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In response to this post I made about the intersection of disability and transhumanism, illicitlearning posted a link to a YouTube video on exactly the same subject, that discusses some facts I wasn't aware of.

The entire video is over an hour long, so for that reason I'm not going to embed it here. I do recommend that anyone interested in ethics, body modification, transhumanism, functional changes to the body, agency, bioethics, or the ownership of the self watch it, however. It's probably not safe for work--there are pictures and descriptions of forms of body modification some folks might not approve of--but it's good to watch regardless.

You can find the YouTube video here.

The person in the video is Quinn Norton, a journalist who's long been interested in both body modification and transhumanism. She's one of the people who first experimented with subdermal rare-earth magnet implants that I talk about here.

One of the things that surprised me to learn from this video is just how profoundly fucked-up our system of bioethics--and I use the term "ethics" in there only loosely--is in this country.

We have the capability to do some really neat things, and we're on the cusp of learning to do some even cooler things. We can, for example, exploit the brain's plasticity to create new senses (as with the aforementioned implanted magnets) or to map one sense onto another (as with experimental devices that allow people to see by mapping images onto the tongue with electric currents).

We're closing in on more interesting things still. For example, one area of nanotech research involves respirocytes, which are tiny machines designed to do what red blood cells do by carrying oxygen to and taking carbon dioxide away from the cells of our body. The trick is that they are thousands of times more efficient, and if they work as projected, would allow someone injected with them to do things like hold their breath for half an hour, run at full speed without breathing for ten or fifteen minutes, and even survive with their heart stopped for thirty minutes or so.

And you know what? All this stuff is considered "unethical"--and much of it is illegal.

Before I get off on the rest of this rant here, I'd like to start with a basic premise from which the entire rest of my argument against this sort of nonsense flows, and that is the value of agency.

Agency--the notion that each of us is a self-determining, self-aware individual, uniquely positioned to choose for ourselves what we do with our own bodies--is, I believe, the most basic of all moral principles, and the one from which all other moral principles flow. Things that we all agree are immoral, such as murder, kidnapping, rape, or torture, ultimately grow from the notion of agency. Each of us is responsible for the consequences of our decisions (else there can be no morality), and each of us has the ultimate right to control of our own bodies (the right which is violated when another person deprives us of our liberty or our life).

In the final analysis, I do not believe any credible system of ethics can ignore or diminish the principle that the first and most basic of all moral principles is the idea that we have the right to choose for ourselves what we do with our bodies.

So. Onward.

According to the American Medical Association's Code of Ethics, there are many techniques and procedures that are considered "unethical" across the board. Among these are "augmentation" technologies--technologies intended or designed to provide someone with greater-than-human-normal abilities or senses.

An example? Cochlear implants. These implants are often used to cure one of the most common forms of deafness, and for this use, they are considered both legal and ethical. The implant is a tiny electronic gadget implanted deep in the ear anal, and connected directly to the auditory nerve. They're implanted into tens of thousands of deaf patients to restore hearing.


A cochlear implant which offers a deaf person some kind of new ability or functionality that a "normal" person does not have is considered unethical across the board. For example, a cochlear implant that had BlueTooth functionality, to allow its user to directly access a cell phone or a computer? Unethical. An American doctor who implanted such a thing would lose his license. A cochlear implant designed to be implanted in a person with normal hearing, to extend the range of his hearing? Also unethical.

And it gets worse.

In the United States, it is considered a breach of medical ethics for a plastic surgeon to change someone's appearance outside the socially accepted standards of physical beauty.

Read that again and think about it. In the United States, it is considered a breach of medical ethics for a plastic surgeon to change someone's appearance outside the socially accepted standards of physical beauty. Medical ethics are dictated by socially accepted standards of physical attractiveness. It is perfectly legal, and perfectly ethical, for a plastic surgeon to put silicone into a woman's tits to make them bigger (because social standards of beauty favor big tits), but it is considered unethical (and in most places, illegal) for a plastic surgeon to do something like pointed ears; a surgeon who does so risks loss of his license, prison, or both.

