Why would anybody want to use cognitive enhancers? To supersize their mental capacities, of course. Depending on the precise method – and the creativity of the given product’s marketing department – touted benefits include superior memory, focus, reflexes, calmness, clarity of thought, problem-solving ability, mental stamina, and ability to function well with little sleep.
Many of these supplements include exotic-sounding ingredients. Gingko Biloba and an herb called Bacopa are two that have shown some promising memory and attention benefits, says Dr. Guillaume Fond, a psychiatrist with France’s Aix-Marseille University Medical School who has studied smart drugs and cognitive enhancement.
In recent years, as the diagnosis of ADD has become more common, and increasing numbers of adults have begun taking stimulant medications as a treatment for ADD, or without a prescription as a study aid, there have been calls for stricter regulation of the diagnosis and the medication.
The need to overhaul our dysfunctional approach to education is not disputed, and some of the pressure to diagnose kids would be relieved by more personalized pedagogies. We need to be protected from abusive workplaces that demand unhealthy hours of attentiveness. It is also true that our predecessors had to bear levels of pain, illness, disability, depression and distractability that we now can avoid by the judicious use of the fruits of medical capitalism.
With or without prescriptions, looking at brain booster uses through the several ethical lenses that are being applied in the emerging debates over cognitive and moral enhancement, the basic point to make is that the use of stimulants and other cognitive enhancing supplements can be warranted by our general moral obligations to exercise more self-control, and to be as attentive and intelligent as possible. Students have specific moral obligations to learn -which can also legitimate their use of cognitive enhancement substances.
The Use of Stimulants in Education
The first medication that began to be used as a treatment for ADD in the 1950s, which was then known as minimal brain dysfunction, was methylphenidate, marketed as Ritalin. Methylphenidate is a dopamine reuptake inhibitor, dopamine being a signal to the brain to pay attention.
One way to understand the ADD brain is it is dopamine deficient, and the ADD child or adult is constantly looking for something to keep themselves awake. By boosting dopamine, they can better attend controlling their own behavior, and to the tasks at hand. Methylphenidate also boosts a form of dopamine that enables learning, encourages brain maturation and the differentiation of neural stem cells, and enhances synaptic plasticity. It also boosts norepinephrine levels which helps to focus attention, while suppressing nerve transmissions in the sensory pathways, so that it is easier to block out extraneous stimuli. This means, where ADD brains are constantly whirring and distracted, with cognitive enhancement, they suddenly have clarity and focus. This is what our Brain Booster does for the minds of both prescription customers and non-prescription.
A theory of virtues is central to almost every religion, and to most of the Greco-Roman philosophies. It is also implicit in some Enlightenment thought, although that is a discussion for a different time. Examining the world’s virtue theories there are some virtues that are present in all, and some that are idiosyncratic. Two that are almost universal are the virtue of self-control or temperance, and the virtue of intelligent decision-making, practical wisdom or prudence.
Before the spread of the ADD diagnosis, kids with the ADD profile were considered simply slow and incorrigible. Someone diagnosed with ADD who got in trouble would be asked, “Did you take your pill?” because their choice to take the pill that allowed self-control and practical decision-making throughout the rest of the day is their first and most important moral decision.
All the virtues –compassion, honesty, fairness- depend upon self-control, and they all are exercised through prudent decision-making.
There is a cognitive fallacy known as the status quo bias in play. If we know that we have a moral obligation not to drink when we drive, work, or take care of children because it makes us stupid, why do we not have an affirmative obligation to take a cognitive enhancement that makes us smarter at doing those tasks? The bias is that being naturally dumb is OK, but smarter with a supplement is wrong.
Another moral positive of greater executive control is that these enhancers reduce the influence of emotive biases in our judgment. There is now substantial evidence that the strength of our frontal cortex in relationship to our amygdala is one of the keys to our capacity to exercise moral reasoning, and override aversion impulses from the amygdala. For instance, when someone is sleep deprived or drunk, they are more likely to be bigoted; but with the increase in executive function from stimulants and cognitive enhancements, our capacity for rational moral deliberation increases and emotive biases reduce.
Exercise of the virtues of self-control and prudential decision-making are general obligations. But there are also virtues specific to specific social roles. The physician should heal impartially, the scientist should record their methods and publish their results, and the student should commit themselves to learning and not to cheat. Since a central virtue of the student is to be dedicated to learning, we are impressed with the research on the use of stimulant enhancers without a prescription, showing their use to aid in studying and writing, and not recreationally. These supplements are generally being used to fulfill virtuous obligations.
But what of the accusation that taking a cognitive enhancing drug is cheating. First, why is this charge not leveled against caffeine, which has the same benefit, to a lesser degree? Second, education is not a sport, an activity with a prior set of agreements about the appropriate ways to prepare for the competition. All athletes have entered into an agreement not to use boosters to enhance their abilities before or during a competition. Students have not made such a commitment and are free to be as mentally sharp as they possibly can be. They have only committed to do their own reading and writing of their own papers and exams.
