Medicine & Personal & Science & Technology 25 Apr 2004 01:07 am
Neuroethics
Neuroethics is a subdiscipline of a subdiscipline that has recently gained popularity in recent years for a few very good reasons. Firstly, the area of neuroscience and neuropharmacology have made rapid advances in the last decade, and is on the verge of plethora of more discoveries that will only broaden understanding in the neurosciences even further. The problem with the neurosciences is that the questions raised by the unfolding developments are coming more quickly than ethicists can handle. This is a problem not unique to neuroscience – bioethics in general has the same problem.
Many people are familiar with the concept of “better than well” that is increasingly gaining popularity – and more importantly, relevance. “Cognitive-enhancers” are increasingly common: dopamine agonists and SSRIs are improving many people's lives, and allowing these individuals to be more productive and happy. But what about those “normal” people that use (or abuse, depending on your perspective) these substances? Are they somehow cheating at life? (Is “cheating at life” even possible?) According to Dr. Leon Kass, head of the President's Council on Bioethics “those areas of human life in which excellence has until now been achieved only by discipline and effort, the attainment of those achievements by means of drugs, genetic engineering, or implanted devices looks to be 'cheating' or 'cheap.'”
Really. What then is “cheating?” I found eleven definitions of what exactly cheating is. The most relevant of these eleven is this: “To violate rules deliberately, as in a game.” (source: Dictionary.com/American Heritage Dictionary) I agree with Dr. Kass when applying his logic to purely physical phenomena: who can run the fastest, jump the farthest, or lift the most weight.(1) But can one cheat at life: something that arguably isn't about winning or losing.
This introduces the “problem” of neuroethics: cognitive enhancers are a whole different animal, and because of this divergence from traditional bioethics, it must become its own discipline. In life, most people grow up, learn, and make their way in the world. Sometimes, someone extraordinary comes along and significantly adds to the sum total of human knowledge, and/or improves the human condition in some way.
But what if (ah, there's always the “what if” clause) someone came along and did something extraordinary… the only difference being that he or she did it with the help of a cognitive enhancer? Would their achievement be any less excellent, or any less beneficial to humankind? Would their achievement be any less noteworthy? Nicolo Machiavelli in his treatise entitled The Prince asserted that the ends justified the means. Most ethicists would disagree with him, and I would as well for any number of obvious reasons; one or two of which you probably had to expound upon in some pointless English paper in high school. In this particular case, however, perhaps the ends do justify the means? (Especially, whereas the means in this case is a moral gray area, even if it is not a legal one.)
If someone came up with a Grand Unified Theory that perfectly married quantum mechanics and relativity, would they be barred from receiving the Nobel Prize simply because they did so with the aid of a cognition-enhancing substance? They probably would not, because they wouldn't have cheated anyone else out of “inventing” said theory. All of this, of course, assumes that the person in question had been “normal” to begin with, and had begun taking a cognitive enhancer that technically, he or she didn't need, in effect making them better than well. (Semi-relevant sidenote: it's interesting that science has a way of making heroes out of social and legal pariahs… though often after their deaths.)(2)
So how about students that use cognitive enhancers when medically, they don't need them? Are they cheating? An argument can be made both ways. Cheating in the traditional sense essentially boils down to a student not knowing something, and relying on another source for the necessary information. In the case of cognitive enhancement, the student arguably knows the material, and thus is not cheating in the normal sense. But what if the professor grades on a curve, and only a certain number of people get As? Has the student essentially “cheated” a classmate out of something that would rightfully have been theirs, by taking “steroids” for the mind? A sticky issue: the person that got the B instead of the A will say they were cheated; the person who took the cognitive enhancer would say that they knew the material better than their classmates, regardless of how the knowledge got there to begin with, and thus they “deserved” the higher grade. Who is right depends on your perspective… much like with everything else in life.
Going back for a moment, I think it's worth noting that different branches of the government feel differently about the use of cognitive enhancers. While Dr. Kass thinks that the augmentation of the normal brain with cognition-enhancing substances “cheapens” human achievement, the US Air Force dispenses dextroamphetamines to their pilots, who have the option of using the “go pills” whilst on a sortie; however, if they refuse to bring them along on the mission, they can be grounded from that flight. (The actual consumption of the drug is optional.) This is quite a departure from Dr. Kass's position, and represents an understandable double-standard within the government itself: a battlefield situation is obviously different than a private citizen poring over a complex math problem.
Are there social dangers to these so-called “lifestyle” drugs? Bioethicists are hard at work attempting to determine whether there are. Certainly there are social ramifications involved, but whether these ramifications are detrimental in nature has yet to be seen. In the meantime, it is difficult to ignore the more immediate potential effects: do those that partake of these medications (legally or otherwise) perform at a higher level than they would normally? I know quite a few individuals that would argue that they do, myself included. Recently diagnosed with ADD, I can definitely see a difference in my performance. Admittedly, it is tempting to see what it would be like to be “better than well” – I can't say that I could stand on the proverbial soap box, and condemn someone for taking a cognition-enhancing medication, even though they technically don't need it.
Regardless of what those more informed than myself decide in the coming years, I don't think we'll see a wide scale adoption of cognitive enhancers by society at large, even if it becomes socially acceptable. The stigma that surrounds taking "a pill" is still quite prevalent among much of the population… for better or worse.
