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April 3 Resource Allocation in Healthcare.docx

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Health Sciences
Health Sciences 2610F/G
Ken Kirkwood

HS 2610 Enhancement of Human Capacities April 3 , 2014 Therapy vs. Enhancement • A brief history of enhancement of human capacities • Typical moral objections to enhancement  Cheating/unfairness  Harm to self, others, the institution  Intrinsic/Extrinsic goods  Zero-sum/non-Zero sum • The future directions: affective enhancement Sandel: • Therapy has an ethical basis in the relationship between health and “human flourishing” • “Species typical functioning” = normality • The purpose of therapy is to restore you to normality (or as close as possible) Enhancement Historically… • Has always been there • Performance-enhancing drug use 1. Predates history 2. Was universal 3. Seems to serve the same purpose The Mouth of a Perfectly Contented Man is Filled with Beer • They thought that alcohol was a medicinal thing – the idea of having beer does not work better • But for a long time, beer was though to be used as a sports drink because of the calories and the uplift • So people were drinking beer to get more work done • Fungus • Bread soaked in opium • Alcohol Milo of Croton • Strongest man – famous for his diet and supplementation and regimen • Ten gallons of red wine was the way to win the competitions and the secret to his success • There are not typical behaviors these are exceptional behaviors • The athlete Olympic site in Greece has an inscription that says “Wreath or Death” • If you were a loser in your hometown back then, you should be ashamed and be disgraced – its not that they try to enhance themselves, it was because there was something at stake Most Popular Drugs in Cycling (1860-1930) • Caffeine • Cocaine • Heroin • Ether • Digitalis – endurance for the heart • Alcohol • Strychnine - trying to lower the heart rate • Opium • Oxygen • Fungi Thomas Hicks • Won the marathon but when he got towards the finish line, he started to weave because he was suffering from an acute overdose • The guys in the car were injecting him as he was running from a moving car Typical Moral Objections to Enhancement • Cheating/unfairness • Harm to self, others, the institution • Intrinsic/extrinsic goods Cheating/Unfairness • What do we mean by cheating? • Stuart Green’s Four Elements of Cheating 1. The rule must be fair and fairly enforced 2. Rule-breaking must take place in a cooperative rule-governed activity 3. The rule-breaker must intend to break rules 4. The rule breaker must intend to gain an advantage Harm to Self, Others, the Institution • Self – sliding scale (doping ≠ abuse)  The activity itself may not be healthy on its own  So why would enhancement be an issue? • Others  Coercion (if you can’t beat them, join them”  Bad faith argument? Bad faith argument – if, for example, athletes will say “I want to compete drug free” – you could respond that they still can and that there isn’t anything stopping them from running or competing because they aren’t on drugs – if what they MEANT to say was that they want to win, and they don
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