Humans have always been fighting, with all the means at their disposal, against disease, pain, and unhappiness, fighting to increase their quality of life. There have been many facts, fictions, and controversies around the enhancement of brain functions in the last 15 years. Ever since the debate started new definitions of enhancement have been proffered, often diverging from each other and leading to debates on a wide field of ethical and social matters (Parens, 1998; Farah et al., 2004; Levy, 2007; Greely et al., 2008; Schermer et al., 2009; Nagel, 2010b). Enhancement interventions come in many varieties: there are manifold methods, goals, motivations, desires, ideals, and values that can invoke heated discussions. Moral deliberation reaches from statements such as those put forward in the President's Council on Bioethics report Beyond Therapy (2003) with an anti-enhancement agenda mainly based on arguments around the concepts of naturalness and dignity, to arguments for the moral obligation to enhance (Harris, 2005; Savulescu, 2005)¹. This wide variety in moral evaluations partly seems to be based on different understandings of the very term. Although “enhancement” is a notoriously vague term, a general consensus of what is meant is often implicitly assumed.

Here, I will attempt to further a particular understanding of the concept that shall serve to improve mutual understanding of the different positions. Furthermore, I suggest distinguishing what enhancement is and how it is motivated from how its usage is ethically evaluated. Julian Savulescu and colleagues distinguish various ways of conceptualizing enhancement and propose a “welfarist definition of human enhancement: Any change in the biology or psychology of a person which increases the chances of leading a good life in the relevant set of circumstances. (….) It singles out well-being as one dimension of value that is constitutive of genuine human enhancement.” (Savulescu et al., 2011, 7). Brian Earp and colleagues contrast this welfarist approach with the “augmentative functionalist approach” to show how diminishment can be enhancement (Earp et al., 2014). John Harris elaborates on how enhancement is about making us better people: “Enhancements will be enhancements properly so-called if they make us better at doing some of the things we want to do, better at experiencing the world through all of our senses, better at assimilating and processing what we experience, better at remembering and understanding things, stronger, more competent, more of everything we want to be (…) In terms of human functioning, an enhancement is by definition an improvement on what went before. If it wasn't good for you, it wouldn't be enhancement.” (Harris, 2007, 2ff). Enhancement is understood as generally being for the better of people. If it was not for an improvement for the better of an individual we would not call it enhancement. In fact, it is a tautology to say “enhancement for the better” as enhancement implies that it improves a given state, a performance, a capacity, an appearance, but also an experience, a feeling and, importantly: one's evaluations thereof.

A popular slogan about enhancement is that it makes people “better than well” (Elliott, 2003). Back in 1998, Erik Parens asked: “is better always good?” The problem actually is what “the better” really is in the plethora of possible cases of individuals in their unique socio-cultural contexts. How to evaluate what is better for a person, for his or her surrounding, or for the wider social context is a central matter for the normative discussion about it (Nagel, 2010b; Racine, 2010; Glannon, 2011). Hence, it is useful to inquire about the purpose of the particular enhancement intervention. Enhancements are usually not driven by the motivation to have merely more of some capacity, but rather by the desire to change for the better². Restricting the concept of enhancement to the addition of capacities or augmentation of function (Bostrom, 2009) does not do justice to the rich variety of forms which enhancement can take, and underestimates the plethora of motivations of people striving for enhancement. The goal of enhancement is improvement. One can argue whether one understands it as improvement beyond the normal, or improvement beyond the natural (Sabin and Daniels, 1994; Daniels, 2000; Buchanan, 2008, 2011)—both understandings lead to their own complex debates, and the concepts themselves require more scrutiny than this article can offer. Each view comes with its problems, and the consequent moral evaluations differ depending on what people feel most committed to (Parens, 2005). First and foremost, the goal of enhancement is about what people strive for most: “How to gain, how to keep, how to recover happiness” as William James put it in 1902. However, while interventions may indeed be motivated by the desire to increase flourishing, it is far from clear that the interventions indeed yield this increase in well-being. This view does not imply a normative evaluation of the enhancement intervention in a particular case. John Harris states that “enhancements per se are not ethically problematic: they are unequivocally good, clearly ethical. Unless the downside can be demonstrated and is significant, enhancement has the moral high ground” (Harris, 2005). While one might agree that enhancement per se always aims for something good, i.e., well-being, the evaluation of an enhancement varies between individuals depending on their situation. The moral evaluation of the intervention in specific cases does not depend solely on the desired goal of the intervention.

The following examples should help clarify the general notion of enhancement as meaning “enhancement for the better,” and demonstrate how this still leads to complex moral challenges.

Various situations of enhancement can lead to more flourishing. However, this does not foreclose ethical discussions. Ethical dilemmas emerge even if the goal of the intervention is increased well-being. I agree with Erik Parens who notes that “some (…) think the term enhancement is so freighted with erroneous assumptions and so ripe for abuse that we ought not even to use it. My sense is that if we didn't use enhancement, we would end up with another term with similar problems” (Parens, 1998, 2). Clearly, there is still work to be done to clarify what we mean with enhancement. Future deliberation should include two issues that have not yet been considered sufficiently in current debates: (1) Studying the nature of well-being, and how it can be increased (Parfit, 1984; Kagan, 1992; Nussbaum and Sen, 1993; Scanlon, 1998), and (2) probing public attitudes on enhancement to allow regulation and political decision-making to be nuanced and sound (Nadler and Reiner, 2010; Fitz et al., 2013). While working on this, it is worthwhile to avoid clamoring for a binary position either “for” or “against” enhancement in general, and instead foster sensitive discussions about the concerns and idiosyncrasies of each different case.