“A practical, insightful guide to the moral and ethical standards of healthcare.
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Packed with helpful information, Medical Ethics For Dummies arms aspiring medical professionals with the philosophical and practical foundation for advancing in a field where critical ethical and moral decisions need to be rapidly and convincingly made.”
In “The Goodness of Fragility: On the Prospect of Genetic Technologies Aimed at the Enhancement of Human Capacities,” Erik Parens encourages us to think about enhancement. He exhorts us to be prudent as we contemplate the use of genetic technologies for the improvement of our own abilities. [1] He asks, “Will we, in some of our attempts to enhance humans, inadvertently impoverish them by reducing what I will call their fragility” (549). He attempts to “reflect upon what life would be like if we could significantly reduce the change and chance to which we – creatures whose forms are largely determined by the genetic hand dealt us by nature – have hitherto been subject” (549).
Before answering his question, he raises three important points. First, when he says that we are fragile creatures, he means that we are creature subject to change and chance. Next, he admits that even if we could reduce change and chance by enhancing ourselves, we would not get rid of all fragility. Last, he does not claim that genetic enhancement should never be used to improve humankind.
“Given the apparently enduring desire of humans to enhance their capacities, and given the likelihood that new genetic technologies will at some point enable us to enhance our capacities in significant and perhaps unprecedented ways, now is the time for society to begin thinking about how far it ought to go in this regard” (Parens, 549)
He then warns us about three desires we have as we contemplate using enhancing technologies: we desire to reduce change, we desire to reduce chance, we desire for paradise. Parens raises objections to these three desires. First, before we reduce chance, we need to consider what it might cost us. We might lose the beautiful experiences that change gives us. A plant, as Parens illustrates, is beautiful because it changes as we anticipate the blossoming and then remember its passing. Additionally, we might lose the relationships of care between people that are possible only if change exist. If, for example, everyone stays young, we will lose the relationships between the generations. Finally, we might lose diversity across life span. We might all look the same and act the same.
Second, Parens shows how chance is part of our world and its plays a crucial role. This echoes his earlier points as humans might all become similar if we reduce the chance to which humans are subject in the natural lottery.
Third, he explains that our view concerning enhancement is embedded in our conception of the relationship between humans and the natural world. He notes how those in favor of enhancement have a similar conception of the relationship between the world and humans as that of Francis Bacon. For Bacon, the mission of science was to repair the damage made by the Fall of Man and to restore humans to their original state of glory. However, as Parens states, they are alternative views, in which this relationship differs. For Bacon, nature is ours to master, but for others nature is not ours. Thus, a different perspective on the relationship between nature and humanity would lead to different ideas about how to use enhancing technologies.
He concludes that,
“It would be cruel, if not stupid, to suggest that we ought never to use genetic technology to heal the sick. It probably would be foolish to suggest that technology ought never to be used for the enhancement of human beings. So too would it be foolish to forget that without the desire to control and master the world there would be no desire to control and master ourselves. My suggestion has not been that we should figure out a way to extirpate our desire to control and alter ourselves and the world; rather, it has been simply that we should think more deeply about how attempts at control and alteration that truly enhance life are different from that impoverish it. It may be that thinking more deeply about that difference will entail rethinking some basic beliefs about our proper relationship to ourselves and the rest of nature” (Parens, 552).
For alternative views concerning the stance between humankind and nature see “Scientists and Theologians are Playing God.”
[1]Erik Parens, “The Goodness of Fragility: On the Prospect of Genetic Technologies Aimed at the Enhancement of Human Capacities,” Contemporary Issues in Bioethics, Tom L. Beauchamp and LeRoy Walters, ed., 6th edition (Wadsworth, 2003), 548-553.
McDonald Centre for Theology, Ethics & Public Lifea research institute at the University of Oxford presents: A conference on the ethics of human enhancement
What is the place of theology in the growing debate over genetic engineering and human enhancement? Are theological reasons of interest only to believers? Or, as Michael Sandel and Jürgen Habermas have both suggested, might they be important for society generally, for secular and religious alike? Reason, Theology and the Genome brings together a distinguished international panel of speakers, representing many different disciplines and points of view, to consider the relevance of theology to one of the most important questions of our time.