Which is pretty damn stupid, if you ask me.

In practice, what that means is the folks who want to get many kinds of body modifications done, from aesthetic mods like pointed ears to functional mods like implanted magnets, must go to unlicensed body-mod artists without formal medical training, who are not medical doctors and who do not have access to anaesthetics, antibiotics, or other basic medical tools. All because the results either give them some functionality outside the "human norm" or take their appearance away from "socially accepted standards of beauty."

The people who practice the art of body modification live under constant threat of legal action. In some states, such as California, they are considered "unlicensed medical practitioners" and are subject to arrest and prosecution if they are caught. In other states, such as Oklahoma, a person willing to do something as simple as tattooing must pay a $100,000 cash bond to do so legally (and that's actually a concession to fans of body art; until 2006, tattooing was illegal everywhere in the state.

Now, you might not be into tattoos or pointed ears. Personally, I think they can look cool on the right person, but whatever. That's not the point. The point is that we as a society have determined that you should only be able to control the way your body looks if the result is what other people would find attractive, and I frankly think that's an appalling and immoral approach to the question of medical ethics.

Look, this is really simple. My body belongs to me; your body belongs to you. Our appearance is not subject to vote. And yet that's exactly what we have--a system whereby if enough people think that something (big tits) is attractive, then plastic surgeons are ethically permitted to give women big tits, but if there aren't enough people who think something else (pointed ears) is attractive, then plastic surgeons are barred from giving folks pointed ears.

It's stupid enough to live in a society that tells people, every day, in a hundred thousand different ways, that there's only one way you are "supposed" to look, but to write that notion into professional ethics and law is stupid beyond belief. We claim to be a society that values plurality, diversity, and individual control over our own lives, yet in the single most basic, fundamental form of individual control of all, individual control of our own bodies, we have adopted a herd mentality and then elevated that heard mentality to the level of ethical absolute.

"I like big tits, so doctors are permitted to perform dangerous and massively invasive surgery to give women big tits. I don't like pointed ears, so doctors are not permitted to perform relatively trivial, simple procedures to give people pointed ears." Someone explain to me exactly how this is "ethical"? When was it, exactly, that common tastes dictated ethics?

And those standards of "socially acceptable beauty" are themselves toxic and unrealistic. A lot of folks might not like the thought of people getting pointed ears, but how do you explain the saga of Melanie Berliet, an attractive 27-year-old model and Vanity Fair writer, who for her piece on cosmetic surgery visited three plastic surgeons, who complied a lengthy, expensive, and medically invasive list of "improvements" they recommended for her? A lot of people talk about how toxic and unrealistic social standards of female beauty are, but when you take it to the ludicrous extreme of thinking that a very attractive woman by ay standards could benefit from surgical "improvement," but that functional or unconventional body modification is inherently wrong, what exactly does that say about social standards?

Folks, this is fucked up beyond all human reckoning.

A great deal of the current legal landscape regarding body modification, particularly "enhancement" and "human norms," can be traced to the opinions of a few people, notably among them Leon Kass and Francis Fukuyama.

These two people were among the eighteen appointed by George W. Bush to the president's Council on Bioethics when Bush took office. The Council on Bioethics is an Administrative cabinet designed to advise the President on the ethical issues surrounding medicine and biotechnology, and as such its goal, at least nominally, is to act as an ethical voice in considerations including legislation, regulation, and research funding in biotechnology.

And who, exactly, are these people?

Leon Kass, the head of the Council under Bush, is an ardent foe of new biotechnology, particularly research involving human reproduction, longevity, and augmentation. He is the architect of Bush's stem-cell research ban, and lobbied Congress unsuccessfully to pass a ban on research aimed at improving human lifespan on the grounds that death is "necessary and desirable end" and "Christians already know how to live forever." He opposes in-vitro fertilization on the grounds that it is an affront to human dignity (an argument which I must admit makes no sense at all to me) and that it obscures moral truths about the essence of human dignity (which basically sounds like handwaving: "It seems yucky to me, so I'll blather about moral truth to conceal the fact that I have no cogent arguments save for the fact that it seems yucky to me").

