Bioethics has changed considerably over the years, the increasing diversity of topics of bioethical interest having led to specialisation if not fragmentation. In this context the term “neuroethics" emerged, and it soon became clear that it could be understood in two ways. The “ethics of neuroscience” assesses the ethical and philosophical implications of research in neuroscience and of the application of these discoveries, especially as regards enhancement of “normal” human faculties or new challenges to privacy. The “neuroscience of ethics” basically (...) turns the tables on ethics: it is ethical reasoning itself that becomes the object of neuroscience research. This provides a “behind the scenes” glance into moral reasoning, challenging aspects of moral philoso-phy and of the conventional philosophical interpretation of human action and free will. On the more practical side, neuroethics increases the level of awareness of the relatively neglected area of diseases of the brain-mind. (shrink)

We ask why pharmacological cognitive enhancement (PCE) is generally deemed morally unacceptable by lay people. Our approach to this question has two core elements. First, we employ an interdisciplinary perspective, using philosophical rationales as base for generating psychological models. Second, by testing these models we investigate how different normative judgments on PCE are related to each other. Based on an analysis of the relevant philosophical literature, we derive two psychological models that can potentially explain the judgment that PCE is unacceptable: (...) the “Unfairness-Undeservingness Model” and the “Hollowness-Undeservingness Model.” The Unfairness-Undeservingness Model holds that people judge PCE to be unacceptable because they take it to produce unfairness and to undermine the degree to which PCE-users deserve reward. The Hollowness-Undeservingness Model assumes that people judge PCE to be unacceptable because they find achievements realized while using PCE hollow and undeserved. We empirically test both models against each other using a regression-based approach. When trying to predict judgments regarding the unacceptability of PCE using judgments regarding unfairness, hollowness, and undeservingness, we found that unfairness judgments were the only significant predictor of the perceived unacceptability of PCE, explaining about 36% of variance. As neither hollowness nor undeservingness had explanatory power above and beyond unfairness, the Unfairness-Undeservingness Model proved superior to the Hollowness-Undeservingness Model. This finding also has implications for the Unfairness-Undeservingness Model itself: either a more parsimonious single-factor “Fairness Model” should replace the Unfairness-Undeservingness-Model or fairness fully mediates the relationship between undeservingness and unacceptability. Both explanations imply that participants deemed PCE unacceptable because they judged it to be unfair. We conclude that concerns about unfairness play a crucial role in the subjective unacceptability of PCE and discuss the implications of our approach for the further investigation of the psychology of PCE. (shrink)

The availability of a range of new psychotropic agents raises the possibility that these will be used for enhancement purposes (smart pills, happy pills, and pep pills). The enhancement debate soon raises questions in philosophy of medicine and psychiatry (eg, what is a disorder?), and this debate in turn raises fundament questions in philosophy of language, science, and ethics. In this paper, a naturalistic conceptual framework is proposed for addressing these issues. This framework begins by contrasting classical and critical concepts (...) of categories, and then puts forward an integrative position that is based on cognitive-affective research. This position can in turn be used to consider the debate between pharmacological Calvinism (which may adopt a moral metaphor of disorder) and psychotropic utopianism (which may emphasize a medical metaphor of disorder). I argue that psychiatric treatment of serious psychiatric disorders is justified, and that psychotropics are an acceptable kind of intervention. The use of psychotropics for sub-threshold phenomena requires a judicious weighing of the relevant facts (which are often sparse) and values. (shrink)

This paper discusses the concept of “human disenhancement”, i.e. the worsening of human individual abilities and expectations through technology. The goal is provoking ethical reflection on technological innovation outside the biomedical realm, in particular the substitution of human work with computer-driven automation. According to some widely accepted economic theories, automatization and computerization are responsible for the disappearance of many middle-class jobs. I argue that, if that is the case, a technological innovation can be a cause of “human disenhancement”, globally, and (...) all things considered, even when the local and immediate effect of that technology is to increase the demand of more sophisticated human skills than the ones they substitute. The conclusion is that current innovations in the ICT sector are objectionable from a moral point of view, because they disenhance more people than they enhance. (shrink)

