There are numerous ways people can improve their cognitive capacities: good nutrition and regular exercise can produce long-term improvements across many cognitive domains, whilst commonplace stimulants such as coffee temporarily boost levels of alertness and concentration. Effects like these have been well-documented in the medical literature and they raise few ethical issues. More recently, however, clinical research has shown that the off-label use of some pharmaceuticals can, under certain conditions, have modest cognition-improving effects. Substances such as methylphenidate and modafinil can (...) improve capacities such as working memory and concentration in some healthy individuals. Unlike their more mundane predecessors, these methods of “cognitive enhancement” are thought to raise a multitude of ethical issues. This paper presents the six principal ethical issues raised in relation to pharmacological cognitive enhancers —issues such as whether: the medical safety-profile of PCEs justifies restricting or permitting their elective or required use; the enhanced mind can be an “authentic” mind; individuals might be coerced into using PCEs;, there is a meaningful distinction to be made between the treatment vs. enhancement effect of the same PCE; unequal access to PCEs would have implications for distributive justice; and PCE use constitutes cheating in competitive contexts. In reviewing the six principal issues, the paper discusses how neuroscientific research might help advance the ethical debate. In particular, the paper presents new arguments about the contribution neuroscience could make to debates about justice, fairness, and cheating, ultimately concluding that neuroscientific research into “personalized enhancement” will be essential if policy is to be truly informed and ethical. We propose an “ethical agenda” for neuroscientific research into PCEs. (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.

The 2015 Varsity Medical Ethics debate convened upon the motion: “This house believes nootropic drugs should be available under prescription”. This annual debate between students from the Universities of Oxford and Cambridge, now in its seventh year, provided the starting point for arguments on the subject. The present article brings together and extends many of the arguments put forward during the debate. We explore the current usage of nootropic drugs, their safety and whether it would be beneficial to individuals and (...) society as a whole for them to be available under prescription. The Varsity Medical Debate was first held in 2008 with the aim of allowing students to engage in discussion about ethics and policy within healthcare. The event is held annually and it is hoped that this will allow future leaders to voice a perspective on the arguments behind topics that will feature heavily in future healthcare and science policy. This year the Oxford University Medical Society at the Oxford Union hosted the debate. (shrink)

ABSTRACT Some of the most compelling contemporary ethical questions surround 21st Century neuroscientific technologies. Among these, neurocognitive intervention technologies allow an unprecedented ability to alter thought. Concerns exist about their impact on individual freedom, behavior and personhood. They could also distort society, eroding core values of dignity, equality, and diversity. Potent laws are needed to anchor regulation in this rising field. The article explores how the long-neglected human right of Freedom of Thought might protect the integrity of the mind at (...) the legal system’s highest level. Sample cases illustrate how it could be given effect ethically and legally to set boundaries for neurocognitive intervention. (shrink)

The growth of esports as a recognized, organized, competitive activity in North America and Europe has evolved steadily from one of the most prominent sport industries in several Asian countries. Esports, which is still pursuing a widely accepted governance structure, has struggled to control the factors that typically act as a breeding ground for sport corruption. Within the esports industry, there is alleged widespread use of both prescription and off-label use of stimulants, such as modafinil, methylphenidate, and dextroamphetamine. Anti-doping policy (...) implementation in this environment may result in either the abuse of the Therapeutic Use Exemptions system or excluding too many competitors who have a legitimate need for these medications. In this paper, we contextualize esports and substance use within this emerging industry. Subsequently, we outline the specific challenges faced by esports organizations in crafting policies to address PEDs—one of the industry’s most pressing issues. Furt... (shrink)

ObjectivesTo understand the ethical principles guiding college students’ abstention from pharmacological cognitive enhancement, and to determine the correlates associated with endorsing different principles.DesignOne-stage cluster sampling was used to implement a paper-based survey among undergraduate students attending one university in the U.S. Thematic analysis was used to explore the ethical principles guiding PCE abstention. Multivariate logistic regression analyses were used to examine sociodemographic correlates associated with endorsed ethical principles.ParticipantsOf the 499 eligible students who completed the survey, 259 students had a negative (...) attitude towards PCE, did not engage in PCE, and provided reasons for abstention.ResultsThe thematic analysis resulted in the identification of eight themes, with respondents often endorsing more than one theme per response. The three themes most endorsed were non-malfeasance, disapproval of drugs and dosage beneficence. The sociodemographic correlates associated with endorsing each theme varied across themes.ConclusionsStudents abstain from PCE for a multitude of reasons, many of which are guided by ethical principles. These findings may be incorporated into future prevention programming messages. (shrink)

The current generation paving the path for new research marks a milestone to attain the ancient goal of improving our cognition. To date, increased prevalence of cognitive enhancers by healthy people has raised the scientific community’s attention as well as media coverage. In particular, nootropics such as piracetam promise to offer modest improvements in cognitive performance. The long-lasting impetus of this “holistic enhancer” convinced scientists as well as ethicists to discuss its potential ethical implications and future directions. Moreover, there are (...) discrepancies in the concept of a true nootropic between pharmacology and contemporary public culture. Here, I review the ethical aspects of nootropics raised by its potential use in cognition enhancement and substantiate the epistemological commentary on the concept of nootropic. (shrink)