In Chapter 11 I discuss the possibility of “moral enhancement” – the use of chemicals or other interventions to increase the likelihood that people will make sound moral decisions. The discussion in that chapter rests on a basic framework of ideas about what constitutes meaningful moral action. This is of course a complex topic, but it is worth laying it out here in (highly) schematic form.  Let us start with the following necessary conditions:
1. Free will. In order to engage in responsible moral behavior, I need an ability to project different scenarios of possible action in my mind, imagining the probable consequences of my action in each scenario, both for myself and for other people. Free will, in other words, means the ability to choose meaningfully among projected courses of action, after weighing the costs and benefits of each one for ourselves and for others. 
2. Free agency. I also require physical, environmental, and societal conditions that allow space for the exercise of free will.
3. Moral character. Finally, I must possess a sense of right and wrong – a moral compass – and a commitment to be the kind of person who seeks to guide my actions according to the dictates of that compass. I must intend for my deed to align consistently with my moral principles.
These conditions – free will, agency, and moral character – are in turn affected by the following factors which always operate together:
A. Biological factors. I refer here to such elements as brain functions that allow us to put ourselves in the shoes of other people; genetic predispositions to feel empathy (or not); and brain states that allow us to project future scenarios in our minds, predicting consequences of various courses of action. 
B. Environmental factors. Here I am thinking of our upbringing, and the moral models given to us by the people with whom we grew up; concepts and moral theories we have learned about ourselves and the world; and the cultural mores and normative expectations of the particular society in which we live.
C. Situational factors influencing the act of choice. What is the context for our decision? Are we under great duress? Are we surrounded by other people who heavily influence the kinds of judgments we make? 
Moral choice comes about through the delicate balancing of these three domains – biological, environmental, and situational factors – each of which plays a key role in influencing our capacities for evaluation and agency. The equilibrium among them is crucial to the moral nature of the action. If one set of factors is either absent or excessively predominant, the balance is lost, and the moral nature of the deed is either undermined or destroyed.
For example, if the brain’s functioning is altered by drugs or by a surge of hormones released in fear or rage, then the biological factors are too strong, and the mind becomes unable to perform its role in envisioning alternative courses of action and rationally assessing their consequences. Moral reflection is compromised, and therefore morally responsible action becomes difficult if not impossible. On the other hand, if one’s upbringing has involved severe cultural techniques of conditioning or brainwashing, such as one finds in certain cults, then the environmental factors are too strong, and the person’s mind becomes less capable of properly evaluating alternatives and consequences.  Again, moral choice is compromised. Finally, if one is surrounded by dozens of other persons who put great peer pressure on us to make a certain decision rather than another, then it is the situational factors that become too strong, and the mind becomes less capable of performing its role as an independent source of judgment. All three sets of factors work together in dynamic equilibrium – not too much, not too little – to produce the space in which moral agency occurs.
Autonomy and ‘Coercive Paternalism’
The discussion of “moral enhancement” in Chapter 12 may seem like a rather abstract and futuristic philosophical issue – but it is not. A striking version of it arose in 2012 in New York City, when Mayor Michael Bloomberg banned the sale of large bottles of high-calorie soft drinks at certain public venues within the city limits. Bloomberg was seeking to address the rampant problem of obesity that afflicts American society – and he was willing to restrict the beverage choices available to New Yorkers in the name of working toward this goal. In this sense, he was following a similar line of reasoning to that of Persson and Savulescu described in Chapter 12. Bloomberg was seeking to pre-channel or pre-limit citizens’ choices, in the name of achieving a desirable end-result. He was trading a (small) measure of human autonomy for an increase in public health.
The ethics of such campaigns to mold public behavior is taken up in Sarah Conly, Against Autonomy: Justifying Coercive Paternalism (Cambridge, 2012); and in a review of Conly’s book by Cass Sunstein: “It’s For Your Own Good!” New York Review of Books (March 7, 2013), 8-11. Sunstein observes:
To Mill’s claim that individuals are uniquely well situated to know what is best for them, Conly objects that Mill failed to make a critical distinction between means and ends. True, people may know what their ends are, but sometimes they go wrong when they choose how to get them. Most people want to be healthy and to live long lives. If people are gaining a lot of weight, and hence jeopardizing their health, Conly supports paternalism—for example, she favors reducing portion size for many popular foods, on the theory that large, fattening servings can undermine people’s own goals. In her words, paternalism is justified when “the person left to choose freely may choose poorly, in the sense that his choice will not get him what he wants in the long run, and is chosen solely because of errors in instrumental reasoning.”
Although I can understand Conly’s well-intentioned arguments in favor of “coercive paternalism,” I am leery of any policy that limits the autonomy of individuals – even if those individuals have a lousy track record when it comes to behaving in their own best interests. Conly holds that, as long as individuals still maintain the final right to decide, then various efforts to pre-emptively channel or ‘pre-shape’ their choices is legitimate. I am uncomfortable with this – for all the reasons detailed above about the importance of maximizing free will and autonomy whenever possible.
As a general principle, it is always better to treat people like responsible, rational agents and to seek to persuade them through educational campaigns and public debate. The cost of taking this route may be high – as someone like Mayor Bloomberg might readily point out. People who are truly autonomous will not always make good decisions. A great many of them will routinely opt for stupid, counterproductive, selfish, or even nasty courses of action. But the ability of an individual to make real choices – meaningful choices based on all manner of good and bad options – is essential to our humanity. Our autonomy may come at a high price, but the costs of limiting it are in most cases even higher. John Stuart Mill had it right when he argued that the only legitimate constraint on our liberty comes at the point where the exercise of one person’s free choices undermines the liberties of other people. Human autonomy is an absolute good, and our public policies should aim to maximize and nurture it, not curtail it.
 David Copp, ed., The Oxford Handbook of Ethical Theory (Oxford, 2006); Hugh LaFollette, The Blackwell Guide to Ethical Theory (Blackwell, 2000); Alasdair MacIntyre, After Virtue (Notre Dame, 1984); Susana Nuccetelli and Gary Seay, Ethical Naturalism: Current Debates (Cambridge, 2012); James Rachels, The Elements of Moral Philosophy (McGraw Hill, 2010); John Rawls and Erin Kelly, Justice as Fairness: A Restatement, 2nd ed. (Belknap, 2001); Michael Sandel, Justice: What’s the Right Thing to Do? (Farrar, Straus, Giroux, 2009); T. M. Scanlon, What We Owe to Each Other (Belknap, 1998); Jeffrey Schaler, ed., Peter Singer Under Fire (Open Court, 2009); Samuel Scheffler, Human Morality (Oxford, 1992); Amartya Sen, The Idea of Justice (Belknap, 2009); Peter Singer, How Are We to Live? (Prometheus, 1995); David Wiggins, Ethics: Twelve Lectures on the Philosophy of Morality (Harvard, 2006); James Q. Wilson, The Moral Sense (Free Press, 1993).
 Kathleen Taylor, Brainwashing: The Science of Thought Control (Oxford, 2006); Steven Hassan, Combatting Cult Mind Control: The #1 Best-selling Guide to Protection, Rescue, and Recovery from Destructive Cults (Park Street, 1990); Joost Meerloo, The Rape of the Mind: The Psychology of Thought Control, Menticide, and Brainwashing (Progressive, 2009).