There are a number of premises underlying much of the vigorous debate on pharmacological cognitive enhancement. Among these are claims in the enhancement literature that such drugs exist and are effective among the cognitively normal. These drugs are deemed to enhance cognition specifically, as opposed to other non-cognitive facets of our psychology, such as mood and motivation. The focus on these drugs as cognitive enhancers also suggests that they raise particular ethical questions, or perhaps more pressing ones, compared to those (...) raised by other kinds of neuroenhancement. Finally, the use of these drugs is often claimed to be significant and increasing. Taken together, these premises are at the heart of the flurry of debate on pharmacological cognitive enhancement. In this article, it is argued that these are presumptions for which the evidence does not hold up. Respectively, the evidence for the efficacy of these drugs is inconsistent; neurologically it makes little sense to distinguish the cognitive from non-cognitive as separate targets of pharmacological intervention; ethically, the questions raised by cognitive enhancement are in fact no different from those raised by other kinds of neuroenhancement; and finally the prevalence rates of these drugs are far from clear, with the bulk of the claims resting on poor or misrepresented data. Greater conceptual clarity along with a more tempered appreciation of the evidence can serve to deflate some of the hype in the associated literature, leading to a more realistic and sober assessment of these prospective technologies. (shrink)

The enhancement debate in neuroscience and biomedical ethics tends to focus on the augmentation of certain capacities or functions: memory, learning, attention, and the like. Typically, the point of contention is whether these augmentative enhancements should be considered permissible for individuals with no particular “medical” disadvantage along any of the dimensions of interest. Less frequently addressed in the literature, however, is the fact that sometimes the _diminishment_ of a capacity or function, under the right set of circumstances, could plausibly contribute (...) to an individual's overall well-being: more is not always better, and sometimes less is more. Such cases may be especially likely, we suggest, when trade-offs in our modern environment have shifted since the environment of evolutionary adaptation. In this article, we introduce the notion of “diminishment as enhancement” and go on to defend a _welfarist_ conception of enhancement. We show how this conception resolves a number of definitional ambiguities in the enhancement literature, and we suggest that it can provide a useful framework for thinking about the use of emerging neurotechnologies to promote human flourishing. (shrink)

Various kinds of alcohol and drug testing, such as preemployment, routine, and for-cause testing, are commonly performed by employers. While healthcare organizations usually require preemployment drug testing, they vary on whether personnel will be subjected to further testing. Recently, a call has gone out for postincident testing among physicians who are involved in serious, preventable events, especially ones leading to a patient's death. This article will offer a number of counterarguments to that proposal and discuss an alternate approach: that health (...) institutions can better improve patient safety and employees’ well-being by implementing an organizational policy of “speaking up” when system operators notice work behaviors or environmental factors that threaten harm or peril. The article will conclude with a description of various strategies that facilitate speaking up, and why the practice constitutes a superior alternative to mandatory alcohol and drug testing in the wake of serious, harm-causing m.. (shrink)

The debate over the propriety of cognitive enhancement evokes both enthusiasm and worry. To gain further insight into the reasons that people may have for endorsing or eschewing pharmacological enhancement, we used empirical tools to explore public attitudes towards PE of twelve cognitive, affective, and social domains. Participants from Canada and the United States were recruited using Mechanical Turk and were randomly assigned to read one vignette that described an individual who uses a pill to enhance a single domain. After (...) reading the vignette, participants were asked how comfortable they were with the individual using the enhancement. People were significantly more comfortable when they read about enhancement of certain CAS domains than others. We found a modest negative correlation between comfort level and the degree to which the PE was perceived as changing core features of the person. We also found a modest correlation between comfort level and the degree to which the PE was perceived as improving success in life. Finally, using a sequential mixed method technique, we found that participants who felt uncomfortable about PE use overwhelmingly focused on a lack of need and, to a lesser degree, expressed concerns about safety; those who felt comfortable about PE use most frequently mentioned the safety of the pill and its ability to provide a positive outcome. The data provide novel insights into public enthusiasms and concerns over the use of PE. (shrink)