In fact, Kass even explicitly acknowledges this "yuck factor." He calls it "the wisdom of repugnance," and says that anything we see as "yucky" is, on its face, inherently immoral--by which definition, things like organ transplants (derided with disgust as "doctors cutting up corpses and sewing bits of dead people into live people" when it first started to develop). Many things seem yucky when they are new, but with familiarity come to be recognized as the lifegiving boons that they are.

Francis Fukuyama is a political economist who somehow believes that his knowledge of politics and economic issues makes him fit to hold a cabinet-level position on the ethics of biotechnology. He has written a book, "Our Posthuman Future," in which he labels transhumanism as the most dangerous idea that has ever developed. He's also noteworthy for another popular book, "The End of History and the Last Man," in which he argues that the progression of history is over and that free-market democracy is the ultimate of all political and social systems. He's one of the leaders of the neoconservative movement, and was one of the architects both of the Reagan Doctrine and of the Iraq war.

Now, you might think it strange that a free-market neocon who favors individual and free-market choices would argue that people should not be free to choose to modify themselves if they want to, and that the free market should not be permitted to offer that choice. Honestly, I've never been quite able to wade through his logical contortions in supporting this notion, but they seem to come down to "I want modern American democracy to be the be-all and end-all of human development, and radical new biotech that offers to change human beings too much might upset that notion and lead rise to new social and political systems that I can't even imagine, and I think that would be bad, so we should ban any new biotechnology that could upset the applecart."

Which strikes me as being a bit like a Roman senator saying "Rome is the pinnacle of human economic and political triumph, so we should ban any new technologies that might lead folks away from the Roman model of civilization." And that, were it put into reality, would mean that you and I would not be having this conversation, since an instantaneous globe-spanning communication network was most definitely not part of the Roman model.

What Mr. Fukuyama doesn't realize is that history never ends. The United States is no more the end of history than the Roman Empire was, and that's a good thing.

It seems to me that these people--tho opponents of transhumanism, the ethics board of the American Medical Association--live in a tiny, conformist world, terrified of change and intolerant of diversity. It's ethical to change someone's appearance, but not if the change doesn't match conventional standards of beauty. It's ethical to tell women that they need bigger tits and fuller lips, but it's not ethical to let them make their own choices about their bodies. It's ethical to implant a device to let a deaf person hear, but not if it lets him hear better than I can.

The bionic man from the TV show The Six Million Dollar Man is, under our current legislative and ethical system, considered an abomination, and the doctors who worked on him would in real life lose their jobs, even if they improved his standard of living. We should help the disabled, but not, y'know, too much.

In the United States, we have long associated "morality" with "sex." This nation can boast such moral luminaries as Charles Keating, the anti-porn moral crusader who made movies and advised President Reagan on moral issues before embezzling $1.2 billion dollars from a savings and loan under his control, touching off a nationwide financial crisis that threatened to rob working families of their lifes' savings...but he was deeply concerned with morality, you see.

Even in bioethics this association continues. We have a medical community whose ideas about medical ethics are predicated on the fact that any change that makes a woman more fuckable to the general population is good; any change that makes a woman less fuckable to the general population is bad.

We are also deeply fearful as a society. We shun the disabled and favor medical technology that makes them more like us--but only so long as it keeps them in their place and doesn't make them, y'know, better than us.

At each step along the way, we construct ethical systems that are the antithesis of agency, that seek to take away control of our bodies from each individual and instead place that control at the mercy of the common, socially accepted standard of beauty.

And I think that it's about time we start re-thinking that approach to morality.


( 60 comments — Leave a comment )
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Mar. 15th, 2009 10:04 pm (UTC)
This was such an outstanding entry, I don't even know where to start.
(Deleted comment)
(Deleted comment)
(no subject) - gentleindiff - Mar. 15th, 2009 10:28 pm (UTC) - Expand
(no subject) - gentleindiff - Mar. 15th, 2009 10:29 pm (UTC) - Expand
Mar. 15th, 2009 10:27 pm (UTC)
OK, I've only skimmed this so this isn't really a valid comment, but a quick blurb anyway.

