The Ethics of Enhancement

Recently I’ve been revisiting some of my old writing and research interests. Below is a research paper on biomedical enhancement that I wrote in 2016:

Last summer, I visited a nanotechnology lab at Stanford. There, I met Wei, an electrical engineering graduate student who showed me the project she was working on: building retinal implants for people who can no longer see. As I squinted at those implants that were only one millimeter across, I was already amazed by the idea that biology and technology could combine to do something I previously thought was impossible — restore sight to the blind. But then, with a casual comment, Wei shifted my concept of “impossible.” She told me that with a couple small adjustments, these retinal implants could also let people see infrared radiation.

I was shocked. It was possible for people to walk around with infrared vision right now, literally seeing the world in a way no person had ever seen it before! I suppose it should not have been too surprising. After all, I was used to the idea that similar technology existed in military night vision goggles that use infrared imaging to let soldiers see in the dark. But implanting night vision directly into people’s eyes so it becomes a part of them? Directly altering people’s bodies and physical capabilities? It seemed like the stuff of crazy sci-fi novels wasn’t so crazy, after all.

As I thanked Wei for her time and headed home from the lab, I started thinking about whether we should alter our bodies beyond their “natural” state, now that we had the means to do so. I, personally, was a bit uncomfortable with the idea. If my previous views on the “impossible” weren’t correct, what were the limits on reality? And what were the ethical implications of modifying ourselves with technology in this way?

I found that many people had similar concerns with technologies like the retinal implants that allow people to interact with the world in “unnatural” ways. Such technologies are called enhancements, or developments that act on people’s bodies in order to create new human abilities or improve existing ones (Beyond Humanity 23). More specifically, biomedical enhancements are biomedical science and technology-related enhancements. They can come in a number of forms such as retinal implants that physically alter a person’s ability to see and drugs that enhance the brain’s information processing, emotion, and memory.

It makes sense that so many people are concerned with biomedical enhancements. After all, people tend to fear the unknown. People tend to fear change. And so many people fear biomedical enhancements, with their exciting potential to alter humans and society as we know it.

Although the idea of altering human bodies, such as by implanting night vision chips into people’s retinas, can be frightening and unfamiliar, careful reasoning reveals that the use of biomedical enhancements can be ethical and even beneficial in a number of contexts.

To understand these ethical benefits, one can compare new biomedical enhancements with existing, comparable technologies in order to analyze their ethical costs and benefits. Because while advanced biomedical technologies — like night vision retinal implants–-are a very recent development, humans have already had a long-standing practice of enhancing their own capabilities.

Literacy, math, medicine, and technology are all tools that have existed in human society for a long time, enhancing people’s minds and bodies. And as it stands, a number of more recent technologies — such as pacemakers, insulin pumps, and heart valve replacements, which help people’s bodies stay healthy and last longer — are beginning to cross the line from medical treatment to bionic enhancement. In general, these technologies have been considered ethically uncontroversial, since they treat people with medical conditions rather than creating any new, “superhuman” capacities. However, this medical progress has greatly increased quality of life and life expectancy, gradually shifting the way we define the capabilities of the “normal human being.”

For instance, a few years ago, scientists were able to create functional substitutes for about fifty percent of the human body (Brumfiel). And a few months ago, a recent project successfully allowed people to control machinery with their minds. Researchers accomplished this by implanting electrodes into patients’ brains, successfully allowing a man who had been paralyzed for over ten years to be able to feel and control a mechanical hand with his mind (Lytton). Loren Ward, a local polytrauma acute rehabilitation physical therapist, who regularly works with prosthetics in order to rehabilitate veterans who have lost limbs in combat, explains that this rapidly developing technology may soon be used commercially. As a result of such dramatic gains and increasingly widespread uses of medical technologies, long-standing issues regarding enhancement are becoming increasingly relevant and pressing.

Currently, reactions to these ethical issues raised by recent technological advancements can be grouped into two main categories: bioconservatives and transhumanists. Bioconservatives are critics of enhancement, who argue that excessive enhancement will alter humans to the extent that they may lose their sense of humanity and identity, increase inequality in society, and cause harmful unforeseen consequences (Beyond Humanity). In contrast, transhumanists are members of an intellectual movement “that affirms the possibility and desirability of fundamentally improving the human condition…[by] enhanc[ing] human intellectual, physical, and psychological capabilities”(Sharon).

