Explainer

Culture

Digital

1 May 2023

7 min read

Challenging transhumanism’s quest to optimise our future

Instead of separating the human from the hardware, Oliver Dürr recommends rediscovering other ways of self-formation and improvement.

Oliver Dürr

Oliver Dürr is a theologian who explores the impact of technology on humanity and the contours of a hopeful vision for the future. He is an author, speaker, podcaster and features in several documentary films.

A plastic sheet strewn with biology-related instruments.

A biohacking kit for a biology workshop.

Xavier Coadic, CC BY-SA 4.0, via Wikimedia Commons

Welcome to the age of transhumanism. In this world, the goal is to overcome all limitations and restrictions that hold human beings back. Science, technology, and medicine should allow us to live longer, healthier, and better lives. So runs the promise. But is there a peril that goes along with it? To answer that question, we need to take a closer look at the phenomenon of transhumanism, particularly the view of human beings that lies behind the glittery promises of an “optimised” future.

Improving humans, however possible

Transhumanism is a global movement that seeks to use all available technological means to “enhance” human beings. From curing illnesses and overcoming physical limitations to expanding mental abilities, the movement aims to overcome all obstacles to the current human condition.

More precisely, it seeks to overcome all obstacles to the individual’s freedom to live the life he or she wants to live. In the attempt to enhance life, transhumanism veers beyond traditional forms of curing impairments (like compensating for bad sight with a pair of glasses) and ventures into more experimental fields (like manipulating the human eye to see ultraviolet or infrared light). Emotional or cognitive deficits (such as lack of concentration) are supposed to be overcome by “smart drugs” (like Methylphenidate / Ritalin) and even genetic modifications, and prostheses are considered to expand human capabilities.

The goal is to create “superhuman” abilities. The holy grail of this movement is drastically extending the human lifespan (if it is in a state of health and vigour). Ultimately, transhumanists want to “overcome” death.

There are two paths within the transhumanist movement on which they hope to arrive at this sacred goal: a biological and a post-biological way.

Biological transhumanism

Let’s have a look at “biological transhumanism” first: The focus here is on our current, carbon and water-based bodies. Weak and fragile as they are, biological transhumanists must make do with them to achieve the greater things they envision. Human beings must be treated with drugs, and a host of prefixed technologies: bio-, gene-, and nano-.

Aubrey de Grey’s project of postponing death by achieving a “longevity escape velocity” is a good illustration of the movement. De Grey is convinced that novel biomedical technologies can achieve a limitless extension of the human life span: “If we can make rejuvenation therapies work well enough to give us time to make them work better,” he writes, “that will give us additional time to make them work better still” and so on. The time gained with a particular innovation must only be greater than the time needed to achieve another such advancement. Therefore, he argues, the effective death of people alive today can be staved off indefinitely.

De Grey is not alone in transhumanist circles to predict such outcomes. Google’s Ray Kurzweil has a similar view: “We have the means right now to live long enough to live forever”.

Such optimistic prognoses bank on a view of human beings as being essentially a body-machine that can be controlled and improved at will. The key to unlocking its potential is information theory.

Think of human beings as an algorithm, and, in principle, all their problems can be solved by engineering. Cultural critic Evgeny Morozov poignantly called this approach “technological solutionism”. From a ‘solutionist’ perspective, humanity is increasingly seen as the problem that needs solving. Thus, not only must we develop new technologies to guarantee human life and freedom, but humanity needs to adapt. Those necessary “transformations” of the “human” are what inform the first dimension of the term “trans-humanism”.

If human beings want a seat at the table in the digital future, they must find a way to merge with and dissolve into the digital sphere—or so the transhumanist narrative goes.

Post-biological transhumanism

The second path is “post-biological transhumanism”, which takes a more radical approach. Here, the focus is on leaving behind our current bodily form altogether and radically transcending the limitations of what it means to be human today. Those alterations, such transhumanists argue, will be so radical that calling the result “human” will no longer be adequate. The preferred means to achieve the future state are taken from the digital sphere: algorithms and information processes.

