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The Medicalization of Love

Abstract:
Abstract:

Pharmaceuticals or other emerging technologies could be used to enhance (or diminish) feelings of lust, attraction, and attachment in adult romantic partnerships. Although such interventions could conceivably be used to promote individual (and couple) well-being, their widespread development and/or adoption might lead to the ‘medicalization’ of human love and heartache—for some, a source of a serious concern. In this essay, we argue that the medicalization of love need not necessarily be problematic, on balance, but could plausibly be expected to have either good or bad consequences depending upon how it unfolds. By anticipating some of the specific ways in which these technologies could yield unwanted outcomes, bioethicists and others can help to direct the course of love’s medicalization—should it happen to occur—more toward the ‘good’ side than the ‘bad.’

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This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Notes

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43. Though note that MDMA (Ecstasy) was used in the 1980s in couples’ counseling, and that scientific interest in its therapeutic potential has recently been rekindled: Sessa B. Is there a case for MDMA-assisted psychotherapy in the UK? Journal of Psychopharmacology 2007;21(2):220–4. There is also anecdotal evidence (Hutchinson, personal correspondence) that MDMA is currently being used, albeit illicitly, by a network of relationship therapists in Canada, although such research cannot be published. Oxytocin is also being used currently by some counselors: Boesveld S. Chemical seduction: How “love drugs” may one day help couples save failing relationships. National Post 2013 Mar 30; available at http://news.nationalpost.com/2013/03/30/chemical-seduction-how-love-drugs-may-one-day-help-couples-save-failing-relationships/ (last accessed 19 May 2014).

44. Abraham defines the term “pharmaceuticalization” as “the process by which social, behavioural or bodily conditions are treated or deemed to be in need of treatment, with medical drugs by doctors or patients”: Abraham J. Partial progress: Governing the pharmaceutical industry and the NHS, 1948–2008. Journal of Health, Politics, Law and Policy 2009;34:100. See also Abraham J. Pharmaceuticalization of society in context: Theoretical, empirical and health dimensions. Sociology 2010;44(4):603–22.

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54. See note 50, Conrad 2008, at 152.

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60. See note 33, Rapley et al. 2011.

61. See note 31, Parens 2013, at 30.

62. Parens E. Toward a more fruitful debate about enhancement. In: Savulescu J, Bostrom N, eds. Human Enhancement. Oxford: Oxford University Press; 2009, at 184.

63. Purdy L. Medicalization, medical necessity, and feminist medicine. Bioethics 2001;15(3):256.

64. See note 31, Parens 2013, at 33.

65. Synofzik M. Ethically justified, clinically applicable criteria for physician decision-making in psychopharmacological enhancement. Neuroethics 2009;2(2):90.

66. It is instructive to note how ‘lovesickness’ emerged as a medicalized condition in the middle ages, with physical causes and treatments: Wack MF. Lovesickness in the Middle Ages: The Viaticum and Its Commentaries. Philadelphia, PA: University of Pennsylvania Press; 1990. Although this might be a prime example of medical social control, it also shows how mechanistic explanations in terms of mental faculties and the four humors did not lead to a medicalization of everything, despite being seen as explanations for much of human behavior, emotion, and thought.

67. See note 21, Earp et al. 2014.

68. See note 59, Tiefer 1996.

69. Gupta K. Protecting sexual diversity: Rethinking the use of neurotechnological interventions to alter sexuality. AJOB Neuroscience 2012;3(3):26.

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74. Goldacre B. Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients. London: Fourth Estate; 2012.

75. Conrad P. The shifting engines of medicalization. Journal of Health and Social Behavior 2005;46(1):314.

76. See note 30, Davis 2010, at 216.

77. See note 69, Gupta 2012.

78. See note 16, Earp et al. 2014, at 4–12.

79. Earp BD, Wudarczyk OA, Foddy B, Savulescu J. Addicted to love: What is love addiction and when should it be treated? Philosophy, Psychiatry, & Psychology; forthcoming.

80. See note 30, Davis 2010.

81. See note 50, Conrad 2008, at 152.

82. See note 50, Conrad 2008, at 152.

83. Lehrer J. Depression’s upside. New York Times Sunday Magazine 2010 Feb 28:42. Note that this example comes from Parens 2013 (see note 31).

84. See note 31, Parens 2013, at 31.

85. Aurenque D, McDougall CW. Amantes sunt amentes: Pathologizing love and the meaning of suffering. The American Journal of Bioethics 2013;13(11):35.

86. See note 63, Purdy 2001, at 255.

87. See note 63, Purdy 2001, at 255.

88. See note 11, Gupta 2013, at 19.

89. See note 65, Synofzik 2009, at 95.

90. Savulescu J, Sandberg A, Kahane G. Well-being and enhancement. In: Savulescu J, ter Meulen R, Kahane G, eds. Enhancing Human Capacities. Oxford: Wiley-Blackwell; 2011:3–18.

91. Kass, LR. Beyond Therapy: Biotechnology and the Pursuit of Happiness. Washington, DC: President’s Council on Bioethics; 2003, at 227.

92. See note 8, Wudarczyk et al. 2013.

93. Juth N. Enhancement, autonomy, and authenticity. In: Savulescu et al. 2011 (see note 90):36.

94. Another angle on the matter comes from Guy Kahane’s recent essay, “Reasons to Feel, Reasons to Take Pills.” Kahane argues that biochemical modification of certain feelings may be morally permissible if it is the case that one ought to feel differently from how one does in fact feel—due, perhaps, to the sometimes irrational nature of human emotional life. Kahane G. Reasons to feel, reasons to take pills. In: Savulescu et al. 2011 (see note 90). Although parent-child love is not the focus of this essay, one argument that has been raised in the literature is that parents ought to love their children: Liao S. Parental love pills: Some ethical considerations. Bioethics 2011;25(9):489–94. Hence if love drugs could help toward this end, they might be worth considering. On the other side of the equation, romantic passion is also capable of causing people to feel things that they ought not to feel. An example we have already discussed is the profound love and attachment an individual might feel for her domestic abuser, preventing her from ending the relationship. If anti-love biotechnology could help break such a dangerous attachment bond, then its use could be permissible in some instances; see note 4, Earp et al. 2013.

95. Wordsworth W. The Major Works. Oxford: Oxford University Press; 1798/2000.

96. Dawkins R. Unweaving the Rainbow: Science, Delusion and the Appetite for Wonder. New York: Houghton Mifflin Harcourt; 2000, at x.

97. Fromm E. Art of Loving. New York: Perennial Classics; 2000.

98. See note 97, Fromm 2000.

99. Feynman R. The pleasure of finding things out. BBC [Interview]; 1981; clip available at http://mentalfloss.com/article/32133/richard-feynmans-ode-flower (last accessed 19 May 2014).

Thanks are due to Marion Godman, Andrew Buskell, Alessa Colaianni, Tomi Kushner, and members of the HPS Philosophy Workshop at the University of Cambridge for helpful feedback on earlier drafts of this manuscript. Please note that this work was supported in part by a Wellcome Trust grant, #086041/Z/08/Z.

Neuroethics Now welcomes articles addressing the ethical application of neuroscience in research and patient care, as well as its impact on society.

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Cambridge Quarterly of Healthcare Ethics
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