Why’re we teaching teenagers about safe sexual practice, when we could just try to treat the underlying psychological issues that make them want to have sex?
Wait, no, that’s stupid . Why’re we allowing people to buy make-up or cosmetic surgery, when we could just try to treat the underlying psychological issues that make people unhappy with their appearance?
Wait, that’s stupid . Why’re we supporting people transitioning to the appropriate gender when we could just try to treat the underlying psychological issues that cause dysphoria?
Wait, that’s also stupid . Why’re we using exercise regimes and gastric bands when the solution to obesity is to treat the underlying psychological issues that make people want to be thin?
Wait, still stupid . Why’re we suggesting improvements to societal structure when clearly we could just treat the underlying psychological issues that make people in modern societies unhappy?
That’s probably stupid.
I’ve seen all of those five arguments made in varying contexts. The point of this selection was to maximise the number of people who have at least one issue on each side, so as to frame the discussion more neutrally. But if you’d have guessed that the origin of the discussion was the highly-contentious third, well, I wouldn’t call your guess wrong. But equally, the aim is to skirt around the highly-abstract last one, which is by far the most important.
Seeing these five side-by-side makes it prudent to start by examining the most common argument that’s made in favour of each of them – a slippery slope argument of the form “but if we accept people getting their noses shrunk, how can we say it’s wrong for them to turn themselves into freakish monstrosities of chitin and tentacles that should be cleansed from the world with fire?” Well, we can’t, same as there’s nothing wrong with people removing their limbs if it’ll make them more comfortable with their body, or people trying to find fulfillment in life rather than altering themselves to find their current circumstances fulfilling. Sure, maybe they’d be better off following Buddha’s advice and trying to become perfectly phlegmatic about things, but that’s ultimately a demand for people to change in an unlikely way.
Now, perhaps with sufficient enlightenment or technological advancement, we could make it less unlikely. We could find drugs that treat gender dysphoria or autism or being unhappy about being overweight. That’d certainly be a start. Why not go further? We could have a pill to cure ennui, a surgical procedure to make Mondays seem less horrible, or a vaccine to prevent liking Nickelback! Wait, is this starting to sound familiar?
The well-read will recognize this as an argument fundamentally about wireheading. Well, perhaps it is not such a good mark of entry into the elite once it has a wiki page. The foresighted will note that I am also constructing a slippery slope argument in the opposite direction: if the answer to the question “how much wireheading do we support” is not “none,” or “only as much as people want to do to themselves,” then how much? If people want to be thin, rather than accept being fat and become happy with it, why should we tell them that correcting their psyche is the better option?
This isn’t exactly the same thing as wireheading on every level, of course. But it certainly seems like any argument that proves that it’s right to alter people’s minds in the listed ways ought to be strong enough to also prove that it’s more generally right to alter minds in any number of unlisted ways. And if we take it as given that we don’t want to just alter ourselves to be permanently blissed out by everything, it follows that any particular argument for why certain people should alter themselves to be happy with any particular thing is in need of justification beyond “it would make them happier.”
There are a handful of such justifications that get seen fairly often. Appeals to Nature or God are of little interest to me; if you wish to make such an appeal, I suppose that’s your prerogative. Sometimes people make appeals to unfair competition – “some people are more attractive, and given the demands of competition, this amounts to a kind of tax on unattractiveness, which would be better off removed.” While I kind of agree, pushing back against the existence of options to alter the environment in favour of altering the individual just seems like a poor way to resolve this. If there are any good ways, I don’t know of them, though.
To go back to an earlier point – in Buddhism, there is a story of a farmer with 83 problems . The story goes that the farmer went to see Buddha, who was known to be wise beyond wisdom, to seek counsel on how to rein in his errant son. Buddha said he could not help with that. Well, said the farmer, maybe you could advise me on how to mend my leaky roof. Buddha said he could not help with that. Okay, said the farmer, maybe you could teach me how to mend shoes. Buddha said he could not help with that. And so on through the farmer’s entire list of problems. At the end of the list, the farmer scowled and said “is there anything you can do?” And Buddha said he could solve the farmer’s 84th problem: that the farmer wanted to not have problems.
This must have made Buddha feel extremely clever, except that I’m pretty sure he was above that. But the farmer’s son was still errant; his roof still leaked; his shoes still tattered. One might even argue – given that Buddha could not wirehead anyone, and could only suggest decades of meditation and self-doubt – that he gave the farmer the 84th problem of feeling like caring about all those other problems was his fault for not being phlegmatic enough. Now, maybe the farmer attained enlightenment and was happy – or whatever positive-affect adjective you use to describe enlightened beings, anyway – and if so, good, but did Buddha really do all that he should in this story? Was it okay for him to sit back, content with having provided only the option to remove the perception of there being any problems?
As with the list of examples above, there’s one simple answer: that if someone prefers not to alter their preferences, then we should not say that having provided the option of doing so fulfills all moral obligations to alleviate their suffering. There are lines to be drawn on how far it is acceptable to go in pursuit of such, but the line is not here unless we want to say that in every case listed so far and many others besides the correct approach is “just don’t care about it.”
Well, I hope I’ve explained a bit about why I think wireheading is the wrong sort of approach to the, hah, problem of having an imperfect world. If people want to alter themselves, sure, but the mere existence of that as an option would not be enough to dismiss unhappiness.
 – Because that sounds completely impossible.
 – Because self-esteem can only get you so far; attractiveness isn’t going to be purely socio-cultural.
 – Again, that also sounds pretty much impossible.
 – Again, social norms aren’t so loose that people can expect to do equally well by following or by defying them.
The important note here at the foot is this: these arguments are constructed without reference to what the patient wants, i.e. no “but they probably don’t want to be cured of that desire.” And if you’re asking some of the questions but in other cases using answers similar to the footnotes, note that these are pretty interchangeable. For instance, obesity kills as surely as cancer does – and so does gender dysphoria, if you accept that “just have them not commit suicide after we insist they live a life that will make them want to” is not a valid method of engineering solutions, in the same way that “adopt the NAP” is not a useful solution to propose for gun violence.
 – It’s not clear why that number in particular, but I did remember the number perfectly despite having heard the story only once. Maybe there’s someting to it!