Our Future

Humanity must decide how best to use the astonishing power we are gaining—through major advances in such fields as genetic engineering, cloning, medicine, robotics and neuroscience—potentially to re-engineer our very existence. In many ways we are being called to rethink what it is to be human [11]. Just how far should we go in modifying ourselves, and our children, in the quest for intelligence, health, beauty, strength and entrepreneurial ability? Many people reach the conclusion that if we allow cosmetic surgery than some types of genetic enhancement without medical reason may also be ethical.

There are a great variety of views about the prospects of changing humanity, and the associated attitudes to the use of science and technology to enable this [23]. Although there has been a generally negative attitude towards genetic enhancement expressed in academic literature in Europe, there are academics who, as discussed in other papers in this issue of the journal, assume varying perspectives. However, the practices that shape medical advancement and cosmetic fads are determined more by the views of consumers as shaped by industrial marketing. This paper explores how positive attitudes to use of science and technology and enhancement in Asia might be assessed ethically.

Attitudes to Enhancement

The public in Asia has a relatively high level of interest in science, and a high level of awareness of specific developments of science and technology [16, 20]. The International Bioethics Survey conducted in 1993 in ten countries in Asia and the Pacific [16, 17] found positive views towards genetic enhancement in China, India and Thailand, with less approval in the Philippines, Singapore, and a majority rejection of this in Japan, Australia and New Zealand. Less than 10 % in all countries in the International Bioethics Survey saw science and technology as doing more harm than good. Overall, most people in industrialised countries around the world perceive more benefit than harm from science. Most people also believe that improved quality of life depends on scientific knowledge.

When asked about specific developments of technology, including in vitro fertilisation, computers, pesticides, nuclear power, biotechnology and genetic engineering, both benefits and risks were cited by many respondents. People show the ability to balance benefits and risks of science and technology [16]. Technology that touches life is perceived to be as worthwhile as technology which does not directly affect living organisms, but people may perceive more risks from technology that directly affects living organisms than from those physical science developments which do not. This is similar internationally, with genetic engineering evoking mixed emotions of benefit and risk. People do not have a simplistic view of science and technology, and can often perceive both benefits and risks. This balancing of good and harm is necessary for bioethics, and is one indicator of the bioethical maturity of a society.

Eugenic ideas found both positive support in some countries, for example for improving genes by genetic screening, with less negative reaction, for example a few people cited social eugenics programs, or many being against gene therapy for enhancement. The questions regarding genetic screening and gene therapy suggest positive support for eugenics among a significant portion of the population, especially in China [15], as well as India and Thailand [16]. Subsequent research has also supported this conclusion that there is significant support for enhancement in the most populous countries in the world, China and India.

Germ-line enhancement is also supported by many persons in these surveys. The acceptance of eugenic arguments linked to use of genetic screening is widespread in interviews conducted in China [26]. The Chinese concept of “Yousheng” (healthy birth) is more appropriate than eugenics as an expression of Chinese social policy and public attitudes. The Chinese word “Yousheng” is similar to the Greek work eugenes meaning “good in birth”. It is consistent with Galton’s eugenics core doctrine of improving the stock of humankind by application of the science of human heredity. In this sense, the Chinese word “Yousheng” can be translated to eugenics.

The actual practices of use of sex selection of children supports this conclusion, with higher frequencies in China and India, and growing tendencies in Vietnam [19]. Despite laws to prohibit female feticide the practices continue in these countries, which raises questions on how laws can be implemented. It suggests that in the future there may also be difficulty to have effective laws.

Whitening creams are widely used in East and South East Asia, and it is difficult to find cosmetics that do not contain whitening agents. Even the dowry prices for ladies to marry is lower for fairer skins in India, and conversely fairer skin tones in Thailand can raise a higher price for the ladies (where men pay the dowry).

There have been studies of attitudes to dental orthodontics which suggest Asian patients are more willing to tolerate discomfort and pain from realignment of teeth than Caucasian patients [14]. Improvement in dento-facial aesthetics following orthodontic treatment enhances the self-confidence and self-esteem of a majority of patients. The same could be said for hair styling and fashion accessories.

