All posts tagged placebo

Book review: Human Enhancement, edited by Julian Savulescu and Nick Bostrom.

This book starts out with relatively uninteresting articles and only the last quarter of so of it is worth reading.

Because I agree with most of the arguments for enhancement, I skipped some of the pro-enhancement arguments and tried to read the anti-enhancement arguments carefully. They mostly boil down to the claim that people’s preference for natural things is sufficient to justify broad prohibitions on enhancing human bodies and human nature. That isn’t enough of an argument to deserve as much discussion as it gets.

A few of the concerns discussed by advocates of enhancement are worth more thought. The question of whether unenhanced humans would retain political equality and rights enables us to imagine dystopian results of enhancement. Daniel Walker provides a partly correct analysis of conditions under which enhanced beings ought to paternalistically restrict the choices and political power of the unenhanced. But he’s overly complacent about assuming the paternalists will have the interests of the unenhanced at heart. The biggest problem with paternalism to date is that it’s done by people who are less thoughtful about the interests of the people they’re controlling than they are about finding ways to serve their own self-interest. It is possible that enhanced beings will be perfect altruists, but it is far from being a natural consequence of enhancement.

The final chapter points out the risks of being overconfident of our ability to improve on nature. They describe questions we should ask about why evolution would have produced a result that is different from what we want. One example that they give suggests they remain overconfident – they repeat a standard claim about the human appendix being a result of evolution getting stuck in a local optimum. Recent evidence suggests that the appendix performs a valuable function in recovery from diarrhea (still a major cause of death in places) and harm from appendicitis seems rare outside of industrialized nations (maybe due to differences in dietary fiber?).

The most new and provocative ideas in the book have little to do with the medical enhancements that the title evokes. Robin Hanson’s call for mechanisms to make people more truthful probably won’t gather much support, as people are clever about finding objections to any specific method that would be effective. Still, asking the question the way he does may encourage some people to think more clearly about their goals.

Nick Bostrom and Anders Sandberg describe an interesting (original?) hypothesis about why placebos (sometimes) work. It involves signaling that there is relatively little need to conserve the body’s resources for fighting future injuries and diseases. Could this understanding lead to insights about how to more directly and reliably trigger this effect? More effective placebos have been proposed as jokes. Why is it so unusual to ask about serious research into this subject?