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Mehlman, throughout his absorbing and thought-provoking book The Price of Perfection, takes the reader on a historical tour of enhancement-use. He begins by discussing the use of easily-accessible enhancements, such as Ancient Greeks consuming herbal energy drinks at the Olympics. From here we examine many other enhancements including modern, poorly-understood, and expensive biomedical enhancements like germline genetic enhancement (i.e., modifying an embryo's genes to make altered qualities inheritable). By following the history of enhancement use, Mehlman sets the stage for asking what he considers fundamental moral-philosophical, socio-psychological, legal, and medical questions regarding biomedical enhancements. These questions, the author argues, are ones that need to be addressed to ensure that a "genobility" does not arise (i.e., those who are financially well-off would have access to biomedical enhancements, consequently exacerbating societal disparities beyond a breaking point) (p. 97). Accordingly, the three primary questions Mehlman is seeking to examine are whether biomedical enhancement should be stopped; whether we, humans are able to stop them; and whether they were meant to be restricted by us in the first place. To support the primacy of these questions, as well as the quality of the points he makes, Mehlman employs clear arguments and capitalizes on enthralling and well-researched examples; making this book an enjoyable and informative read.
Mehlman tactfully begins by providing clear working definitions of central terms such as enhancement, biomedical, personal liberty, and paternalism. Next, he continues by distinguishing between two distinct uses of biomedical enhancements: those used for personal gain and those used for social benefit. While discussing the former, Mehlman, arguing for personal liberty, concludes that competent adults ought to have a right to enhance themselves as long as such acts cause no identifiable harm to third parties (p. 48). The question of harming others however, brings up different and much less easily-refutable arguments against enhancements (e.g., enhancements give users a competitive advantage over other persons).
Mehlman goes on to discuss the futility of arguments against enhancements such as the one grounded in the notion of meritocracy. Toward the middle of the book, Mehlman arrives at instances that, he believes, warrant societal control of enhancement-use: in cases of vulnerable persons, in situations where individuals might feel overwhelming pressure to use enhancements or when enhancements comprise unsafe and ineffective products, and when it comes to the problem of equal access to enhancements. The latter for example occurs because current laws block competition on biomedical enhancements. Thus, these procedures and substances are very expensive and would only be available to the most well-off, potentially leading to the abovementioned dangerous performance-gap.
The main thesis of the book and the author's proposed solution could be summed up as follows: 1) an attempt to completely ban enhancements would raise similar practical and constitutional difficulties as occur with the War on Drugs and doping (e.g., intolerably intrusive methods, a police state, and unfeasible amounts of government spending to enforce a ban); 2) therefore, "the best way to ensure that biomedical enhancements promote the public good is to make them as safe and effective as possible" (p. 230). In addition, because providing universal access to enhancements would be too costly (p. 96), the problem of equal access to enhancements can be solved by either creating a system where persons receive subsidized enhancements, or by the establishment of a national enhancement lottery.
Mehlman relies heavily on both bringing supporting examples from sports and on using the antidoping movement as an analogy for his discussion of biomedical enhancements. While this comparison is ingenious, it also serves a potential disservice to some of Mehlman's arguments. For instance, to discuss why persons should or should not have enhanced capacities, Mehlman examines and refutes a number of highly diverse opinions against enhancement-use. One such argument is that the reward enhancements provide is unfair, athletes who do not use them do not have an equal opportunity to win, and, as such, doping calls into question the integrity of sports. The counterargument, as posed by Mehlman, is that the entire field of sports is unfair to begin with: pitting countries with different degrees of economic development and from different parts of the world against one another in competition is highly inequitable. In sum (but an oversimplification), sports are unfair regardless of the use of enhancements, therefore the use of these just simply creates another form of unfairness (p. 67). In other words, here Mehlman views fair and unfair as a dichotomy and so argues that by increasing the unfairness of a practice that is already unfair, fundamental changes do not occur. However, an immoral or unjust practice cannot be justified by arguing that it is already being conducted in an unfair or immoral manner. If that line of thought is followed ad infinitum, it may lead to a potential slippery slope and run the risk of nihilism.
In a parallel yet different manner, Mehlman agrees that there already are disparities in-between the socioeconomic statuses of different social classes (just like in sports). Yet, when it comes to enhancements used for social reward creating too large a performance gap, Mehlman agrees that enhancement use can exacerbate these disparities beyond the breaking point (and create a tyrannical, anti-democratic society). So in this instance, he argues that disparities are to be considered on a continuum and there are acceptable and unacceptable limits. It is unclear why issues that have parallel logical makeups are treated inconsistently either as a dichotomy or as a continuum and further discussion by the author about the severity of the consequences or the degree of the resulting unfairness would have been beneficial.
Nevertheless, this book serves an excellent groundwork for summarizing the history of enhancements, deciphering the status quo of this emerging field, and asking and addressing the principle questions necessary for understanding the ethical and psychological controversies related to the topic. Although certain chapters are more technical than others, the less technical ones are written in such a way that they remain intriguing, while the more technical ones are written clearly and can be understood by readers unfamiliar with enhancements or bioethics. As a consequence, both readers who have a strong background in the conceptual framework under discussion as well as those with merely an interest in it can enjoy this book. The careful and well-balanced examination of the diverse topics covered in the book, Mehlman's innovative and creative solution to the problems raised by enhancements, and the very interesting, unique, well-researched examples make this book entertaining for anyone interested in social sciences, law and public policy, biology and bioethics, or athletics and sports in general.
© 2010 Nora Bunford
Nora Bunford is pursuing a PhD in Clinical Child Psychology at Ohio University. She received her B.A. degrees in Psychology and Philosophy from Southern Illinois University Carbondale and her M.S. degree in Clinical-Counseling Psychology from Illinois State University. While completing her doctoral studies in Psychology, Nora is also concurrently pursuing a master's degree in Philosophy. Her academic interests center around Bioethics, Psychology and its theoretical underpinnings, and research science. E-mail: firstname.lastname@example.org