Under the influence of scientific and technological developments, the theme of ‘engineering peo- ple’ is receiving increasing attention. The health care system also, to an increasing degree, has to deal with the possibilities provided by the biomedical sciences for perfecting healthy people in accordance with their own preferences. In medical ethics, this theme is known as ‘enhance- ment’: the use of genetic, biomedical or pharmacological knowledge to make improvements in human characteristics. This enhancement can involve people’s appearance, performance or per- sonality. At present, the best-known forms of enhancement are found in cosmetic surgery and, more covertly, in the use of anabolic steroids in sports. However, there is an impression that conventional medicines (for example Prozac, Ritalin and Viagra) are also being used more and more often for non-medical purposes. Furthermore, during the next decade, new substances and methods for engineering healthy people will probably emerge in a rapid tempo. They vary from cosmetic gene therapy and a new generation of anxiety inhibitors and mood modulators, to psy- chotropic medication that boosts cognitive abilities (concentration, memory) and a drug that would allow women to optimise their sexual functioning. Billions are being invested in develop- In our society, all adult and competent individuals are themselves responsible for the use of enhancers, at least in so far as they cause no harm to others. In principle, the government should adopt a neutral position towards ideas about personal well being which are at the root of this use of enhancers. It does, however, have a major responsibility to ensure that adequate information is provided, to protect minors and legally incompetent individuals, to safeguard quality, to protect public goods in so far as the use of enhancers constitutes a threat to them, to monitor access to enhancement and to encourage a public discussion. This should cover the conditions for the inclusion of enhancement in the responsibilities assigned to doctors. In any case, it is clear that this question will not be answered on conceptual grounds (for example on the basis of a concept of disease). The question is normative in nature and moral considerations Ethics and Health Monitoring Report 2003 _ Health Council of the Netherlands
  • Health Council of the Netherlands
  • The Centre for Ethics and Health (Dutch abbreviation CEG) is a joint venture of the Health Council (Gezondheidsraad) and the Cou.
  • The CEG’s annual ‘Ethics and Health Monitoring Report’ (in Dutch) provides a compilation of these alerts. In May 2003, the first.
  • Via its website the CEG also functions as a source of information on ethical issues in the field of (public) health.
  • This report has been drawn up by the Health Council’s Standing Committee on Medical Ethics and Health Law (see Appendix 1 for composition).
  • Author: Alex Bood, scientific secretary of the Standing Committee on Medical Ethics and Health Law.
  • Preferred citation: Health Council of the Netherlands. Human enhancement (Ethics and Health Monitoring Report 2003 no. 4). The Hague: Health Council of the Netherlands, 2003. Publication no. 2003/08-04E. ISBN: 90-5549-585-9.
  • This publication can be downloaded from
  • 3.3 Individual responsibility and autonomy
  • 3.4 Minors and mentally incapacitated individuals
  • 4.2 Ensuring that adequate information is provided
  • 4.3 Protecting minors and mentally incapable individuals
  • 4.6 Monitoring access to enhancement
  • 5 Conclusions and recommendations
  • Standing Committee on Medical Ethics and Health Law
  • (Beraadsgroep Gezondheidsethiek en Gezondheidsrecht)
  • prof. JA Knottnerus, president of the Health Council of the Netherlands; Health Council, The Hague, president
  • prof. JKM Gevers, professor of health law; Academic Medical Centre, University of Amsterdam, vice-president
  • prof. ID de Beaufort, professor of medical ethics; Erasmus University Medical Centre, Rotterdam
  • dr GCML Christiaens, gynaecologist; University Hospital, Utrecht
  • prof. RPTM Grol, professor of quality of care; University Medical Centre St Radboud, Nijmegen
  • prof. JCJM de Haes, professor of medical psychology; Academic Medical Centre, University of Amsterdam
  • prof. GA den Hartogh, professor of ethics; University of Amsterdam
  • prof. HAMJ ten Have, professor of medical ethics; University Medical Centre St Radboud, Nijmegen
  • dr AC Hendriks, health lawyer; Dutch Equal Treatment Commission, Utrecht
  • dr WLM Kramer, pediatric surgeon and traumatologist; Wilhelmina Childrens’ Hospital, University Medical Centre, Utrecht
  • prof. FE van Leeuwen, professor of epidemiology; Netherlands Cancer Institute, Amsterdam
  • dr M van Leeuwen, executive director of the Health Council of the Netherlands, adviser
  • dr J Legemaate, health lawyer; Royal Dutch Medical Association (KNMG), Utrecht
  • prof. HDC Roscam Abbing, professor of health law; Utrecht University
  • prof. M de Visser, vice-president of the Health Council of the Netherlands; Health Council, The Hague
  • prof. GMWR de Wert, professor of biomedical ethics; Institute of Health Ethics, Maastricht University
  • prof. DL Willems, professor of medical ethics; Academic Medical Centre, University of Amsterdam
  • A Bood; Health Council of the Netherlands, The Hague, scientific secretary
  • dr WJ Dondorp; Health Council of the Netherlands, The Hague, scientific secretary
  • Source:


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