There are some associations between particular psychological states and tendencies to undergo cosmetic surgery [27], such as greater psychological investment in physical appearance and greater internalisation of mass media images of physical beauty [25]. Swami et al. [27] found that less open and more emotionally closed individuals had a greater likelihood of accepting cosmetic surgery in order to maximise its self-oriented benefits. Such emotionally closed individuals may maintain more negative evaluations of their appearance, which leads to a greater acceptance of cosmetic surgery if it is able to enhance their appearance. This may because of lower self-confidence in themselves. It would be interesting however to see the relationship between being relaxed to talk about cosmetic enhancement, and actually doing it. In some communities it appears that people will be proud to talk about their cosmetic enhancement experiences, such as in USA, when compared to some other communities, such as Thailand or China.

How to Decide What is Ethical

There are a variety of approaches to deciding whether a practice is ethical or not. Are there indeed universal values which can be agreed upon across the many cultures of the world, and is there a universal language of making these values acceptable as well as applicable across the many communities? In the Western Abrahamic and post-Enlightenment worldviews, there is a strong belief that universal values can be realized through objective criteria. Contrastingly, the Indic systems believe that while universal values exist, they are not achievable, because human beings apply their own subjective experiences and emotions to their knowledge of values. Therefore, whereas the former ascribes a degree of objectivity as a prerequisite for legitimacy, the latter considers subjectivity as a major influencing factor specific to individuals, groups, cultures, etc. [24]. This world view will tolerate many individual choices as long as they do not do harm, and will also tolerate belief in attempting to improve ourselves.

Aristotle in Nicomachean Ethics wrote that morality is the pursuit of a “final good” or “supreme good”. This may be accepted widely, but the question is what this “good” is? The final good was often interpreted as happiness, which leads us to one of the main teleological theories, utilitarianism. Utilitarianism looks at the consequences of an action, and is based on the work of Jeremy Bentham (1748–1832) and John Stuart Mill (1806–1873). They could have been rediscovering what Mo Tzu had taught in China in the 6th century B.C. [18]. The benefit of the community over individual is a widespread ethic across Asian countries, as is the sacrifice of individuals for the greater good.

If a substantial majority of a community consider a practice to be ethical does it make it ethical? The principle of utility asserts that we ought always to produce the maximal balance of happiness/pleasure over pain, or good over harm, or positive value over disvalue. Initially utilitarians focused on the value of happiness, however other intrinsic values including friendship, knowledge, health, beauty, autonomy, achievement and success, understanding, enjoyment and deep personal relationships have been included [2]. Harmony is an important principle in Asian bioethics [18].

Examining the outcomes we have to ask whether enhancement actually will harm anyone? The attempts to modify the body will be treated with caution in many countries, however in Asia the main concern is physical safety. However, probable educational enhancement through intense suffering of many children is promoted across Asian educational systems. There is a need for broad social debate on the goals of a good and happy society. There is a need for all areas of society to be involved in the discussions of the future of enhancement, not just those in bioethics [5].

Most people appreciate good motives over bad ones, although the consequences may be the same. If we were trying to enhance our intelligence in order to solve problems that will help others, this would be considered ethical. This is also a justification for the pursuit of artificial intelligence (AI) systems that will have equal intelligence to the human mind after the point in time called the singularity, and will be expected to rapidly rise to intelligence beyond humans. Cyborgs using artificial implants for particular neurological traits that were exceeding human ability could enhance other aspects of the human brains although these might be less rapidly replicated in AI systems. We already enhance the ability of some persons with sensory deficiencies such as deafness or blindness with electronic technology, and laser treatment for myopia is becoming very popular.

Asian Religious Values

Asia is diverse, but we can take several example traditions to illustrate the types of views that inspire persons ethics. Heine and Hamamura [9] reviewed studies of self-enhancement psychologically and found that East Asians were significantly less likely to enhance their own image compared to Westerners, which means that East Asians have a lower self-image. This means that they may be drawn to cosmetic methods that will assist improved self-image. Despite the aesthetic and religious ideas to accept who they are, people will also work hard to improve themselves, morally and economically. There is increasing acceptance of cosmetics and cosmetic surgery, supplementing the strong drive for education.