Not being allowed to go away from physical standards of beauty - BULLSHIT

but in terms of above-norm abilities - wouldn't allowing this make the rich even more better off than the poor, in theory? Not to say that's the reason for the law, but how do we overcome that argument?
Mar. 15th, 2009 10:34 pm (UTC)
i for one, find pointed ears to be very, very sexy.
(no subject) - tacit - Mar. 16th, 2009 03:39 am (UTC) - Expand
(no subject) - datan0de - Mar. 19th, 2009 04:01 am (UTC) - Expand
Mar. 15th, 2009 11:22 pm (UTC)
I'm not sure this is totally a question of morality, but a question of "what is human". You can see why religious people might object ("God's image"; if we allow deviation from that...). But there is, overall, a question of what it means to be human. Clearly it's not "two arms, two legs, able to reproduce with another human" or similar definitions (are all the victims of Thalidomide not human? Those who are sterile?).

Technology allows us to take the standard human form and change it. We could cut off legs and replace them with artificial equivalents which may perform better (cf your earlier post). Add senses (although I'm not too sure that this is correct; my gut feeling is that with things like the subdermal implants we're enhancing existing senses rather than adding new senses). Today we can't replace an eye, but we're getting there (eye socket camera); who knows about 10, 20 years time. Steve Austin's bionic eye could soon be reality.

What happens if we ever invent technology that allows "form change"; what if you could change your form into something aquatic? What would that mean to being human? How could you distinguish a human from an animal? Yeah, now we're into the realm of SciFi (indeed, these questions form the background to "Proteus In The Underworld" by Charles Sheffield), but the distinction between that fiction and today is merely one of scope, not of essence.

What is "human"? I think this is the question that the bioethics restrictions are really answering, and it's being answered from a religious viewpoint. The "yuk" factor is perfectly valid when considered from this perspective.

And I find that yukky.
Mar. 15th, 2009 11:45 pm (UTC)
What happens if we ever invent technology that allows "form change"; what if you could change your form into something aquatic?

Well, there is the group from WETA workshop that made prosthetic fins for a disabled woman to make her a mermaid. I know that's not the sort of full-scale form change you're talking about, but combined with the respirocytes that Franklin mentioned (or some synthetic gill structure), it very well could be possible.
(no subject) - afterannabel - Mar. 21st, 2009 12:15 pm (UTC) - Expand
(no subject) - tyskkvinna - Mar. 16th, 2009 02:24 am (UTC) - Expand
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(no subject) - sweh - Mar. 18th, 2009 10:30 pm (UTC) - Expand
Mar. 16th, 2009 12:14 am (UTC)
"According to the American Medical Association's Code of Ethics, there are many techniques and procedures that are considered "unethical" across the board. Among these are "augmentation" technologies--technologies intended or designed to provide someone with greater-than-human-normal abilities or senses."

While a very interesting article, the lack of citation for that bit leaves me feeling a little weird, since it's easy to see it "plausible folk wisdom" rather than research.

Of course, the AMA has made fit to charge $55 for a copy of their code of ethics (um... why does that leave me feeling squicked?) so that made it a bit hard to just research it myself. I don't particularly doubt that it's true, but it'd be nice to have a citation when showing it to others, rather than just "Tacit said it was true" :)
Mar. 16th, 2009 03:33 am (UTC)
There are some citations suggested in the video. I looked online for citations after I watched, it, and found a lot of people talking about the AMA's guidelines but, as you noticed, the guidelines themselves are pay-for-access.

