In light of the World Anti Doping Agency’s 2013 Code Revision process, we critically explore the applicability of two of three criteria used to determine whether a method or substance should be considered for their Prohibited List, namely its (potential) performance enhancing effects and its (potential) risk to the health of the athlete. To do so, we compare two communities of human guinea pigs: (i) individuals who make a living out of serial participation in Phase 1 pharmacology trials; and (ii) (...) elite athletes who engage in what is effectively ‘unregulated clinical research’ by using untested prohibited or non-prohibited performance enhancing substances and methods, alone or in combination. Our comparison sheds light on norms of research ethics that these practices exacerbate with respect to the concepts of multiplicity, visibility, and consistency. We argue for the need to establish a proper governance framework to increase the accountability of these unregulated research practices in order to protect the human guinea pigs in elite sports contexts, and to establish reasonable grounds for the performance enhancing effects, and the risks to the health of the athlete, of the methods and substances that might justify their inclusion on the Prohibited List. (shrink)

The use of medical stimulants to sustain attention, augment memory and enhance intellectual capacity is increasing in society. The use of Methylphenidate for cognitive enhancement is a subject that has received much attention in the literature and academic circles in recent times globally. Medical doctors and medical students appear to be equally involved in the off-label use of Methylphenidate. This presents a potential harm to society and the individual as the long-term side effect profile of this medication is unknown.

This issue of Criminal Law and Philosophy contains three papers on a topic of increasing importance within the field of "neurolaw"-namely, the implications for criminal law of direct brain intervention based mind altering techniques. To locate these papers' topic within a broader context, I begin with an overview of some prominent topics in the field of neurolaw, where possible providing some references to relevant literature. The specific questions asked by the three authors, as well as their answers and central claims, (...) are then sketched out, and I end with a brief comment to explain why this particular topic can be expected to gain more prominence in coming years. (shrink)

Some have claimed that moral bioenhancement undermines freedom and authenticity – thereby making moral bioenhancement problematic or undesirable – whereas others have said that moral bioenhancement does not undermine freedom and authenticity – thereby salvaging its ethical permissibility. These debates are characterized by a couple of features. First, a positive relationship is assumed to hold between these agency-related concepts and the ethical permissibility of moral bioenhancement. Second, these debates are centered around individualistic conceptions of agency, like free choice and authenticity, (...) which hail from an atomistic tradition of autonomy. My view is that emphasizing individualistic conceptions of autonomy do not provide particularly strong foundations on which to argue about the issue of the permissibility of moral bioenhancement. This is because individualistic autonomy is not the kind of agency-related consideration we ought to value. Instead, I propose that we investigate the relationship between moral bioenhancement and a more relational kind of autonomy. Focusing on this latter relationship, on my view, clarifies the potential for moral bioenhancement to support or enhance people’s autonomy. (shrink)

The paper discusses criticisms against pharmacological cognitive enhancement from a liberal perspective. The criticisms point to the consequences of cognitive enhancement in third parties and in the agents, as well as in independent values. According to the article, these criticisms are not convincing. On the contrary, it argues that under certain assumptions there are good reasons in favor of free access to cognitive enhancement.

The debate about how neurotechnologies impact authenticity has focused on two inter-related dimensions: self-discovery and self-creation. In this paper, we develop a broader framework that includes the experimental and relational dimensions of authenticity, both understood as decisive for shaping one’s narrative identity. In our view, neurointerventions that alter someone’s personality traits will also impact her very own self-understanding across time. We argue that experimental authenticity only needs a minimum conception of narrative coherence of the self and that reversibility should remain (...) a key feature in the ethical assessment of neurotechnologies. The relational dimension of authenticity derives from the fact that a process of self-constitution is never a solitary business. The significant others act not just as subsequent judges of one’s life decisions, but as real co-authors of one’s self. We discuss relevant cases in which others are actively contributing to the meaning-making process, as to the direction one’s life is taking. We also claim that the experimental and the relational dimensions of authenticity should aim to correct each other. The relational dimension introduces socially approved standards as well as limitations to the array of available possibilities of self-fashioning or human enhancement. The experimental side enables us to avoid confusing one’s personal identity with a social and narrative construct that only bears the mark of social pressure and conformism. (shrink)

