What does it mean for human beings to be themselves? Do cosmetic, surgical, and pharmaceutical interventions irrevocably alter the basic “stuff” of the person? Do such enhancements create a “new you”? Do beta-blockers taken to alleviate performance anxiety mask the identity of the performer, or do they simply make him or her better? Should people be encouraged, or even allowed, to have surgeries that are not needed medically but which they insist are needed psychologically? At what juncture does therapeutic mature into aberrant?
Ethicists struggle with these serious questions. Carl Elliott, whose professional life immerses him in the moral conundrums of bioethics and philosophy, is one of them. An understanding of what defines and delimits humanity and personal identity is necessary to finding solutions to many moral issues. These are the species of questions addressed in Better than Well. They are not questions easily answered, and Elliott’s exposition does not necessarily leave the reader satisfied that he has done so.
Elliott’s explorations attempt to juxtapose the idea of identity—who and what constitutes a person—with the available modern tools that change this reality. If Susan gets a face lift, is the person present after the bandages are removed still Susan? If Susan is still herself after a face lift, what if she has more than a face lift? What if surgery changes Susan into Sam? An article in a local newspaper pictured Leonardo da Vinci’s Mona Lisa with lip and breast enhancements, hair weaving, removal of the tiny mole next to her eye, and a slight blush of color created by tanning lotion. Is she still recognizable as the subject of the famous painting? At least now, suggested the article, she can compete in American culture. Her face and figure conform to the standards demanded by modern society.
Much of what troubles Elliott in his exploration is that enhancement therapies are tied to consumerism and profit rather than to any objectively demonstrable bettering of the person. He points to commercial promotions of prescription drugs such as Viagra, Prozac, and Claritin, to name only a few, which cost more money than those selling Coca-Cola. A market is created by the producers of the product rather than by the self-perceived need of the consumer. Elliott details the insidious practice of artificially creating a sense of what people need by those who will profit from the sale of these products. There was a time when the culture did not demand that a natural human odor be masked by the flowery scents of deodorants. There may come a time when the universal soma of Aldous Huxley’s Brave New World (1932) will become the cultural norm through products beyond Effexor and Zoloft. While the drug industry is not the only cause of the stampede to create cultural imperatives, it is certainly one of the most successful.
The author illustrates the nature of the moving-target self with John Howard Griffin’s Black Like Me(1961). Griffin was a white man who had his skin darkened in order to “pass” in the South as a black man. Elliott notes that in the book, Griffin sometimes refers to himself as white and at other times slips into language which locates him as part of the “we” who are black. While it is clear that Griffin is not black, his concept of his own identity becomes a bit slippery as he faces a black man in the mirror every day and deals with the racism he encounters in his travels. Further, standards which compel African Americans to buy enhancement products have often been standards that reflect a “white” beauty. Cosmetic companies, even those run by and targeting persons of color, take in money to make their intended consumers appear more white.
Elliott’s most interesting chapters deal with the notion of aging in the United States and the raising of children. In the former, he details the preoccupation of American culture with postponing aging and denying...
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