Human Enhacement Through the Ableism Lens
Gregor Wolbring
An e-mail interview made by Francisco Guzmán. April 2010
Dr. Gregor Wolbring is an Assistant Professor, University of Calgary, Faculty of Medicine, Dept. of Community Health Sciences, Program in Community Rehabilitation and Disability Studies. Member Review Board of the journal Review in Disability Studies. Member International Editorial Advisory Board of the journal Studies in Ethics, Law and Technology. Member Editorial Review Board of the International Journal of Nanotechnology and Molecular Computation (IJNMC).
His interests cover Ability and ableism ethics and governance; Disability Studies; Social, ethical and governance issues of new, emerging and converging sciences and technologies (S&T), such as nanoscale S&T, cognitive sciences, neuromorphic engineering, genetics, synthetic biology, governance of bodily enhancement S&T, artificial intelligence and robotics; impact of S&T on: marginalized populations, especially disabled people; ableism and transhumanism; foresight studies, bioethics issues, and biochemistry.
You can find some of his writings in these webpages:
International Center for Bioethics, Culture and Disability:
http://www.bioethicsanddisability.org 
Ableism and Ability Ethics and Governance blog:
http://ableism.wordpress.com
Column The Choice is Yours:
http://www.innovationwatch.com/commentary_choiceisyours.htm 
NBICS Blog:
http://wolbring.wordpress.com/
Ableism
1. Ableism is a concept used by the disabled people community and further expanded on by you. What is the contribution of this concept to the enhancement controversy? 
The term ableism evolved from the civil rights movements in the United States and Britain during the 1960s and 1970s to question and highlight the prejudice and discrimination people experienced whose body structure and ability functioning was labelled as ‘impaired’ as sub species-typical. Ableism of this flavour was defined as a set of beliefs, processes and practices that favours species-typical normative body structure based abilities and labels subnormative species-typical biological structures as deficient, as not able to perform as required, as being in need of fixing. The disabled people rights discourse and scholars of the academic field of disability studies (for a list of disability studies programs see (Steven Taylor, 2003)) questions the favouritism for normative species-typical body abilities (Carlson, 2001; Finkelstein, 1996; Mitchell & Snyder, 1997; Olyan, 2009; Rose, 2003; Schipper, 2006; Fiona A. K. Campbell, 2001; Carlson, 2001; Overboe, 2007).
The discourse around deafness and Deaf Culture (Burch, 2000; Abberley, 2003; Chimedza, 1998; Hladek, 2002; Kersting, 1997; Lane & Bahan, 1998; Sparrow, 2005) would be one example where many people expect the ability to hear and see deafness as a deficiency to be treated through medical means whereby many Deaf people do not perceive deafness as a deficiency and hearing as an essential ability. Within the disabled people rights framework ableism was set up as a term to be used like sexism and racism.
However ableism is evident far beyond the species-typical, sub species-typical dichotomy. Ableism is one of the most societal entrenched and accepted “isms” and it exists in many forms such as biological structure based ableism, cognition based ableism, ableism inherent to a given economic system, and social structure based ableism (Wolbring, 2008a). The ableism’s that expects the ability a) to generate a high GDP and be productive and efficient; b) to consume products and c) to be competitive are just three ableism’s outside of the species-typical, sub species-typical dichotomy cherished by many. The favouritism of abilities furthermore contributes to other isms such as racism, sexism, cast-ism, ageism, speciesism, anti-environmentalism and other ism’s (Wolbring, 2008f).

