In this series of interviews. I ask scientists, engineers, and ethicists how technology might change our future. We had these conversations during the research for my book, Welcome to the Future (Quarto, 2021).
Interview 9 – Lawrence Prograis, bioethicist
Dr. Lawrence Prograis is a physician and expert in bioethics, which is the study of right and wrong practices in biology and medicine. Now retired, he was a professor and researcher at the Center for Clinical Bioethics at Georgetown University Medical Center and has also worked at the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. He also co-edited the book, “African American Bioethics: Culture, Race, and Identity.” We spoke in February 2021.
People may someday use genetic engineering or robotic parts to give themselves superpowers, like extreme strength of speed, or keen intelligence, vision, or hearing. What are your thoughts about this?
It’s not a future I would look forward to. I think it would make us all unequal. People can say that we’re already unequal. There are athletes that can do things right now that the average person can’t. But to have those “superpowers” would create an unfairness beyond these normal standards.
A good example of that would be – what would you feel like competing against someone in a hundred yard dash – and that individual has taken steroids? Or what if that individual had been given certain genes to increase muscle sizes and those muscles make them run faster? At the same time, what if you were competing against someone who had a prosthesis that was “super-charged,” so to speak. And you had to run against that individual. Would you feel that that would be fair? What is fair in that particular case would be the question.
This already happened! In 2008, some swimmers started wearing “super suits” that gave them an unfair advantage. Professional swimming soon banned these suits because otherwise swimmers would have to buy one to compete fairly.
Yes, there is an unfairness in economics. Everybody may not be able to afford it. So how does one balance those issues? That becomes the key issue. We have to have rules or policies that make the playing field equal when we’re running a race or swimming or when we are competing. If there’s an advantage that everybody has – then fine. But if it’s an advantage only one person has, the magic “power” that one person has should be held to be out of bounds at that particular point.
There’s another argument saying, what if these advantages aren’t being used in sport or in unfair competition, but for firefighters or rescue workers or other people who need this enhanced strength or speed to deal with dangerous or life-threatening situations?
That’s an excellent example. Are there members of society who do work in hazardous conditions so that we need to identify those individuals and give them that superpower or give them a protective ability to manage crime or fire or dangerous environments? I think that’s going to be a harder question to answer. Those individuals that we entrust with that kind of power, we’re going to have to be assured that they don’t want to misuse that power for their own advantage. That may turn out to be a very small, selective group of people who have to go through an enormous amount of training and testing to be sure.
I also think the question could be flipped. Do we want to give our parents power? To be sure that they take good care of us and protect us? If so, do we want to give our mothers the power to always be able to fight off a bad person? What if mom gets upset? Now she has that power and she wants to discipline us for something we haven’t done. So it’s a balance of who do we give this power to, and should we?
In those particular cases, knowing human behavior and how people can use things for good and bad, we have to be extremely selective. I think there will be very small fraction of people that we entrust this kind of power to. Not everyone. We may also want to use robotics for that kind of activity, and not necessarily humans. Because we may not necessarily have the ability to control human behavior.
But you could control robot behavior more easily, perhaps?
If there’s a kill switch.
That’s a good point. We may be able to give super strength or speed or other powers to robots more fairly than to humans.
That’s right. We may need to think about using robots to do those kinds of things for us: to go into fires, to go into areas where there’s uranium exposure, or to deal with criminals. At the same time, we need to be able to control those robots and not give them the ability to think for themselves.
That’s an interesting puzzle as well. Can robots do that type of work without thinking for themselves?
That is a conundrum. As we move forward with AI, I think we’re going to have to be able to integrate AI activities along with human responsiveness. So we allow the AI to have its thinking capacity, yet at the same time we’re still able to work along with them.
To me AI is one of the most frightening things I think we have in the future. I use the word frightening from the standpoint of the ability for human calculation and human reasoning. If we were to grade it at a level of between 1 and 10, most humans would function at a 5, 6, or 7. If AI is functioning at level of 10, 11, or 12, we can’t catch up with that. Then all of a sudden, we have a transhuman or an entity that is outthinking us, in every different capacity.