Vigorous debate over the moral propriety of cognitive enhancement exists, but the views of the public have been largely absent from the discussion. To address this gap in our knowledge, four experiments were carried out with contrastive vignettes in order to obtain quantitative data on public attitudes towards cognitive enhancement. The data collected suggest that the public is sensitive to and capable of understanding the four cardinal concerns identified by neuroethicists, and tend to cautiously accept cognitive enhancement even as they (...) recognize its potential perils. The public is biopolitically moderate, endorses both meritocratic principles and the intrinsic value of hard work, and appears to be sensitive to the salient moral issues raised in the debate. Taken together, these data suggest that public attitudes toward enhancement are sufficiently sophisticated to merit inclusion in policy deliberations, especially if we seek to align public sentiment and policy. (shrink)

The article explores some of the issues that have arisen in the discourse on pharmaceutical cognitive enhancement (PCE), that is, the use of stimulant drugs such as methylphenidate, amphetamine and modafinil by healthy individuals of various populations with the aim of improving cognitive performance. Specifically, we explore the presumed sizes of existing PCE user populations and the policy actions that have been proposed regarding the trend of PCE. We begin with an introductory examination of the academic stances and philosophical issues (...) involved in defining PCE. We then focus on an examination of the population sizes of presumed current PCE users that have been listed in the academic literature on PCE, on presuppositions, which have been problematized by some authors as based on anecdotal or misinterpreted survey data. We follow this with an empirical examination of a potential PCE user population in a national context (students at the University of Ljubljana in Slovenia). We then proceed to examine the regulatory options proposed in the academic literature to address PCE, finally comparing them with an empirical overview of the policy recommendations on PCE produced in the multinational context of several national ethics advisory bodies (EABs) in Europe. Our main conclusion is that there is still little debate among the national EABs on what type of public policy responses, if any, are needed to address PCE in European countries, and that the issues they do address are similar to those discussed and proposed in the academic articles on PCE. (shrink)

This paper presents a novel view of the concept of cognitive enhancement by taking a population health perspective. We propose four main modifiable healthy lifestyle factors for optimal cognitive functioning across the population for which there is evidence of safety and efficacy. These include i) promoting adequate sleep, ii) increasing physical activity, iii) encouraging a healthy diet, including minimising consumption of stimulants, alcohol and other drugs including nicotine, iv) and promoting good mental health. We argue that it is not ethical (...) to promote or sanction the use of pharmaceutical drugs as putative cognitive enhancers without acknowledging the adverse effects on population cognitive health of failing to encourage the pursuit of healthy behaviours. We conclude with recommendations to increase the public health relevance of bioethical analyses of the cognitive enhancement debate. (shrink)

Since it is now broadly acknowledged that ethics should receive early consideration in discourse on emerging technologies, ethical debates tend to flourish even while new fields of technology are still in their infancy. Such debates often liberally mix existing applications with technologies in the pipeline and far-reaching visions. This paper analyses the problems associated with this use of ethics as “preparatory” research, taking discourse on human enhancement in general and on pharmaceutical cognitive enhancement in particular as an example. The paper (...) will outline and discuss the gap between the scientific and technological state of the art and the ethical debates, pointing out epistemic problems in this context. Furthermore, it will discuss the future role of genuine ethical reflection in discourse on human enhancement, arguing also that such discourse needs to include a technology assessment—in the broad sense of the term—which encompasses, inter alia, anthropological perspectives and aspects of social theory. (shrink)

The present work critically examines two assumptions frequently stated by supporters of cognitive neuroenhancement. The first, explicitly methodological, assumption is the supposition of effective and side effect-free neuroenhancers. However, there is an evidence-based concern that the most promising drugs currently used for cognitive enhancement can be addictive. Furthermore, this work describes why the neuronal correlates of key cognitive concepts, such as learning and memory, are so deeply connected with mechanisms implicated in the development and maintenance of addictive behaviour so that (...) modification of these systems may inevitably run the risk of addiction to the enhancing drugs. Such a potential risk of addiction could only be falsified by in-depth empirical research. The second, implicit, assumption is that research on neuroenhancement does not pose a serious moral problem. However, the potential for addiction, along with arguments related to research ethics and the potential social impact of neuroenhancement, could invalidate this assumption. It is suggested that ethical evaluation needs to consider the empirical data as well as the question of whether and how such empirical knowledge can be obtained. (shrink)