2. In spite of all that it seems to be impossible to organize a society without putting in order some set of essential abilities. Could it be possible to define a set of abilities that lead to the most beneficial scenario for the maximum number of people? And in case this is possible, how can we avoid social discrimination of that people who could not, or refuse to adopt these set of abilities?
Yes of course, but we need the following knowledge tools to achieve all these goals. I suggested these new fields of inquiry:
Ability Studies is the study of (a) the social, cultural, legal, political, ethical and other angles which influence the judgment of any given ability and which leads to the favouritism of one ability over another (b) the impact and consequence of the favouritism of certain abilities and rejection of others (c) the consequences of ableism in its different forms and its relationship and impact on other isms (d) the impact of new and emerging technologies on ableism and the favouritism towards certain abilities and rejection of other abilities (e) what abilities would lead to the most beneficial scenario for the maximum amount of people in the world.
Ethics of Ableism/Ableism Ethics is a framework of standards and values that (a) guide beliefs, processes and practices that produces based on ones abilities a particular kind of understanding of oneself, one’s body and one’s relationship with others of one’s species, other species and one’s environment and includes one being judged by others; (b) guide the favouritism for certain abilities and how one decide which abilities to favour over others; (c) guide the reactions towards humans and other biological entities that are seen -real or perceived- to lack these essential abilities. The study of the Ethics of Ableism/Ableism Ethics, also includes (a) the study of those standards and values, incorporating the perspectives of many different groups especially of the people labelled as lacking certain ‘essential’ abilities or labelled as exhibiting ‘as negative seen abilities’; (b) the impact assessment of different forms of ableism onto different ethics theories and ethical principles including health ethics theories and their use to govern science and technology and health research, care and policy and (c) identification of ethical actions that flow from a favouritism for certain abilities.
Governance of Ableism/Ableism Governance is about how we govern ableism, the favouritism for certain abilities and the reaction towards non favoured abi-lities. This field is seen as an essential tool to help address existing and future challenges in the governance of science and technology and many other fields such as health policy.
Finally, Ableism Foresight is to anticipate and understand shifting social dynamics e-nabled by advancing sciences and technologies.

3. Proponents of human enhancement may argue that these technologies are to provide people the possibility of seek and adopt those abilities they are free to consider essential for carrying out their projects. What can be said about this through the ableism lens?
In many of my writings I highlight how the desire for certain abilities and the exhibition of certain ableism’s favour the acceptance of enhancement pro-ducts.
Individuals, households, communities, groups, sectors, regions, countries and cultures cherish and promote certain abilities while viewing others as non-essential (favoritism of abilities). A step beyond the dynamic of favoring certain abilities is the dynamic of ableism where one not only cherishes certain abi-lities but where one sees certain abilities in oneself or others as essential. Ableism leads to an ability based and ability justified understanding of oneself, one’s body and one’s relationship with others of one’s species, other species and one’s environment. (Wolbring, 2008a) Ableism often leads to disablism (Miller, Parker, & Gillinson, 2004), the discriminatory, oppressive, and non-supportive behavior arising from the belief that certain abilities are essential. Ableism has been used historically and still is used by various social groups to justify their elevated level of rights and status in relation to other social groups, other species and the environment they live in (Wolbring, 2008a; Wolbring, 2008b; Wolbring, 2008e).

4. What is transhumanization of ableism?
Transhumanized form of ableism is where people perceive the improvement of human body abilities beyond species-typical boundaries not only as desi-rable but as essential (Wolbring, 2008f; Wolbring, 2008b).

5. Functional diversity is a new term proposed (Romañach and Lobato, 2005) to refer to people who are in the moment labelled as impairment people in a positive or neutral way, as none of the common terms (like disabled, handicapped, invalid, impaired etc) used cu-rrently is so. Even it has been suggested to use functional diversity to refer to all human beings, even those who shows normal or beyond species-typical biological structures or abilities given that all people function in diverse ways (Patston, 2007). Do you think it could be a good term for the design of a more inclusive society in order to deal with human enhancement possibilities and risks?
Sure it’s one possibility. There are many terms. Some use differently able. I use the term Variability from time to time (Wolbring, 2009). I developed a Glossary that I find is more accurate. It also makes a distinction between body structure function and social reaction. It uses the term disability only for the social reaction part. (Wolbring, 2009)

Enhancement controversies.
6. Normally enhancement debates swings between the defence of species-nature essentialism and the transhumanist defence to go beyond species-typical boundaries with the help of technology. However we can find currently multiple social movements and research frameworks, disability studies amongst them, that argue against the existence of an essential human identity founded on any biological structures or abilities. Does it make any sense to oppose the enhancement technologies development from the essentialist perspective?
No. I think that as long as certain enhancements are seen as useful for certain people to fulfill certain private or societal goals beyond species-typical body enhancements will be used. One can only stop it if one changes the equation on the demand side. Enhancements are too diverse in their product line and impact and consequences to just oppose them with one argument. Even if one would employ the Species-nature argument it could not be applied to all forms of enhancement like external and body attached enhancements. I would think this argument could only be used for intrinsic body enhancement and even there for certain ones the argument might be weak. I think it’s much more useful to deal with enhancement from a societal, ableism lens to highlight what drives it and what the consequences are. And then it’s up to the people to decide. I cannot do more than highlight the situation and dynamics. If people see ability x as essential they will accept nearly any product that facilitates and enables the advancement of ability x. 

