Is there a right to beauty ? Life as an aesthetical project
Joseph Schmucker-von Koch,
University of Regensburg
(Opening lecture given on
organized by the President of the
German Association of Aesthetical-Plastic Surgery, Dr. Neuhann-Lorenz,
I.
Dear colleagues,
Ladies and Gentlemen,
I would like to begin my lecture with a very personal experience which results from more than 25 years
of activity in the field of ethical assessment of biomedical research and developments.
This kind of activity did not only deal with basic ethical principles and their
relevance for scientific developments. As a bioethicist
who is involved in review and consulting activities on a national level as well
as within the framework of the European Commission´s
scientific programs one has also to deal
with the hard facts of current
developments within medical science and research and has to analyze whether they are in accordance with certain sets of established ethical and legal regulations.(1) This, of course,
takes place in close cooperation with the other committee members who are
colleagues from the medical and life sciences and analyze also whether a
project or study or parts of it are
“state of the art” or not.
It was within this context of highly innovative developments in the life
sciences that I often had to ask myself whether the set of norms and values many refer to in
public debate is still sufficient and flexible enough to adequately assess the huge
potential and impact of the various dimensions of this process.
The developments within the general framework of the life sciences will
have a tremendous impact on the further development of aesthetical-plastic
surgery the dimensions of which we are just beginning to realize. Wayne Morrison,
the winner of the Dieffenbach medal 2002, entitled
his lecture in Heidelberg on the occasion of this award “Expanding the horizon of plastic surgery –
from microsurgery to tissue engineering”(2). Thus he pointed already to one of
the many dimensions which aesthetical-plastic surgery will realize in order to
promote its most valuable task: the beauty of human beings.
Concerning the possible expansion of the horizon of plastic surgery
including aesthetical-plastic surgery I would like to make a few comments
from a philosophical point of view and will discuss a few ideas and scenarios which
can of course not be more than a tour d´ horizon since we are still proceeding
on virgin soil - slowly but steadily so to speak.
II.
Referring to the title of today´s lecture and
its subtitle I would like to propose the
following thesis: Just as ethics over thousands of years of human history tried
to form the inner man while life was conceived of primarily (especially in the
fundamentally religious epochs) as an ethical project, so we will now be able
–within the context of the developing scientific revolutions- to consider life as an aesthetical project,
i.e. form man anew and optimize him on the basis of the material elements of
his nature. We for the first time in human history will be able to live life as
an aesthetical project.
Within this frame of reference for the first time in human history
something like a right to beauty could be constituted. Aesthetical-plastic
surgery will be an important part in this overall revolutionary process.
This perspective, of course, seems quite unusual at the first glimpse and it will
remain so until we haven´t described the horizon of
this process more properly within which life is beginning to establish itself
as an aesthetical project.
Today mankind is experiencing
a scientific and technological revolution which deeply affects our
understanding of man and the world he lives in. This process can only be
compared to the fundamental change in historic epochs which radically changed man´s understanding of himself and the surrounding nature
in general (for instance from medieval man to modern man). The coordinates of
this progressing change the dimensions of which we were able to have a first
look at through the worldwide debate on human embryonic stem cell research and
cloning, are constituted by the rapid
development of three innovation
processes, namely the mutual influence and synergies of information technology, biotechnology and
nanotechnology. The elements of living matter as well as those of non-living
matter are more and more placed at our disposal and can be interconnected in
ways never experienced before. I am not only thinking here of neurotechnological systems or interface technologies for
biotechnical systems. Nanotechnology based analysis in the field of
pharmacological and chemical synthesis as well as characterization of various medical
substances, the element specific analysis of the local influence of a medical
substance as well as procedures to reach a more exact dosing and better local
targeting of a
substance for instance in a patient´s tumour will be
the basis for further therapeutic progress.
Within this nanotechnological context there will be
available in a foreseeable future synthetic biohybrid
organs, repair machines and alert systems which act in the human body and will
stop or eliminate pathological processes
resp. processes that deviate from a programmed norm status.
