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The Medicalization of Love: Response to Critics

Abstract:
Abstract:

In 2015, we published an article entitled “The Medicalization of Love,” in which we argued that both good and bad consequences could be expected to follow from love’s medicalization, depending on how the process unfolded. A flurry of commentaries followed; here we offer some preliminary thoughts in reply to the more substantial of the criticisms that were raised. We focus in particular on the nature of love itself as well as the role it plays (or should play) in our lives; we also touch on a number of practical issues concerning the likely effects of any plausible “real-life” love drugs and conclude with a call for careful regulation.

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1. Savulescu J, Sandberg A. Neuroenhancement of love and marriage: The chemicals between us. Neuroethics 2008;1(1):3144.

2. Earp BD, Sandberg A, Savulescu J. Natural selection, childrearing, and the ethics of marriage (and divorce): Building a case for the neuroenhancement of human relationships. Philosophy & Technology 2012;25(4):561–87.

3. Earp BD. Love and other drugs. Philosophy Now 2012 July/Aug;91:14–17.

4. Wudarczyk OA, Earp BD, Guastella A, Savulescu J. Could intranasal oxytocin be used to enhance relationships? Research imperatives, clinical policy, and ethical considerations. Current Opinion in Psychiatry 2013;26(5):474–84.

5. Earp BD, Wudarczyk OA, Sandberg A, Savulescu J. If I could just stop loving you: Anti-love biotechnology and the ethics of a chemical breakup. American Journal of Bioethics 2013;13(11):317.

6. Earp BD, Sandberg A, Savulescu J, Andersen R. The case for using drugs to enhance our relationships (and our break ups). Atlantic 2013 Jan 31; available at http://www.theatlantic.com/technology/archive/2013/01/the-case-for-using-drugs-to-enhance-our-relationships-and-our-break-ups/272615/ (last accessed 28 Apr 2016).

7. Earp BD, Sandberg A, Savulescu J. Brave new love: The threat of high-tech “conversion” therapy and the bio-oppression of sexual minorities. American Journal of Bioethics: Neuroscience 2014;5(1):412.

8. Savulescu J, Earp BD. Neuroreductionism about sex and love. Think: A Journal of the Royal Institute of Philosophy 2014;13(38):712.

9. Earp BD, Nguyen V. Les biotechnologies de l’amour. L’Amnésique 2014 Feb;10:5–8.

10. Robson D, Earp BD. A dangerous prescription? New Scientist 2014;221(2956):27–8.

11. Earp BD, Sandberg A, Savulescu J. The medicalization of love. Cambridge Quarterly of Healthcare Ethics 2015;24(3):323–36.

12. Earp BD. Drogen nehmen—um Wohl unserer Kinder? GEO Magazine 2015;10(1):62–3; available at https://www.researchgate.net/publication/281987913_Drogen_nehmen_-_zum_Wohl_unserer_Kinder (last accessed 28 Apr 2016).

13. Vierra A, Earp BD. Born this way? How high-tech conversion therapy could undermine gay rights. The Conversation 2015 Apr 21; available at https://theconversation.com/born-this-way-how-high-tech-conversion-therapy-could-undermine-gay-rights-40121 (last accessed 28 Apr 2016).

14. Earp BD, Hauskeller M. Binocularity in bioethics—and beyond. American Journal of Bioethics 2016;16(2):W3W6.

15. Earp BD, Savulescu J. Love drugs: Why scientists should study the effects of pharmaceuticals on human (romantic) relationships. Paper presented at the Social Trends Institute Experts Meeting: “Technology and the Good Society.” University of Navarra, Barcelona, Spain; 2016 Feb 4–6; available at https://www.academia.edu/21966987/Love_drugs_Why_scientists_should_study_the_effects_of_pharmaceuticals_on_human_romantic_relationships (last accessed 28 Apr 2016).

16. 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; available at https://www.academia.edu/3393872/Addicted_to_love_What_is_love_addiction_and_when_should_it_be_treated (last accessed 28 Apr 2016).

17. Earp BD, Foddy B, Wudarczyk OA, Savulescu J. Love addiction: Reply to Jenkins and Levy. Philosophy, Psychiatry, & Psychology; forthcoming; available at https://www.academia.edu/3393872/Addicted_to_love_What_is_love_addiction_and_when_should_it_be_treated (last accessed 28 Apr 2016).

18. Earp BD. Can you be gay by choice? In: Edmonds D, ed. Philosophers Take on the World. Oxford: Oxford University Press; forthcoming; available at https://www.researchgate.net/publication/299535258_Can_you_be_gay_by_choice (last accessed 28 Apr 2016).

19. See note 11, Earp et al. 2015.

20. Nyholm S. The medicalization of love and broad and narrow conceptions of human well-being. Cambridge Quarterly of Healthcare Ethics 2015;24:337–46.

