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)

Entry on "Neuroenhancement" in the Routledge Encyclopedia of Philosophy Online.

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 is the second paper in a three-part series on the state of the enhancement debate. We report current trends and give an overview of established positions in the field of neuroenhancement. Unlike a number of articles on the bioethics of enhancement, we try to highlight connections between the contemporary debate and established positions in philosophical ethics. This specific perspective inspired the breakdown of our three-part series into consequentialist, deontological and virtue-ethical arguments.

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)

In an age of modern technology and an increasing movement towards a 24-h working culture, life for many is becoming more stressful and demanding. To help juggle these work commitments and an active social life, nootropic medication, (the so-called ‘smart pills’) have become a growing part of some people’s lives. Users claim that these drugs allow them to reach their maximal potential by becoming more efficient, smarter and requiring less sleep. The use of these medications and the role of health (...) professionals in their distribution raises many ethical questions. (shrink)

In the debate on the ethics of the non-medical use of pharmaceuticals for cognitive performance enhancement in healthy individuals there is a clear division between those who view “cognitive enhancement” as ethically unproblematic and those who see such practices as fraught with ethical problems. Yet another, more subtle issue, relates to the relevance and quality of the contribution of scholarly bioethics to this debate. More specifically, how have various forms of speculation, anticipatory ethics, and methods to predict scientific trends and (...) societal responses augmented or diminished this contribution? In this paper, we use the discussion of the ethics of cognitive enhancement to explore the positive and negative contribution of speculation in bioethics scholarship. First, we review and discuss how speculation has relied on different sets of assumptions regarding the non-medical use of stimulants, namely: terminology and framing; scientific aspects such as efficacy and safety; estimates of prevalence and consequent normalization; and the need for normative reflection and regulatory guidelines. Second, three methodological guideposts are proposed to alleviate some of the pitfalls of speculation: acknowledge assumptions more explicitly and identify the value attributed to assumptions; validate assumptions with interdisciplinary literature; and adopt a broad perspective to promote more comprehensive reflection. We conclude that, through the examination of the controversy about cognitive enhancement, we can employ these methodological guideposts to enhance the value of contributions from bioethics and minimize potential epistemic and practical pitfalls in this case and perhaps in other areas of bioethical debate. (shrink)

Selective serotonin reuptake inhibitors’ wide use, combined with the blurry limit between health and psychological illness, have led neuroscientists, clinicians and ethicists to envision the possibility of these medications’ use in non-clinical populations. This prospect has evoked ethical debates, which have often ignored the findings of the empirical literature. In this context, an evaluation of the empirical evidence for SSRIs’ personality enhancing effects is needed. The present paper examines SSRIs’ effects on healthy personality, including the Five Factor Model traits Neuroticism (...) and Extraversion, as well as some of their facets: Angry Hostility, Impulsiveness, Vulnerability, Warmth, Gregariousness and Assertiveness. The review encompasses investigations in healthy humans, human clinical populations, as well as relevant animal studies. Emerging data raise the possibility that SSRIs, when used by people without a currently diagnosable mental disorder, may reduce some facets of Neuroticism, especially Angry Hostility. On the other hand, very limited support exists for an SSRI-driven change in other Neuroticism facets, such as Impulsiveness, in healthy humans. An increase in Extraversion is possible, but currently available evidence is only indirect. Future research is needed, both to clarify methodological ambiguities in existing studies, and to answer unaddressed questions, such as ones of the stability, predictors, moderators, dose- and context-dependency of the effects. (shrink)

Donepezil, an acetylcholinesterase inhibitor used in the treatment of Alzheimer's disease, has been widely cited in media and bioethics literature on cognitive enhancement (CE) as having the potential to improve the cognitive ability of healthy individuals. In both literatures, this claim has been repeatedly supported by the results of a small study published by Yesavage et al. in 2002 on non-demented pilots (30-70 years old). The factors contributing to this specific interpretation of this study's results are unclear.

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)

Arguments in the neuroenhancement debate are sometimes based upon idealistic scenarios involving the assumption of using a drug that has no or negligible side effects. At least it is often implicitly assumed – as technology and scientific knowledge advances - that there soon will be a drug with no or negligible side effects. We will review evidence from neuroscience, complex network research and evolution theory and demonstrate that - at least in terms of psychopharmacological intervention – on the basis of (...) our understanding of brain function it seems inconceivable that there ever will be a drug that has the desired effect without undesirable side effects. We will illustrate this by reference to enhancing edge detection in V2 in monkeys and demonstrate that even for this localised single neuron coded function there would be numerous side effects. Taking the more realistic case of pharmacological enhancement that is inevitably associated with side effects will change consequentialist arguments for neuroenhancement and have implications for the conception of autonomy, specifically in the case of performance enhancement. We conclude that a neuroethics debate that aims to inform policy decisions should take these findings into account. We hope that our article will precipitate more interdisciplinary research in neuroscience and philosophy. (shrink)