These systems may also –via specific signal structures- send information to a
surgeon who will then
take the necessary measures. The reaction of biological cells to
variable nanotopographies may also be used for self
organisation in bio-layers. Cells, as we know, react just like the tips of an
Atomic Force Microscope. When they get close to surfaces, they test whether the
docking station is of the right sort for them. If you produce defined structures and attach the
right cells for the proliferation of certain functions to these surfaces, cells
can for instance be installed in defined lines which is important for producing
artificial skin for instance.(3)
These examples should show the wide range of perspectives plastic
surgery as well as aesthetical-plastic surgery will be part of in the context of the mutual influence and synergies of
nanotechnology, biotechnology and information technology. I would like to state
very clearly here that there are no limits in sight for this endeavour, or I
should better say: only limits that we will overcome step by step in the
future as science always did since its beginning in the 17th
century. Just to give you another example. If I , as a philosopher, would have
told somebody 30 years ago that we should start thinking about the ethical
implications of cloning human embryos I
would have been attributed a lively phantasy or in a
more friendly way some kind of influence
of science fiction literature would have been stated. But what would have been attributed
to the realm of phantasy 30 years ago has now become hard facts of the
concrete scientific progress and one of
the most important topics of the international scientific and public debate ! I
would like to conclude that aesthetical-plastic surgery is continuously “expanding
its horizon”(Wayne Morrison) due to revolutionary scientific and technological developments
which continuously expand the whole range of possible applications. From new
biomaterials based on nanotechnological inventions to
the complex initiating and steering of anti-aging-bioprocesses there will be in
this context of synergies of biotechnology, nanotechnology and information
technology a whole new range of applications which will allow for the beauty of
a human being in toto
to be envisaged as an object of concrete technological measures. Why should we
be afraid of this ? For the first time in human
history our physical appearance will not be a matter of fate anymore which we
have to accept and
which perhaps can be optimized with cosmetic measures. It can now be optimized
beginning with its structural elements.
A new kind of freedom, the freedom to beauty is on the horizon, the freedom to have
the physical appearance an individual wishes to have.
Accompanied by intensive communication between patient and doctor
including psychological consultation the new work, or rather art of freedom can
be performed which is the achievement of beauty in accordance with the freely
declared and informed will of the patient. It is only within this context where
the up to now limited potential of anti-aging strategies will have become a
common medical practice, that a self-evident demand for a then self-evident medical practice can establish
itself. Only within this context where on the horizon of the mutual influence
and synergies of bio-, nano- and information
technologies a plethora of various resources is available to realize life as an
aesthetical project, for the first time
in history the concept of a right to beauty can be outlined on a reasonable
basis. Rights originate from sociocultural contexts,
and they can change with the change of these contexts or even disappear as
these contexts disappear. In medical contexts rights have very much to do with
the common availability
of a treatment and the resources necessary for it. The new
scientific-technological revolution will create a plethora of resources
hitherto unknown which aesthetical-plastic surgery can make use of. Today, in
this phase of transgression and new developments we still have to literally
reckon with limited
resources and limited possibilities.
Therefore, under present circumstances, the concept of a right to beauty appears to be something phantastic
and far from any availability ever. The promise contained in this concept seems
to be locked up for us and a matter of unrealistic hopes. But when there are
biomaterials available that can reproduce themselves ( we
have already started with that ), inexhaustible resources of vitalisation
things look quite different. Who then will not want to delay for as long as
possible the several forms of infirmity connected with old age
? Who then will not want to have fitness and physical beauty at one´s disposal for as long as possible ?
Who will not want to enjoy one´s vitality to the fullest ? This then has nothing to do with a pathological
illusion of juvenileness or a psychological inability to accept getting older.
Why should we accept constraints and restrictions which we had to accept up to now if there
is no necessity anymore to accept them ? It will be as difficult for anyone to give a rationale
for such restrictions just as it would be for a short-sighted person that is unable
to read , but constantly refuses to wear glasses or contact lenses in order to
eliminate this deficiency. Where is it written in the book of life that there
is anything in our physical appearance that we have to accept just as it is ? There were times in human history where most of the
features of human life had to
be accepted because it was not possible to influence or change them. Most of
human history is characterized by such a necessity. Those times have made it
their business to morally over- interpret the scarcity of resources with twisty
arguments and such make a virtue of necessity: the virtue of humbly and submissively accepting what could not be
changed anyway.