There are articles on the subject here (the Journal of Philosophy, Ethics, and Humanities in Medicine), here (National Review of Medicine; this article is published in Canada and discusses Canadain physician's ethical dilemmas about body mods, but Canadian doctors are not prohibited from doing them); and a number of other articles I can only find abstracts for online (typically the full article requires payment). The Elective Home Surgery FAQ on BME says "The "legitimate" medical community has a remarkably limited range of elective procedures that they are able to offer without facing intense scrutiny and potentially sanctions from their peers. As such, there are a myriad of procedures (including atypical implants, transdermal implants, subincisions, silicone injections, castration, and amputation to name only a few) that are unavailable using the Western medical industry," which is consistent with what I've heard elsewhere, but also doesn't list references.

It's really frustrating; I spent about three hours looking for references before I started writing this post, and came up with slim pickings. I found a few interviews with anonymous plastic surgeons complaining about the restrictions, but that's about it.
(no subject) - aclaro - Mar. 16th, 2009 12:56 pm (UTC) - Expand
Mar. 16th, 2009 12:19 am (UTC)
There is a really good science-fiction novel (and I am SPACING on the author/title at the moment) regarding a man with terminal lung cancer who underwent a procedure to give him experimental gills. And it worked.

And . . . then nobody knew what to do with him. He was alive, in a tank, but he had no freedom.

Interesting book, and it did address a number of these issues.

(And I agree with you -- I'm SUPREMELY annoyed at this. I'd like to see some regulation of procedures that are likely to cause harm to the recipients -- i.e., as much as I believe in individual freedom, I don't especially want to see people undergoing elective lobotomies to treat nymphomania or something -- but I also think that the idea of plastic surgeons not being permitted to perform procedures that would take someone outside of the "attractiveness norm" is ridiculous.)

And that plastic-surgery article is just . . . *gross* . . . I cannot believe that someone would tell that poor girl that she has "waist wads" and needs liposuction, FFS!

-- A o___O
Mar. 16th, 2009 12:24 am (UTC)
"The Experiment," by Richard Setlowe :)

(I see that someone else wound up having the same question, heh. If you search on Amazon for it by title without the author name, it won't come up, since it's out of print . . . but it's still available used.)

-- A <3
(no subject) - soylent_bomb - Mar. 16th, 2009 12:48 am (UTC) - Expand
(no subject) - ashbet - Mar. 16th, 2009 12:59 am (UTC) - Expand
(no subject) - tacit - Mar. 16th, 2009 11:01 pm (UTC) - Expand
Mar. 16th, 2009 01:23 am (UTC)
Unrelated to topic...
Are you going to Frolicon this year?
Mar. 16th, 2009 02:43 am (UTC)
Re: Unrelated to topic...
Yep! That's the plan. :)
Mar. 16th, 2009 01:24 am (UTC)
Thank you for this wonderful post!
Mar. 16th, 2009 01:59 am (UTC)
thank you
I for one watched the hourlong video you posted-- remarkably informative. If nothing else, I'd never thought to link tongue studs, cochlear implants and cock rings, or for that matter Lasik and steroids in pro ballplayers. But it does come down to disability vs. superpowers, and what is "ethical". What is human, really?

I mean, Aimee Mullins' artificial legs, with some improvements, could make her faster than Usain "Lightning" Bolt-- but would she even be allowed to compete in the Olympics?

is human more than just the bell curve of what is observed, with exceptions made for those who are exceptionally good at what we think is good?
Mar. 16th, 2009 02:10 am (UTC)
Crazy Meds
Excellent video. Thanks!

Would you happen to know what the crazymeds website is that she spoke about. I tried crazymeds.org and a few of the obvious variants but they're all domain traps.
Mar. 16th, 2009 02:42 am (UTC)
Re: Crazy Meds
I believe the site she's referring to is the one at