21. Bamford R. Unrequited: Neurochemical enhancement of love. Cambridge Quarterly of Healthcare Ethics 2015;24:355–60.

22. Ferraro D. On love, ethics, technology, and neuroenhancement. Cambridge Quarterly of Healthcare Ethics 2015;24:486–9.

23. Hauskeller M. Clipping the angel’s wings: Why the medicalization of love may still be worrying. Cambridge Quarterly of Healthcare Ethics 2015;24:361–5.

24. O’Reilly M. Two concerns about the medicalization of love. Cambridge Quarterly of Healthcare Ethics 2015;24:490–2.

25. Giubilini A. Normality, therapy, and enhancement: What should bioconservatives say about the medicalization of love? Cambridge Quarterly of Healthcare Ethics 2015;24:347–54.

26. Minerva F. Unrequited love hurts: The medicalization of broken hearts is therapy, not enhancement. Cambridge Quarterly of Healthcare Ethics 2015;24:479–85.

27. Enck G, Ford J. A responsibility to chemically help patients with relationships and love? Cambridge Quarterly of Healthcare Ethics 2015;24:493–6.

28. MacGregor O. Trivial love. Cambridge Quarterly of Healthcare Ethics 2015;24:497500.

29. Emmerich N. Limitations in the bioethical analysis of medicalisation: The case of love drugs. Social Theory & Health 2016;14(1):109–28.

30. See note 20, Nyholm 2015.

31. See note 20, Nyholm 2015, at 337, slightly paraphrased.

32. See note 20, Nyholm 2015, at 340.

33. See note 20, Nyholm 2015, at 342.

34. See note 20, Nyholm 2015, at 340.

35. See note 20, Nyholm 2015, at 342.

36. Coontz S. What’s love got to do with it? Psychotherapy Networker 2005;29(3):5661 and 74, at 56. Please note that Plato, as represented in this passage, “was referring not to the love of women, ‘such as the meaner men feel,’ but to the love of a man for another man, which was the Greek ideal for the purest form of love” (Coontz 2005, at 56). The essay cited here is based on a longer book by the author: Coontz S. Marriage, a History: From Obedience to Intimacy or How Love Conquered Marriage. London: Penguin Books; 2005.

37. See note 36, Coontz 2005, at 57.

38. In another essay, Nyholm does seem to appreciate this point. Specifically, he writes that his aim has been not to analyze love from

a Sidgwickian “point of view of the Universe”—or a Nagel-inspired wholly objective “view from nowhere” [but rather] to ask whether or not the values that we do in fact have in relation to love are such that, as we now tend to think about love, it would be possible and advisable to try to create and maintain the sort of love that we seek with the help of biomedical enhancements. And my argument has been that, with respect to this set of values, the particular intrinsic goods that we associate with love are not ones we can deliver into each other’s hands with the help of biomedical enhancements. . . . This is perfectly compatible with its possibly being the case that, in some supposedly more enlightened future time-period, we might collectively look back upon the values I have appealed to, and then regard them as having been rather silly and old-fashioned.

See Nyholm S. Love troubles: Human attachment and biomedical enhancements. Journal of Applied Philosophy 2015;32(2):190–202, at 200 and 201, emphasis added.

39. See note 20, Nyholm 2015, at 343.

40. See note 11, Earp et al. 2015, at 333.

41. As Erik Parens has recently argued, there is often something useful to be gained from “oscillating between the insights afforded by the subject and object lenses,” in a habit of thinking he calls “binocularity.” See Parens E. Shaping Our Selves: On Technology, Flourishing, and a Habit of Thinking. Oxford: Oxford University Press; 2015, at 5.

42. See note 20, Nyholm 2015, at 342 and 343.

43. For a technical discussion, see Werner G. The many faces of neuroreductionism. In: Başar E, ed. Dynamics of Sensory and Cognitive Processing by the Brain. Berlin/Heidelberg: Springer; 1988:241–57.

44. See note 22, Ferraro 2015.

45. See note 22, Ferraro 2015, at 486.

46. See note 22, Ferraro 2015, at 487.

47. See note 22, Ferraro 2015, at 487.

48. See note 11, Earp et al. 2015, at 326, emphasis added.

49. See note 4, Wudarczyk et al. 2013, at 481, emphasis added.

50. Ferraro suggests that our focus on neurochemistry makes it seem as though “love” can be located within the brain of a single individual and modified accordingly: “It becomes affective and, ultimately, individualistic, a matter of how one feels” (see note 22, Ferraro 2015, at 486). But let us just grant that love should be seen as something that only exists, in some sense, between individuals—that it requires that I care about your well-being for its own sake, for example. It can still be meaningful to ask, we would contend, what the effects of certain neurochemical substances (as applied to the brain of a single individual) would be on the love between individuals understood in this way. For example, there is evidence that SSRIs can sometimes blunt not only people’s “lower-level” sex drives but also their “higher-level” ability to care about the feelings of others, i.e., as a side effect (see note 5, Earp et al. 2013). Thus, a drug administered to a single individual—and which has a certain kind of effect on the way that person “feels”—nevertheless can have meaningful implications for more complex, interpersonal conceptions of love than Ferraro thinks we are aware of. In short, love doesn’t have to be “located in a single individual’s brain” for interventions into that single individual’s brain to affect love (on a more robust conception) in significant ways.