The extra-therapeutic use of psychotropic drugs to improve cognition and to enhance mood has been the subject of controversial discussion in bioethics, in medicine but also in public for many years. Concerns over a liberal dealing with pharmacological enhancers are raised not only from a biomedical–pharmacological perspective, but particularly from an ethical one. Within these ethical concerns, there is one objection about the normative differentiation between “natural” and “artificial” enhancers, which is theoretically indeed widely discredited in bioethics, which has, however, (...) entrenched itself in such a persistent way in everyday moral consciousness that it keeps a crucial influence on the assessment of pharmacological enhancers made by the public and medical professionals. This paper tries to first show why a normative differentiation between “natural” and “artificial” enhancers is highly problematic. In a second step, the resulting implications for our current dealing with pharmacological enhancers shall be examined. In a specific comparison of synthetic pharmaceuticals (modafinil, SSRIs) with phytopharmaceuticals (ginkgo biloba, St. John’s wort) and other already established enhancers (alcohol, caffeine), argumentative inconsistencies are pointed out which, at least partly, result from a rationally untenable preference for the “natural” over the “artificial”. Therefore, it is conclusively argued the case for an unprejudiced assessment of pharmacological enhancers beyond a “natural”–“artificial” dichotomy, which equally takes into account biomedical and ethical aspects. The goal is to reach a coherent dealing with pharmacological enhancement in the long run. (shrink)

Debates about dual-use research often turn on the potential for scientific research to be used to benefit or harm humanity. This dual-use potential is conventionally understood as the product of the magnitude of the harms and benefits of dual-use research, multiplied by their likelihood. This account, however, neglects important social aspects of the use of science and technology. In this paper, I supplement existing conceptions of dual-use potential to account for the social context of dual-use research. This account incorporates relational (...) and positional concerns that feature in the success or failure of dual-use. I then defend this account against foreseeable objections. (shrink)

One objection to enhancement technologies is that they might lead us to live inauthentic lives. Memory modification technologies (MMTs) raise this worry in a particularly acute manner. In this paper I describe four scenarios where the use of MMTs might be said to lead to an inauthentic life. I then undertake to justify that judgment. I review the main existing accounts of authenticity, and present my own version of what I call a “true self” account (intended as a complement, rather (...) than a substitute, to existing accounts). I briefly describe current and prospective MMTs, distinguishing between memory enhancement and memory editing . Moving then to an assessment of the initial scenarios in the light of the accounts previously described, I argue that memory enhancement does not, by its very nature, raise serious concerns about authenticity. The main threat to authenticity posed by MMTs comes, I suggest, from memory editing. Rejecting as inadequate the worries about identity raised by the President’s Council on Bioethics in Beyond Therapy , I argue instead that memory editing can cause us to live an inauthentic life in two main ways: first, by threatening its truthfulness, and secondly, by interfering with our disposition to respond in certain ways to some past events, when we have reasons to respond in such ways. This consideration allows us to justify the charge of inauthenticity in cases where existing accounts fail. It also gives us a significant moral reason not to use MMTs in ways that would lead to such an outcome. (shrink)

An increasing amount of very diverse scholarship self-identifies as belonging to the field of neuroethics, illuminating a need to provide some reference points for what that field actually entails. We argue that neuroethics is a single field with distinct perspectives, roles, and subspecialties. We propose that—in addition to the three traditional perspectives delineated by Eric Racine—a fourth, socio-political perspective, must be recognized in neuroethics. The socio-political perspective in neuroethics focuses on the interplay between the behavioral as well as the brain (...) sciences and the socio-political system; this interplay includes social regulation in addition to all other realistic elements of social and political neurodiscourses. Thus, defining what—if any—roles the socio-political perspective in neuroethics might have is a pressing issue. Doing so could provide guidance for defining the criteria for prospective ethical evaluations in neuroethics. A promising approach to doing this could be by describing the roles of neuroethics in terms of the more concrete examples of the roles of political philosophy in general, as in the tradition of John Rawls. We take klotho, the supposed “longevity protein,” as a modern neuroethics case to exemplify the obstacles faced in securing neuroethics’ legitimacy and how the Rawlsian framework we propose may be applied to handle cases such as this. Ultimately, the socio-political perspective in neuroethics should not be swayed by the media hype and ought to offer useful ethical guidance and articulation of genuine ethical concerns to policy makers and the public alike. (shrink)