In Theravada Buddhism the four prime virtues are mindfulness of friendliness (metta), compassion, joy and equanimity. In Buddhism in general the self-less love is the bodhisattva in Mahayana Buddhism. The bodhisattva, by virtue of his decision to decline the rewards of nirvana, “until the last blade of grass has been liberated” is revered in Buddhism as the infinite and inexhaustible reservoir of compassion (karuna). The bodhisattva could have passed himself into eternal bliss, but remains in the mortal while other beings are bound by the triple evils of greed, hatred, and delusionment. The six Perfections are giving, morality, patience, vigour, meditation and wisdom) and other virtues include friendliness, good will, loving kindness, benevolence and sympathetic joy. Benevolence and altruism have broader meanings, not being restricted to suffering. Enhancement of these traits in people will be viewed positively.

Many human activities are performed with a longer term perspective than just one or two generations in mind. In some societies parents may even disagree with their children seeking partners and try to dominate the life of a child so that the child dedicates their whole life to look after the parents without having children. Other parents however will take their children to cosmetic clinics with the intention of assisting them to conform to some sense of beauty, that may help them find a good mate. The genetically programmed behaviour for gene survival (which would desire children to reproduce as much as possible) is replaced by the individual desire of the parents for personal survival (by having the children devote their time to look after their parents), at the expense of gene survival. This is another sign that in some human beings behaviour is less controlled by evolutionary forces than love of our own life. These differences may however has some value as a society that we do not simply understand.

One factor that is often discussed that may lead to even greater selfishness is the reduction in family size, so that the proportion of one children family increases in society and children get used to receiving what they desire. Their objects of love may become material goods, toys, as well as affection and devotion from family who can focus upon the one child. Many children in the world are now deprived of nothing except perhaps the chance to be unselfish, and the joy of giving. The one child per family policy in China has been criticized when it was strictly being enforced for various reasons, although it has decreased population pressure on the planet. One of the reasons is that families are focusing all their parental love onto one child, with many claims that selfish children are the result.

Another consequence of modern society is the love of materials. However, this could be explained more readily as the tendency for pursuit of power, property, a feature found across most species, that is indirectly related to later gene survival by the accumulation of power that will support more mates. Love of money is not always that same as love of oneself, as it depends what the money will be used for. It may be to give to the extended family, though as will be discussed, where selfishness for one person and one family or community ends and love for others begins, is not clear. However, money is often used as a goal to inspire children to work harder, or for people to aspire to. In addition, many services are now available only through money, such as for education, water, land, medicine and so on. A good career in the image of parents is seldom one which does not pay well. The alternative is one which will make one happy, which is also centred on selfish goals, unless it focuses on the happiness of the other.

Dignity and Love

The term love is usually omitted from international law, whereas the concept of human dignity is often cited. Human dignity is arguably even more difficult to define than love. For example, in the Universal Declaration on the Human Genome and Human Rights (UNESCO, 11 Nov. 1997), Article 11 states, “Practices which are contrary to human dignity, such as reproductive cloning of human beings, shall not be permitted”. Why cloning is always against human dignity is not clear. For example, if it was the only way a family could have a genetically related child why is that against human dignity? Especially when using donated sperm and eggs or a surrogate mother is permitted in many countries, even for commercial contracts. Yet, at the time following the cloning of Dolly the sheep by nuclear transfer in February 1997, it became a popular call for many government leaders to say it was against human dignity.

Another expression of love of our own life that is dominant in medical ethics is the sanctity of life. This sanctity of life is also often imposed upon others on the behalf of the person who has their life threatened. The argument is also used by opponents of abortion, claiming the fetus also has a sanctity of life. Jewish Law gives overriding value and sanctity to human life, rejecting any Hippocratic, Christian or modern compromises [12]. The duty to preserve life is the dominant obligation, and this is reflected in their medical ethics, however preservation of fetal life was not reflected in the International Bioethics Survey results from Israel [16].

The Indian philosophy also includes the idea of to do no harm, ahimsa, as one guiding principle. Indian medical ethics today includes Hindu and Western influences, plus many folk traditions and other religious groups. India includes followers of many religions, and a long tradition of living together, and has a holistic environmental ethic [1]. In Jainism patience is regarded as a good and pleasure is a source of sin, so that true freedom is independence from outside things. Depending upon how removed we attempt to be from the material world, we might accept our fate without taking medicine. This reminds us of the Taoist urge to flow with nature [10]. However, there is a long tradition of use of curative and cosmetic remedies in Indian medicine, suggesting that like elsewhere, people seek to cure sickness and enhance their body and emotions.