Careful analysis of the potential impact of enhancements on human identity, their impact on inequality and culture in our larger society, and the consequences of their use in the military — seems to lean more heavily on the transhumanist side, suggesting that the use of biomedical enhancements can be ethical, just as the use of an insulin pump or a pacemaker can be ethical.

Enhancements and Identity: Blurring the Line between Humanity and Technology

Before learning about the ethical implications of biomedical enhancements for society as a whole, I was initially interested in how biomedical enhancements would impact people on the individual level. I started by thinking small and personal. I wondered how night vision retinal implants might affect my life, if one day, I were to receive the implant surgery and suddenly become able to see in the dark. How would seeing the world differently cause me to see myself differently?

This issue of identity and shifting our conception of “humanity” is a central issue to the enhancement debate. For those opposed to biomedical enhancements, the fear that altering people until they become so different from “natural” humans that they lose their sense of “humanity” is a large ethical concern. For instance, in a paper arguing that radical enhancement could damage our sense of identity, Nicholas Agar, a professor of ethics at the Victoria University of Wellington, writes, “the radical extension of our life spans could eliminate experiences of great value from our lives.” Agar argues that enhancements, such as those that extend people’s lives, could alter the individual’s human experience so drastically that people could lose their sense of perspective and gratitude for the life that they have. In short, drastically changing people with enhancements could cause them to lose some of their humanity, some of the “great value” in their lives.

What Agar does not address in his concern for “losing our sense of humanity” is that improvements in nutrition, quality of life, medicine, and technology have already radically extended people’s lives. The average life expectancy for a male child “born in the UK between 1276 and 1300 was 31.3 years. In 1998, it [was] 76” (“A Millennium of Health Improvement”). That means life expectancy has more than doubled in the UK since the Middle Ages. But Agar did not argue that the advancements in medicine that enabled the doubling of life expectancy since the Middle Ages have made individuals worse off by “eliminating experiences of great value from our lives.” He and other major anti-enhancement voices (Beyond Humanity) did not support their abstract “humanity” arguments with concrete evidence from the past when listing their fears for the future.

People today still experience the losses and celebrate the joys that make them human, and increased lifespans and other improvements to their individual human experiences have yet to erase their human identities.

The issue of humanity and identity is also closely linked to the issue of separating the individual’s sense of selfhood from his or her environment. One non-controversial example of this, mentioned earlier, is the average person’s increasing reliance on modern medical technologies such as insulin pumps and cochlear implants. Many people today cannot function at a “normal,” healthy level without the help of such penetrating or implanted devices, which raises an interesting question: How can people draw the line between themselves and the devices that have become a part of them? As modern technologies become increasingly more invasive, physically becoming a part of people, is the once-definite border between the environment and the human body becoming blurred?

On the extreme end of this ever-weakening barrier between the individual and the environment is the concept of “mind uploading”(Better than Human). This is the idea of preserving the mind by transferring a person’s entire mental state — -such as memories, personality, and sense of “self” — -from his or her brain to a computer (Hendricks). Such an idea leads to many questions about identity and “humanness:” If the entirety of a person’s mind is stored in a computer, would that “uploaded mind” be considered a person or a computer? Conversely, would a computer that has been built to think and feel, implanted into a human body, be considered a computer or a person?

While mind uploading is not exactly within the grasp of current technologies, thinking about the possibility of mind uploading raises questions about the degree to which a person can be altered while still being considered a person. This is, after all, what Agar and other opponents of enhancement are concerned about, claiming that it would be wrong to change people so radically.

The ethical implications of such an extreme, hypothetical situation are not as obvious as the concrete example of lifespan. And while pondering the potential consequences of radical enhancements such as mind uploading is interesting, for the sake of the ethical debate, such abstract theorizing is senseless. As Dr. Michael Hendricks — biology professor at McGill University and writer for the MIT Technology review — explains, current scientists are nowhere near simulating the mind of the simple, well-studied roundworm C. elegans, much less the mind of a human. Instead of being paralyzed by the potential ethical issues of mind uploading and enhancements far outside of today’s technological grasp, it makes sense to focus on making progress by considering the real, pressing ethical impact of current enhancement technologies.

