil this alternative way of speaking and thinking. Prenatal testing has received critical philosophical attention from both disability theorists and feminists. Adrienne Asch suggests that prenatal testing and diagnosis stigmatizes already-existing persons with disabilities by suggesting that bodily deviance is intolerable. Licia Carlson coined the phrase “prenatal prototypes” to describe the obfuscating results of genetic profiling carried out on the fetus. The philosophical conversation Asch and Carlson stimulate involves higher stakes now that testing uncovers fetal genotype and reveals mere genetic deviation in order to aid reproductive decision-making. I argue that prenatal testing, and especially the most recently developed testing procedures described above, forecloses Scully’s alternative discourse of genetic variation by supporting an ideal of a singular “healthy genotype,” deviance from which is to be uncovered and avoided. Mobilizing this insight by drawing on the work of feminist disability scholars like Asch and Carlson, I seek to foreground the play between norm and deviance. I expose the normalizing field of statistical risk, operating in excess of medical diagnosis, which requires potential parents to manage and avoid deviance itself.

Transhumanist arguments in support of radical human enhancement are inimical to disability justice projects. Transhumanist thinkers, the strongest promoters of human enhancement, and fellow travelers who claim enhancement is a moral obligation, make arguments that rely on the denigration of disabled embodiment and lives. These arguments link disability with risk. The promotion of human enhancement is therefore open to significant disability critique despite transhumanism’s claims to allyship with disability justice activism. This chapter lays out such a disability critique of enhancement and further supports its claims by describing bioethics, and therefore transhumanism, as biopolitical in the sense Michel Foucault uses the term. Finally, this chapter develops an alternative vision of enhancement. This alternative vision poses a disability-inclusive future, accepts the risks of embodiment, and lays groundwork for a counterdiscourse of enhancement.