The view of “the human as a machine” becomes more specifically “the human as a computer”. Mind, spirit and consciousness are understood to be the software within the hardware of the body. Human beings are perceived to be biological computers and thus in direct competition with digital computers. And those are becoming increasingly powerful by the hour. If human beings want a seat at the table in the digital future, they must find a way to merge with and dissolve into the digital sphere—or so the transhumanist narrative goes.

Immortality in the Cloud?

For post-biological transhumanists, the ultimate goal is called “mind-uploading”. The idea is that we can upload our minds (selves) to the internet and achieve immortality—at least if all we are is the sum of information processes in the brain and as long as the internet infrastructure is still available. Mind uploading requires leaving behind our current biological form of life altogether and dissolving into virtuality.

This vision of virtual immortality is why post-biological transhumanists tend to place their hopes in information technologies, software algorithms, robotics and artificial intelligence research. They aim to overcome and entirely leave behind the “human” as it is. This move to “transcend” informs the second dimension of the term “trans-humanism”.

In classical humanism, at least from the Renaissance to the 1970s, “human improvement” meant education, moral, intellectual, and practical formation and refinement towards a concrete ideal of humanity and the shaping of a society that enables such formative processes.

Is there a solution?

But can those transhumanistic approaches really deliver on their promises?

Human beings have always tried to improve themselves—not least through technology. What is new today is how transhumanists define “better” and some means of realising those perceived benefits. With its solutionist approach to life, transhumanism discards large swaths of traditional techniques to “improve” human beings and their lives. In classical humanism, at least from the Renaissance to the 1970s, “human improvement” meant education, moral, intellectual, and practical formation and refinement towards a concrete ideal of humanity and the shaping of a society that enables such formative processes.

But in the age of transhumanism, there is a tendency to believe that we can delegate such hard work of the self to a new technocracy and their algorithmic tools—who, to put it mildly, may not always have our best interests at heart.

Freedom is best conceived, not as a mere “choice” to do what we please, but the liberty to live a truly fulfilling life, which almost always includes others .

The main problem, however, is that ultimately, we cannot delegate our future to machines because, after all, we aren’t machines. Instead, we must learn to live with ourselves, our limitations, and our finitude, or we will never be free. Freedom only ever begins once we learn to let go of ourselves and start living for and with others.

The reason for this is that freedom is best conceived, not as a mere “choice” to do what we please, but the liberty to live a truly fulfilling life, which almost always includes others. Many of the things that make a future worth wanting in the first place are shared goods, relational, communitarian, cultural values and practices that needn’t be optimised or automated at all—at least not technologically.

When building a sandcastle with my toddlers, that process needn’t be optimised (which realistically would mean excluding the toddlers from the process altogether). Rather, the process of doing it together is the point. Political decision-making processes, to take another example, also don’t have to be automated or made more efficient through algorithms. Struggle in deliberating how our society should look is the point. Without such moral deliberation, our public life is diminished. In many cases, the slowness, strenuousness and inefficiency of such processes is a feature, not a bug.

A tech future beyond transhumanism

Having this in mind changes the questions we pose in light of novel technologies: How (if at all) can they be integrated into our lives in such a way that they open up the world in its complexity, allowing us to experience the fullness of life and enabling us to shape the future we really want?

It is time to rediscover and bring back religious and humanistic traditions of self-formation into our public debates about the future. Far from being relics of the past, soon to be discarded, they can provide us with tried and true values, practices and virtues around which we can organise our societies in the digital future. They provide us with the tools to unlock the sources of care and the will to create a better social framework in which human beings and technology find their place. The future need not be transhuman to be better; being fully human is quite enough.

Article

Assisted dying

Care

Culture

Death & life

13 November 2024

8 min read

The deceptive appeal of assisted dying changes medical practice

In Canada the moral ethos of medicine has shifted dramatically.

Ewan Goligher

Ewan is a physician practising in Toronto, Canada.

a doctor consults a tablet against the backdrop of a Canadian flag.

Once again, the UK parliament is set to debate the question of legalizing euthanasia (a traditional term for physician-assisted death). Political conditions appear to be conducive to the legalization of this technological approach to managing death. The case for assisted death appears deceptively simple—it’s about compassion, respect, empowerment, freedom from suffering. Who can oppose such positive goals? Yet, writing from Canada, I can only warn of the ways in which the embrace of physician-assisted death will fundamentally change the practice of medicine. Reflecting on the last 10 years of our experience, two themes stick out to me—pressure, and self-deception.