Over the past few years the use of stimulants such as methylphenidate and modafinil among the student population has attracted considerable debate in the pages of bioethics journals. Under the rubric of cognitive enhancement, bioethicists have discussed this use of stimulants—along with future technologies of enhancement—and have launched a sometimes forceful debate of such practices. In the following paper, it is argued that even if we focus solely upon current practices, the term cognitive enhancement encompasses a wide range of ethical (...) considerations that can usefully be addressed without the need for speculation. In taking this position it is suggested that we divide cognitive enhancement into a series of empirically-constructed frameworks—medical risks and benefits, self-medication and under-prescription, prescription drug abuse and over-medication, and finally, the intention to cognitively enhance. These are not mutually exclusive frameworks, but provide a way in which to identify the scope of the issue at hand and particular ethical and medical questions that may be relevant to enhancement. By a process of elimination it is suggested that we can indeed talk of cognitive enhancement as an observable set of practices. However, in doing so we should be aware of how academic commentaries and discussion may be seen as both capturing reality and reifying cognitive enhancement as an entity. (shrink)

This article challenges recent assumptions that physicians may ethically and legally prescribe psychopharmacological enhancement drugs to patients and the counterintuitive notion that in some cases ingesting an enhancement drug constitutes the more ethical choice than forgoing this option. Enhancement proponents have touted modafinil as an ideal mechanism to improve concentration, alertness, and forgo sleep and keep pace with our society's demands. However, patients who use modafinil for these reasons risk potentially severe side effects and addiction, and face unintended consequences related (...) to their cognitive, emotive, and physiological functioning. Importantly, prescribing a controlled substance such as modafinil for performance enhancement and sleep avoidance runs contrary to a physician's ethical duty to the patient and the standard of practice set forth in legal requirements governing the prescription of controlled substances. (shrink)

In this article, we analyse content from two recent reports to examine how a public health framework to cognitive enhancement is emerging. We find that, in several areas, these reports provide population-level arguments both for and against the use of cognitive enhancers. In discussing these arguments, we look at how these reports are indicative of potentially innovative frameworks—epidemiological, risk/benefit and socio-historical—by which to explore the public health impact of cognitive enhancement. Finally, we argue that these reports are suggestive of both (...) tensions between the bioethical and public health approaches and are also indicative of how these two frameworks can, in part, be seen as complementary. (shrink)

This paper argues that many ethical issues in neuroeducational research cannot be appropriately addressed using the principles and guidance available in one of these areas alone, or by applying these in simple combination. Instead, interdisciplinary and public dialogue will be required to develop appropriate normative principles. In developing this argument, it examines neuroscientific and educational perspectives within three broad categories of ethical issue arising at the interface of cognitive neuroscience and education: issues regarding the carrying out of interdisciplinary research, the (...) scrutiny and communication of findings and concepts, and the application of research and associated issues of policy likely to arise in the future. To help highlight the need for interdisciplinary and public discussion, we also report the opinions of a group of educators (comprising trainee teachers, teachers and head teachers) on the neuroeducational ethics of cognitive enhancing drugs, infant screening, genetic profiling and animal research. (shrink)

This paper identifies human enhancement as one of the most significant areas of bioethical interest in the last twenty years. It discusses in more detail one area, namely moral enhancement, which is generating significant contemporary interest. The author argues that so far from being susceptible to new forms of high tech manipulation, either genetic, chemical, surgical or neurological, the only reliable methods of moral enhancement, either now or for the foreseeable future, are either those that have been in human and (...) animal use for millennia, namely socialization, education and parental supervision or those high tech methods that are general in their application. By that is meant those forms of cognitive enhancement that operate across a wide range of cognitive abilities and do not target specifically ‘ethical’ capacities. The paper analyses the work of some of the leading contemporary advocates of moral enhancement and finds that in so far as they identify moral qualities or moral emotions for enhancement they have little prospect of success. (shrink)

Building upon an earlier critique of the Food and Drug Adminstration (FDA) granting of a humanitarian device exemption for deep brain stimulation in treatment-resistant obsessive compulsive disorder, this article considers how we regulate and finance DBS. It suggests that these devices are mosaic in nature: both potentially therapeutic and probative and that their dual roles need to be appreciated to maximize their therapeutic and investigational potential.