7. Opponents to human enhancements say these technologies promote negative attitudes towards people who are seen as not having these abilities and raise concerns that such negative attitudes might result in harmful public policies and practices e.g. job discrimination, barriers to health insurance or funding cuts for healthcare. However it seems to be inevitable that these enhancements applications become more and more frequent. So that the enhanced will have to live with the no enhanced. Is it possible to think about a social model for this case, I mean a social design which enable any person whether they are identified as not having certain essential species-typical abi-lities, species-typical abled or enhanced abled?
Of course, as long as we come to an understanding as to which abilities are desirable and which aren’t and how to develop a societal framework around them that is the least harmful. Space and support has to be provided that allows for people to live with their set of abilities without being judged negatively. If we continue on the path of ableism as in negatively judging people who are seen as having sub species-typical abilities and if we continue with the disablement dynamic (lack of support, accommodation...) of the today as sub species-typical defined people it makes it logical to apply the same dynamic to the dichotomy of the haves an haves not of enhancement abilities. It seems illogical to expect that the ableism and disablism evident in the sub species-typical versus species-typical dichotomy will not be employed in other ability related dichotomies.

8. For instance, there are concerns that genetic modification violates an individual’s right to an open future. If parents choose the genetic make up of their child, the child may feel enormous pressure to live up to the expectations of his/her parents. Proponents argue, ho-wever, that none of us gave consent to be born with the genetic make-up that nature randomly bestowed upon us and question why the genetically engineered children of the future would feel any di-fferently about themselves than we do today. What might it be said on this issue from the ableist approach?
Let me first say that in regards to enhancement the focus on genetics is a red herring1 . The enhancement products for quite awhile will be mostly of the non genetic flavour and as such the social policy around how to deal with enhancements and how enhanced and ‘non-enhanced people will relate to each others will be developed there. And once genetic enhancement in a broad meaningful way become feasible I think one already has come to a societal agreement (sort of) related to the enhancement situation. As to the argument about the open future; the pressure of expectations exists all the time. This is where the ableism lens can contribute valuable inside. I think the arguments mostly do not hold as they are developed with the special case of genetics without taking into account and questioning the same dynamic happening outside the case of genetics. If the argument of pressure of expectations is to be tenable in the genetics discourse one has to also question and deal also with the other incidents of pressure of expectations. The negative image of the sub species-typical is one example of pressure of expectations. It adds to the species-typical ableist flavour of the genetic discourse especially the prebirth discourse. As I wrote elsewhere “It seems that every argument used to justify sex selection prohibition could also be used to demand disability deselection prohibition. Furthermore any arguments used to denounce the demand for the prohibition of disability deselection can be used just as well to denounce the arguments used to demand the prohibition of sex selection”(I used in that case the term disability with the meaning of impairment). (Wolbring, 2003) However many legal instruments and policy document make a distinction between sex selection and impairment deselection. The pressure of expectations also exist in other areas; the need to be productive is another example and there are many more. And one can of course expect such pressure of expectations also in the case of enhancements. 

9. What do you think about the line of reasoning that describes the internal human performance enhancements as the culmination of a process that begun with the adoption of external performance enhancements, so that there would be no important difference between enhancement possibilities and what we have done until now?
There are of course differences. For example all the external performance enhancements used to be reversible or non continuous (like we can fly by plane but we can also decide to not to on a case by case basis) whereas many especially device related internal human performance enhancements are difficult to reverse to the former state (it is not that simple to continuously through surgery add and remove implants). Even drugs that might lead to enhancements it might not be that easy to just stop them as one might get addicted to them 2. However at the same time it’s true that the push for external and internal enhancements can often be traced back to the same root of favouritism for certain abilities (ableism is dealt with further up).

