Being all that you can be

In their recent book The Techno-Human Condition, Brad Allenby and Dan Sarewitz address a number of issues that arise when thinking about enhancements. One of the points that they make, which bears some consideration, is that the most enhanced people in our society today are soldiers. The military has an interest in enhancing its soldiers – physically and mentally – and as a result soldiers are at the tip of the spear of enhancement technologies. Nonetheless, as Allenby and Sarewitz wryly point out, there is no groundswell of desire to become a soldier so that one can be enhanced.

Lest one think that this is all just idle speculation, one need only read a 2005 paper by Andrew B. Meadows, a US Air Force Major with the title Fatigue in Continuous and Sustained Airpower Operations: Review of Pharmacologic Countermeasures and Policy Recommendations.  The paper begins by reviewing the Tarnak Farms friendly fire incident:

“On the evening of 17 April 2002, two US F-16s were airborne near Kandahar, Afghanistan providing on-call support for coalition ground forces as part of Operation ENDURING FREEDOM. The two pilots, COFFEE 51 and COFFEE 52, had been flying for approximately six hours when they detected what they perceived to be surface-to-air fire off the right side of their formation. Subsequently, COFFEE 52 requested permission from the Airborne Warning and Control System (AWACS) aircraft to employ his 20mm cannon in response to the threat. After a series of radio communications between the F-16s and the AWACS, COFFEE 52 called “self-defense” in response to seeing several men gathered near an artillery piece and released a 500-pound laser guided bomb on the target. Two minutes and twenty seconds had elapsed from the request for 20mm cannon fire and release of the bomb. The bomb detonated three feet from the gathering of men, killing four and wounding eight. The men were Canadian – friendly forces conducting a training exercise in the area (Dumas 2002).”

Meadows goes on to tell us that not only did the incident strain relations between the US and Canada, but there ensued a debate about what, if any, disciplinary actions might be brought to bear against the pilots. One of the key issues which arose in the subsequent investigation was the use of pharmacological enhancers by the pilots.

“Specifically, both pilots ingested dextroamphetamine tablets during the flight in question, with COFFEE 52 taking his 10mg dose approximately two hours before releasing the weapon (Dumas 2002). The issue of US pilots taking psychologically active controlled substances to counteract the effects of fatigue quickly ignited a public debate, further fueled by one of the defense attorney’s assertion that the Air Force had pressured his client to take dextroamphetamine, which, he argues, may have impaired the pilot’s judgment (Simpson 2003).”

The Tarnak Farms friendly fire incident certainly raised interest on the part of the military in alternatives to amphetamines (known in military jargon as Go Pills), and as Meadows documents in careful detail, the availability of modafinil filled that gap quite nicely. Re-reading this article today convinced me that that Allenby and Sarewitz are correct – soldiers are the ones who are most likely to be using today’s enhancement technology – a field experiment for ‘being all that you can be”.

For a rather hyperbolic view of the issue, take a peek at this video from The Hungry Beast, a weekly TV show on the Australian TV network ABC.

As an aside to the discussion of enhancement, Meadows goes on to tell us that not only did the incident strain relations between the US and Canada, but there ensued a debate about what, if any, disciplinary actions might be brought to bear against the pilots.

“Specifically, both pilots ingested dextroamphetamine tablets during the flight in question, with COFFEE 52 taking his 10mg dose approximately two hours before releasing the weapon (Dumas 2002). The issue of US pilots taking psychologically active controlled substances to counteract the effects of fatigue quickly ignited a public debate, further fueled by one of the defense attorney’s assertion that the Air Force had pressured his client to take dextroamphetamine, which, he argues, may have impaired the pilot’s judgment (Simpson 2003).”

He then points out something that has always seemed a bit ambiguous to me. I had read somewhere (a news article?) that commanders were able to order their subordinates to use pharmacological agents in the battlefield, but Meadows says otherwise.

Medically related requisites before use of either Go Pill include informed consent and ground testing. The informed consent process consists of counseling between the aircrew member and the flight surgeon that includes an explanation of the risks and benefits associated with either dextroamphetamine or modafinil, with clarification and emphasis that the use of Go Pills is voluntary on the part of the aviator.

I find that reassuring, but a bit of sleuthing turned up a somewhat variant view. Writing in Virtual Mentor, the lawyer Lee Black recounts the story of mandatory anthrax vaccinations in the military beginning in the late 1990’s, and the concerns that soldiers had about side effects, ultimately resulting in a lawsuit Doe v Rumsfeld. He concludes by stating that

If a soldier refuses a mandated anthrax vaccination, he or she may be demoted, discharged, or even imprisoned for disobeying an order. In the military, there are valid arguments for providing certain treatments without consent, where either the health of the individual or of the whole is at stake. And while it is true that the armed forces are exempt from many rules that govern the conduct of private citizens, to require treatment known to have a relatively high incidence of side effects tests the limits of these arguments.

Of course, anthrax vaccination and Go Pills are quite different matters, and it is unclear to this observer whether consent is a reality of the soldier’s life. What is clear is that the issue is sticky, complicated, and ripe for ethical analysis.