AbstractAuthor: Robert Sparrow
The American Journal of Bioethics, Volume 10, Issue 7, July 2010
In this short 15 minutes lecture, which is part of a series about the “Future of Human Health,” Krishna Shenoy of Standford University presents some of his research. He has been busy building neural prostheses (brain chips) that could be put into someone’s brain, in order to write information into the brain or take information out of the brain or nervous system. This is good news for people with neurological diseases. Indeed, information could be taken out of the brain of people who are unable to to communicate on their own. Moreover, it could potentially “enable paralyzed patients to control prosthetic arms and computer cursors.”
As we can rejoice about the potential therapeutic benefits of these new technologies, one cannot help but wonder what type of harmful side effects or unintended consequences such technology could be used for or produce.
Watch it on Academic Earth
According to “12 Events that will change Everything,” an article in the latest issue of Scientific American, the cloning of humans will likely happen before 2050. How likely? This article contemplates “12 possibilities and rate their likelihood of happening by 2050” (36) and use the following scale: Very unlikely, Unlikely, 50-50, Likely, and Almost certain. We shall then prepare ourselves to meet our Mini-Me(s).
The author, Charles Q. Choi, suggests that since the cloning of Dolly, the further step is inevitably the cloning of humans. However, Choi recognizes, like most scientists would, that the procedure is not only more complex with humans, but also raise some ethical concerns. Should we, for example, clone someone without her consent?
Nonetheless, human cloning would have some advantages and new possibilities. A clone might have a better life as she could learn from her old ‘self.’ If someone learns at only 25 that she is talented in music, she could tell her 5 year old clone to take music lessons. Moreover, extinct species like the Neanderthal could be revived.
Finally, Choi recognizes that the ‘yuck’ factor can play a major role in human cloning. We might find the idea of cloning ourselves disturbing now, the same way we did with IVF. But in a few years, we might not even think much about it.
For Aristotle, good conduct produces a morally good person. For him, “we become just by performing just acts” (32). Thus, in a sense ‘doing’ precedes ‘being’. But how can we even know what a ‘good’ act look like, if we are not good? In The Nicomachean Ethics, which looks more like a self-help book rather than a book on moral philosophy, Aristotle suggests a way to enable us to make good decision.
At the end of book II, “Moral Goodness,” he suggests some practical advice. First, keep away from extremes; choose the lesser evil if necessary. Second, notice your own errors and drag yourself in the opposite direction. Third, beware of pleasures and pleasant things.
Concerning the advice on keeping away from extremes, Aristotle expands. For him, the key is to choose the right ‘mean’ between two extremes. For instance, if one is unsure how to act between fear and confidence, she will follow Aristotle’s advice by choosing between two extremes: rashness or cowardice. Rashness is an excess of confidence, while cowardice is a deficiency of confidence.
Here is a graph:
| Sphere of Action or Feeling | Excess | Mean | Deficiency |
| Fear and confidence | Rashness | Courage | Cowardice |
While reading Aristotle, the argument presented by Erik Parens in the debate about human enhancement comes to mind. In the second part of his essay, “Towards a more fruitful Debate about Enahncement,” Parens looks at the two different frameworks used by critics and proponents of enhancement. Parens distinguishes between two philosophical/ethical frameworks that “people seem to come to the academic debate about enhancement technologies.” The first framework desires “to mend and transform ourselves and the world.” Because of this desire to create and change creation, Parens names this framework: Creativity. The second framework takes a different approach. It reminds us that we are not creators and that life is a gift. This view, which he calls Gratitude, tends to let nature be. He writes, “According to Genesis, and it seems to me much of Judaism, our responsibility is not merely to be grateful and remember that we are not the creators of the whole. It is also our responsibility to use our creativity to mend and transform ourselves and the world. As far as I can tell, Genesis and Judaism do not exhort us to choose between gratitude and creativity. Rather . . . it is our job to figure out how to maintain that fertile tension, making sure that neither stance gets more than its share” (189).
This search for a “fertile tension” sounds indeed Aristotelian as Parens seeks for the right mean between two extremes.
Here is another graph:
| Sphere of Action or Feeling | Excess | Mean | Deficiency |
| Enhancement | Creativity
Transform All Nature |
Fertile Tension | Gratitude
Let Nature Be |
Parens and Aristotle may be on to something important here.