This kind of
unworthy humility will be a thing of the past – if the nanotechnological, biotechnological and IT (information
technology) transformation of reality can go forward unimpeded.
What is called “augmented reality” in the realm of IT optimisation of
real object perception , i.e. the integration of real
object perception und virtual reality which reaches out into
interface-techniques of bio-technical systems, can beyond this specific application
be conceived of as the key concept and program for human nature in general.
From the present scientific and technological developments we can conclude that
humankind is on its way to “augmented reality”. Human nature is deficient and
not perfect. And which serious argument could be brought up against the
endeavour to eliminate such deficiencies wherever we can do so with the help of
scientific and technological innovations ? I would
like to recommend here a 400 page document containing the report on a workshop
organized by the U.S. National Science Foundation in December 2001. US
technology experts from the government, from science and the industry were discussing the potential of
innovations which is to be expected from the mutual influence and the synergies
of nanotechnology, biotechnology,
information technology and cognitive science. The report is entitled:
“Converging technologies for improving human performance. Nanotechnology,
biotechnology, information technology and cognitive science”.(4)
There you also find a discussion about nanoinformational
biofeedback-mechanisms which can produce
small, highly specific biological changes in the human body.
A broad public debate on all of these perspectives of paramount
importance is still a desideratum. And there is a danger that things are going
the same way again as they went concerning the discussion on human stem cell
research or cloning. First many cannot imagine such possibilities, they deny
–among those even scientist- that something like that
could ever happen, and all of a sudden the results are there and become hard
facts of science. Then people don´t know how to
integrate the whole development into their own every
day concept of life. The consequence is that out of complete surprise and fear massive
restrictive measures are declared due to
the pressure exerted by a shocked public – restrictions that due to the rapid progress of science are
already outdated when they are imposed.
The process of interconnection of biotechnology, nanotechnology and
information technology will allow an optimization of the human body which can
now start with the elementary material structures. We are still at the
beginning, and therefore this perspective also sounds quite unusual and for
many hard to grasp. And, of course, there will be setbacks in the course of
these developments, suffering that cannot be foreseen and which biomedical
progress cannot exclude a priori. I
only remind here of the first bone marrow transplantations performed with great
hope in children suffering from leukemia. But some
children died and so
quite a few scientists and an alerted public demanded at that time that these
experiments should be stopped since they would have no ethical justification
anymore. Today bone marrow transplantation is a favourite therapy option for
children suffering from leukemia, and the responder
rate is quite significant.
III.
There is a rising willingness among the general public, especially
among young people, to optimize the
physical appearance of the body. We have some very informative statistics in
According to a poll by the Allensbach research
institute one year before the FORSA poll the self-assuredness of 72 percent of
the female population and also of 44 percent of the male population depends on whether they feel they were looking
good.
An estimated 300 000 – 800 000 times a year measures by
aesthetical-plastic surgery are taken in
The surgeon in this context is both: scientist as well as artist. The
beauty of the patient is his work and he reaches this goal when the new features , the change he performed in human nature look like
being “natural”. The “natural look”, an appearance that reflects the
individuality of the patient and makes him look like he would always have been
looking that good, is the visible sign of the surgeon´s
success.
Interdisciplinary research of engineers, cell scientists, biologists,
chemists, scientists in the field of materials research and clinical
professionals will open up hitherto undreamed-of possibilities. Let me explain
this in a more philosophical and abstract way: The border lines, caused by our
imperfect knowledge and abilities, between our imperfect reality and the
perfection which we up to now can only admire outside ourselves with deep aspiration in the great works of art,
are beginning to fade at the same pace our scientific knowledge and abilities broaden extensively. Imperfection in
controlling and shaping the human and non-human nature will gradually cease.
Speaking symbolically: More and more we are being handed over into our own hands. Medical thinking
and practice which meets the
requirements of a more than 2500 year old ethical tradition, namely to foster
health and to alleviate pain and suffering, will guarantee that these are good
hands which are taking care of us. They will be able, on the basis of the
ongoing scientific and technological progress, to perform with us what in the
previous history of mankind we only could admire outside ourselves with deep aspiration in the great works of art.