International institutions such as UNESCO are deliberating on a new standard setting instrument for neurotechnologies. This will likely lead to the adoption of a soft law document which will be the first global document specifically tailored to neurotechnologies, setting the tone for further international or domestic regulations. While some stakeholders have been consulted, these developments have so far evaded the broader attention of the neuroscience, neurotech, and neuroethics communities. To initiate a broader debate, this target article puts to discussion twenty-five (...) considerations and desiderata for recognition by a future instrument. They are formulated at different levels of abstraction, from the big picture to technical details, seek to widen the perspective of preparatory reports and transcend the narrow debate about “neurorights” which overshadows many richer and more relevant aspects. These desiderata are not an exhaustive enumeration but a starting point for discussions about what deserves and what requires protection by an international instrument. (shrink)

In enhancement ethics, evolutionary theory has been largely perceived as supporting liberal views on enhancement, where decisions to enhance are predominantly regulated by the principle of individual autonomy. In this paper I critique this perception in light of recent scientific developments. Cultural evolutionary theory suggests a picture where individual interests are entangled with community interests, and this undermines the applicability of the principle of autonomy. This is particularly relevant for enhancement ethics, given how – I argue – decisions to enhance (...) are often influenced by desires to increase social status. The “service view on enhancement”, based on principles of service and trust, is proposed as offering better guidance for the challenges of social living. (shrink)

The author examines whether Kantian ethics would condone the use of pharmaceutical drugs to enhance one’s moods and cognitive abilities. If key assumptions concerning safety and efficacy, non-addictiveness, non-coercion, and accessibility are not met, Kantian ethics would consider mood and cognitive enhancement to be impermissible. But what if these assumptions are granted? The arguments for the permissibility of neuroenhancement are stronger than those against it. After giving a general account of Kantian ethical principles, the author argues that, when these assumptions (...) are granted, Kantian ethics no longer justifies the prohibition of neuroenhancement, and responds to two objections. (shrink)

In recent years, discussion around memory modification interventions has gained attention. However, discussion around the use of memory interventions in the criminal justice system has been mostly absent. In this paper we start by highlighting the importance memory has for human well-being and personal identity, as well as its role within the criminal forensic setting; in particular, for claiming and accepting legal responsibility, for moral learning, and for retribution. We provide examples of memory interventions that are currently available for medical (...) purposes, but that in the future could be used in the forensic setting to modify criminal offenders’ memories. In this section we contrast the cases of dampening and enhancing memories of criminal offenders. We then present from a pragmatic approach some pressing ethical issues associated with these types of memory interventions. The paper ends up highlighting how these pragmatic considerations can help establish ethically justified criteria regarding the possibility of interventions aimed at modifying criminal offenders’ memories. (shrink)

Across normative and empirical disciplines, considerable attention has been devoted to the prevalence and ethics of the non-medical use of prescription and illegal stimulants for neuroenhancement among students. A predominant assumption is that neuroenhancement is prevalent, in demand, and calls for appropriate policy action. In this paper, we present data on the prevalence, views and knowledge from a large sample of German students in three different universities and analyze the findings from a moral pragmatics perspective. The results of our study (...) indicate that neuroenhancement is a well-known phenomenon among German students, but not prevalent. 2.2 % of our sample reported having used a prescription medication for neuroenhancement. Exams and competitive situations were predominant motivators of use. Students were unenthusiastic and critical about neuroenhancement in the academic context and disapproved of neuroenhancement for professionals. The majority of respondents agreed that neuroenhancing substances should be regulated by the state. These stances were based on strong beliefs in resisting peer pressure, avoiding the creation of injustice and valuing of hard work. From a moral pragmatics standpoint, these results challenge the assumption that policy on neuroenhancement is necessary in academic environments. (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)

In their recent paper in this journal, Heinz and colleagues accuse proponents of cognitive enhancement of making two unjustified assumptions. The first of these is the assumption that neuroenhancing drugs will be safe; the second is that research into cognitive enhancement does not pose particular ethical problems. Heinz and colleagues argue that both these assumptions are false. Here, I argue that these assumptions are in fact correct, and that Heinz and colleagues themselves make several assumptions that undermine their argument. Neuroenhancement (...) does raise several ethical concerns, but safety and research in this area pose no unique difficulties. (shrink)