“Geoffrey Bourne, former director of the Emory University primate center, once stated that ‘it would be very important scientifically to try to produce an ape-human cross.’ Other researchers have suggested using women as ‘hosts’ for the embryos of chimpanzees or gorillas” (See Francis Fukuyama, Our Posthuman Future, Consequences of the Biotechnology Revolution, 207. )
On a related topic, Julian Savulescu writes in Human Enhancement:
It has been possible since about 1980s to transfer genes taken from one species into another. ANDi is a rhesus who has had a jellyfish gene incorporated into his DNA. This results in a unique fluorescent green glow. Alba is a genetically engineered rabbit created by French scientists for artist Eduardo Kac. She also has a fluorescent glow. These transgenic animals show that a gene from one species can be successfully transferred and activated in a completely different genome in a different species. There is no reason why genes from other species could not be transferred to human beings, creating transgenic humans. [2]
Savulescu continues:
“Transgenesis could be used to introduce genes coding for superior physical abilities from other animals. For example, humans could have the hearing of dogs, the visual acuity of hawks, the night vision of owls, or even be able to navigate by sonar employed bats.” [3]
These questions are portrayed in the soon to be released movie: Splice.
[2] Savulescu, Julian and Nick Bostrom, ed. Human Enhancement (Oxford University Press, 2009),212.
[3] Ibid, 213.
Dr Aubrey de Grey from the University of Cambridge is a fascinating fellow. In a 2004 article on BBC News, he explains why we will be able to live to 1,000 years.
Life expectancy is increasing in the developed world. But Cambridge University geneticist Aubrey de Grey believes it will soon extend dramatically to 1,000. See the article here.
Question: Suppose we can live to 1,000, does that mean that we should?
If artificial feet make you run faster, last longer, and are generally speaking a better version of your ‘natural’ ones, would it be wise to exchange the lesser version of your feet for a more enhanced and improved man-made version?
2009 Boston Marathon runner with spring steel artificial feet. Photo by Stewart Dawson available online: http://mustangdaily.net/professor-talks-on-science-fiction-becoming-reality/
Biotechnologies already on the horizon will enable us to be smarter, have better memories, be stronger and quicker, have more stamina, live longer, be more resistant to diseases, and enjoy richer emotional lives. To some of us, these prospects are heartening; to others, they are dreadful. In Beyond Humanity a leading philosopher offers a powerful and controversial exploration of urgent ethical issues concerning human enhancement. These raise enduring questions about what it is to be human, about individuality, about our relationship to nature, and about what sort of society we should strive to have. Allen Buchanan urges that the debate about enhancement needs to be informed by a proper understanding of evolutionary biology, which has discredited the simplistic conceptions of human nature used by many opponents of enhancement. He argues that there are powerful reasons for us to embark on the enhancement enterprise, and no objections to enhancement that are sufficient to outweigh them.
“Geoffrey Bourne, former director of the Emory University primate center, once stated that ‘it would be very important scientifically to try to produce an ape-human cross.’ Other researchers have suggested using women as ‘hosts’ for the embryos of chimpanzees or gorillas” (See Francis Fukuyama, Our Posthuman Future, Consequences of the Biotechnology Revolution, 207. )
In order to keep up with new medical technologies in neuroscience, I would like to attend this 11 days “Boot Camp” on neuroscience.
“Applications are now being accepted for the 2010 Neuroscience Boot Camp at the University of Pennsylvania. We are excited about the second annual boot camp, keeping what worked so well this past summer — great teachers, a small but very diverse group of students, and a varied set of teaching methods — and making it even better!”
“Through a combination of lectures, break-out groups, panel discussions and laboratory visits, Boot Camp participants will gain an understanding of the methods of neuroscience and key findings on the cognitive and social-emotional functions of the brain, lifespan development and disorders of brain function. Like last year’s faculty, the 2010 Boot Camp faculty consists of leaders in the fields of cognitive and affective neuroscience who are committed to the goal of educating non-neuroscientists.”
“Penn’s Neuroscience Boot Camp has been endorsed by the Neuroethics Society as a way for non-neuroscientists to gain a better understanding of the science behind the proliferation of new “neurofields” including neuroethics.”
The deadline for admission and scholarship is February 1st. I will give it a try!