That individual stands outside the norms of human society. We don’t know whether their intent is good or bad. Historically in our society, we’ve had individuals who’ve had bad intent and good intent, and nations have come together to stop those individuals with bad intent. We would have to be able to come together in some kind of way to stop that robot or AI that has bad intent. But if it’s constantly out-thinking us, we might not be able to stop it.
Getting back to superpowers, the history of attempts to “improve” humanity includes some of the most terrible things people have done to each other, including the holocaust and eugenics experiments. How would you talk to a young audience about this history and what we should learn from it?
I think the question that I think kids should realize, is that humans are constantly evolving. We evolve not only from a physical standpoint and a mental standpoint, but we add new elements such as prostheses – eye implants, ear implants. There’s no doubt that we will have computer chips, heart valves, and other improvements to our health. Those changes are good changes.
“Superpower” changes I think could be good, but there are going to have to be committees. Outside groups of individuals are going to have to set laws and rules that say what can be done, when it can be done, and how it can be done. Mankind has to be able to do that because human behavior is both good and bad. The holocaust, eugenics, and those types of issues are going to stay with us. So we have to have outside forces that continue to remember history.
There are individuals in science, my colleagues that I have worked with, who are super excited and curious about the world around them. They just want to see what the experiment will do. Can I create this? Can I create a new drug? Can I create a new AI? Can I create a new explosive – just to see what it’s like? And being human, we may choose not to look at the consequences of, “I just want to see what it’s like.” There has to be some controlling aspect, and that’s where ethics come into play.
Could you talk a little more about the role of ethics in bringing new technology to society?
When we work with scientists, when we work with health care professionals, when we work with government agencies, we’re saying, what’s the consequence of doing that law? Or the consequence of creating that prosthetic limb that an individual could use to crush a stone? Do we want to give that to everyone? And if so, what are the guidelines that individual has to follow? There have to be limits around these new activities that we are going to be able to engage in.
When you were talking, I was thinking, a lot of these things you’re saying are good changes, such as prostheses, are not meant to improve a person beyond what someone could normally do, but to bring someone who has some disparity in ability to the same level as someone else.
Exactly. If you’re not able to hear, you can get a cochlear implant. If your heart is not beating properly, you can put a new valve in it. We want to improve people, but to improve them so everybody has sort of the same playing field, the same abilities. To go beyond those abilities, to be able to have x-ray vision, maybe not. Because not everybody should have that. Everybody is not going to be an honorable person. And even the honorable person may at some point want [to use x-ray vision] to look through the wall of the house just for the sake of looking.
In other words, even if we develop this technology for good reasons, if it is out there, someone will use it for a bad reason? So we must take that into account.
There are always two sides to an issue that we have to balance. For example right now, the COVID-19 infection, we’ve created vaccines against it. And we know some vaccines are working very well. But I can guarantee you, somewhere in the world, someone has isolated that virus, and they are enhancing the infectivity or mortality of that virus. They could be scientists who just want to manipulate the virus [to better understand it]. All of a sudden, they change one gene to another and the virus becomes more lethal. They have no negative intent – it just happens. On the other side, a true malintent can hypothetically hold the world at ransom, saying if you don’t give something to me, I will release this [deadly virus] as a biological weapon.
We have to always be vigilant. We have to always be aware that the good can always be in service of the bad.
In ethics, we say that the means does not necessarily serve the ends. So we have to be careful as to what he means are before we get to the ends.
In the introduction of my book, I mention that technology is a tool. Technology on its own is never good or bad, it’s what we do with it that matters.
Yes, exactly. Absolutely correct. It’s what we do with it, and how we do it.
You were talking about how it does seem to be morally sound to use technology to bring people to more of an even level. For example, to give people with impaired hearing or sight better hearing or sight. Or to give people with impaired movement better movement. Is this a problem if everyone is more equal? Will that reduce diversity in the world?
I was going to take exactly what you said and add a caveat to that. It’s morally sound to use technology to bring people to more of an even level, as long as individuals want that improvement. I think a great example of that is the hearing-impaired and sightless communities. Not every individual in the hearing-impaired community wants to have a cochlear implant. Not every individual in the sightless community wants to be able to see. Those individuals should have a choice of whether or not they want an implant.