Response Content Type Journal Article DOI 10.1007/s11673-010-9255-1 Authors Cynthia Forlini, Neuroethics Research Unit, Institut de recherches cliniques de Montréal, 110, ave des Pins Ouest, Montréal, QC Canada H2W 1R7 Eric Racine, Neuroethics Research Unit, Institut de recherches cliniques de Montréal, 110, ave des Pins Ouest, Montréal, QC Canada H2W 1R7 Journal Journal of Bioethical Inquiry Online ISSN 1872-4353 Print ISSN 1176-7529 Journal Volume Volume 7 Journal Issue Volume 7, Number 4.

The hopes and fears expressed in the debate on human enhancement are not always based on a realistic assessment of the expected possibilities. Discussions about extreme scenarios may at times obscure the ethical and policy issues that are relevant today. This paper aims to contribute to an adequate and ethically sound societal response to actual current developments. After a brief outline of the ethical debate concerning neuro-enhancement, it describes the current state of the art in psychopharmacological science and current uses (...) of psychopharmacological enhancement, as well as the prospects for the near future. It then identifies ethical issues regarding psychopharmacological enhancements that require attention from policymakers, both on the professional and on the governmental level. These concern enhancement research, the gradual expansion of medical categories, off-label prescription and responsibility of doctors, and accessibility of enhancers on the Internet. It is concluded that further discussion on the advantages and drawbacks of enhancers on a collective social level is still needed. (shrink)

Advances in psychopharmacology raise the prospects of enhancing neurocognitive functions of humans by improving attention, memory, or mood. While general ethical reflections on psychopharmacological enhancement have been increasingly published in the last years, ethical criteria characterizing physicians’ role in neurocognitive enhancement and guiding their decision-making still remain highly unclear. Here it will be argued that also in the medical domain the use of cognition-enhancing drugs is not intrinsically unethical and that, in fact, physicians should assume an important role in gating (...) their usage. For finding normative orientation, concepts of disease, normality or medicine will not be helpful since—due to their cryptonormative nature—they rather hamper than allow targeted discussion and decision-making. As an alternative, the common and widely accepted bioethical criteria of beneficence, non-maleficence, autonomy and distributive justice allow a clinically applicable, highly differentiated context- and case-sensitive approach. By embedding decision-making in a participative physician–patient relationship extrinsic objections against neurocognitive enhancement (e.g. invalid perceptions about efficacy, benefit or risk; questionable voluntariness; restrained decision-making capacity) can be curtailed. (shrink)

Opinions about cognitive enhancement (CE) are context-dependent. Prior research has demonstrated that factors like peer pressure, the influence of authority figures, competition, moral relevance, familiarity with enhancement devices, expertise, and the domain of CE to be enhanced can influence opinions. The variability and malleability of patient, expert, and public attitudes toward CE is important to describe and predict because these attitudes can influence at-home, clinical, research, and regulatory decisions. If individual preferences vary, they could influence opinions about practices and regulations (...) due to disagreements about the desirable levels of risks and benefits. The study of attitudes about CE would benefit from psychological theories that explain judgments. In particular, we suggest that variability in risk and benefit sensitivity could psychologically mediate judgments about CE in many contexts. Drawing from prospect theory, which originated in behavioral economics, it is likely that framing effects, shifted reference points, and the tendency to weigh losses (risks) more heavily than gains (benefits) predict decisions about CE. We suggest that public policy could benefit from a shared conceptual framework, such as prospect theory, that allows us to describe and predict real-world decisions about CE by patients, experts, and the public. (shrink)

Current developments in the area of neuroenhancement pose multiple ethical and societal questions. Improvements in general cognitive capacities can have important positive effects. With the use of several interventions, ranging from pharmaceutics through microsurgery to non-invasive and invasive methods, new possibilities of enhancing human abilities can be achieved. Yet, they have to be critically evaluated from the point of view of both individual and societal consequences that are involved. The aim of this paper is to address societal benefits and challenges (...) that are related to these interventions. These new developments, especially in the specific area of their military application, pose important questions with regard to safety of their use, long-term results, coercion to use them, and issues of inequality. Often, these consequences are unforeseeable at the present moment and can greatly interfere with development of both individuals and societies. Therefore, as in both areas – civilian and military – the long-term consequences are still difficult to predict, prudency is prescribed. Consequently, any use of the methods of enhancement should be under exceptional scrutiny from the ethical as well as legal and social point of view. (shrink)