The Benefit of Enhancements to Individuals

After neutralizing the main fears and anti-enhancement arguments surrounding questions of identity, it makes sense to analyze the benefits of enhancements. After all, even though enhancements do not seem to have any ethical repercussions serious enough to completely halt all technological progress, it wouldn’t make sense to develop them if they didn’t have any serious benefits, either. Luckily for advocates of enhancement, current enhancement technologies do have a powerful potential for good, for improving quality of life.

An ethical analysis of the impact of enhancements on the individual level would be remiss if it didn’t address this humanitarian aspect of existing enhancements.

In his TED talk, Hugh Herr, head of the MIT Media Lab’s Biomechatronics group, gives a firsthand account of the ways in which prosthetics technologies are improving people’s lives. Herr is a mountain climber who began using bionic limbs himself after he lost both his legs to frostbite. He explains the positive role prosthetic enhancements have played in his life: his specialized mountain-climbing “narrow-edged feet [allow him] to climb steep rock fissures, where the human foot cannot penetrate, and spiked feet enable [him] to climb vertical ice walls, without ever experiencing muscle fatigue.” So Herr’s prosthetic legs give him a “superhuman” rock-climbing ability. This is a powerful example of a current enhancement technology that is enabling people to enjoy and experience their lives in ways that would not be possible otherwise. As Herr says, “our expression, our humanity can be embedded into electromechanics.”

In this way, current bionic enhancements (like Herr’s specialized rock-climbing legs) help people on the individual level by improving people’s life experiences. Because Herr’s bionic legs are not very extreme alterations of his body, there seems to be no significant ethical controversy over his use of these enhancements. The benefits of Herr’s leg enhancements to his quality of life, including his enjoyment of his rock climbing hobby, outweigh potential ethical issues such Agar’s concern that enhancements can make us less human. In fact, in Herr’s case, his increased ability to appreciate life, shows that enhancements, in some respects, can make us more ‘human.’

Implications for Society and Culture

While the benefits of enhancements are clear at the individual level, a couple of major ethical concerns of biomedical enhancements emerge at the societal level. Critics argue that enhancements have the potential to increase inequality in society and disrupt the existing social order through the creation of more “superior,” enhanced humans. However, enhancements do also have the potential to greatly improve society — -and, as some existing examples reveal, society has already been drastically improved by enhancements.

The first major concern towards the morality of biomedical enhancement is that it will increase inequality and the rift between the haves and have-nots, since wealthier people will most likely be able to afford more enhancements. After all, enhancements like retinal implants that give people infrared vision are bound to be expensive. But while at first glance, the impact of extreme biomedical enhancements on inequality may seem untested, similar situations do, in fact, already exist.

For instance, literacy, an enhancement of the mind, can be used as an analogy to biomedical enhancements, an enhancement of the body. According to the Russian psychologist Vygotsky, the developing child’s vocabulary and ability to speak through his or her thought processes in new words help the child learn to think about new concepts like simple arithmetic more quickly (Myers). Therefore, language is a kind of enhancement that increases the mental capacity of developing children. In the first and second grade, I and the rest of the children in my class were evaluated on our reading and vocabulary abilities, then placed on advanced, average, and special needs tracks. This practice of “tracking” amplified the effect of the existing inequality in our reading levels, as students who already had more advantages such as more affluent or nurturing home environments continued to gain an even greater advantage in school by learning more than the disadvantaged students. Similarly, some argue that biomedical enhancements will just amplify existing inequalities. This is a reasonable concern. After all, if people were to make expensive biomedical enhancements that increase health and productivity available only to those wealthy people who can afford them, they would be reinforcing inequality and injustice, in the same way that giving more fortunate children access to more advanced education does.

But just as it would be wrong to lock all children up and withhold education and language from them for fear of increasing inequality between them, it would also be wrong to withhold biomedical enhancements from all people. The education and biomedical enhancements in themselves are not bad — it’s how they could be unfairly distributed that is of ethical concern. Therefore, the potential for enhancements to be unequally distributed should be weighed against the potential benefits to individuals and society. And, as it turns out, enhancements do have a lot of potential to alleviate inequality and help society.