51. See note 22, Ferraro 2015, at 486.

52. See note 21, Bamford 2015.

53. See note 21, Bamford 2015, at 359.

54. See note 20, Nyholm 2015, at 345.

55. See note 38, Nyholm 2015.

56. See note 38, Nyholm 2015, at 190–1, emphasis added.

57. Naar H. Real-world love drugs: Reply to Nyholm. Journal of Applied Philosophy 2015; e-pub ahead of print available at http://onlinelibrary.wiley.com/doi/10.1111/japp.12141/full (last accessed 28 Apr 2016).

58. See note 57, Naar 2015, at 2, paraphrased.

59. See note 57, Naar 2015, at 3, emphasis added in the second quotation.

60. See note 57, Naar 2015, at 3, summarized.

61. See note 57, Naar 2015, at 4.

62. See note 57, Naar 2015, at 4.

63. See note 57, Naar 2015, at 4. For a related argument, see Earp BD, Douglas T, Savulescu J. Moral neuroenhancement. In: Johnson S, Rommelfanger K, eds. Routledge Handbook of Neuroethics. New York: Routledge; forthcoming.

64. See note 11, Earp et al. 2015, at 326.

65. See note 57, Naar 2015, at 4.

66. They might, for example, make it easier for couples to see each other’s perspective. Or they might help them notice new (or rediscover old) appealing aspects of their partners’ personalities—aspects that had previously been obscured by a self-absorbed mindset. Such biological interventions would, in short, make “true” love much more probable.

67. See note 23, Hauskeller 2015.

68. See note 25, Giubilini 2015, and note 26, Minerva 2015. Questions about the nature and limits of medicine (and medicalization), health, well-being, and the treatment/enhancement distinction are also explored by Nyholm, Hauskeller, Bamford, MacGregor, and Enck and Ford (see the preceding relevant notes for the full citations).

69. See note 23, Hauskeller 2015, at 363.

70. See note 23, Hauskeller 2015, at 363.

71. See note 23, Hauskeller 2015, at 363.

72. See, e.g., note 12, Earp 2015. See also Earp BD, Savulescu J, Sandberg A. Should you take ecstasy to improve your marriage? Not so fast. Practical Ethics 2012 June 14; available at http://blog.practicalethics.ox.ac.uk/2012/06/should-you-take-ecstasy-to-improve-your-marriage-not-so-fast/ (last accessed 28 Apr 2016).

73. For further discussion see, e.g., Ellens JH, Roberts B, eds. The Psychedelic Policy Quagmire: Health, Law, Freedom, and Society. Santa Barbara, CA, and Denver, CO: Praeger; 2015.

74. Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schäfer H, Bötzel K, et al. A randomized trial of deep-brain stimulation for Parkinson’s disease. New England Journal of Medicine 2006;355(9):896908.

75. See, e.g., Mayberg HS, Lozano AM, Voon V, McNeely HE, Seminowicz D, Hamani C, et al. Deep brain stimulation for treatment-resistant depression. Neuron 2005;45(5):651–60.

76. See, e.g., Wu H, Van Dyck-Lippens PJ, Santegoeds R, van Kuyck K, Gabriëls L, Lin G, et al. Deep-brain stimulation for anorexia nervosa. World Neurosurgery 2013;80(3):S29–e1.

77. Koivuniemi A, Otto K. When “altering brain function” becomes “mind control.” Frontiers in Systems Neuroscience 2014;8(202):16, at 1.

78. See note 77, Koivuniemi, Otto 2014, at 1.

79. See note 15, Earp, Savulescu 2016, at 4.

80. See note 15, Earp, Savulescu 2016, at 4.

81. Levy N, Douglas T, Kahane G, Terbeck S, Cowen PJ, Hewstone M, et al. Are you morally modified? The moral effects of widely used pharmaceuticals. Philosophy, Psychiatry, & Psychology 2014;21(2):111–25, at 123.

82. See note 24, O’Reilly 2015.

83. See note 7, Earp et al. 2014, at 7.

84. Coady CAJ. Playing god. In: Savulescu J, Bostrom N, eds. Human Enhancement. Oxford: Oxford University Press; 2009:155–80, at 165, emphasis added.

85. See note 21, Bamford 2015.

86. Gupta K. Protecting sexual diversity: Rethinking the use of neurotechnological interventions to alter sexuality. AJOB Neuroscience 2012;3(3):24–8.

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Cambridge Quarterly of Healthcare Ethics
  • ISSN: 0963-1801
  • EISSN: 1469-2147
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