There may be benefits from having a level of diversity within society. Those of us who have sight and hearing may not understand what it’s like to not have sight or to not have hearing. Those individuals who don’t see or hear tend to use other senses more intently than we do. So that brings a different atmosphere to them than what we feel we have. And so individuals should have a choice as to whether or not they want to have these tools to make them “normal.” What we call “normal” is not necessarily normal for everyone.
What about when parents choose for their child? Parents could someday choose to prevent deafness in an unborn baby using gene editing.
Again, we should have policies around that. The assumption that parents only want what is best for the unborn or for the child may not necessarily be correct. When that individual becomes sentient they should have some discussion about what it is he or she wants for themselves. That may take 18 years. But there needs to be some policy around what can be given [to unborn or young babies]. If it’s to correct a heart malfunction and keep an individual alive, yes. But if it’s about sight or hearing or a prosthetic arm, maybe not until there’s a way to find out what that individual might want.
These are very complex questions. They’re very difficult. We all think parents want only the best for their children, but there are parents who may not necessarily want the best. We do know of parents who are abusive, and parents who may be impaired themselves, who may not be able to take care of the child. Therefore there has to be this balance of what a parent wants versus what that individual may need at that point. What is good for them? What is in their best interest?
There is something in ethics we call the best interest doctrine for children. It is a doctrine that articulates the balance of what parents and healthcare do for the child and how that child has to have a role. You don’t expect the child to have say so when they are 1 year old. But what is in the best interest for that 1-year-old when we look within the full context?
It’s not just the parents having a say, but the larger community saying what should be good for a 1-year-old in general?
Yes. That has to be taken into consideration. It’s a hard concept. But it’s one that reflects the developmental stages of growth of an individual.
Let’s say we get to a point where people do have the option to improve themselves beyond what people are normally capable of. What repercussions might this have in terms of racism, classism, ableism? What are you afraid of happening in these areas?
I think we’ll have another “ism.” I think if we start to see a class of individuals who have a certain technological advantage, intellectual advantage, or physical advantage, then I think as a society we’re going to have to identify that group. We already do this with ageism, racism, classism. Racism is based on ethnic coloration. Agism is based on age. We’re going to be classing out a group of individuals with different technological capabilities.
I think as a society, we will start to look at those individuals as being different. Whether or not those individuals do things for the good or bad of society, judgement will be based around that. If an individual with muscle implants is winning all of the races, then I think we will have a group of people for which we will probably say, those individuals stand outside of the norm. Racing against those individuals is not the correct thing to do for the majority of people. Society will probably say that each person who enters the race has to undergo genetic screening or tests. It’s the same kind of thing that we do right now in wrestling, or boxing, or gymnastics, or any other sports. We have certain weight categories. And certain skill categories. So we will have categories for [technologically enhanced] individuals. Everyone with the same prosthesis will compete against each other.
What about discrimination that might happen because of these differences? Who would be discriminated against – those with or without enhancements?
I see it going against both sides. We all are engaged in biases. There will be those of us who look at those individuals [with enhancements] as being outside the norm. There will be religious biases against those individuals, from the standpoint that they may not be made in the eyes of God. At same time, those individuals might discriminate against those of us who don’t have those capabilities and see us as being lesser mortals than them.
I wonder if you’d also see something like what we already see when people with privilege from being raised in a family with money, or from the color of their skin or their gender, they may not see their success as a result of those things but as a result of their hard work. They take credit for all of it even if it was just that they were lucky and advantaged.
There’s no doubt about it. It’s hard to self-reflect. Most of us choose not to look at our advantages and disadvantages. So if you came up within a society where everyone drove a Rolls Royce, then that’s just normal. For you to have that advantage, you may not consider it an advantage. You could just consider it a norm.
One thing I’ve thought about is that no one really knows what a “better human” would look like, or act like. Everyone has their own idea of what it would mean to be a better human. The ideal human does not exist.