For one thing, enhancements are not a zero-sum game. In the past, non-biomedical enhancements such as better agricultural practices, government, and economies have increased society’s productivity and resources. In the future, biomedical enhancements that will improve people’s health, decrease disabilities at the end of life, and extend life expectancy would make society as a whole more productive as well. Allen Buchanan, a professor of philosophy and ethics at Duke University explains that while being more productive is not necessarily a morally “good” thing in itself, more productive and developed societies as a whole tend to have “less disease, less premature death, less disability…and more opportunity for people to…pursue their own conception of the good life”(Beyond Humanity 44). Also, more developed societies are more capable of using their surplus wealth to combat inequality by providing their citizens with better social programs. So with the enormous potential benefits of enhancements to society, it could be unethical not to allow the research and use of biomedical enhancements.

More specifically, for instance, consider the impact of the vaccine on society. The vaccine — -an immune system enhancement that has existed since 1796 (Riedel) — -is a perfect counter-argument to the inequality argument. The more people are immunized in a society, the more each individual benefits from the existence of the vaccine because it makes each person less likely to contract the disease. Although the rapid spread of diseases such as polio and measles were once considered an unpleasant but unavoidable part of living in contact with large numbers of people in organized society, the invention of vaccines have greatly reduced “disease, disability, death, and inequity worldwide”(World Health Organization).

In the same way that people of the eighteenth century might not have been able to imagine living in a society so largely freed from the threat of lethal diseases, today’s twenty-first century inhabitants may not be aware of the significant ways in which further biomedical enhancements to the human immune system may collectively improve their lives. Those opposed to biomedical enhancements downplay the benefits that enhancements can bring, claiming that attempts to alter humankind’s natural endowments show a lack of appreciation for what people have been given (Beyond Humanity).

Along with improving quality of life on a societal level, biomedical enhancements could help people by serving as an equalizer. Think of pharmaceuticals today that unethically spend research money on developing products like “hair loss remedies and super-Viagra” instead of on less profitable “treatments or vaccines for malaria or dysentery”(Beyond Humanity 247) which could save millions of lives. Similarly, refusing to develop and provide equitable access to other enhancements that could help the people that need them the most (e.g., drugs that function as better emotional enhancements for people with depression) would similarly be unethical. This is especially true since problems with mental and physical health disproportionately affect people with a lower socioeconomic status (Lorant et. al). So if biomedical enhancements are regulated against the dangers of immoral commercialization, enhancements could be a powerful tool for fighting extreme levels of inequality.

The second major ethical concern towards enhancements that arises at the societal level is the potential disruption of cultures and social order. Bioconservatives, fearing the potential negative consequences of enhancements, frequently argue that eventually, extreme enhancements may lead to the creation of “posthumans,” or humans who have been enhanced so dramatically that they can experience the world in a manner completely inaccessible to “regular” humans (Beyond Humanity 209). Due to their improved, altered state,“posthumans” might have a higher social status, and new, different posthuman rights that will set them apart from unenhanced humans. Bioconservatives fear that this could lead to issues such as discrimination against unenhanced humans. Posthumans might treat humans as though they had inferior rights, the way people have used Social Darwinism, racism, and other forms of prejudice to justify the inferior treatment of people labeled a certain way.

One way to imagine this somewhat vague concept is through the existing, analogous situation of cochlear implants. Just like bioconservatives fear radical enhancement may give rise to another opportunity for humans to divide themselves into groups and subcultures that foster prejudice, “therapeutic uses of cochlear implants can be disruptive to the integrity of [deaf] subcultures”(Campbell, et. al).

Deaf communities have suffered long-standing discrimination, based in audism, or “the belief that it is inherently better to be able to speak and hear”(Ringo). For instance, in the 1860s, Alexander Graham Bell, a famous advocate of teaching speech and lip-reading to deaf people, claimed to be working for the deaf community, while “remov[ing] Deaf faculty from schools…and advocat[ing] against ‘deaf intermarriage.’” This prejudice against deaf people has resulted in the widespread misunderstanding in the mainstream community that the most desirable course of action for deaf children is to receive cochlear implants at a young age, so that they can learn to speak and hear and be a part of the mainstream community rather than learn ASL. However, this is a controversial issue, since by choosing to have their children receive cochlear implants, Deaf parents belonging to the Deaf subculture would essentially be unable to communicate and connect with their own children.