In To Relieve the Human Condition, Gerald McKenny starts his book with the following sentences: 
In Book III of the Republic, while discussing the training for the guardians of his ideal city, Plato addresses the role of medicine in their formation. His underlying question is how the pursuit of health can be so managed that medicine serves rather than hinders or dominates our moral projects. This question in turn breaks down into several more specific questions: How much attention or vigilance should we devote to our bodies in the effort to optimize their capacities? How much control should we allow physicians to exercise over our bodies? What ends, individual and collective, should determine what counts as a sufficiently healthy body? What limits should we observe in our efforts to improve our bodily performance and remove causes of suffering (Plato, 403c-407a)? [1]
Those same questions need to be asked again in the debate concerning human enhancement. Should we, for example, use genes from other animals in order to improve our performances? Consider the following excerpt from Julian Savulescu in Human Enhancement:
It has been possible since about 1980s to transfer genes taken from one species into another. ANDi is a rhesus who has had a jellyfish gene incorporated into his DNA. This results in a unique fluorescent green glow. Alba is a genetically engineered rabbit created by French scientists for artist Eduardo Kac. She also has a fluorescent glow. These transgenic animals show that a gene from one species can be successfully transferred and activated in a completely different genome in a different species. There is no reason why genes from other species could not be transferred to human beings, creating transgenic humans. [2] (For more little green animals see http://timesonline.typepad.com/science/2009/05/the-sciencecentral-glowing-animals-gallery.html )
Savulescu continues, “Transgenesis could be used to introduce genes coding for superior physical abilities from other animals. For example, humans could have the hearing of dogs, the visual acuity of hawks, the night vision of owls, or even be able to navigate by sonar employed bats.” [3] It seems, therefore, that Plato’s question needs to be asked once again: “What limits should we observe in our efforts to improve our bodily performance and remove causes of suffering?” We may also consider that if we are able to do something, it does not mean that we should do it.
[1] Gerald P. McKenny, To Relieve the Human Condition, Bioethics, Technology, and the Body (Albany, NY: State University of New York Press, 1997).
[2] Savulescu, Julian and Nick Bostrom, ed. Human Enhancement (Oxford University Press, 2009),212.
[3] Ibid, 213.

Toward A More Fruitful Debate
In this essay, Erik Parens wants to “illuminate the structure of the debate” in neuroethics, particularly in the issues

related with “the enhancement of human traits and capacities” (181). He rightly thinks that if “we get better at noticing the structure of the debate about enhancement, we might engage in a more fruitful debate” (180). He points out three important issues.
First, he shows how critics and proponents of enhancement technology both seek to be authentic human beings. He states, “[M]any in fact are striving to live up to the moral ideal of authenticity. Whether or not they achieve it, they aspire to find self-fulfillment and to become who they really are” (182). Unfortunately, critics and proponent differ in their understanding of authenticity. He writes, “[T]he knockers and boosters –or critics and proponents–of ‘enhancement technologies’ share the moral ideal of authenticity, but they understand authenticity differently: they have different views about what it consists in, and thus about how to achieve it” (183). For the critics, enhancement can be a threat to who we really are. They would worry that “mood-alternating drugs will separate us from the actions and experiences that normally accompany those moods . . . we will be separated from who we really are and from how the world really is” (184). On the other hand, for the proponents, enhancement can help us be more authentic. They sees enhancement not as “a threat to authenticity, but rather as tools that can facilitate our authentic efforts at self-discovery and self-creation” (186).This disagreement about authenticity comes from a disagreement raised by two different frameworks used to look at the world, which Parens analyses in the second part of his essay.
Second, he looks at the two different frameworks used by critics and proponents. This section echoes one of his earlier essays. In “Creativity, gratitude, and the enhancement debate” and in this essay, Parens distinguishes between two philosophical/ethical frameworks that “people seem to come to the academic debate about enhancement technologies.” The first framework desires “to mend and transform ourselves and the world.” Because of this desire to create and change creation, Parens names this framework: Creativity. The second framework takes a different approach. It reminds us that we are not creators and that life is a gift. This view, which he calls Gratitude, tends to let nature be. He writes, “According to Genesis, and it seems to me much of Judaism, our responsibility is not merely to be grateful and remember that we are not the creators of the whole. It is also our responsibility to use our creativity to mend and transform ourselves and the world. As far as I can tell, Genesis and Judaism do not exhort us to choose between gratitude and creativity. Rather . . . it is our job to figure out how to maintain that fertile tension, making sure that neither stance gets more than its share” (189).