I still remember quite distinctly the day that it dawned on me that the moral ethos of medicine in Canada was shifting dramatically. Traditionally, respect for the sacredness of the patient’s life and a corresponding absolute prohibition on deliberately causing the death of a patient were widely seen as essential hallmarks of a virtuous physician. Suddenly, in a 180 degree ethical turn, a willingness to intentionally cause the death of a patient was now seen as the hallmark of patient-centered doctor. A willingness to cause the patient’s death was a sign of compassion and even purported self-sacrifice in that one would put the patient’s desires and values ahead of their own. Those of us who continued to insist on the wrongness of deliberately causing death would now be seen as moral outliers, barriers to the well-being and dignity of our patients. We were tolerated to some extent, and mainly out of a sense of collegiality. But we were also a source of slight embarrassment. Nobody really wanted to debate the question with us; the question was settled without debate.

Yet there was no denying the way that pressure was brought to bear, in ways subtle and overt, to participate in the new assisted death regime. We humans are unavoidably moral creatures, and when we come to believe that something is good, we see ourselves and others as having an obligation to support it. We have a hard time accepting those who refuse to join us. Such was the case with assisted death. With the loudest and most strident voices in the Canadian medical profession embracing assisted death as a high and unquestioned moral good, refusal to participate in assisted death could not be fully tolerated.

We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it.

Regulators in Ontario and Nova Scotia (two Canadian provinces) stipulated that physicians who were unwilling to perform the death procedure must make an effective referral to a willing “provider”. Although the Supreme Court decision made it clear in their decision to strike down the criminal prohibition against physician-assisted death that no particular physician was under any obligation to provide the procedure, the regulators chose to enforce participation by way of this effective referral requirement. After all, this was the only way to normalize this new practice. Doctors don't ordinarily refuse to refer their patients for medically necessary procedures; if assisted death was understood to be a medically necessary good, then an unwillingness to make such referral could not be tolerated.

And this form of pressure brings us to the pattern of deception. First, it is deceptive to suggest that an effective referral to a willing provider confers no moral culpability on the referring physician for the death of the patient. Those of us who objected to referring the patient were told that like Pilate, we could wash our hands of the patient’s death by passing them along to someone else who had the courage to do the deed. Yet the same regulators clearly prohibited referral for female genital mutilation. They therefore seemed to understand the moral responsibility attached to an effective referral. Such glaring inconsistencies about the moral significance of a referral suggests that when they claimed that a referral avoided culpability for death by euthanasia, they were deceiving themselves and us.

The very need for a referral system signifies another self-deception. Doctors normally make referrals only when an assessment or procedure lies outside their technical expertise. In the case of assisted death, every physician has the requisite technical expertise to cause death. There is nothing at all complicated or difficult or specialized about assessing euthanasia eligibility criteria or the sequential administration of toxic doses of midazolam, propofol, rocuronium, and lidocaine. The fact that the vast majority of physicians are unwilling to perform this procedure entails that moral objection to participation in assisted death remains widespread in the medical profession. The referral mechanism is for physicians who are “uncomfortable” in performing the procedure; they can send the patient to someone else more comfortable. But to be comfortable in this case is to be “morally comfortable”, not “technically comfortable”. We deceive ourselves if we think that doctors have fully accepted that euthanasia is ethical when only very few are actually willing to administer it.

We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem.

There is also self-deception with respect to the cause of death. In Canada, when a patient dies by doctor-assisted death, the person completing the death certificate is required to record the cause of death as the reason that the patient requested euthanasia, not the act of euthanasia per se. This must lead to all sorts of moments of absurdity for physicians completing death certificates—do patients really die from advanced osteoarthritis? (one of the many reasons patients have sought and obtained euthanasia). I suspect that this practice is intended to shield those who perform euthanasia from any long-term legal liability should the law be reversed. But if medicine, medical progress, and medical safety are predicated on an honest acknowledgment about causes of death, then this form of self-deception should not be countenanced. We need to be honest with ourselves about why our patients die.

