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DOI 10.1007/s10728-012-0230-3
ORIGINAL ARTICLE

Ethical Consequences of the Positive Views
of Enhancement in Asia
Darryl Macer! Springer Science+Business Media New York 2012

Abstract There are positive views towards use of science and technology in all
Asian countries, and positive views towards use of enhancement in China, India andThailand. After considering of the widespread use of cosmetic surgery and otherbody enhancements in Asian countries, and the generally positive views towards
letting individuals make choices about improvement of themselves, the paper
concludes that we can expect other enhancements to also be adopted rapidly in Asia.
There will be future ethical dilemmas emerging from this with concepts of preservation of nature, flow with nature, and definitions of human-ness, along withconcepts of harmony and social justice. Japan is less willing to engage in genetic
enhancement compared to China, India and Thailand, despite widespread cosmetic
surgery across Asia.
Keywords Asia ! Attitudes ! Bioethics ! Enhancement ! Gene therapy !
Genetic engineering
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
D. Macer (&)
Regional Unit for Social and Human Sciences in Asia and the Pacific (RUSHSAP),UNESCO Bangkok, 920 Sukhumvit Road, Prakanong, Bangkok 10110, Thailande-mail: d.macer@unesco.org
URL: www.unescobkk.org/rushsap

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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, andthe 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 inother papers in this issue of the journal, assume varying perspectives. However, thepractices that shape medical advancement and cosmetic fads are determined moreby 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 levelof awareness of specific developments of science and technology [16, 20]. The
International Bioethics Survey conducted in 1993 in ten countries in Asia and thePacific [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 theworld 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]. Technologythat touches life is perceived to be as worthwhile as technology which does notdirectly affect living organisms, but people may perceive more risks fromtechnology that directly affects living organisms than from those physical sciencedevelopments which do not. This is similar internationally, with genetic engineering
evoking mixed emotions of benefit and risk. People do not have a simplistic view ofscience and technology, and can often perceive both benefits and risks. Thisbalancing of good and harm is necessary for bioethics, and is one indicator of thebioethical 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 afew 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 andIndia.

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Germ-line enhancement is also supported by many persons in these surveys.
The acceptance of eugenic arguments linked to use of genetic screening is widespreadin interviews conducted in China [26]. The Chinese concept of ‘‘Yousheng’’ (healthy
birth) is more appropriate than eugenics as an expression of Chinese social policy andpublic 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 thesecountries, which raises questions on how laws can be implemented. It suggests thatin 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 forladies to marry is lower for fairer skins in India, and conversely fairer skin tones inThailand can raise a higher price for the ladies (where men pay the dowry).
There have been studies of attitudes to dental orthodontics which suggest Asianpatients 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 ofpatients. The same could be said for hair styling and fashion accessories.
There are some associations between particular psychological states andtendencies to undergo cosmetic surgery [27], such as greater psychologicalinvestment in physical appearance and greater internalisation of mass media imagesof physical beauty [25]. Swami et al. [27] found that less open and more emotionallyclosed individuals had a greater likelihood of accepting cosmetic surgery in order tomaximise 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, andactually doing it. In some communities it appears that people will be proud to talkabout their cosmetic enhancement experiences, such as in USA, when compared tosome 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 Indicsystems believe that while universal values exist, they are not achievable, because

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human beings apply their own subjective experiences and emotions to theirknowledge 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 toone of the main teleological theories, utilitarianism. Utilitarianism looks at theconsequences 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 doesit 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, probableeducational enhancement through intense suffering of many children is promoted
across Asian educational systems. There is a need for broad social debate on the goalsof a good and happy society. There is a need for all areas of society to be involved in thediscussions 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 ajustification 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 withsensory deficiencies such as deafness or blindness with electronic technology, andlaser treatment for myopia is becoming very popular.

Asian Religious Values
Asia is diverse, but we can take several example traditions to illustrate the typesof views that inspire persons ethics. Heine and Hamamura [9] reviewed studies of123Author's personal copy
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self-enhancement psychologically and found that East Asians were significantly lesslikely 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 andcosmetic 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 loveis 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’’ isrevered 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, anddelusionment. 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 justone 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 childdedicates their whole life to look after the parents without having children. Other
parents however will take their children to cosmetic clinics with the intention ofassisting them to conform to some sense of beauty, that may help them find a goodmate. The genetically programmed behaviour for gene survival (which would desire
children to reproduce as much as possible) is replaced by the individual desire of theparents 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 somehuman beings behaviour is less controlled by evolutionary forces than love of ourown 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 insociety 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 ofnothing 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 theplanet. 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, afeature found across most species, that is indirectly related to later gene survival by
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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 towork 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 goodcareer 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 ofhuman 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 andHuman Rights (UNESCO, 11 Nov. 1997), Article 11 states, ‘‘Practices which arecontrary 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 motheris 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 humandignity.
Another expression of love of our own life that is dominant in medical ethics isthe sanctity of life. This sanctity of life is also often imposed upon others on thebehalf 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 aholistic environmental ethic [1]. In Jainism patience is regarded as a good andpleasure 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 curesickness and enhance their body and emotions.
Autonomy is also applied to many life choices that are bioethical dilemmas, forexample personal transport in an automobile is associated with high environmental

