« Converging Technologies for Improving Human Performance » was the title of a 2004 report that based American research strategies in the technology of the future [1] : nanotechnologies, biotechnologies, information technology and cognitive science (NBIC). Information technology is already improving “human performance” by making organizations more productive, but this is a case of acting directly on the human being. Its first applications are medical: the detection and even prevention of disease, repairing damaged tissue (and treating certain degenerative diseases such as Alzheimer’s), or the use of electronic implants to help certain handicaps, such as cameras that partially restore sight, or direct connections between nerve endings and prostheses. But the line between prevention, repair and “enhancement” is a tenuous one. Already in Britain today, scientists are authorised to select embryos in order to avoid congenital squints; tomorrow, other genetic predispositions could be considered as handicaps. And we haven’t even got to the potential military applications…

Human enhancement technology can be placed in four categories[2] : –Cognitive enhancement: improve memory (or modify it, to « unlearn » phobias, for example), improve vigilance, remove certain inhibitions to increase creative function, etc. –Life extension: prolong the regenerative capacity of cells, activating adult stump cells to regenerate organs and tissue, etc. –Mood enhancement and improvement of subjective living conditions: regulate sleep, fight depression, stimulate certain areas of the brain, etc. –Enhanced physical performance: change cell activity so that they produce certain substances that act on resistance, (EPO), blood flow, and physical strength… or attach mechanical devices to the body, such as exoskeletons.

The urgent need for an ethics

Human enhancement is an old dream that’s becoming a reality, but one that asks huge ethical questions. This will undoubtedly be one of the main ethical, scientific and economic subjects of the years ahead:

• What are the long-term effects on the organism, behaviour, or future generations? Can it be authorized if we don’t know these effects?
• Does medicine have the right to interfere in any declared pathology, and to what degree? Don’t we run the risk of making social problems, such as stress, into medical ones by treating the symptoms instead of the causes, and at ever-increasing cost?
• What effect would the prolonged use of some of these technologies have on society? What, for example, might be the consequences of spectacular life extension on the global population, fecundity, intergenerational relationships, cycles of active professional life, etc?
• How do we avoid unequal access to these technologies creating unbreachable differences between “enhanced” populations and others?
• How do we define « good” and “bad” enhancement? How do we avoid harmful forms of social and behavioural control?
• How much uncertainty can we allow when it comes to applying these techniques to human beings? Biotechnology and neurotechnology today are far from producing totally predictable results, as we saw with GMOs, the results of which are far from the grandiose (or apocalyptic) predictions of a few years ago.
• When does a person that has been « enhanced, » even of his or her own volition, become a different person? Does this pose a problem?

The « precaution principle » does not replace an ethics

The “precaution principle” here refers to questions of human health and the transmission of acquired characteristics to future generations. But faced with the rapid development of research on “human enhancement,” even the most offensive principles have to be confirmed:

• Finality and proportionality: proposed “enhancements” must have a clear, explicit finality that can be accepted after debate. They should be able to prove that the means to implement them, and the consequences they might have on their users, as on their environment, are adequate and proportionate to the named goal.
• Free will: “enhancements” should be fully desired and their consequences understood. They cannot be forced upon a person.
• Access for all for approved forms of enhancement: we must avoid creating an indomitable divide between different classes of human being.
• Identity: « enhancements » should preserve or enrich the identity of the people getting them, not transform it.
• Reversibility: “enhancements  » should be reversible, as much for the sake of the individual as from the point of view of their collective consequences. What action can be taken?

Which actions ?

Four short-term actions would allow for the implementation of the basic framework of an “ethics of human enhancement”:

• Open development of biotechnologies and cognitive sciences: Access to knowledge in these fields should remain largely open, to encourage debate and accelerate the progress of knowledge. A large part of the research should be carried out independently of short-term industrial objectives. We should fight against the appropriation of basic knowledge, such as human gene sequences or maps of cognitive function.
• Definition and rapid construction of open epidemiological databases on the effects of “enhancement”: knowledge of the long-term effects of human enhancement (including medication such as Prozac, Modafinil and some drugs) is still very limited, which is a major risk. Their long-term effects must be closely monitored and studied, and this knowledge should be freely shared and discussed, as a matter of classic epidemiology.
• Support of interdisciplinary research work on the ethics of human enhancement on both a European and a global scale, which focuses as much on the intentions of the researchers and the people financing them as on the possible impact on society. This supposes that researchers in the human sciences who work on these matters should be able to easily access information resources.
• Creation of an evolving regulatory framework built on a means of inclusive evaluation: the « precaution principle » is not a sufficient base for (in)action, and many other countries won’t enforce it. A large regulatory framework that defines its own conditions of (public and open) evaluation and evolution would allow us to carefully and progressively define the conditions under which certain forms of enhancement could or could not be authorized, their means of application and evaluation, and so on.