Third, Parens discusses two cases to illustrate how critics and proponents can learn from each other. He discusses a problem for an honest proponent and then for an honest critic. First, he demonstrates that in some cases a pill (or enhancement) might not foster authenticity, but hinders it. He points out the example of the creation of a pill who could engender the “perception of intimacy” in order to encourage a woman to experience the desire for sexual intercourse. He rightly thinks that “honest proponents will acknowledge that the idea of a pill that would, in the absence of genuine intimacy, create the perception of intimacy is perplexing” (193). Indeed, the person taking this pill would not live truly or authentically. Second, he demonstrates how, in some cases, enhancement might help someone to become who she/he truly is. He gives the examples of transgenders, to whom surgeries enable them to change their anatomies in order to become more authentic. He writes, “Different from the ‘pill of intimacy,’ which undermines the purpose of achieving genuine intimacy and relationship, [transgender]’s surgeries seem to promote that purpose” (195).
Parens is really helpful in distinguishing both frameworks used in the enhancement debate in neuroethics. Instead of focusing on major differences they might have, he tries to make them work together. He argues that the biblical story and Judaism contains both frameworks. He acknowledges that “it is our job to figure out how to maintain that fertile tension” between Creativity and Gratitude (189). Unfortunately, he does not reflect on how we could have those two frameworks working together. It would be helpful to understand the cultural mandate in order to understand in what ways humans are allowed or able to alter nature. Furthermore, the Fall has not only affected human creativity but has also forced us to be innovative in order to fight sickness and diseases. One will need to take this in consideration in order to make those two frameworks work together.
Parens is also right in pointing out that both critics and proponents seek to become authentic human beings. The idea of authenticity raises some problems which religious people and theologians have struggle with for a long time. As Sandel writes in The Case Against Perfection, “To grapple with the ethics of enhancement, we need to confront question largely lost from view in the modern world–question about the moral status of nature, and about the proper stance of human beings towards the world. Since these questions verge on theology, modern philosophers and political theorist tend to shrink from them. But our new powers of biotechnology make the unavoidable” (Sandel, 9). I suppose religious people also desire to become authentic human beings, but differ about what is authenticity and how one should achieve it. One may wonder if someone should be encouraged to take an enhancer in order to become fully human.
In his article “Playing God,” in Human Enhancement, C. A. J. Coady looks at “the accusation of playing God” (179) when one is altering creation (nature). This accusation is often made “against secular agents, such as scientists, and very often made by clergy and theologians” (179). But first, Coady points out the positive and negative aspects of three Christian stances towards Creation: 1) dominion, 2) stewardship, and 3) co-creation. He rightly points out that “the first two have been prominent in debates about the role of Christianity in promoting what many have seen as bad attitudes to the natural environment” (157). However, he does remind us that some Christians have followed the example of St Francis of Assisi. Coady writes, “Instead of viewing God as handing the created world to humans for domination and exploitation, the picture is one of God giving humans the task of caring for the creation on God’s behalf” (157). His critique continues, “The stewardship model tends to the opposite faults of the dominion model. Where the latter seems to ignore or fail to acknowledge properly the respect that is due to the non-human world, the stewards seem to have too passive attitude to what there is” (159). Codly then writes that “theologians have been moved to the metaphor of co-creation as a more adequate picture of the relation between God and man” (160). This might be problematic as “the distance between God and creatures” (161) might disappear. He concludes this first part, “It seems to me that all three pictures have an element of truth in them and that the dialogue between them exhibits the tensions that need to be kept in view by believers in negotiating the mystery of humanity’s place in the created order” (161).
Coady is really helpful by distinguishing those three Christian stances towards creation. However, while the stewards might be indeed too passive towards the world (159), if one considers the Christian idea of the Fall, it seems that even the stewards would know that the evil and suffering need to be fought against. Thus this would encourage the stewards to be less passivie. Moreover, the attitude towards Creation is not only reflected in Genesis 3 (which seems to be what Coady mainly refers to), but in the rest of the biblical narrative also. Just the idea that our story starts in a garden and ends up in a city points towards some changes in Creation.