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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 havesanctity of life because of intrinsic moral status. Whale baleen used to be widelyused 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 belimited 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 theendangered 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 humanlife as well? A challenge however, is that many cosmetic choices are not beyond theeconomic 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 ofvalues and philosophies, and universalism deprives some communities and peopleof their own value systems. Thus, Eastern traditions believe that the type ofdogmatic 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 suchas compassion, honesty, justice, and work fit within these relationships. These sets
of values and directions form the essential nature of Chinese society regardless ofthe ‘religion’ of the person. In fact, if religion is usually both about a metaphysicaltheory 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, butrather 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.
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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 forchildren’s use of gene therapy. Lo et al. [15] found similar results in China with thesame questions. Indians and Chinese were the most supportive, and Thais the least
for personal use, but when asked about use on children, Thai respondents wereamong the most willing [16, 21]. When compared to US results, we find a generaltendency for Asians to be more accepting of gene therapy. The surveys did not findany significant differences dependent upon sex, age, education or religiosity. The
major reasons given in open comments were to save life and increase the quality oflife. 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 forusing gene therapy.
There was extremely high support for use of gene therapy to cure disease, bothas somatic cell therapy (for fatal, and late onset diseases) or inheritable therapy (forfatal, and non-fatal diseases); and high support for gene therapy approaches to an
AIDS vaccine. There was lower support for enhancement uses (improving physicalcharacters, intelligence, making people more ethical) than for treating disease,suggesting some discretion in what people judge to be ethically good. In India andThailand 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 whatmight 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 mostcommon 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 ofomission. This is the principle of beneficence. This is a powerful impetus for further
research into ways of improving health and agriculture and living standards.

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The principle of beneficence asserts an obligation to help others further theirimportant 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 withthem. 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.
BeautyBeauty should be judged in the eyes of the beholder, and there are diverse viewsof who is beautiful. However, there are social pressures in many countries toconform to certain stereotypes of beauty [3]. People die due to the excesses of eating
disorders, and these diseases are transmitted by stereotypes introduced in theWestern media. In Fiji before Western television was portrayed there werereportedly 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 theirvacations in Asia. We can also see medical tourism linked to the lower prices forundergoing 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.

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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, andthey 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 placesin higher education, and better employment, reinforces the idea that we should loveourselves. 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 ofautonomy. 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 isa 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 yourcompassion, the greater your resilience in confronting hardships and your ability totransform them into more positive conditions’’. Hare [8] wrote, ‘‘Those who do notlove 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 affecton 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 slothrather than pride [22]. Laziness means that whatever potential we have is lost, and thepotential 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 canbe universal, illustrated here by two political principles, namely welfare andfreedom of expression. As for the former, socialism holds that as the state takes overthe meta-organisation of human beings, it is incumbent upon the state to ensure thatthe 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 thatthe welfare state leads to people becoming dependent upon state handouts, which in123

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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 theInternational Covenant on Economic, Social and Cultural Rights 16 into conflictwith 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 andhousing, and to the continuous improvement of living conditions. The States Parties
will take appropriate steps to ensure the realization of this right, recognizing to thiseffect the essential importance of international cooperation based on free consent’’.
While the socialist traditions consider a strong welfare state to be consistent withfulfilling these articles, the capitalist system sees such a position to be dangerous toa strong and vibrant economy. It would appear that while the articles are idealistic
and communitarian, their universality is immediately brought into contest bycompliance and interpretation—two different levels of commitment to theideological systems. Socialism might limit enhancement but capitalism would
embrace it within a market system.
The second political principle concerns the freedom of expression, which isreaffirmed in Article 19.2 of the International Covenant on Civil and Political Rights(The United Nations International Covenant on Civil and Political Rights, enteredinto force 23 March 1976, http://www.hrweb.org’/legal/cpr.html) The article assertsthat ‘‘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 offrontiers, either orally, in writing or in print, in the form of art, or through any othermedia 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 toopportunities to improve life that enhancement offers. As has been discussed for
decades, attempts to ban human germ-line genetic change would need to be madeinternational if they would be effective [17]. We can see examples withreproductive surrogacy that medical tourism is widespread to evade laws thatprohibit 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 toaccumulate human capital in skilled workers. If some parents or nations begin
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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 motivationof 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 ideaof 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 anunderstanding 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, andthe broader accumulated social impact of the growing practices. Is this thecommunity 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 wehave. Asians will also pursue their capabilities with assistance, be that wearing
coloured contact lens, whitening creams, cosmetic surgery. I do not believe thatinternational law to prohibit development of technology will protect society andindividuals from making choices to enhance themselves. History has shown thatpeople reject stringent laws or legalistic religions. Education of mature and tolerant
citizens is a more effective and longer term solution.

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