Bioconservatives fear that radical enhancements will result in a similar discrimination against normal humans by posthumans, along with the difficult ethical choices similar to the ones that deaf parents are forced to make on whether or not to ostracize his or her children from the family’s deaf subculture.

While these concerns are certainly reasonable, it is important to distinguish between the differences that could exist between people, such as hearing ability, race, gender, or biomedical enhancements, and the discrimination and negative issues that arise from immoral reactions to those differences. Failing to do so could lead to the same faulty reasoning that leads some people to believe that differences between people lead to discrimination, when in fact, it is the failure to include and understand those differences that leads to discrimination. Such people believe that everyone should assimilate into a mainstream culture rather than preserving different perspectives and cultural heritages because it takes extra effort to understand and accommodate those different from oneself into one’s life.

But societies benefit from diversity. Countries with more diverse populations tend to be more moral, and diverse perspectives lead to more creative solutions (Myers). So rather than blaming diversity for causing tension, people should work harder to diminish the negative consequences of discrimination. Rather than blaming enhancements as a potential source of difference and conflict between people in the future, people should be focusing on how to mitigate discrimination, as they would with any other source of difference between people in a diverse society.

It is not possible to know for certain how the course of society will be altered by biomedical enhancements. However, if used wisely, enhancements have great potential to improve society as a whole in many ways, from reducing inequality to enriching society with another dimension of diversity.

Enhancements in the Military

The issues of morality become less clear-cut in the context of war. While normally, killing massive numbers of people is clearly immoral, historically in times of war, it has been lauded as heroism.

The oxymoron of morality in war is particularly relevant for the application of biomedical enhancements to make enhanced soldiers, who are commonly referred to as “supersoldiers” in popular films, video games, and sci-fi literature. After all, as in any situation, ethical guidelines do exist in war, yet the introduction of enhancements into war may invert these guidelines. While most bioconservative and transhumanist arguments lack a careful consideration of the potential impact of biomedical enhancements on the ethics of war, this one narrow application of enhancements is among the most morally ambiguous and therefore interesting aspects of the enhancement debate.

One of the major challenges of considering the ethics of supersoldiers is the safeguards set in place in an attempt to prevent the horrors that are all too common in warfare. For instance, the UK Royal Society’s report “Neuroscience, Conflict and Security” suggests that biologically enhancing soldiers “could violate either the Biological or Chemical Weapons Conventions.” As another example, the Geneva and Hague Conventions, treaties outlining rules for the humane treatment of civilians, prisoners of war, and soldiers during wartime declare torture of enemy combatants unethical. But would these laws make sense to enhanced soldiers, for which the Geneva Convention’s “underlying assumptions [about human limitations]…. — -that humans respond to a certain level of pain and need sleep and food”(Lin) are no longer valid?

Those opposed to enhancing soldiers argue that allowing the use of supersoldiers in war will degrade the authority of these important conventions, making it easier for militaries to justify atrocious uses of biological warfare and torture in the future (Lin). But as biomedical enhancements begin to redefine soldiers’ capabilities, people will simply need to reconsider the specific letters of the law of morality. For instance, if an enhanced prisoner of war only needs one hour of sleep per day to function normally, it would not be considered torture for his or her captors to only permit him one hour of sleep each night. And while forcing prisoners to hold weights is involved in a form of torture known as strappado (“Interpretation of Torture”), the full-bodied bionic EKSO skeletons that enhances soldiers’ ability to carry heavy packs in the field redefine the amount of weight that a soldier can carry before it becomes painful (Ward).

Additionally, enhanced soldiers actually have the potential to improve warfare. Perhaps “supersoldiers” with superhuman abilities to precisely aim weapons may result in fewer civilian deaths, and soldiers enhanced specifically to handle the psychological challenges of warfare could suffer less post-traumatic stress upon returning home from war.

Thus, as with many other aspects of the enhancement debate, people can make the most of biomedical enhancements through careful action to avert potential negative side-effects coupled with the use of enhancements in the areas where they can do the most good.

The application of enhancements to the military is only one facet of the way biomedical enhancements can revolutionize the human experience. People are already using enhancements such as retinal implants to restore sight to the blind, vaccines to boost the immune systems, and prosthetic legs to mountain-climb. And people are continuing to find ways to responsibly and morally incorporate the use of biomedical enhancements into everyday life.

