In recent years, there has been controversy about the use of medications like Ritalin and amphetamines by people without a medical diagnosis to warrant their use to boost performance in school and on tests. Some feel that this is cheating, giving students with access to these medications an unfair advantage over those who do not. Others see this as just a small step on the way to true cognitive enhancement. But what is cognitive enhancement? In fact, what do we mean when we talk about any kind of human enhancement? There are many different definitions of enhancement but in general, enhancements would be interventions beyond what is necessary to sustain health. Julian Savulescu defines them as “any change in the biology or psychology of a person which increases the chances of leading a good life in the relevant set of circumstances.” (Nagel, 72; Mohamed, 534). Nagel also quotes John Harris as saying enhancements will:
“make us better at doing some of the things we want to do, better at experiencing the world through all of our sense, better at assimilating and processing what we experience, better at remembering and understanding things, stronger, more competent, more of everything we want to be… In terms of human functioning, an enhancement is by definition an improvement on what went before. If it wasn’t good for you, it wouldn’t be enhancement.” (72)
Cognitive enhancement specifically improves the capacities of the human mind. Cognitive enhancement might allow us better concentration and focus, better memory, and better reasoning ability. Some speculate it might also alter the way we perceive the world around us, enhancing our senses. It might also potentially offer ways to influence emotion and behavior, allowing us to be more empathetic for example. We already have some ability to enhance our cognitive performance; caffeine is often used by people to promote alertness and concentration ability and medications like Ritalin, Adderall, and amphetamines offer some people these advantages, too. Some researchers feel it will be possible to improve our cognitive abilities, our abilities to process information, reason and remember, even farther. This might be accomplished through medication or through stimulation of specific areas of the brain by an external technology. As we learn more about genetics, we might potentially be able to influence cognitive ability through genetic manipulation as well.
Why is there concern about the development of methods for cognitive enhancement? Who wouldn’t want to be smarter, after all. The arguments both for and against are many, but the three areas I would like to focus on here are authenticity, autonomy, and justice.
Authenticity refers to our concept of self. In other words, what makes each of us as individuals who we are from within, what motivates us, our essential beliefs that we feel define who we are. Critics of cognitive enhancement fear that such practices would alter this inner sense of self and damage authenticity. They worry that practices that alter cognition might change our natural tendencies and emotions and might ultimately result in a loss of empathy and our sense of “humanity”. They often point to the experience that some people have on antidepressant medication and potential cognitive enhancers like Ritalin who describe that using these medications somehow makes them feel less of who they truly are, leaving them feeling blunted and “not themselves”. Conversely, proponents of cognitive enhancement present the testimony of other users of these same medications who feel as if they were only really able to discover their true selves and be authentic with the help of these medications. Cognitive enhancement, some supporters feel, through the increase in awareness and ability to reason which they see as part of this change, will actually allow us more access to our “true” selves and increase our ability to empathize.
The notion of authenticity in and of itself is not without controversy, but I mention it here in the debate over cognitive enhancement because it can be a very emotional subject and makes us susceptible in this setting to arguments supported by appeals to emotion, half-truths and observational bias on both sides. For instance, in the examples stated above, what were the circumstances that required the people with these changes in their sense of authenticity to be on these medications in the first place? How many people in that circumstance have a similar experience? Certainly, the experiences of people who have used medication or undergone some type of therapy or procedure which may lead to cognitive enhancement cannot be discounted, but relying on the sense of authenticity, an entirely subjective experience, should be done with great caution.
Autonomy according to Beauchamp and Childress is characterized by “intentionality, understanding, and absence of controlling influences.” (Schaefer, 125) It is our freedom to make our own decisions and withstand outside influences. Our ability to reason and deliberate, evaluating the information we have on a subject and weigh the pros and cons before we come to a decision, is a key factor in being able to make the most of our autonomy and gives us the power to avoid manipulation. Proponents of cognitive enhancement like Schaefer often argue that by increasing cognition and our ability to process and understand information, we would be enhancing our ability to remain autonomous decision makers. They explain that improved cognition would decrease our susceptibility to outside influences, conformity and manipulation by preserving independent thought.
One concern of critics of cognitive enhancement is specific to genetic enhancement (either through genetic manipulation or selection) of cognition. Dena Davis argues that parents actions that result in genetic selection for a specific trait limits the child’s right to an open future by “limiting” a child’s options later in life from what they would be naturally. (Schaefer, 131) Another issue opponents see with genetic enhancement are how parental expectations will affect a child’s future autonomy. “Even traits that are useful for all life plans (such as intelligence) may be chosen with a specific life plan in mind, with expectations that may restrict the child’s future freedom,” Schaefer quotes Davis. (p132). Parents might be intolerant of a child’s own choices and try to influence the children in some way.
I agree with Schaefer that these arguments against cognitive enhancement though genetics are by themselves, very weak. As mentioned, improving cognition will likely lead to greater autonomy, not less, and improving cognitive ability is hardly likely to limit a child’s future options. Even if parents did try to influence their child’s choices out of a commitment to some specific life plan, the improved autonomy offered by increased cognition would actually aid a child in overcoming that parental influence if they desired and even open up options they might not otherwise have had. It doesn’t seem likely that the parents would have been any less likely to try influence their child if they had a specific life plan in mind were cognitive enhancements not at play.