There has also been self-deception about whether physician-assisted death is a form of suicide. Some proponents of assisted death contend that assisted death is not an act of deliberate self-killing, but rather merely a choice over the manner and timing of one's death. It's not clear why one would try to distort language this way and deny that “physician-assisted suicide” is suicide, except perhaps to assuage conscience and minimize stigma. Perhaps we all know that suicide is never really a form of self-respect. To sustain our moral and social affirmation of physician-assisted death, we have to deny what this practice actually represents.

There has been self-deception about the possibility of putting limits around the practice of assisted death. Early on, advocates insisted that euthanasia would be available only to those for whom death was reasonably foreseeable (to use the Canadian legal parlance). But once death comes to be viewed as a therapeutic option, the therapeutic possibilities become nearly limitless. Death was soon viewed as a therapy for severe disability or for health-related consequences of poverty and loneliness (though often poverty and loneliness are the consequence of the health issues). Soon we were talking about death as a therapy for mental illness. If beauty is in the eye of the beholder, then so is grievous and irremediable suffering. Death inevitably becomes therapeutic option for any form of suffering. Efforts to limit the practice to certain populations (e.g. those with disabilities) are inevitably seen as paternalistic and discriminatory.

There has been self-deception about the reasons justifying legalization of assisted death. Before legalization, advocates decry the uncontrolled physical suffering associated with the dying process and claim that prohibiting assisted death dehumanizes patients and leaves them in agony. Once legalized, it rapidly becomes clear that this therapy is not for physical suffering but rather for existential suffering: the loss of autonomy, the sense of being a burden, the despair of seeing any point in going on with life. The desire for death reflects a crisis of meaning. We deceived ourselves into thinking that assisted death is a medical therapy for a medical problem, when in fact it is an existential therapy for a spiritual problem.

We have also deceived ourselves by claiming to know whether some patients are better off dead, when in fact we have no idea what it's like to be dead. The utilitarian calculus underpinning the logic of assisted death relies on the presumption that we know what it is like before we die in comparison to what it is like after we die. In general, the unstated assumption is that there is nothing after death. This is perhaps why the practice is generally promoted by atheists and opposed by theists. But in my experience, it is very rare for people to address this question explicitly. They prefer to let the question of existence beyond death lie dormant, untouched. To think that physicians qua physicians have any expertise on or authority on the question of what it’s like to be dead, or that such medicine can at all comport with a scientific evidence-based approach to medical decision-making, is a profound self-deception.

Finally, we deceive ourselves when we pretend that ending people’s lives at their voluntary request is all about respecting personal autonomy. People seek death when they can see no other way forward with life—they are subject to the constraints of their circumstances, finances, support networks, and even internal spiritual resources. We are not nearly so autonomous as we wish to think. And in the end, the patient does not choose whether to die; the doctor chooses whether the patient should die. The patient requests, the doctor decides. Recent new stories have made clear the challenges for practitioners of euthanasia to pick and choose who should die among their patients. In Canada, you can have death, but only if your doctor agrees that your life is not worth living. However much these doctors might purport to act from compassion, one cannot help see a connection to Nazi physicians labelling the unwanted as “Lebensunwortes leben”—life unworthy of life. In adopting assisted death, we cannot avoid dehumanizing ourselves. Death with dignity is a deception.

These many acts of self-deception in relation to physician-assisted death should not surprise us, for the practice is intrinsically self-deceptive. It claims to be motivated by the value of the patient; it claims to promote the dignity of the patient; it claims to respect the autonomy of the patient. In fact, it directly contravenes all three of those goods.

It degrades the value of the patient by accepting that it doesn't matter whether or not the patient exists.

It denies the dignity of the patient by treating the patient as a mere means to an end—the sufferer is ended in order to end the suffering.

It destroys the autonomy of the patient because it takes away autonomy. The patient might autonomously express a desire for death, but the act of rendering someone dead does not enhance their autonomy; it obliterates it.

Yet the need for self-deception represents the fatal weakness of this practice. In time, truth will win over falsehood, light over darkness, wisdom over folly. So let us ever cling to the truth, and faithfully continue to speak the truth in love to the dying and the living. Truth overcomes pressure. The truth will set us free.