This article proposes a model for regulating use of cognition enhancement drugs for nontherapeutic purposes. Using the method of reflective equilibrium, the author starts from the considered judgment of many citizens that treatments are obligatory and permissible while enhancements are not, and with the application of general principles of justice explains why this is the case. The author further analyzes and refutes three reasons that some influential authors in the field of neuroethics might have for downplaying the importance of justice: (...) (1) Justice applies only to public funds and state action—not to individual choice or corporate actors. (2) “Performance enhancement” does imply questions of justice, while “performance maintenance” does not. (3) There is no sufficient difference between cognition-enhancement drugs and other technologies to warrant the importance of justice for the debate. The challenges are refuted by taking into account the difference between consumption and tool use, and the influence of socioeconomic pressure for widespread use that existing drugs could have on the basic structure of society and equal autonomy of citizens. The analysis of requirements of justice points to a conclusion that introducing economic disincentives for the use of cognition-enhancement drugs would be the most legitimate public policy. With the imposition of taxes, fees, and requirements of additional insurance, the use and indirect coercion to use would be less profitable and less widespread, while additional funds thus created could be allocated to meet basic medical needs and/or education. (shrink)

This article analyzes appropriate public policies for enhancement use of two most important stimulant drugs: Ritalin (methylphenidate) and Adderall (mixed amphetamine salts). The author argues that appropriate regulation of cognition enhancement drugs cannot be a result of a general discussion on cognitive enhancements as such, but has to be made on a case-by-case basis. Starting from the recently proposed taxation approach to cognition enhancement drugs, the author analyzes available, moderately permissive models of regulation. After a thorough analysis of relevant characteristics (...) of methylphenidate and amphetamine, the author concludes that a moderately liberal permissive regulation of enhancement use by healthy adults might be appropriate for extended release forms of methylphenidate. However, due to their danger profile, amphetamine and instant release forms of methylphenidate should not be made readily available to healthy adults and would need to be prohibited. (shrink)

We investigated the acceptability and frequency of the use of cognitive enhancement (CE) drugs and three different types of academic misconduct (plagiarism, cheating in exams, and falsifying/fabricating data). Data from a web-based survey among German university students were used. Moral acceptability was relatively low for CE drug use and moderate for academic misconduct, while the correlation of their respective acceptability was moderately weak. Prevalence of CE drug use was lower than for academic misconduct and (very) lightly correlated with the prevalence (...) of plagiarism and fabrication/falsification. Acceptability of the investigated behaviors was associated with higher prevalence rates of each behavior. (shrink)

This paper examines the claims in the debate on cognitive enhancement in neuroethics that society wide pressure to enhance can be expected in the near future. The author uses rational choice modeling to test these claims and proceeds with the analysis of proposed types of solutions. The discourage use, laissez-faire and prohibition types of policy are scrutinized for effectiveness, legitimacy and associated costs. Special attention is given to the moderately liberal discourage use policy (and the gate-keeper and taxation approaches within (...) this framework), as many authors presuppose that this type of policy would best serve public interest. Different more or less articulated models in the taxation approach (Tobacco regulation analogy, Coffee-shop system, Regulatory Authority for Cognitive Enhancements and Economic Disincentives Model) are analyzed from the point of view of justificatory liberalism. The author concludes that prohibition and laissez-faire types of policy would neither be effective nor justified. A moderately liberal public policy shows more promise, but not all approaches within this type of policy would be legitimate and effective. The “gate-keeper” approach and related models could not be justified whereas approach based on taxation with suitable models might be legitimate and effective. (shrink)

The article examines the so-called slippery slope argument (SSA) against the legalization of active voluntary euthanasia (AVE). According to the SSA, by legalizing AVE, the least morally controversial type of euthanasia, we will take the first step onto a slippery slope and inevitably end up in the moral abyss of widespread abuse and violations of the rights of the weakest and most vulnerable patients. In the first part of the paper, empirical evidence to the contrary is presented and analyzed: None (...) of the forecasted regrettable trends can be elicited from the body of existing statistical data. Accordingly, we have no good reason to believe either that we already are, or are sooner or later going to be, sliding into a moral abyss. A related question is then considered: Would it not be wiser and safer to stick to the status quo and preserve the existing legal ban on AVE even if the risk of its abuse is uncertain and may well turn out to be relatively low? It is argued that such an appeal to precautionary reasoning fails to justify an outright legal ban on AVE for at least two reasons: (i) it grossly underestimates the hidden moral costs of current legal arrangements (competent terminal patients suffer both disrespect for their autonomous will and deprivation of the good of a timely death) and (ii) the ban is both too inefficient and disproportionate to qualify as a reasonable measure of precaution. (shrink)