10. Biotechnologies, as well as information and cognitive sciences are converging with nanotechnologies in a new research framework called Nano-Bio-Info-Cogno-sciences (NBIC’s) whose research program seeks possibilities to analyze and improve human performance. Opponents raise concerns that it might be used to do away with diversity or to eradicate people with disability, as well as it might put in risk our essential human nature. Why do you think that this enhancement approach was chosen to promote the development of the NBIC Technologies, despite these controversies?

First let me say that there are many other possible fields for Nanoscale and nanoscale enabled products and processes. Nanoscale science and technologies increasingly are part of various science and technology fields such as physics, chemistry, material sciences, biotechnology, biology, genetics, synthetic biology, information and communication technology, cognitive sciences and neuro-engineering, bioengineering, geo-engineering and others. Applications and products are envisioned in areas such as the environment, energy, water, military applications, globalization, agriculture, health and others (my regular column (so far over 70) that is on nano applications http://www.bioethicsanddisability.org/articles.htm covers many nanoscale applications; see also these references (National Academy of Engineering of the National Academies, 2008; Salamanca-Buentello et al., 2005; UN Millennium Project’s Task Force on Science & Calestous Juma and Lee Yee-Cheong, 2005; Coenen et al., 2009; Nature, 2008) 
Cientifica a long time very influential nanotechnology consulting group predicts that “....some 80% of the 2015 US$ 1.5 trillion market will be accounted for by applications of nanotechnologies in the pharmaceuticals and healthcare sectors”(Cientifica Ltd, 2007) Various nanomedicine taxonomies (Neil Gordon & Uri Sagman, 2003; Freitas R, 2005), and roadmaps (VDI/VDE Innovation + Technik GmbH, 2005) (The National Institute for Health (NIH, 2005) exist. Many nano health applications are envisioned, in development, or already in use (The National Institute for Health (NIH, 2005; René de Groot, 2006; Wolbring, 2005; Silva & Van Calster, 2008).
As I wrote elsewhere (Wolbring, 2008f) “Introducing the concepts of ‘NBIC convergence’ and ‘convergence on the nanoscale’ one can argue was not enough to gain access to funding and high visibility. Funding and visibility is linked to promised products and achievement of goals. The organizers had to come up with a goal they felt would a) be applicable to many different areas seen as important by the government and funding agencies b) be sellable as being essential for the advances of the different important areas marked for the well being of the USA and its citizens; c) seen as being able to fit with the chosen BIC and the nanoconvergence; d) have a history of interventions; e) generate little public outcry. The goal of human performance enhancement fits all the above criteria.” One could also say that the enhancement choice fitted with the prevailing favouritism of abilities that are seen essential by politicians and others. Also that it fits certain ability favouritism might explain that environment health and safety issues http://www.politicsofhealth.org/wol/2008-4-30.htm have much more visibility and led to more voicing of concerns in the nano discourse than the enhancement angle. 

11. One of the proponents’ arguments for these researches is their capacity for alleviate the suffering which nobody wants to experience from a utilitarian perspective. Given the social and commercial pressures engaged in the enhancement technologies promotion, does still make any sense claiming for a cancellation of these researches based on their possible negative impact which could provoke their bad use?
The alleviation of suffering is an unconvincing argument as under give social dynamics it will also generate new sufferings. Furthermore there are many other ways to alleviate existing suffering with changes in social dynamics and re-evaluation of science and technology goals. However pure prohibition of certain products and research endeavours without changing social dynamics that lead to the demand for the product in the first place is untenable. For the most part products do not come is if there is a lack of desire. 

12. In human enhancement debate, as a bioethics issue, two ideological trends are said to appear: one more conservative, opposed to these technologies and based on religious moral, and another trend supposedly more “open” to their implementation3 . I think it is possible to raise concerns about the consequences and risks of human enhancement out of moral religious background. Why does it frequently happen that every caution stand about these technologies is so easy taken for granted that is driven by some kind of essentialism or religious background?
To start, although some enhancements might be in opposition to some religious values not every religion will judge every enhancement the same. Furthermore if people believe in certain forms of ableism they will not oppose many enhancements. Consumerism and Competitiveness mostly trumps religious values in the West for example. Also we have various arguments pro con enhancement beside the two mentioned above but this above polarization of these two views suits media coverage. But it does not reflect the reality of the discourse arguments.

