Is it ethical to use enhancement technologies to make us better than well?

December 27, 2004

A variety of biomedical technologies are being developed that can be used for purposes other than treating disease. Such "enhancement technologies" can be used to improve our appearance and regulate our emotions, with the goal of feeling "better than well." While these technologies can help people adapt to their rapidly changing lifestyles, their use raises important ethical issues.

In a provocative debate in this month's PLoS Medicine, the premier open-access medical journal, two of America's foremost medical ethicists, Arthur Caplan and Carl Elliott, lay out the pros and cons respectively of these new enhancement technologies.

Caplan, who chairs the Department of Medical Ethics at the University of Pennsylvania School Of Medicine, says that "nobody is perfect--but why not try to be better?" He argues that it is in our human nature to strive for self-improvement and he sees real value in using technology to "enhance our vision, memory, learning skills, immunity, or metabolism." What's more, says Caplan, "putting the brakes on biologically driven human betterment would have real consequences for science. Some lines of research would be slowed or restricted." There is no reason why we "should not try to improve the biological design with which we are endowed."

But Elliot, Associate Professor at the Center for Bioethics at the University of Minnesota, and author of the book Better Than Well, worries "about the larger social effects of embracing medical enhancement technologies too enthusiastically." For example, athletes taking steroids may improve their own ability but they set off "a steroid arms race" that could destroy their sport. Manufacturers of enhancement technologies "will usually exploit the blurry line between enhancement and treatment in order to sell drugs." Citing the story of the diet drug Fen-Phen, Elliot says that "an alarming number of supposedly risk-free enhancements have later been associated with unanticipated side effects."
Citation: Caplan A, Elliott C (2004) Is it ethical to use enhancement technologies to make us better than well? PLoS Med 1(3): e52.


Arthur Caplan
University of Pennsylvania
Center for Bioethics
3401 Market St. Suite 320
Philadelphia, PA USA 19104-3308

Carl Elliot
University of Minnesota
Center for Bioethics
N504 Boynton
410 Church St SE
Minneapolis, MN USA 55455-0346

Gavin Yamey
Public Library of Science
185 Berry Street, Suite 1300
San Francisco, CA USA 94107
+1-415-546-4090 (fax)


All works published in PLoS Medicine are open access. Everything is immediately available without cost to anyone, anywhere--to read, download, redistribute, include in databases, and otherwise use--subject only to the condition that the original authorship is properly attributed. Copyright is retained by the authors. The Public Library of Science uses the Creative Commons Attribution License.

About PLoS Medicine
PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of human health and disease, together with commentary and analysis of important global health issues. For more information, visit

About the Public Library of Science
The Public Library of Science (PLoS) is a non-profit organization of scientists and physicians committed to making the world's scientific and medical literature a freely available public resource. For more information, visit


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