Summary of the impact

Public debate on the philosophical issues surrounding the nature of health and technological alteration of the human body has been informed and influenced by means of public events, media interviews and freely available online resources. These have informed both the general public and stakeholder groups, building on insights from research at UWE Bristol. Meacham has written for a general audience on the use of pharmaceutical enhancement in sports and education, influencing attitudes toward `doping' in these two spheres. Public debates (on eugenics and smart drugs) have impacted individual practice toward disabled people and attitudes of stakeholders toward the use of `smart drugs'. Meacham's interventions in the international press have been used as a model of effective communication by major trade unions.

Underpinning research

The underpinning research stemmed from a philosophical concern that the discourse surrounding the ethics of human enhancement (or alteration) technology is overly centred on the autonomy of the rational subject. This approach risks neglecting the embodied and socially embedded nature of the subject. Meacham's research favours an approach that places greater emphasis on the role of bodily and intersubjective relations in structuring the subject and its ethical relations. The phenomenological approach to the embodied and social dimensions of subjectivity was developed in [R1] and [R2]. These two pieces developed a theory of the subject and intersubjectivity around the concepts of `Institution' and `Style'.

Drawing on the conceptual framework elaborated in this fundamental research, [R3] addressed the question of doping as a violation of `human nature' and the `normal' in sport. [R3] argues that negative attitudes toward enhancement in sport are connected to a discomfort with a perceived violation of the `normal'. Using Husserl's phenomenology, Meacham argues that an ideal norm of experience is something that structures experience in its sharedness, and that it forms something like the pole around which a common world of collective projects can be formed. Discomfort with enhancement in sport—the most visible arena for enhancement technology—can be linked the idea of losing (to greater or lesser degree) the pole of a commonly experienced world in which collective praxis is based. While this must be separated from a narrow moral outrage with cheating, it does relate to the aesthetics of sport: human capacity is understood as a kind of common project, and watching the way it gets pushed creates a sort of aesthetic pleasure. By blurring the parameters of sport as a common project, enhancement can harm the aesthetic experience of sport.

This research began with an invitation to speak at a workshop on human nature and athletic enhancement at the University of Leuven in March 2011. The paper was published as a book chapter in January 2013. Meacham was at UWE for the duration of the research.

Meacham is further developing the theoretical basis for the argument made in [R3]. In a paper titled, `Empathy and Alteration: The Ethical Relevance of a Phenomenological Species Concept', he argues that ethical behaviour, and in particular relations of solidarity, are founded in an experience of empathy, which entails sharing a common world and similar enough structures of experience. The paper contends that, in terms of relations of solidarity, it is especially important to be able to empathize with another's experiences of illness or vulnerability to illness and injury. Meacham explores whether some forms of enhancement technology might weaken these relations of empathy and the bonds of solidarity that they underpin and addresses the manner in which the `species integrity' question is dealt with in the literature, arguing that both sides of the debate (species integrity matters ethically or not) miss the point that what is ethically salient is how others are experienced and this is not a question of biological taxonomy. Versions of the paper have been presented at a conference on Human Enhancement at the University of Texas, Dallas (April 2011) and the University of Bristol Philosophy of Medicine Seminar Series (March 2013). It is currently in press in the Journal of Medicine and Philosophy.

Meacham has argued that the potential social and political impact of enhancement is best studied phenomenologically, i.e. in terms of how the meanings of ethical and social structures are constituted by subjects' lived and embodied relations to the world and to others. He has also argued that this phenomenological approach has distinct advantages over approaches that might attempt to apply abstract ethical theory to the novel ethical and social situations that human enhancement technologies may present.

References to the research

Details of the impact

Meacham has consistently sought to engage wider audiences with his research. For example, he organised a series of public debates and events stemming specifically from the underpinning research described above. He also engaged in several media interviews (particularly surrounding the topic of `smart drugs') and wrote for a general audience on topics concerning `smart drugs' and doping in sport in OpenDemocracy, the Huffington Post and The Philosophers Magazine. In addition a letter written to the New York Times on the topic of health care has been used by the United Steelworkers Union (USA) as a model of how stakeholders should express their positions in a public forum [S1]. Meacham also participated in a `Festival of Ideas' / mircophilosophy@foyles public event with Professor Steve Fuller. They discussed Fuller's recent book `Humanity 2.0' in front of around 100 members of the public. The model of intersubjective relations developed in the underpinning research was used as a counterpoint to Fuller's arguments about post-human future of humanity [S3].

In December 2011, Meacham organised and moderated a public debate `Experiencing Disability: The right to be impaired vs. the legacy of eugenics', held at the Watershed Media Centre in Bristol. The event consisted of short presentations by Professor Christien van den Anker (UWE), a political theorist and disability rights activist, and Alex McKeown (University of Bristol) followed by a discussion and debate. The presentations addressed the lived-experience of impairment and how the legacy of eugenics in its various forms impacts upon the lived experience of impairment. This links directly to the phenomenological approach to health and enhancement that Meacham developed in the underpinning research. The ethics of `liberal eugenics' is a major topic in the discourse around `enhancement and health'. Attitudes often accepted by the general public were challenged at the event, which was attended by more than eighty people. For example, an interior designer for impaired people wrote: `I found it interesting because the presentation challenged ideas and put forward a personal experience of this world that was very relevant, yet different to my experience. As professionally I have to engage with design for disability, it was useful for raising awareness.' [S2]. Professor van den Anker's contribution to the debate will appear in a volume, Medicine and Society: New Continental Perspectives, edited by Meacham.