Second, Coady looks at reasons the non-religious world has been accused of “playing God.” He defines playing God as “going beyond the limits we have in these three aspects, acting in ways that ignore the in-built constraints on our knowledge, power, and benevolence” (163). The critique of playing God is the critique towards an attitude that desires omnipotence, omniscience and benevolence (characteristic usually given to God). He reminds us of the ecological disaster that we brought by relying too much on our own understanding (164). He writes, “The greatest achievement of science and the prospects they open up for us can lead us to an exaggerated sense of what we know, to misplaced confidence in our powers to change the world and blindness to our own moral deficiencies” (164). This clearly lacks “a degree of humility about how much we now know” (164). Moreover, because of our human limitations, we “do well to be on guard about exaggerated claims, public relations hype, and insufficient efforts to discover what can be known about effects and implications” (165). He concludes this section by reminding us that, “The Critique of playing God is primarily a criticism of an attitude and only derivatively of a program or proposal” (165). This attitude might “embody an unjustified confidence in knowledge, power, and virtue beyond what can reasonably be allowed to human beings” (165).
Third, Coady analyses cases “in which the intentions of the agent are benevolent, but are criticized for seeking to transcend legitimate limits on what it is to be human” (166). He points example of “playing God with the genes,” “Changing Human Nature,” and “Damaging autonomy.” I will write more on this section later.
He concludes:
Since the accusation of playing God is invariably made against secular agents, such as scientist, and very often made by clergy and theologians, it is worth reflecting on the possibility that the charge could be turned in the opposite direction. After all, it is often religious authority that claims to be representing God and God’s purposes. Have the Churches been playing God in the crisis created by new technologies? (179)
He adds, “The temptation to act in ways that ignore or make light of the in-built constraints on human knowledge, power, and benevolence is certainly one to which all humans are prone, including bishop, theologians, and priests” (179).

The age of enhancement
Here is a great article I read this morning about “a cornucopia of drugs [that] will soon be on sale to improve everything from our memories to our trust in others.”
While a lot of the promises for a better world seem attractive, I wonder if our quest to master our own body and brain will produce some side effects that are still unseen. One can think of how the human quest to master nature has brought us in a big environmental mess. I think that neuroethics could probably learn a lot from environmental ethics. It seems that the question, “How far should we be able to modify our environment?” reflects the question, “How far should we be able to modify ourselves?”

Human Enhancement: What should be permitted?
Human Enhancement: What should be permitted?
20-21 October 2009, Geneva, Switzerland
Biomedical science is increasingly yielding technologies that can be used to enhance the capacities of healthy people, as well as to treat disease. This two-day workshop will aim to advance the debate on the ethics of human enhancement by considering
(1) What enhancements are likely to become possible?
(2) What enhancements will be ethically permissible?
(3) What enhancements should be legally permitted?
(4) What criteria should be used to answer 2 and 3?
See more here: http://www.brocher.ch/pages/sympvenir_details.asp?id=15

Surrogates
On September 25, 2009 except to see Bruce Willis save us all, in the upcoming movie: Surrogates. From the movie trailer (watch below), it seems that issues of brain enhancement, transhumanism and gnosticism are back on the screen. This time the setting is in the year 2017, where humans live their lives through robotic bodies. Will the technology be ready in 2017 to accomplish what the trailer portrays? Will Bruce sacrifice himself to save us all, once again?

Michael Sandel
In the 2009 Reith Lectures, Professor Michael Sandel argues, in “Genetics and Morality,” that as a society we should not seek genetic enhancement (outside of therapeutic enhancement), because to do so is to lose the appreciation of the giftedness of life, humility, solidarity, and responsibility. Even though the lecture focuses on genetic enhancement, much of what has been shared can be applied to others form of enhancement (biotechnological enhancement, neurological enhancement). What might help to answer a question concerning the difference between the use of botox, gel, and braces is that we need to make a difference not only between therapy and enhancement, but also between the use of an external object (umbrella, medicament . . .)to help a person and engineering a new person with various means.
Furthermore, Sandel acknowledges that much of this discussion is theological in character. He states:
“In order to grabble with the ethics of enhancement, we need to confront questions largely lost from view in the modern world, questions about the proper stance of human beings towards the given world. Since this questions verge on theology, modern philosophers and political theorists tend to shrink from them, but our new powers of biotechnology make these questions unavoidable” (See the recording at 6 minutes 20).