The bioethics of enhancing human performance for spaceflight.

There are many ways of enhancing human performance. For military aviation in general, and for spaceflight in particular, the most important tools are selection, training, equipment, pharmacology, and surgery. In the future, genetic manipulation may be feasible. For each of these tools, the specific modalities available range from the ethically acceptable to the ethically unacceptable. Even when someone consents to a particular procedure to enhance performance, the action may be ethically unacceptable to society as a whole and the burden of risk for the individual may be too great. In addition, there are several characteristics that define the quality and the acceptability of the consent. Each method of enhancing performance will be examined in the context of the principles of medical ethics in a western society: autonomy, non-maleficence, beneficence, and justice. The aim is to draw the attention of aeromedical practitioners to the complexities of ethical dilemmas such as this particular one in order to help them to develop a morally justifiable code of practice that balances society's needs against individual ambitions and corporate goals.