The widespread use of stimulants among healthy individuals to improve cognition has received growing attention; however, public attitudes toward this practice are not well understood. We determined the effect of framing metaphors and context of use on public opinion toward cognitive enhancement. We recruited 3,727 participants from the United States to complete three surveys using Amazon’s Mechanical Turk between April and July 2017. Participants read vignettes describing an individual using cognitive enhancement, varying framing metaphors (fuel versus steroid), and context of (...) use (athletes versus students versus employees). The main outcome measure was the difference in respondent-assigned level of acceptability of the use of cognitive enhancement by others and by themselves between the contrasting vignettes. Participants were more likely to support the use of cognitive enhancement by others than by themselves and more when the use of enhancement by others was framed with a fuel metaphor than with a steroid metaphor. Metaphoric framing did not affect participants’ attitudes toward their own use. Participants supported the use of enhancement by employees more than by students or athletes. These results are discussed in relation to existing ethical and policy literature. (shrink)

So-called cognitive enhancing drugs are relatively common in higher education, especially among students who are white, male, and attend highly selective institutions. Using qualitative data from a diverse sample of 32 students at an elite university, the present study aims to examine whether students perceive CED use to be advantageous, equitable, and fair. Participants were either medical or nonmedical users of CEDs—primarily ADHD stimulant medications such as Adderall. Data were first coded openly, then axially into themes, and finally arranged to (...) respond to research aims around social and ethical concerns. Ethical perceptions and behavioral justifications varied by participants’ personal use frequency, class standing, and perceived social norms surrounding CEDs. Among the salient themes to emerge was the belief that CED use is a lesser or more tenable form of cheating, that the vagueness and prevalence of ADHD justifies nonmedical use, and that above all, CEDs are advantageous. Some participants expressed concern about the advantageousness of CEDs when coupled with a perceived imbalance of their use among students from traditionally underrepresented backgrounds, with one calling it “the white version of cheating.” Implications for cheating and drug use prevention are discussed, situating cognitive enhancement as an emerging ethical and social equity concern in higher education. (shrink)

The article investigates the sociocultural implications of the changing modern workplace and of pharmacological cognitive enhancement as a potential adaptive tool from the viewpoint of social niche construction. We will attempt to elucidate some of the sociocultural and technological trends that drive and influence the characteristics of this specific niche, and especially to identify the kind of capabilities and adaptations that are being promoted, and to ascertain the capabilities and potentialities that might become diminished as a result. In this context, (...) we will examine what PCE is, and how and why it might be desirable as a tool for adaptation within the workplace. As human beings are, or at least should be allowed to be, more than merely productive, able-bodied and able-minded workers, we will further examine how adaptation to the workplace niche could result in problems in other domains of modern societal life that require the same or other cognitive capabilities. In this context we will also focus on the concept of responsibility and how it pertains to PCE and the modern workplace niche. This will shed some light on the kind of trends related to workplace niche construction, PCE and capability promotion that we can expect in the future, and on the contexts in which this might be either beneficial or detrimental to the individual as a well-rounded human being, and to other members of society. (shrink)

The Ethical, Legal, and Social Implications (ELSI) program of the Human Genome Project stands as a model for how to organize bioethical inquiry for a rapidly changing field. Neuroscience has experienced significant growth in recent years and there is increasing interest in organizing critical reflection on this field, as evidenced by the creation of “neuroethics.” A nascent framework for reflection on the implications of neuroscience is emerging but significant work remains, given the pace and scope of neuroscientific developments. The adoption (...) of an ELSI program, modeled on that of the ELSI program of the Human Genome Project, promises a way for neuroscience to meet important organizational, educational, and policy objectives. Review of recent criticisms of the HGP ELSI program suggests that an ELSI program for neuroscience would face certain obstacles. Those interested in a neuroscience ELSI program will need to develop appropriate resources to overcome these obstacles. (shrink)

In this issue of CQ we introduce a new feature, in which noted bioethicists are invited to reflect on vital current issues. Our first invitee, John Harris, will subsequently assume editorship of this section.

