“I wonder how many readers of this book, like me, use spectacles? All who do are using an enhancement technology. Now you might say “yes, but that restores normal functioning or repairs or corrects disease, damage, or injury.” So it does.
Those who say this will probably know of the work of Boorse and Daniels, who have each defined health and, hence, illness, in terms of departures from normal functioning or departures from species-typical functioning.
Now consider the use of a telescope or pair of binoculars orr a microscope. These tools are not used to restore normalcy or treat disease or injury. They are done to enhance powers and capacities.
Again I wonder how many of those who have ever used binoculars thought they were crossing a moral divide when they did so? How many people thought (or now think) that there is a moral difference between wearing reading glasses and looking through opera glasses? That one is permissible and the other wicked?”
The reasoning is misleading in that it tacitly assumes that the moral boundary in question must be one between permissible and impermissible (wicked) actions. But not everybody who thinks that there is a moral difference between restoring normal functioning and the enhancement of normal functions thinks that the moral difference in question consists in one being permissible and the other not so.
Another important moral boundary is the one between what we owe to each other, as a matter of justice, and personal desires (or needs) whose being unfulfilled does not impose an obligation on other people. Some people, perhaps many people, think that enhancing capacities and restoring normal functiong differ as a matter of justice. In this perspective, the rethorical question to ask should have been:
“How many people thought, or now think, that there is a moral difference between government funding of reading glasses and government funding of opera glasses?”
The answer to this question is “many”. As a matter of fact, many countries – such as Germany – fund reading glasses as part of a comprehensive and largely state subsidized health care program for all German citizens. No state in the world has ever dreamed of funding opera glasses or binoculars.
Hence there is at least a superficial difference between enhancing normal functioning and restoring it, one that many people have reflectively endorsed (as it is reflected in the laws that several communities have adopted).
Whether this difference is only “superficial”, that is to say, one that can be explained by deeper moral principles and distinctions which may produce a justification for funding enhancements, is, of course, a different question.
(A counterexample to what I just wrote is provided by considering reading glasses against presbyopia, a difficulty which, being almost universal among humans over 40, may be regarded to be “part of normal functioning”. For it is not obvious that, if reading glasses are to be funded at all as part of a comprehensive program for health care, reading glasses against prebyopia should be excluded.
This objection raises difficult issues that I have discussed in other posts, such as the one whether the concept of “normalcy” that produces meaningful social obligation should be defined in a way that makes it age-group-relative. This is a serious difficulty for those who, like Boorse and Daniels, thinks so, and moreover think that the concept of health as normal functioning must be defined in this precise way, for reasons that are, broadly speaking, scientifically objective and naturalistic. But perhaps the present objection can be avoided by developing an alternative conception of citienzes’ health as normal functioning.)