After Thomas Douglas introduced the concept of MBE in 2008,[1] its merits have been widely debated in academic bioethics literature.
[11] Some also distinguish invasive from non-invasive, intended from resultant, treatment-focused from enhancement-focused, capability-improving from behavior-improving, and passive from active ME interventions.
[4] Douglas originally suggested MBE as a counter-example to what he calls the "bioconservative thesis," which claims that human enhancement is immoral even if it is feasible.
[1][8][19] For example, Douglas calls it “intuitively clear” that any given person has a reason to undergo moral self-enhancement by reducing counter-moral emotions through self-reflection.
Douglas says that at least some of the intuitive reasons that anyone should become morally better through self-reflection, like increasing concern for others or good consequences, apply to voluntary MBE.
[7][8] Given that moral education and liberal democracy are insufficient, MBE is needed at least as a supplementary method to solve these problems.
Persson and Savulescu conclude that the intervention of extensive human moral enhancement is a necessary component to address this threat.
[7][8] Central issues debated in literature about MBE include whether there is an urgent need for it, if a sufficient consensus on the definition of morality is achievable, technically feasible and ethically permissible interventions to carry out MBE, the ability to ensure no violation of consent in those interventions, and the ability to ensure no harmful social side-effects that they produce.
[7]: 113–114 Several MBE proponents have pointed out that Harris's "Freedom to Fall" assumes the controversial view that if someone's actions are fully determined by previous causes, then that person cannot act freely.
[26] Murray argues that political and social pressure are sufficient to improve behavior, explaining that although certain Islamic countries state that women should be forced to wear the burka and stay indoors because men cannot control their sexual urges, this is shown to be false by men in Western countries, both Muslim or otherwise, exercising their ability to control their sexual urges.
What Savulescu and Persson do is to similarly treat the will not to be moral on a larger scale as though it were an inevitable and natural part of human biology rather than a political and cultural choice.
DeGrazia’s idea of this overlapping consensus includes disapproval of antisocial personality disorder, sadism, some kinds of moral cynicism, defective empathy, out-group prejudice, inability to face unpleasant realities, weak will, impulsivity, lack of nuance in moral understanding, and inability to compromise.
[30] He suggests that the current disease-focused medical model needs to be changed, otherwise enhancement drugs could not be researched well and introduced to the market.
Along with this feasibility objection, he notes that public funding for enhancement drugs research projects is currently very limited.
"[26] She argues that MBE allows for "paternalistic interventions" from medical experts to "redirect the individual's behaviour to conform to their or society's 'best interests.