Human enhancement [English translation of chapter 4 from: 'Signalering ethiek en gezondheid 2003' (2003/08)]

Under the influence of scientific and technological developments, the theme of ‘engineering people’ is receiving increasing attention. The health care system also, to an increasing degree, has to deal with the possibilities provided by the biomedical sciences for perfecting healthy people in accordance with their own preferences. In medical ethics, this theme is known as ‘enhancement’: the use of genetic, biomedical or pharmacological knowledge to make improvements in human characteristics. This enhancement can involve people’s appearance, performance or personality. At present, the best-known forms of enhancement are found in cosmetic surgery and, more covertly, in the use of anabolic steroids in sports. However, there is an impression that conventional medicines (for example Prozac, Ritalin and Viagra) are also being used more and more often for non-medical purposes. Furthermore, during the next decade, new substances and methods for engineering healthy people will probably emerge in a rapid tempo. They vary from cosmetic gene therapy and a new generation of anxiety inhibitors and mood modulators, to psychotropic medication that boosts cognitive abilities (concentration, memory) and a drug that would allow women to optimise their sexual functioning. Billions are being invested in development.

Committee

Standing Committee on Medical Ethics and Health Law (Beraadsgroep Gezondheidsethiek en Gezondheidsrecht)

• prof. JA Knottnerus, president of the Health Council of the Netherlands; Health Council, The Hague, president
• prof. JKM Gevers, professor of health law; Academic Medical Centre, University of Amsterdam, vice-president
• prof. ID de Beaufort, professor of medical ethics; Erasmus University Medical Centre, Rotterdam
• dr GCML Christiaens, gynaecologist; University Hospital, Utrecht
• prof. RPTM Grol, professor of quality of care; University Medical Centre St Radboud, Nijmegen
• prof. JCJM de Haes, professor of medical psychology; Academic Medical Centre, University of Amsterdam
• prof. GA den Hartogh, professor of ethics; University of Amsterdam
• prof. HAMJ ten Have, professor of medical ethics; University Medical Centre St Radboud, Nijmegen
• dr AC Hendriks, health lawyer; Dutch Equal Treatment Commission, Utrecht
• dr WLM Kramer, pediatric surgeon and traumatologist; Wilhelmina Childrens’ Hospital, University Medical Centre, Utrecht
• prof. FE van Leeuwen, professor of epidemiology; Netherlands Cancer Institute, Amsterdam
• dr M van Leeuwen, executive director of the Health Council of the Netherlands, adviser
• dr J Legemaate, health lawyer; Royal Dutch Medical Association (KNMG), Utrecht
• prof. HDC Roscam Abbing, professor of health law; Utrecht University
• prof. M de Visser, vice-president of the Health Council of the Netherlands; Health Council, The Hague
• prof. GMWR de Wert, professor of biomedical ethics; Institute of Health Ethics, Maastricht University
• prof. DL Willems, professor of medical ethics; Academic Medical Centre, University of Amsterdam
• A Bood; Health Council of the Netherlands, The Hague, scientific secretary
• dr WJ Dondorp; Health Council of the Netherlands, The Hague, scientific secretary