The neural basis of human memory is incredibly complex. We argue that the diversity of neural systems underlying various forms of memory suggests that any discussion of enhancing ‘memory’ per se is too broad, thus obfuscating the biopolitical debate about human enhancement. Memory can be differentiated into at least four major systems with largely dissociable neural substrates. We outline each system, and discuss both the practical and the ethical implications of these diverse neural substrates. In practice, distinct neural bases imply (...) the possibility, and likely the necessity, of specific approaches for the safe and effective enhancement of various memory systems. In the debate over the ethical and social implications of enhancement technologies, this fine-grained perspective clarifies—and may partially mitigate—certain common concerns in enhancement debates, including issues related to safety, fairness, coercion, and authenticity. While many researchers certainly appreciate the neurobiological complexity of memory, the political debate tends to revolve around a monolithic one-size-fits-all conception. The overall project—exploring how human enhancement technologies affect society – stands to benefit from a deeper appreciation of memory’s neurobiological diversity. (shrink)

BackgroundAlthough some of the most radical hypothesis related to the practical implementations of human enhancement have yet to become even close to reality, the use of cognitive enhancers is a very tangible phenomenon occurring with increasing popularity in university campuses as well as in other contexts. It is now well documented that the use of cognitive enhancers is not only increasingly common in Western countries, but also gradually accepted as a normal procedure by the media as well. In fact, its (...) implementation is not unusual in various professional contexts and it has its peak in colleges. Even when certain restrictions in the legislation of a country are indeed in place, they are without doubts easy to overcome. The legitimacy and appropriateness of such restrictions will not be the focus of our investigation.DiscussionOur concern is instead related to the moral and social reasons to publicly acknowledge the use of cognitive enhancers in competitive-selective contexts. These reasons are linked to a more neutral analysis of contemporary Western society: it is a fact that an increasing number of competitive-selective contexts have a substantial number of contenders using cognitive enhancers.SummaryThrough the use of five explicative examples, in this paper we want to analyse the problems related to its use. In particular, it will be our aim to show the tension between one of the main argument used by bio-liberals and the actual implementation of the drugs in competitive, or semi-competitive contexts. (shrink)

ZusammenfassungMedizinethische Untersuchungen zum Thema Neuroenhancement (NE) wenden sich oft der Frage zu, inwiefern der Einzelne wie auch die Allgemeinheit durch NE zu Schaden kommen können. Gerechtigkeitsprobleme, ein befürchteter Wandel des Menschenbildes oder die Gefahr einer unerwünschten, schleichenden Veränderung der Gesellschaft werden problematisiert. Bezüglich individueller Risiken bleibt es aufgrund des vermeintlichen Zugewinns an Selbstbestimmung und Eigenverantwortung gerne beim Verweis auf die subjektive Kosten-Nutzen-Abwägung. Innerhalb der NE-Debatte gibt es bisher kaum Arbeiten, die die Aspekte der Motivation für die Nutzung von NE aus (...) tiefenpsychologischer Perspektive beleuchten. Das Ziel der vorliegenden Arbeit ist es, diese Aspekte zu analysieren. Die Arbeit soll einen Beitrag zu einem neuen Blickwinkel auf Selbstbestimmung und subjektive Einschätzung der Vor- und Nachteile von NE leisten. Es werden psychologische Aspekte thematisiert, welche die im Kontext von NE übliche Annahme, dass Konsumenten zur Selbstverantwortung fähig seien, problematisch erscheinen lassen, da sie die Wahrnehmung dieser Verantwortung erschweren oder gar unmöglich machen können. In diesem Zusammenhang wollen wir versuchen, für die psychologischen Gefahren und Folgen von NE zu sensibilisieren. Es wird beispielsweise darüber diskutiert, inwiefern der Gebrauch von NE-Technologien eine Persönlichkeit nachhaltig prägen und gerade deshalb das Erleben von Selbstwirksamkeit beeinträchtigen kann. Dies stellt die für die liberale Position zentrale Prämisse, wonach Individuen sich frei und vernünftig entscheiden können, infrage. (shrink)