The ideal human does not exist. It’s an ideal. It always makes me laugh when in the political arena, we talk about a “more perfect” union, and we use the term, “more perfect.” if we’re perfect, how can we be more perfect? The ideal is that we are always ascribing to that perfection, but we have not yet reached that asymptotic compartment. The more perfect human does not exist. We are constantly striving to become better humans.
Also there’s the idea that what it means to be better depends on your background and values.
There is no doubt about it. Those in India are different than those in Western Culture, versus those in Asia, versus those in Africa, or in Australia. We each have our own views of what a better culture would be, or what a better human would be.
I think what I want to impart to kids about this is that we need to listen to those different views and respect them. People making decisions about technology need to take into account all these different values and backgrounds, not just their own.
I think that’s the hardest part of your book. One should be open and tolerant not to the point of submission, but open and tolerant to the point of understanding. One might have a different view from you, but you should listen, and you should hope that the person on the other side listens to your view. That doesn’t mean you have to accept theirs. One of the beautiful things that we have right now is that you can be a friend with someone of a different religion.
If you have a little more time, I have a chapter on the possibility of greatly extending human lifespans. Is there anything that I should make sure to include in that chapter?
Global society is going to have to evaluate that. The expansion of life engages more resources that we will have to use, the more food that we will need, the more heat that we will need, the more clothing that we will need, the more space to live that we will have to have. That brings up the development of new territories within our global atmosphere, let alone going to other planets in the future, 100 years from now, and setting up colonies there to live.
There is no doubt we will continue to expand [human lifespans]. If you just take the past 100 years, good nutrition, improvement in vitamins, and improvement in sanitation have reduced diseases, increased the ability for us to get taller and bigger and healthier, and increased our lifespan.
As medicine continues, we will continue to identify and conquer certain diseases, cure certain diseases, and improve on the treatment of certain diseases, which will expand life and age. Right now throughout the entire globe, there are seven different areas within the world where the norm is to live to be 100.
So it is not unheard of for us to continuously expand our life or to have improvement in life. But with that comes the other issues I mentioned earlier. How do we go about improving our life? Where do we live? What will we eat? Not that that’s a bad thing.
There’s a movie I’ve watched quite a few times now that I thought was quite interesting. It’s called Bicentennial Man, with Robin Williams. It’s a science fiction movie where Robin Williams was created as a robot, sort of like Data on Star Trek. And he was unique. But he wanted to be human, or find out about being human, so he continuously invented things. He was able to invent things for humankind to live longer. He lived for 200 years, but not everybody lived to be 200 years. The woman he married told him that there comes a time in each person’s life, where our existence… I think the better way of saying it, is that we have enjoyed our living. And it is now time for us to let others continue to live. Because there may be people around us who we outlive. And if those people mean something to us, then what is our existence for if those people are no longer around? Like partners who live together for 50 years, and one passes on. Generally the other does not live that long after.
We may not like the idea of ourselves dying, but death is a normal part of life and something our whole society is built around. If that goes away, it would be a very strange world.
It would, but there would probably be people who would want to live forever. We have to always realize and reflect, there will be some group that wants that. It’s within us as humans. That’s just who we are. Not all of us will want to live forever, but there might be someone who does.
We don’t really know if people could continue to be productive and creative and sane for hundreds of years. Would they continue to function as human beings? We don’t know that.
That’s something we have no information about. There have been science fiction movies in which we download our entire brain function into a computer — can we say that computer is you? It may not have your body, but it has your mind. Is that you? Do you want to be that? That becomes another crazy kind of question for the future. Science fiction has created a lot of these scenarios. Being a kid, I was an avid science fiction reader. They are things to think about.
As we move forward, I think from your viewpoint as you start your book, these are possibilities that might exist, but we need to think about them. We need to reflect on them not only for us but for others as well. You can start by saying, how does that affect me? But you also need to think, how would it affect my parents? How would it affect my sisters and brothers? Suppose my sisters and brothers had that, and I didn’t?
And beyond that, how does it affect people I don’t even know on the other side of the world?
Yes. Absolutely. The world is a small place today.