Autonomy is also applied to many life choices that are bioethical dilemmas, for example personal transport in an automobile is associated with high environmental load. People are free to pursue sports that consume large amounts of energy, or to buy large cars or large homes that are beyond what is necessary for a comfortable life. Personal or cultural freedom in continuing to eat whale meat in Norway, Iceland or Japan is considered more important that concerns that whales might have sanctity of life because of intrinsic moral status. Whale baleen used to be widely used in woman’s corsets in the West, and today many endangered animals are used to make cosmetic products.

There are precedents for limiting autonomy in behaviour towards the environment. Personal taste in tropical timber products is one choice that has began to be limited by restrictions on tropical forest logging. Another limit is personal choice in use of ivory in statutes and personal name stamps in many countries due to the endangered status of elephants. Limiting personal choice of expensive choices that affect other beings may therefore be accepted. Human beings are one part of nature, closely interwoven with each species. Can we enhance all species to enhance human life as well? A challenge however, is that many cosmetic choices are not beyond the economic choices that societies let individuals pursue, and they do not directly harm others.

Indic cultural systems would be uncomfortable with a ‘universal’ set of values arrived at through a consensus of human reason or legitimised through divine revelation [24]. A pluralistic approach exists in most Eastern civilisations, including the Far East and China. It is understood that human society lives by a diverse set of values and philosophies, and universalism deprives some communities and people of their own value systems. Thus, Eastern traditions believe that the type of dogmatic absolute universalism often promoted by Western (and United Nations) legal ideologies is an infringement on a human being’s basic right to enjoy one’s own values and belief system. People should be able to exercise their choices if they do not harm others.

Confucianism has two interesting characteristics that set it apart from Abrahamic and Indic traditions. First, it does not dwell on God or other metaphysical theories. This leaves the individual free to believe in any ‘spiritual’ truth he or she may wish to follow, and enhancement is a common belief. Confucianism is a set of ethics on relationships between the individual and government, the individual and society, individual and family and the individual and friends. It describes how concepts such as compassion, honesty, justice, and work fit within these relationships. These sets of values and directions form the essential nature of Chinese society regardless of the ‘religion’ of the person. In fact, if religion is usually both about a metaphysical theory and human relations, then Confucianism can be said to be a religion which does not concern itself with metaphysical aspects.

Secondly, Confucianism emphasizes harmony among humans and between humans and nature. Confucianism does not proffer divine origins of harmony, but rather a set of values that are derived from reason and a spiritual awareness. Harmony influences the ethics of Confucians towards nature and society. In the future when differences between those who are enhanced and those who are not become significant, there will be some challenges to harmony for these reasons. Growing socioeconomic gaps however have been tolerated over time, so we can question whether people will really apply concepts of justice to the way people think.

Positive Attitudes to Gene Therapy

Macer et al. [21] found that about three quarters of all samples in the International Bioethics Survey supported personal use of gene therapy, with higher support for children’s use of gene therapy. Lo et al. [15] found similar results in China with the same questions. Indians and Chinese were the most supportive, and Thais the least for personal use, but when asked about use on children, Thai respondents were among the most willing [16, 21]. When compared to US results, we find a general tendency for Asians to be more accepting of gene therapy. The surveys did not find any significant differences dependent upon sex, age, education or religiosity. The major reasons given in open comments were to save life and increase the quality of life. Some respondents gave a reason like “improving genes”, which will be discussed below under “enhancement”. About 5–7 % rejected gene therapy considering it to be playing God, or unnatural. There was very little concern about eugenics (0.5–2 %). The most significant reason for disapproving of gene therapy was health risk, except in Thailand where more people gave a response that it was unnatural. About 10 % of Thai respondents gave “improving gene” reasons for using gene therapy.

There was extremely high support for use of gene therapy to cure disease, both as somatic cell therapy (for fatal, and late onset diseases) or inheritable therapy (for fatal, and non-fatal diseases); and high support for gene therapy approaches to an AIDS vaccine. There was lower support for enhancement uses (improving physical characters, intelligence, making people more ethical) than for treating disease, suggesting some discretion in what people judge to be ethically good. In India and Thailand more than 50 % of the 900+ total respondents in each country supported enhancement of physical characters, intelligence, or “making people more ethical”. There was no qualification of what to make people more ethical meant, and a few persons indicated they were aware of the complexity of setting standards for what might be psychologically considered to be a “good” person socially. It could suggest several things: that poor living standards and infectious disease make people more pragmatic about “improvement”. It is interesting if this is still a general trend in developing countries, as it could have significant implications for international policy.