To clarify why is it supposed that every caution argument is based on religious values, even when it does not have to be based on such va-lues or believes. For example, caution argument concerning disabled people (or possible future techno poor ‘impaired’ (as you call them in one of your writings) discrimination may promote the idea of giving same high value to every human life, whatever his ‘impairment’ might be. In contrast, many enhancement proponents may argue that life value mainly depends on the best body performance that an indivi-dual can get to achieve his personal goals, and they will probably consider it irrational, to refuse the adoption of such enhancements to avoid social discrimination based on ‘obsolete’ religious or traditional believes. Personally I think that all this might be some enhancement proponent’s tactic to easy reject many opponent’s arguments.
Well sure there is that, that by labelling your opponent in a way that decreases the positive sentiment towards them and which leads to the disregarding of their arguments due to the label its achieves is a tool. The same is true for how the term bio conservative is used and how disabled people who have certain views that make an ableist agenda more problematic are labelled as disabled people rights extremists. For sure an ableism lens and disabled people rights argument are more difficult to deal with as they do not fit existing boxes.

13. Could it become a matter of rights enabled by any human enhancement state program as it is the Medical insurance program in other countries?
Yes I actually just have a peer reviewed book chapter coming out (Wolbring, 2010) that makes this point that the medical insurance system of the future might be there to ensure that people can upgrade themselves (linked to a change in the meaning of health where one is seen as ill if not enhanced). Of course that does not mean that everyone has access to this insurance. That will depend on countries and how accessible their medical insurance systems are normally.

14. Sometimes it happens that research programs have more impact, not because of their direct outcomes, but because of the imaginarium they involve. E.g. anti-aging therapies haven’t yet reached their main goals, that is to interrupt or reverse natural aging processes, ho-wever they have already contribute to promote physical youth as an important social value. To what extent human enhancement constitutes a real possibility or simply acts as a way to state some human stereotype? 
I think its goes both ways. People look for longevity products because they want to keep the ability of youth and if longevity products would be available more people would go for them (assuming that it’s ‘longevity in a healthy state’). Human enhancement constitutes a real possibility and indeed we move towards it all the time. Whether some of the more long term visions such as uploading ones consciousness, immortality.... come to pass who knows but these visions that many see as outlandish take the focus of the fact that there will be increasingly products that will questions existing ability expectations and ability hierarchies (see the labelling of a prosthetic leg as techno doping and the huge debate around whether a Paralympic athlete (Pistorius) should be allowed to compete against an Olympic athlete if the artificial legs give an unfair advantage)(Wolbring, 2008d). It’s up to societies whether these advancements will be used to further existing stereotypes and exclusionary ableism practices (Wolbring, 2008b). If we go on with existing social dynamics we will see the appearance of what I call the techno poor impaired and disabled (Wolbring, 2008c).

15. The expenses involved in enhancement are foreseen as the cause of a new divide between those who can afford them and those poor techno-impaired who cannot. This divide is quite similar to digital divide between information and communication technologies (ICT) users and lacking training or infrastructure not users for who a reduction in costs and full ICT access is promoted. Is it reasonable to think all these technologies will become someday fully accessible for everyone?
No, as we can see today with water and food security. Even these basic issues have not been solved yet. There will not be an equitable access. However although equitable access will not be the case to just use this argument for the enhancement discourse is problematic. As long as we do not seriously try to rectify other inequitable situations the pro-enhancement people will state that why should equity all by a sudden play a role here. As long as we do not fight inequity in general this argument will not stop the enhancement use. 

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Wolbring, G. Obsolescence and body technologies, Dilemata, International Journal of Applied Ethics, nº4 (2010)


Notes
1. Note from the interviewer: A Red Herring is a fallacy in which an irrelevant topic is presented in order to divert attention from the original issue. The basic idea is to “win” an argument by leading attention away from the argument and to another topic. The name of this fallacy comes from the sport of fox hunting in which a dried, smoked herring, which is red in color, is dragged across the trail of the fox to throw the hounds off the scent.
2. Wolbring, G. “Obsolescence and body technologies”, paper accepted to publish in Dilemata, International Journal of Applied Ethics, nº4 (2010)
3. As exposed in “The REMEDIE (Regenerative Medicine in Europe) Project” interview to John Harris by Iñigo de Miguel in Dilemata, International Journal of Applied Ethics, Nº2 (2010), pp. 131-137