Constructing Viable Alternative Courses of Action; Identifying Constraints

Director has at least several viable alternatives to consider. She has already developed an active program to improve troop management as well as communications between troop members and between the members and other responsible military personnel—a program that is paying dividends on the battlefield. Is the likely benefit from augmenting her program to include the proposed new area worth the diversion of investment from these other areas? What information would help to address this question? What values need to be considered?

Assessing Consequences, Public Defensibility, and Institutional Barriers

There are ways for Director to test her moral intuitions about the activities she is supporting and the one she has under consideration. She can ask herself what guidance her colleagues or profession might provide. She can consult an ethics officer or the office of the general counsel in her organization. (There may not be an ethics officer, but legal advice is almost certainly available.) She can ask about potential harms, as noted above and taken up again below. She can ask whether she could comfortably defend the additional activities publicly and whether, should harm come to her as a result of one of these activities, she would still think it was good to have supported it.21

Undertaking a research program to augment human performance by using drugs raises ethical questions about the potential benefits, risks, and costs. Evidence of effectiveness is not beyond dispute, and there is considerable evidence that administration of certain drugs can lead to a variety of abuses. Even without abuse, a major area for concern is the equity implications in a system where availability may be based on ability to pay. Thus, the virtues of performance enhancement, in uneven expansion to the wealthy, may exacerbate inequalities. Further, dystopian fiction has long made a vice of the virtue of such interventions—pointing out that they may become required rather than elected.

On the other side, enhancements for certain limited purposes may receive a more positive reception, particularly if they can be shown to preserve lives and lower injury. If this research is under consideration in military agencies, institutional barriers may be low. Should the decision of this program director about whether or not to proceed take account of

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21 Daniel A. Vallero, citing M. Davis, in Google e-book, “Biomedical Ethics for Engineers: Ethics and Decision Making in Biomedical and Biosystems Engineering,” April 1, 2011, Academic Press, Waltham, Mass., p. 339.



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