When we consider justice in this setting, the most commonly cited concern is the availability of cognitive enhancements. As with most new technologies or medications, initially new cognitive enhancement options will only be available to a small group of people largely due to the cost of such measures when they first enter the market. An even smaller group will have had access even before this through participation in research. Critics fear that this uneven distribution will result in a widening of the gap between the haves and the have-nots. Those who have had some cognitive enhancing therapy will likely have more success academically and professionally and place them at further economic and political advantage. Those who cannot gain access to such treatment will be relegated to lower paying positions with little opportunity for social or economic advancement. Some feel that using cognitive enhancements is “cheating”, giving a person an unfair advantage over those who do not have access or choose not to use such therapies.
I do feel that these concerns are valid. There will be a distinct advantage to the group of people who have earlier access to cognitive enhancement therapies and it could be seen as unfair.But I think these arguments show an omission bias and a tendency to risk aversion. Omission bias holds that harms that occur as the result of taking a specific action are worse than harms that occur as the result of not taking action (such as the notion that the potential harm of side effects from receiving a vaccine is worse than the harm that occurs if you do not get vaccinated and become ill). In this instance, opponents fear the inequality that will occur if we pursue cognitive enhancement is a greater risk than not pursing cognitive enhancement even though enhancement may lead to scientific advances that could ease the burden of disease and potentially promote economic and political stability (factors that might lessen disparity) even if these techniques are applied to a small sub-set of the population. We do need to proceed with caution in this arena, but I don’t feel that the concerns about disparities in access should be the sole deciding factor in the debate over enhancement.
Cognitive enhancement offers many exciting possibilities. If we improve on our ability to process information, to reason and reach rational decisions, to improve our memory and our focus on the task at hand, and maybe improve creativity as well, we are likely to see incredible advances in our productivity as well as a better understanding of the world around us. We will likely see amazing breakthroughs in science and medicine. Hopefully our improved understanding could lead to solutions to the worlds social and economic problems as well and advance all of society.
As Eric Racine suggests, in order for any type of enhancement technology to be morally acceptable, it “requires that enhancement technologies fulfill scientific (eg risk assessment), ethical (eg informed consent), social (eg health coverage), and regulatory criteria (eg approval mechanisms).” (Mohamed, p 357) The evaluation of the merits of cognitive enhancement needs to continue as our understanding of neurobiology, genetics and technology improves. All of the factors mentioned above certainly need to be considered and the ethics of whether we should actively pursue cognitive enhancement does require open discussion. Saskia Nagel calls for “studying of the nature of well-being, and how it can be increased, and probing public attitudes on enhancement to allow regulation and political decision-making to be nuanced and sound,” cautioning against taking a strong stance for or against to allow for honest, sensitive discussion. (p 3) This sounds like an excellent place to start.
In this post I have only just scratched the surface of some of the really tough controversies surrounding this issue. I will confess to an optimistic bias in my personal view of cognitive enhancement but I have learned a great deal while researching this topic. My personal words of caution in approaching debates about cognitive enhancement (especially when considering specific therapies such as medications): 1) keep in mind there is unlikely going to be a one size fits all answer, people will have a variety of responses to treatments and we have to learn how to best apply those treatments to offer the benefits while minimizing untoward experiences, and 2) similarly avoid categorical stances, clearly there are valid arguments on both sides of most arguments so stay open to new ideas and discover ways conflicts might be resolved. In closing, I’d also like to encourage everyone to do what they can to promote their own and others cognitive enhancement: eat healthy, ensure adequate sleep, manage medical issues, promote learning and access to education throughout the lifespan, and expand your understanding of the world through new experiences and talking with people who aren’t just like you.
Mohamed, A.D. (2014) Neuroethical issues in pharmacological cognitive enhancement. WIREs Cognitive Science. 5:533-549. doi: 10.1002/wcs.1306
Nagel, S.K. (2014) Enhancement for well-being is still ethically challenging. Frontiers in Systems Neuroscience. 8:72. doi: 10.3389/fnsys.2014.00072
Schaefer, G.O., Kahane, G., Savulescu, J. (2013) Autonomy and Enhancement. Neuroethics. 7:123-136. doi: 10.1007/s12152-013-9189-5
Gunson, D., McLachlan, H. (2013) Risk, Russian-roulette and lotteries: Perrson and Savulescu on moral enhancement. Med Health Care and Philos. 16: 877-884. doi: 10.1007/s11019-012-9461-1
Santonio de Sio, F., Faulmuller, N., Vincent, N.A. (2014) How Cognitive enhancement can change our duties. Frontiers in Systems Neuroscience. 8:131. doi: 10.3389/fnsys.2014.00131
Schleim, S.(2014) Whose well-being? Common conceptions and misconceptions in the enhancement debate. Frontiers in Systems Neuroscience. 8:148 doi: 10.3389/fnsys.2014.00148