The `Experiencing Disability' event was part of a series of public seminars and debates on the theme of `Medicine and Society', sponsored by the Royal Institute of Philosophy. These also included talks by Dr Niall Keane (Limerick) on the `Enigma of Health', Dr John Sellars (Birkbeck College) on `Stoicism and Cognitive Psychotherapy', Professor S.K. Toombs (Baylor) on `Three Primary Manifestations of Vulnerability in Illness', and Dr. Eran Dorfman (Tel Aviv) on `Writing on Illness and Other Emergency Phenomena'. All of these talks were held at a local cultural venue and each attracted capacity audiences of more than forty people. Impact from these events have included Niall Keane being invited back to Bristol to give a masterclass with Meacham on health and hermeneutics to nursing and other medical professionals. The podcast from Toombs's talk has also been provided for use in nursing education [S4]. S.K. Toombs was a pioneer of the phenomenological approach to health and impairment that is further developed in the underpinning research.

The final `Medicine and Society' event was a public debate on the use of so-called `smart drugs' in education (9 January 2013). The idea for a debate on the ethics and fundamental questions surrounding the use of `cognitive enhancing' pharmaceuticals was based in the approach to doping that was developed in `Outliers, Freaks and Cheats: Constituting Normality in the Age of Enhancement' [R3 above]. The aim of the `Should Students Take Smart Drugs?' debate was to involve stakeholders in the debate over the use of `cognitive enhancement' drugs in education, including those who are responsible or will be responsible for designing and implementing secondary school and university policy concerning the use of cognitive enhancing pharmaceuticals in education. The event attracted considerable media attention leading to interviews with Meacham in the following media outlets: BBC Bristol Morning News, Heart Radio evening news, Jack FM evening news, and BBC Gloucestershire morning news. The event was also discussed on the BBC web pages [S5]. As a result of the debate, the UWE student newspaper The Western Eye called for the university to develop a `smart drugs policy' [S6].

Stakeholder Feedback from the debate included the following comments [S7]:

• The event definitely provided me with an expanded view point on the issue, and made me aware of new perspectives. Given that info, I would absolutely be interested in a future public event similar to this one. Overall I think it was a success!
• It made me question the efficacy of SMART drugs and whether there was any proven evidence of their effectiveness. The discussions around the topic also gave me an insight to other disadvantages of these drugs which I hadn't considered before
• I came to the event with misgivings (about use of `Smart Drugs') that I was quite willing to have dispelled, as I wasn't entirely sure they weren't based on ignorance, and I would be very interested in a bit of cognitive enhancement. But I was interested to hear that many on the panel, and a pharmacologist in the audience, also had informed doubts and objections. There are still so many questions and risks involved.
• (The) evidence of efficacy or lack of (was) interesting [from a neuropsychologist's point of view]

The smart drugs debate was complemented by three general audience pieces written by Meacham in OpenDemocracy [S8], Huffington Post [S9], and The Philosophers' Magazine [S10]. All of these pieces present for a lay audience and are based upon positions developed in the underpinning research. Comments from these contributions have included:

• This article evinces the sort of careful consideration which has gone sorely lacking in the coverage of the Armstrong debacle. Dr. Meacham asks tough questions, and advances some uncomfortable conclusions regarding where the line in the ever shifting sands of what is considered legitimate enhancement are to be drawn; if anywhere.
• Interesting article — I totally agree with the author's rejection of the moral case against doping. It is entirely hypocritical because it's basis is the wish to provide a "level playing field" in sport that is wholly absent in matters of political economy. If free market ideology were true then the playing field ought to level itself (which it sort of would by the free purchase of anabolic steroids....)

Meacham's work on the nature of health and impairment and the ethics of enhancement have had an impact on a broad range of stakeholders including trade unions, students, designers, and psychologists. The public events and interventions in the media have helped to mould and inform the public debate around these issues, and they have challenged established norms.

Sources to corroborate the impact

S1. http://assets.usw.org/News/Economy/Manufacturing_tool_kit/lte_stack.pdf

S2. Email correspondence with attendees of public debate `Experiencing Disability: The right to be impaired vs. the legacy of eugenics', held at the Watershed Media Centre in Bristol (available from UWE, Bristol).

S3. Podcast of `Festival of Ideas' / mircophilosophy@foyles public event with Professor Steve Fuller is available at http://www.microphilosophy.net/?p=265

S4. Email correspondence with event attender corroborating use of podcast of Toomb's talk in nursing education — available from UWE, Bristol

S5. BBC coverage of debate on `Should Students Take Smart Drugs?'
http://www.bbc.co.uk/news/uk-england-bristol-20910906

S6. http://www.westerneye.net/news/2013/02/should-students-take-smart-drugs/

S7. Feedback from `Should Students Take Smart Drugs?' debate, gathered following event — available from UWE, Bristol.

S8. `Lessons from Lance — Moralities of the human cyborg'
http://www.opendemocracy.net/ourkingdom/darian-meacham/lessons-from-lance-moralities-of-human-cyborg

S9. `What we can still Learn from Lance Armstrong' http://www.huffingtonpost.co.uk/darian-meacham/lance-armstrong-cycling-doping_b_2063331.html;`Getting Clever About Smart Drugs: A Few Remarks for Students, Parents and educators' http://www.huffingtonpost.co.uk/darian-meacham/smart-drugs_b_3667862.html

S10. `Should Students Take Smart Drugs' The Philosophers Magazine 62
http://www.pdcnet.org/tpm/content/tpm_2013_0062_0085_0091