Re: Crazy Meds - wolfieboy - Mar. 16th, 2009 06:21 am (UTC) - Expand
Mar. 16th, 2009 02:53 am (UTC)
I am still curious about how Lasik is allowed, which often gives people better than "perfect" vision, and although it's a surgery that corrects a "deficiency", it is still mostly considered "elective", and how the lizard guy got his tongue split in two and raised brow ridges with scale tattoos if anything at all that makes people "better than" or "not socially attractive" is illegal?
Mar. 16th, 2009 03:28 am (UTC)
OK, just read your twitter response. So you're saying that people have had actual implants made without anesthetic of any sort and without a medical doctor to oversee implant rejection and they survived the pain of a surgical procedure and no implant rejection issues without said medical personnel?
(no subject) - tacit - Mar. 16th, 2009 03:41 am (UTC) - Expand
(no subject) - awfulhorrid - Mar. 16th, 2009 02:23 pm (UTC) - Expand
Mar. 16th, 2009 05:22 am (UTC)
Just as an FYI...there's a fairly large contingent of the deaf community who do not consider the cochlear implant ethical for *any* reason. My sister, who's been involved in deaf education for 2 decades and is in the process of adopting a deaf child, has very strong opinions about this - particularly since it doesn't usually produce anything resembling "normal hearing" as the hearing community understands it. I don't know enough about the details to argue a case for or against, but I've certainly heard my sister go off on it a time or two. :)
Mar. 16th, 2009 11:04 pm (UTC)
I've heard that, and it strikes me as absolutely fascinating that folks would want, for example, to have children born absent a sense, simply because it reinforces their ideas of community and culture.

I think that culture should server human beings, not the other way around, myself. To me, there seems to be a whiff of Linux command-line philosophy ("this user interface was hard for me to figure out, so it should be hard for you too!) in that attitude. "It was difficult for us to create a community and we had to work hard to overcome many obstacles to make it happen, so other people should have the same handicaps as well!"
(no subject) - (Anonymous) - Mar. 19th, 2009 04:04 am (UTC) - Expand
Mar. 16th, 2009 08:03 am (UTC)
What About the Ethics of Enforcing Beauty Standards
My partner, who was burned as a child over 60% of her body, had an interesting reaction to this post. She said:

"Yeah, what about the ethics of multiple torturous surgeries imposed on kids in an effort to get them as close as possible to the standard of 'normal' appearance?"

In my partner's case, she had numerous surgeries over several years to fix both functional and cosmetic effects of the burns. However, at some point when she was comfortable with the results, she said "enough," although the doctors wanted to continue to schedule procedures. To this day (30+ years later), doctors still suggest things she could do to fix this or that scar. Understand that fixing a scar in one place requires creating one in another (albeit a milder one), because the skin has to come from somewhere.

There are also examples of doctors "fixing" congenital differences in children that have no negative functional effects, such as what is commonly done to intersexed babies.

As you say, agency is, or should be, the most basic test of ethical validity.

Mar. 16th, 2009 11:06 pm (UTC)
Re: What About the Ethics of Enforcing Beauty Standards
When I was doing some research to start writing this article, I found a profile of a person on BME who likewise had been burned as a child, and considered the scars as a form of body art rather than as something to be 'fixed.' (Same person, perhaps?) I have the same problem with the notion that this is not a valid choice as I have with the notion that plastic surgeons should be limited by accepted social standards of beauty: at the end of the day, one's body belongs to one's self, and nobody else has the right to dictate what we do and do not do with it.
Mar. 16th, 2009 08:11 am (UTC)
Awesome post, I had no idea that so many people oppose these things! Actually, my problem with transhumanism when I first learned about it (from you) was "But doh -- it's obvious! Why are these people banging on open doors?" And then I realized... that they aren't. Yeah, some folks actually believe that the current capabilities of our bodies and minds are perfect as they are, and improvements should be forbidden by law... :-O
Usually I'd say "Whatever...", but: http://xkcd.com/154/
Mar. 16th, 2009 11:06 pm (UTC)
Love, love, love hat XKCD.

This stuff seems obvious to me as well, and the ferocity of the resistance to it sometimes still surprises me.
Mar. 16th, 2009 08:36 am (UTC)
Only tangentially related, but if you haven't, you really ought to read Kurt Vonnegut's short story "Harrison Bergeron".
Mar. 16th, 2009 05:10 pm (UTC)
For the reader's convenience: http://instruct.westvalley.edu/lafave/hb.html

I'd completely spaced on it. Nice catch!
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