Ethical Considerations in the Framing of the Cognitive Enhancement Debate
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ORIGINAL PAPER
Ethical Considerations in the Framing of the Cognitive Enhancement Debate Simon M. Outram
Received: 16 June 2011 / Accepted: 23 June 2011 / Published online: 5 July 2011 # Springer Science+Business Media B.V. 2011
Abstract Over the past few years the use of stimulants such as methylphenidate and modafinil among the student population has attracted considerable debate in the pages of bioethics journals. Under the rubric of cognitive enhancement, bioethicists have discussed this use of stimulants—along with future technologies of enhancement—and have launched a sometimes forceful debate of such practices. In the following paper, it is argued that even if we focus solely upon current practices, the term cognitive enhancement encompasses a wide range of ethical considerations that can usefully be addressed without the need for speculation. In taking this position it is suggested that we divide cognitive enhancement into a series of empirically-constructed frameworks— medical risks and benefits, self-medication and under-prescription, prescription drug abuse and overmedication, and finally, the intention to cognitively enhance. These are not mutually exclusive frameworks, but provide a way in which to identify the scope of the issue at hand and particular ethical and medical questions that may be relevant to enhancement. By a process of elimination it is suggested that we can indeed talk of cognitive enhancement as an observable set of practices. However, in doing so we
S. M. Outram (*) Novel Tech Ethics, Dalhousie University, 1234 Le Marchant Street, Halifax, Nova Scotia B3H 3P7, Canada e-mail: [email protected]
should be aware of how academic commentaries and discussion may be seen as both capturing reality and reifying cognitive enhancement as an entity. Keywords Bioethics . Cognitive enhancement . Framing . Stimulants
Introduction: What is Cognitive Enhancement? Cognitive enhancement has attracted the attention of many in the bioethics community interested in the societal and individual-level consequences of the new technologies such as deep brain stimulation or new uses of existing technologies such as psychotropic drugs [1–6]. Conversely, several commentators have argued that bioethics is being led into unwarranted territory with little scientific and sociological empirical evidence to support the underlying claims being made regarding efficacy and usage [7–9]. In an attempt to redress the balance between future and present contexts, the following paper examines how we might envisage the ethical questions concerned with the use of cognitive enhancements as practiced today. The following paper is thus addressed to the bioethics community involved in this debate and is also addressed to those most involved with cognitive enhancement as practiced—the users of cognitive enhancers (in particular, college students) and the sometimes inadvertent suppliers of cognitive enhancers, namely physicians and neurologists [10–12]. In sum-
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mation, cognitive enhancement raises current ethical issues that
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