The Pharmacy of the Future and You

Will new psycho-pharmaceuticals make a more authentic you?

One of the perennial concerns of conservative bioethicists like Leon Kass and Francis Fukuyama is that some portion of humanity will rush to adopt various biotech enhancements to their detriment. In his essay "Disenchantment," from Philosophers Without Gods: Meditations on Atheism and the Secular Life, University of Sheffield philosopher David Owens worries about the problems that future neuro-enhancements will pose.

Owens posits this case: You have developed some nagging doubts about your partner's fidelity. Although you sometimes think your doubts are irrational, you remember certain lingering looks at parties, and your happiness is spoiled. You're not the sort to hire a private detective, but you have heard of a new pharmaceutical, the anti-doubt pill, Credon. Credon lulls your suspicious nature, but doesn't make you gullible to car sales people. It works only in the context of intimate relationships. The manufacturer does warn that Credon has sometimes generated excessive trust between lovers. So off you go to "The Pharmacy of the Future" for Credon.

Once there, the conscientious pharmacist confirms that Credon does usually work, but asks if you've considered alternative treatments. For example, why not take the new anti-possessiveness pill Libermine? Patients using Libermine don't care if their partners have an occasional fling. Or why be a couple at all? Solox, the emotional independence pill, enables patients to have a wide and emotionally satisfying circle of friends but liberates them from the tedium of having only one intimate partner. Owens then posits that the price of Credon is about as much as for a candy bar, while Libermine and Solox costs as much as good bottle of wine. So on what grounds do you choose among these options?

Owens suggests that one response might be that it's "normal" to want to be in relationship. The pharmacist reminds you that people born with extra Solox in their brains are just as "natural" as people without it. Surely you would agree that such free spirits should not be regarded as somehow inadequate. Another response is that taking Libermine would so change you that you wouldn't be you anymore. Of course, the whole point of taking Credon is to change you so that you, in some respects, aren't you anymore.

So why not flip a coin? Would that mean that the choice doesn't matter any more to you than choosing between two brands of coffee? Surely one's emotional state and the state of one's most intimate relationship should matter more than choosing between Bustelo and Starbucks.

Let me now quote Owens at length:

"For Trotsky, the better we understand how human beings work, the freer we shall be. But The Pharmacy of the Future suggests that the more we learn about ourselves, the less free we will be. A scientific understanding of man is a threat to our freedom because it undermines our capacity to govern our own lives by making decisions. If man is just a bag of chemicals, once we know what these chemicals are, we can re-mix them at will. And by re-mixing them at will, we can give ourselves whatever character we like. But if we can choose a character at random, our current needs and interests lose their authority as grounds for making any decision. And what other grounds for making decisions are there?"

What other grounds might people use to justify their decisions? "In Western Europe, religious belief used to be the source of those fixed points that make decision making possible," writes Owens. "In the rest of the world, it still is." Owens laments that scientific disenchantment is undercutting the authority of religious belief.

The "fixed points" supplied by religious belief may have been useful guides in earlier, less prosperous times. Before the 20th century, most women who bore children out of wedlock could not earn enough to support them, so religion sanctioned stoning and honor killing to discourage fornication. Another previously "fixed point" in Western Europe was that divorce was not permitted. With prosperity and the advent of effective birth control pills and pharmaceutical abortions, the "fixed points" of religiously sanctioned stoning and marriage-for-life were overthrown. Americans and other modern societies are still working out how the pill and burgeoning prosperity have shifted the battle lines in the immemorial war between the sexes, but stoning as a punishment for fornication is still condoned only in some backwards regions of the world. That will change as the 21st century progresses. So even some guides long-established by religion are not "fixed." (On the other hand, given everyone's interest in the preservation of their bodies, one point that is fixed is that murder is wrong.)

Owens' larger concern seems to be an anxiety about authenticity. Are you the real you? But what is the real you? Were you, you, when you 10 years old? 20? 45? Were you the real you before you had graduated college? Were married? Were a parent? Were you more real when you were shy before you "came out of your shell" after joining the basketball or debate team? Are you the real you when you drink coffee to boost your concentration in order to finish that new sales report? Or are the real you when you take Viagra to boost your sexual performance? Turn the question around: are people who choose to use Viagra, cosmetic surgery, hair-coloring, propranolol to overcome stage fright, fakes? A strong case can be made that people who take advantage modern technologies are seeking to become more authentically who they believe themselves to be. Demands for authenticity turn out to be just a way for other people to impose their views of your proper social status on you.

Owens concludes that religious "beliefs may all be delusions but, as technology advances, the need for such fixed points becomes more, not less pressing." However, as we've seen, such "fixed points" don't really exist. Owens wants to liken the human journey to following the signposts of a well-marked Rand-McNally atlas. Instead, humanity is a team of explorers who constantly push forward into undiscovered territories. With many false starts and dead ends, we chart the map of the future as we go along. Like all analogies, the map analogy is inexact—we not only make the map, we also create the landscape of human possibilities through which we travel.

Another way to think of it is that we are not following a pre-determined blueprint as we build our societies. We are constructing the scaffolding and the edifice as we go along. Sometimes whole wings which housed us for a long time must be dismantled and rebuilt to fulfill our new requirements.

Just as humanity is still learning how to use the contraceptive pill and to handle divorce, so too will we engage in a process of trial-and-error social learning about how to use (or not) new psycho-pharmaceuticals. Not only is that as it should be, it's as it has always been. Nothing could be more human.

Ronald Bailey is reason's science correspondent. His most recent book, Liberation Biology: The Scientific and Moral Case for the Biotech Revolution, is available from Prometheus Books.