Let me cut a long story short and say it in a more provocative way: the lively
human being as a lively work of art is getting closer to the realm of possibility.
With each aesthetical-plastic restitution of a hand the fingers of which
were cut off by an accident, with each aesthetical-plastic harmonization of a
deformed face, with each successful facelift we already can see this work of art become
reality.
Though in single cases such practice will find global acceptance the general process of scientific and
technological developments in this field will demand some reasonable
corrections of some patterns of self
understanding and everyday orientation. Traditional patterns of
self understanding which humankind got used to over thousands of years will have to be
relativized if not abolished in certain cases in
favour of a growing freedom of
creatively modelling the material processes of man´s
nature. We are witnessing a breathtaking development that unveils to us with
every scientific success more and more of man´ s ability to model the basic
processes of life even up to the human spirit (brain research). Yet there is
still a big step to be taken by humankind to adjust to these developments,
perhaps at times in contrast to its rich spiritual tradition which up to now
formed the main frame of reference for self orientiation.
On the occasion of the 50 th anniversary of the
discovery of the DNS double-helix-structure by Crick and Watson Christian Schwaegerl
of the “Frankfurter Allgemeine Zeitung”(
However, in spite of the great advantages of the ongoing scientific and
technological progress we should not loose out of sight what Johann Wolfgang
von Goethe had been a prominent example of
and what he said in a conversation with Eckermann
on March 11, 1828 about the characteristics of a man of genius: “If entelechia (an
inner tendency) is strong enough as we find in men of genius it will not only
have through its vitalizing potential a strengthening and sublimating impact on
the organisation of the body but will also try continuously to assert its
privilege of eternal youth due to its spiritual superiority. Hence we find in very
talented persons even in old age still fresh epochs of great productivity; it
seems like they time and again would experience a temporary rejuvenescence.”(5)
The growing scientific and technological abilities which allow us to contribute to visible
beauty of a human being, must be complemented –and that´s
what we can learn from Goethe here- by an endeavour from within, by a strong
will to model the inner self, a continuous fostering of positive attitudes and
values, a positive and creative way of thinking that allows us to experience
life as something beautiful and act accordingly for our fellow citizens. They will in turn
experience our existence as a positive contribution to their lives which can
give them the feeling -so important nowadays- that life is beautiful in itself.
----------------------------------
1) see “Basic Bioethical Guidelines” on my
homepage: http://www.schmucker-von-koch.de
2) see program of the German
“Vereinigung der Deutschen Plastischen
Chirurgen/ Vereinigung der
Deutschen Aesthetisch-Plastischen Chirurgen (September 18-
21, 2002, Heidelberg. URL: http://www.vdpc-2002.de/Programm-vdpc-2002.pdf)
(3)vgl. Robert F. Service:
Biotechnology: Designer Tissues Take Hold. In: Science (1995) (vol.270,
13.10.95), 230ff; a
continuously updated survey of current
research and developments can be found
on the website of the „Materials Research Society“: http://www.mrs.org. There you also
find the MRS-Bulletin.
Quite helpful: the website of the National Science Foundation: http://www.nsf.gov. Concerning nanotechnological
developments and their ethical implications see: Anisa Mnyusiwalla, Abdallah
S. Daar, Peter A. Singer:
‘Mind the gap’: Science and Ethics in Nanotechnology. In: Nanotechnology
14 (March 2003) R9–R13 (http://www.iop.org/EJ/S/UNREG/journal/0957-4484)
(4) see http://www.wtec.org/ConvergingTechnologies/Report/nbic-complete-screen.pdf.
The respective homepage can be found under the URL: http://www.wtec.org/ConvergingTechnologies/
(5) Johann Peter Eckermann: Gespraeche mit Goethe in den letzten Jahren seines Lebens (Conversation with Goethe during the last years of
his life), 11. Maerz 1828. The
text has been published as part of the Gutenberg-project under the URL
http://gutenberg.spiegel.de/eckerman/gesprche/gsp3069.htm
Address:
Prof.Dr.Dr.Joseph
Schmucker-von Koch
University of Regensburg
Institute of Philosophy
Universitaetsstrasse 31
D-93040 Regensburg