cover image THE PURSUIT OF PERFECTION: The Promise and Perils of Medical Enhancement

THE PURSUIT OF PERFECTION: The Promise and Perils of Medical Enhancement

Sheila M. Rothman, David J. Rothman, . . Pantheon, $25 (320pp) ISBN 978-0-679-43980-6

This thoughtful but inconclusive book sends a mixed message as to whether it's the proper role of doctors to medicate or perform surgery on patients whose only medical complaint is unhappiness or inconvenience. Professors, respectively, of public health and of social medicine and history at Columbia University, Sheila Rothman and David Rothman consider the various uses of estrogen, testosterone, human growth hormone, liposuction and genetic manipulation, showing that these options have from the beginning blurred the line between cure and enhancement. Focusing heavily on how pharmaceutical corporations and physicians profit in the promotion of enhancement therapies, the authors argue that products were marketed to the public without due attention to their possible risks and that studies questioning their benefits and citing related health hazards have been consistently downplayed. At the same time, however, they acknowledge that consumers continue to demand enhancement therapies even when risks are known. Liposuction, for example, has become the most commonly performed plastic surgery, despite a "startling" mortality rate of one in 5,000. Since there is "no consensus on the meaning of enhancing the body" and because consumers perceive liposuction as easy and desirable, the procedure is here to stay. The prose is dry, and there's a shortage of interesting medical case histories, but the book ends with an intelligent exploration of how genetic research could lead to procedures that would double existing life spans. Admitting the serious ethical reservations such a possibility raises even among physicians themselves, the authors end on a disappointingly equivocal note: "Yes, there will be risks—but just imagine enjoying the benefits of an extra seventy years." Photos not seen by PW. (Nov. 4)