Positive Attributes to be Enhanced?

One of the underlying philosophical ideas of society is to pursue progress. The most common justification for this is the pursuit of improved medicines and health, which is doing good. A failure to attempt to do good, is a form of doing harm, the sin of omission. This is the principle of beneficence. This is a powerful impetus for further research into ways of improving health and agriculture and living standards.

The principle of beneficence asserts an obligation to help others further their important and legitimate interests. It means that if you see someone drowning, providing you can swim, you have to try to help them by jumping in the water with them. If you cannot swim, you have to try to find another way to save them. If you could give everyone the ability to swim, just in case they fell into the water, or had to struggle to survive in the wake of a tsunami, it would seem to be basically ethical. When we consider the thousands of persons who lost their lives in the 2004 Indian ocean tsunami simply because they could not swim (not counting those who were killed by the force of the waves), it would have saved lives to simply give everyone the innate ability to be good swimmers and survive in water, rather than relying upon being taught.

Beauty

Beauty should be judged in the eyes of the beholder, and there are diverse views of who is beautiful. However, there are social pressures in many countries to conform to certain stereotypes of beauty [3]. People die due to the excesses of eating disorders, and these diseases are transmitted by stereotypes introduced in the Western media. In Fiji before Western television was portrayed there were reportedly no incidences of anorexia nervosa, but after the television these disorders arose.

Kung [13] described reasons for increased cosmetic surgery in East Asia, especially in Republic of Korea, Taiwan, Thailand and Japan, saying “double eyelid (blepharoplasty) and nose (rhinoplasty) surgeries has become akin to getting braces”. There is less social stigma attached to the cosmetic surgery in those Asian countries, so that many Asian-American girls undergo the surgery during their vacations in Asia. We can also see medical tourism linked to the lower prices for undergoing these treatments in some Asian countries, compared to Europe. One can expect enhancement tourism to expand in countries in South East Asia, such as Thailand, that are marketing to Arab and Western countries.

Physical Body Strength

Enhancement, for example of the immune system or for avoiding memory loss, could also be accepted in the spirit of current medicine. Already some enhancement is accepted, whether it be vaccination, vitamins, cosmetics, or cosmetic surgery. We also accept enhancement of other species to make better foods, and even to adapt our diet to our personal genetic traits (nutrigenomics). We will also expect improvement of digestive systems by gene therapy, for example, overcoming lactose intolerance.

Making smaller bodies with decreased environmental impact would be an example of enhancement for benefits of nature. It could also be reinforcing in cultures where body size is smaller. However, globally increased size is applauded and associated with increased chance of employment and income.

Intellect

The ethic of hard work and reward for studying hard is widespread in Asia. Many parents will send children to cram schools and force them to study very hard, and they are focused on the results of the examination systems. They will also spend a lot of money on education in private schools. However, cheating in exam systems is also found, as elsewhere in the world, although discouraged in public.

People teach their children that they must take care of themselves and strive to do the best in what they are doing. We are taught from an early age to work and study hard, because it will be better for us. Education at school and competition for places in higher education, and better employment, reinforces the idea that we should love ourselves. Respect for people’s love of themselves or of their family, and giving people freedom of self-determination, can be derived from the ethical principle of autonomy. The surveys towards use of gene therapy to improve intelligence [21] suggest that it will be supported. It is difficult to argue that improved intelligence is a harm again anyone.

Goodness

There is a strong belief that love and compassion constitute ideal ethical behaviour and a reflection of our true humanity. We need to be able to love to be fully human, and to enhance this would seem to be ethical [18]. It is another universal belief that it is better for one’s soul to be nice than nasty, to be loving rather than unkind. As the Dalai Lama [4] wrote, “There are various positive side-effects of enhancing one’s feeling of compassion. One of them is that the greater the force of your compassion, the greater your resilience in confronting hardships and your ability to transform them into more positive conditions”. Hare [8] wrote, “Those who do not love their fellow men are less successful in living happily among them”. There is a popular saying that it is better to give than to receive, reflecting the positive affect on ourselves of giving. Few, however, would call the art of giving selfishness, if the motive is love of others.

There is broad religious and moral support to have concern about our own flourishing and development, and in this view the moral evil may be inactivity or sloth rather than pride [22]. Laziness means that whatever potential we have is lost, and the potential to love the life we have been given, and to love others or God has been lost.

