Cognitive Enhancement: Treating or Cheating?

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In this article I provide an overview of the moral and medical questions surrounding the use of cognitive enhancers. This discussion will be framed in light of 4 key considerations: (1) is there a difference between therapy and enhancement? (2) How safe are these interventions? (3) Is the use of nootropics cheating? (4) Would enhancers create a further divide of social inequality where only the very wealthy have access to them?

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Which are These Types of Enhancers and Who is Using Them?

Over the past few years, research directed toward treating or preventing cognitive decline due to neurodegenerative disorders has increased exponentially. Some of the medications developed to treat Alzheimer disease and Parkinson disease, for example, have had the unanticipated side effect of enhancing cognition in those without impairment.1 Drugs used to treat Attention Deficit Hyperactivity Disorder, including Adderall and Ritalin, are also reported to enhance working memory, problem solving,

Assessing Therapy vs Enhancement

Even if nootropics are in their relative infancy it is clear that effective enhancers are on the horizon and we ought to consider the particular questions they raise sooner rather than later. The first question is whether such drugs ought to be regarded as treatment of disease, and therefore should be covered by insurance, or as enhancement and considered in the same realm as vitamins and dietary supplements? This dichotomy would accept nootropics as therapy for those who have a medical

Safety Concerns

Safety concerns are often cited as the reason to summarily reject the use of nootropics and associated interventions. Ritalin and Adderall can cause negative side effects, including addiction, heart problems, nausea, anorexia, anxiety, and insomnia. They have been linked to cerebrovascular disease and potential triggers for underlying mental illness.22 This perspective suggests that the delicate human brain may not tolerate fluctuations in neurochemistry by powerful pharmaceutical agents.

Is It Cheating?

Perhaps the most morally problematic argument against the use of nootropics is that it constitutes a form of cheating. For some, the idea of taking a pill to concentrate, to stay awake longer to study for an examination, or to meet a deadline is regarded as inauthentic and diminishes the hard work of those who put in the effort naturally. Some have worried that it deforms our character and devalues the spirit of perseverance and self-discipline.17 Accordingly, if achievements come too easily

Equal Access

The final issue under consideration is whether the use of nootropics would worsen social inequality. Buchanan argues that this would depend primarily on the kinds of interventions that are considered in the category of enhancement.29 Implantable brain chips or embryonic screening, for example, would likely remain expensive and available to a small few. Addressing the issue of genetic improvement and unequal access, Princeton biologist Lee Silver has suggested the possibility that this could

Looking Toward the Future

Along the spectrum of cognitive enhancers are pharmaceuticals designed specifically to diminish functions, including memory, attachment, and even sexual function. Some philosophers have endorsed diminishment as enhancement under a Welfarist claim that the definition of enhancement should be broad enough in scope to include biological or psychological changes that promote a person’s welfare under a particular set of circumstances.31

Accordingly, Earp et al argue that some drugs that reduce

References (32)

  • B. Maher

    Poll results: Look who’s doping

    Nat News

    (2008)
  • Do cognitive-enhancing drugs work? BBC News. Available at:...
  • D. Hurley

    Smarter: The New Science of Building Brain Power

    (2013)
  • C.R. Madan

    Augmented memory: A survey of the approaches to remembering more

    Front Syst Neurosci

    (2014)
  • Steroids for the Brain: Are They Worth the Risk? 2012. Available at:...
  • K. Muhammed

    Cosmetic neurology: The role of healthcare professionals

    Med Health Care Philos

    (2014)

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