A final consideration of the virtue approach is the virtue of authenticity, since some consider any accomplishment achieved with the aid of a enhancer to be inauthentic. But consider the diabetic. It is possible to control blood sugar through diet alone, yet most diabetics take insulin and other medications to regulate blood sugar. Some people prefer to climb mountains with bare hands and feet, while others use boots, pitons and safety harnesses. Some prefer to manage depression with Prozac and others with non-medical means. Authenticity is not a priori; it is a subjective matter of personal definition. Many eschew the use of cognitive enhancements on the grounds that they feel inauthentic, and for them perhaps they would be, but only for them.
Between 2008 and 2010 Ilina Singh interviewed 150 British and American children taking stimulant medications and asked them about the threat to moral agency and authenticity posed by their use of the drug.
She concluded, majority of the children believed the drugs improved their moral agency -such as their ability to perform in the classroom and manage aggressive behavior, and that they did not pose a threat to their authenticity.
Cognitive Liberty and Autonomy
A second moral frame for the right to cognitive enhancement is based on the liberal individualist rights logic that emerged in the Enlightenment, that we all have a right to control our own bodies and brains and use them as we see fit so long as we don’t harm others. In a liberal democratic society, the grounds for interfering in someone’s right to self-determination is if their actions harm others, or if they are sacrificing their own self-determination.
Brain Booster enhances autonomy, since self-control and executive function are the basis for exercising autonomy. Insofar as we have an obligation to respect our own and one another’s autonomy we should not only respect the right of others to take enhancements that increase self-control, but even encourage it.
A third ethical framework for considering the ethics of taking these supplements is consequentialism, the greatest good for the greatest number. We adopt rules of thumb that are based on general consequentialist intuitions. Instead of arguing for individual liberty as a priori right of self-possession we can argue John Stuart Mills case, that the society which allows its citizens the greatest possible freedom to find their own lifeways will generate the greatest happiness.
Applied to cognitive enhancing drugs what is our moral intuition about the general consequences of students taking supplements that permit them to study and perform at a higher level? In the first place these enhancers have a slight mood-elevating effect, although not enough to be addictive, so in that small way they have a beneficial effect on social well-being.
The improved performance of social roles by people using these supplements will in general lead to more social well-being as well as their use by the stock broker or DEA agent, the benefits generated by their use by the truck driver, the airline pilot, the medical intern, the harried mother, and the fatigued teacher all make up for the occasional occupation where a little less diligence might be a good thing. The student considering whether to use Brain Booster should not only consider that it may improve their own virtue but that it may also, in the long run, be good for society.
There is an important difference to be made here between positional goods and intrinsic goods. A positional good, like extra height on the basketball court or extra speed on the field, is something that no longer provides an advantage if everyone has it. In that case, taking whatever risks there are to gain the advantage does create a competitive world in which eventually there will be only the pains and no gains. An intrinsic good however is one which may create competitive pressure, but which is still a good for everyone who has it once it is achieved. Cognitive enhancement is an intrinsic good, which is why no one complained about the unfairness of the spread of literacy. Certainly, the spread of literacy meant that the illiterate felt compelled to learn to read or be left behind, and some were. But literacy, like the capacity for attention and self-control, is a good-in-itself. The goal is to ensure that as many people as possible have access to the good, not to forbid its spread.
If social well-being is defined in terms of happiness – whatever that is – then we will soon be in a future in which neurotechnologies, likely some fusion of pharmaceuticals and nanotechnology, will be able to provide whatever moods and experiences we choose. Defining the good as “happiness” in that future will then mean that everyone has their dopamine, endorphins and serotonin turned up to 11, regardless of their life situation. That is a deeply unsatisfying definition of the good life or the good society.
Instead, what Sen, Nussbaum and the capabilities theorists suggest is that we define the good in terms of the capabilities that we think everyone should able to enjoy, and that we should have social policies to maximize those capabilities in society, whether they make people happy or not. Some of the capabilities that Nussbaum considers basic are the capacities for reason and self-control, which brings us back to the virtue theory as Nussbaum intends. Even if the spreading use of cognitive enhancing drugs don’t make the users or society happier, they do increase the aggregate capacities for reason and self-control. And as John Stuart Mill charged, ‘It is better to be a human being dissatisfied than a pig satisfied; better to be Socrates dissatisfied than a fool satisfied.”
Surveys of student use of cognitive enhancement drugs in the United States have varied widely, from 4% to 35% using the drugs in the last year. In a survey of 1600 academics in 60 countries conducted by Nature magazine in 2007 they found 20% of the academics were taking cognitive enhancement drugs to improve concentration. Of all the respondents 80% thought that healthy adults should be able to take the drugs if they want to, and 70% said they would risk mild side effects to take such drugs themselves.
In recent years a growing number of bioethicists and neurologists have argued for a more liberal approach to the use of cognitive enhancing drugs by adults. These arguments largely rest on the claims of cognitive liberty and autonomy. There is a stronger claim, that it can be a moral obligation to enhance our capacities for reason, intelligence and self-control.
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