Ethical issues in moral and social enhancement

8.2. Are ‘compulsions for the good’ beyond moral review?
8.2.1. Introduction 
Shaftesbury asserted that:
‘every reasoning or reflecting Creature is, by his Nature, forc'd to 
endure the Review of his own Mind, and Actions; and to have 
Representations of himself, and his inward Affairs, constantly 
passing before him, obvious to him, and revolving in his Mind.’ 
(Shaftesbury, 1699 II.1)
MB could be detrimental to freedom and rational moral agency if it resulted in the 
creation of what I am going to call ‘compulsions for the good’ – strong inclinations 
that are more likely than not to result in the agent acting consistently with the 
good.
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Here, the agent would be as unfree with regards to her desires as a (willing 
or unwilling) addict. Harris (2011) argued that insofar as MB results in creating 
such compulsions, MB bypasses reasoning and is beyond moral review. However, I 
will argue that such compulsions 
are
subject to moral review. In this section I will 
distinguish between offline and online moral review and offline and online moral 
control and use an example of an obsessive-compulsive disorder (OCD) to argue 
that even where online control is affected, it does not follow that the online and 
offline moral reviews are fatally diminished.
8.2.2. Online and offline moral review vs online and offline moral control 
I propose that we introduce two distinctions when discussing biomedical emotion 
modulation. First, it is important to distinguish between ‘moral review’ and ‘moral 
control’. I will understand 
moral review
of actions as an evaluation of actions 
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One could object that without the guidance of reason we are not able to reliably achieve 
outcomes consistent with the good. This may be likely, so I have set the bar much lower 
(see also the penultimate section of this chapter for further justification of such lower 
requirements). At this point it is not crucial to demonstrate that the notion of ‘compulsions 
for the good’ makes sense. Since I will consider here the statement that ‘if they are 
possible, they would preclude moral review,’ we can for now simply agree that the 
argument is conditional on the existence of such compulsions. The conclusions of the 
argument will later be applied to cases when MB does not involve compulsions, and here I 
set out to demonstrate that even in the more troubling case of MB involving compulsions, 
the issue of moral review is not a strong argument against MB. 

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undertaken from a moral perspective.
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In this discussion I will assume that moral 
review will be rational and deliberative in nature, although the extent of the 
deliberation may vary from very little to the writing of philosophical tractata. In 
contrast, 
moral
control
refers to the exercise of a capacity to modify actions within 
the parameters of what is prescribed by moral review. A second distinction helpful 
in the current discussion is a distinction between what I will call ‘online’ and 
‘offline’ control and review. I will understand 
online review and control
to take 
place as the behaviour or emotion unravels; 
offline review and control
will refer to 
appraisal and control that takes place either 
post-factum
(e.g. reflecting on the 
appropriateness of an emotional reaction after the emotion subsided) or before the 
event (e.g. stimulus avoidance, contingency planning).
Strong desires, emotions and the resultant compulsions to act are subject to review 
in two ways. Firstly, even if we cannot make our will effective at a given time, we 
can take a position towards that compulsion in a similar way that an addict may or 
may not endorse their effective desire for a drug (offline review). This may not 
make any difference in that particular instance or while an agent acts on that desire, 
but provides a background for an effort to modify such desires or mitigate the 
impact of actions flowing from those desires (offline control). If a certain dose of 
oxytocin resulted in me being so sensitive to witnessed suffering that I feel an 
inescapable compulsion to help, this does not preclude my reflection on whether 
that was an all-things-considered good thing