Cosmetic Genetics and Virtue-Based Restraints on Autonomy

The American Journal of Bioethics, Volume 10, Issue 4.

 By Laurence B. McCullough

There are persistent tendencies in the bioethics literature to be imprecise about what “enhancement” means, to treat genetic enhancement as ethically sui generis. “Enhancement” in general means the improvement of human anatomy and therefore human appearance and of human physiology and therefore of human performance from the baseline of congenital anatomy and physiology. Such improvement can be undertaken for purposes of preventive medicine, i.e., improving human anatomy or physiology to reduce the incidence of mortality, morbidity, disability, pain, distress, or suffering in a population of patients. By its very nature, preventive improvement appeals to the ethical principle of beneficence (McCullough and Chervenak 1994), so some forms of enhancement are beneficence-based. Mortality, morbidity, disability, pain, distress, and suffering that result from pathology such as infectious disease are statistically abnormal and generally disvalued departures from what is valued as normal anatomy and physiology. When Fan addresses genetic improvement of physiology, i.e., genetically engineered improved immune response to infectious diseases, he is invoking beneficence-based genetic enhancement.

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