The progress of biomedical technologies is catapulting society towards drastic change. Though at first glance, biomedical enhancements may seem new and completely unrecognizable, in reality, these enhancements actually just require the reexamination of age-old issues of identity, inequality, elements of a moral society, and warfare in a new context.

Enhancements have already played a major role in shaping humankind, and biomedical enhancements may literally redefine what it means to be human. Examining the impact of existing enhancements on society and extrapolating these to the impact of future biomedical enhancements can help people understand today what consequences enhancements may have tomorrow. It does not take special night vision retinal implants to see that biomedical enhancements have a serious potential to improve individuals’ lives and to improve society as a whole.

Works Cited

Agar, Nicholas. “Radical Life Extension Would Make People Less Human.” Extending the Human Lifespan. Ed. Tamara Thompson. Detroit: Greenhaven, 2013. At Issue. Rpt. of “What Is Radical Enhancement?” Humanity’s End: Why We Should Reject Radical Enhancement. Vol. 1. MIT Press: Boston, 2010. N. pag. Opposing Viewpoints in Context. Web. 19 Jan. 2016.

Brumfiel, Geoff. “The Insane and Exciting Future of the Bionic Body.” Smithsonian. Smithsonian Magazine, Sept. 2013. Web. 20 Oct. 2015.

Buchanan, Allen E. Better than Human: The Promise and Perils of Enhancing Ourselves. New York: Oxford UP, 2011. Print.

Buchanan, Allen E. Beyond Humanity?: The Ethics of Biomedical Enhancement. Oxford: Oxford UP, 2011. Print.

Campbell, Courtney S., Lauren A. Clark, David Loy, James F. Keenan, Kathleen Matthews, Terry Winograd, and Laurie Zoloth. “The Bodily Incorporation of Mechanical Devices: Ethical and Religious Issues (Part I).” Biotechnology and Bioethics The Bodily Incorporation of Mechanical Devices: Ethical and Religious Issues (Part I) (n.d.): n. pag. Stanford HCI Group. Stanford University, 1 Dec. 2006. Web. 12 Dec. 2015.

Hendricks, Michael. “The False Science of Cryonics.” MIT Technology Review. MIT, 15 Sept. 2015. Web. 3 Apr. 2016.

“Interpretation of Torture in the Light of the Practice and Jurisprudence of Intarnational Bodies.” (n.d.): n. pag. United Nations Voluntary Fund for Victims of Torture. Web. 3 Apr. 2016.

Lin, Patrick. “More Than Human? The Ethics of Biologically Enhancing Soldiers.” The Atlantic. Atlantic Media Company, 16 Feb. 2012. Web. 18 Jan. 2016.

Lytton, Charlotte. “How Close Are We to a Fully ‘Bionic Body’?” The Daily Beast. Newsweek/Daily Beast, 19 Sept. 2015. Web. 19 Oct. 2015.

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Moore, Pete. Enhancing Me: The Hope and the Hype of Human Enhancement. Chichester, England: Wiley, 2008. Print.

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Neuroscience, Conflict and Security. London: Royal Society, 2012. UK Royal Society. Web. 3 Apr. 2016.

The New Bionics That Let Us Run, Climb and Dance. Perf. Hugh Herr. TED, Mar. 2014. Web. 10 Jan. 2016.

“Prosthetic Limbs, Controlled by Thought.” The New York Times. The New York Times, 20 May 2015. Web. 21 Oct. 2015.

Riedel, Stefan. “Edward Jenner and the History of Smallpox and Vaccination.” Proceedings (Baylor University. Medical Center). Baylor Health Care System, 18 Jan. 2005. Web. 12 Mar. 2016.

Ringo, Allegra. “Understanding Deafness: Not Everyone Wants to Be ‘Fixed’” The Atlantic. Atlantic Media Company, 9 Aug. 2013. Web. 06 Apr. 2016.

Sharon, Tamar. Human Nature in an Age of Biotechnology: The Case for Mediated Posthumanism. Vol. 14. New York: Springer Science+Business Media, 2014. Print. Philosophy of Engineering and Technology.

Ward, Loren. Personal interview. 12 April 2016.

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