Welfare and Freedom of Expression

There are some inherent contradictions in the assumption that ethical values can be universal, illustrated here by two political principles, namely welfare and freedom of expression. As for the former, socialism holds that as the state takes over the meta-organisation of human beings, it is incumbent upon the state to ensure that the vulnerable are cared for with basic provisions, such as shelter, food and decent life opportunities. The capitalist model is, however, critical of this and believes that the welfare state leads to people becoming dependent upon state handouts, which in turn leads to lack of incentives to work, weakening the economy as a result. The capitalist system believes that private philanthropy and minimal state support, if any, should form the basis of any welfare system protecting the vulnerable [24].

These two positions on the role of the welfare state bring Articles 9 and 11 of the International Covenant on Economic, Social and Cultural Rights 16 into conflict with regard to interpretations and compliance. Article 9 states that “The states parties to the present covenant recognize the right of everyone to social security, including social insurance”. Additionally, Article 11 asserts that, “The States Parties to the present Covenant recognize the right of everyone to an adequate standard of living for himself and his family, including adequate food, clothing and housing, and to the continuous improvement of living conditions. The States Parties will take appropriate steps to ensure the realization of this right, recognizing to this effect the essential importance of international cooperation based on free consent”. While the socialist traditions consider a strong welfare state to be consistent with fulfilling these articles, the capitalist system sees such a position to be dangerous to a strong and vibrant economy. It would appear that while the articles are idealistic and communitarian, their universality is immediately brought into contest by compliance and interpretation—two different levels of commitment to the ideological systems. Socialism might limit enhancement but capitalism would embrace it within a market system.

The second political principle concerns the freedom of expression, which is reaffirmed in Article 19.2 of the International Covenant on Civil and Political Rights (The United Nations International Covenant on Civil and Political Rights, entered into force 23 March 1976, http://www.hrweb.org’/legal/cpr.html) The article asserts that “Everyone shall have the right to freedom of expression; this right shall include freedom to seek, receive and impart information and ideas of all kinds, regardless of frontiers, either orally, in writing or in print, in the form of art, or through any other media of his choice”. Freedom of action is considered a fundamental right in many secular political systems.

Would a Ban be Possible?

A universal ban on enhancement, including genetic intervention would not be supported by most Asian value systems who are opposed to both universal limitations on the decisions that people make, as well as being rather positive to opportunities to improve life that enhancement offers. As has been discussed for decades, attempts to ban human germ-line genetic change would need to be made international if they would be effective [17]. We can see examples with reproductive surrogacy that medical tourism is widespread to evade laws that prohibit it. Even if one country prohibited it (as some do) through intermarriages genetic changes would eventually be spread among every ethnic group and nation.

If genetic enhancement is feasible, it is likely that there will be demand for it because parents compete to produce able children and nations compete to accumulate human capital in skilled workers. If some parents or nations begin using genetic enhancement, this will change these competitions in ways that increase the incentives for others to use it. Therefore, a ban on genetic enhancement would be unstable, because once the ban was breached by defectors the motivation of others to uphold it would weaken, making the ban liable to collapse [7].

One of the basic applications of the principle of autonomy to bioethics is the idea of informed consent. There is debate over the definition of informed consent and its origin. Faden and Beauchamp [6] define three conditions necessary for informed consent: (1) a patient or subject must agree to an intervention based on an understanding of (usually disclosed) relevant information; (2) consent must not be controlled by influences that would engineer the outcome; (3) the consent must involve the intentional giving of permission for an intervention.

The same conditions apply to enhancement, and should be applied for cosmetic surgery along with important questions such as the necessity of the intervention, and the broader accumulated social impact of the growing practices. Is this the community we aim to become? Consideration of the accumulated social consequences of individual actions is an ethical principle that Asian communities easily relate to.

Conclusions

Maybe we can only become complete moral beings when we also love our own life, pursuing our capabilities, gifts and desires to achieve more of the potential that we have. Asians will also pursue their capabilities with assistance, be that wearing coloured contact lens, whitening creams, cosmetic surgery. I do not believe that international law to prohibit development of technology will protect society and individuals from making choices to enhance themselves. History has shown that people reject stringent laws or legalistic religions. Education of mature and tolerant citizens is a more effective and longer term solution.