Brain doping: academics say yes

A commentary in Nature by a group of psychologists, ethicists and neuroscientists has a controversial message:

Based on our considerations, we call for a presumption that mentally competent adults should be able to engage in cognitive enhancement using drugs. [their emphasis]

The authors call for a rejection of the common knee-jerk notion that cognitive enhancement in healthy individuals - using drugs like amphetamines or the fatigue suppressant modafinil, or other means such as brain stimulation - is somehow "cheating", "unnatural", or "drug abuse". None of these criticisms hold up to close scrutiny, they argue, and certainly do not justify a blanket ban on the use of enhancement techniques. Instead, the possible benefits of cognitive enhancement both for individuals and for society at large should be carefully weighed up before a decision is made.

The authors do acknowledge several substantive areas of concern that would need to be addressed before cognition-enhancing treatments became widespread:

  1. Safety: obviously widespread treatments must not cause overt harm, so there must be "an evidence-based approach to the evaluation of the risks and benefits of cognitive enhancement";
  2. Freedom from coercion: that is, ensuring that individuals who don't wish to use the treatments are free to make that decision, which the authors acknowledge will pose challenges; and
  3. Fairness: ideally, enhancement should be equally available to all - the authors go so far as to suggest "giving every exam-taker free access to cognitive enhancements, as some schools provide computers during exam week to all students".

The authors go on to propose a range of policy measures, which they argue should be further developed in a collaboration between "physicians, educators, regulators and others". These measures are: an accelerated programme of research into the risks and benefits of cognitive enhancement; the broad dissemination of information "concerning the risks, benefits and alternatives to pharmaceutical cognitive enhancement", and finally, "careful and limited legislative action to channel cognitive-enhancement technologies into useful paths."

It will be interesting to see how this debate progresses.

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I emphatically agree that cognitive enhancement drugs, if proven safe with supervision, should be available. However, today it's illegal to have these drugs without a prescription, and how does one go about to get a prescription without a "disease?" Further, why not other body-enhancing drugs and supplements like, say, myostatin inhibitors? Even further, why not genetic engineering for positive traits? Same argument archetypes: it's safe, it's obviously an advantage, but is it "fair?"

Right now, you go to a doctor, say you've always had trouble focusing on your work and feel you're not fulfilling your potential, and walk away with a diagnosis of adult ADD and a script for Ritalin. But of course the authors argue that this subterfuge shouldn't be necessary, and that drugs proven (relatively) safe should be available to anyone who wants them.

As for physical enhancement, the article deals with this to some extent:

In the context of sports, pharmacological performance enhancement is indeed cheating. But, of course, it is cheating because it is against the rules. Any good set of rules would need to distinguish today's allowed cognitive enhancements, from private tutors to double espressos, from the newer methods, if they are to be banned.

I think it's fair to draw some analogy between doping in sport and cognitive enhancement among students, as in each case the individual is explicitly competing against others on what is meant to be a level playing field. The authors thus suggest that if enhancement is allowed it should be available to all students (i.e. not restricted to those who can afford it). I guess this is analogous to Julian Suvalescu's argument that doping should be allowed for all athletes.

But in any case the analogy falls apart if you apply it to the use of cognitive enhancement outside the environment of study. Sure, science is competitive, but it's not a zero-sum game: even if only a few scientists were to boost their cognition, science and society as a whole would benefit from their increased productivity. Does some nebulous concept of "fairness" outweigh the broader benefits of increasing scientific productivity? I certainly don't think so.

As one who possesses some libertarian values, it is nice to see some promotion of freedom in the academic world of political correctness. My students have been coming to exams with cups of coffee for decades and who knows what they have done to themselves before arriving for the exam. I suggest that "brain performance enhancement" has been tried for a long time already. I do have two points:

1. What is the evidence that any of these enhancement ploys actually work beyond keeping the individual from falling asleep?

2. The pills that are to be popped are to be "safe." Lots of luck on this one with the large number parasitic lawyers in our society. I can smell class action lawsuit from here.

Nope. Unworkable. In spite what they say, the elite (wealthy) will have access to better dope, better enhancements, and be able to better defend themselves against accusations of cheating due to their money and political connections. I know that they have specified that ideally the playing field should be level. I am just saying the reality is that it won't be. You are not going to be able to keep politics and money out of it, don't fool yourselves about that. Especially when the stakes are high, like for getting into a top university, or winning a competition for money or scholarships.

And I agree with Bob, what do they do besides keep someone a little more awake longer? If cognitive enhancements are over-used, they interfere with sleep patterns, brain-wave activity, or possibly even inhibit crucial functions of consciousness such as dreaming.

Plus, given the human proclivity for developing addictions (they don't have to be physical addictions, we can get psychologically addicted just as easily), the danger is that we will end up creating addicted monsters who are mental wimps with out their fix - intellectual hulks that fizzle out when the drug dies down.

I think it is ethical to search for ways to improve the human condition, and genetics and drugs can play a role. But the focus should always be on growing healthy people who can function on their own bodies' resources, without needing "fixes" of whatever kind of substance keep them going.

Where the line is can be debated, but I am just telling you that an actual "genius" is not somebody who is just pumped up on drugs for exam day.


I haven't dug hard, but so far I've mostly found small association studies suggesting effects of these agents on things like memory and executive function. Still, that's part of the argument in the article: that research into the possible enhancing potential of these agents has been held back by public unease about the notion of enhancement, and that this research now needs to be done. The fact that these agents are used by a non-trivial proportion of students and academics suggests that they provide some advantage (or at least the perception of an advantage!)

The existing candidates have high addiction liability and high brain plasticity liability with chronic use. Much like with caffeine and nicotine (our traditional cognitive enhancers) this raises the very difficult problem of preserving the drug effect. With sustained use, one tends to simply subside back to baseline performance on drug and under baseline performance when off drug. So the notion that fantastic pro-cognitive drugs without other liabilities is a pipe dream. It is possible, but not likely at this point.

I object to the notion that science is unlike sports doping because of the slippery slope implications. What would we justify on the basis of the "greater good"? Where would we draw the line. Clearly in sports we make similar distinctions. It is OK to engage in repetitive workouts and violent sports that might have a tendency to decrease personal health in the immediate and longterm. There are similar distasteful elements of the science career including implications for earning potential, child rearing, spousal interactions etc. However, we draw the line and (officially) prohibit steroids in sports because this is considered too great a health risk for the implied benefits. So if a given institute of research found out that significant fractions of their faculty were on Ritalin for cognitive enhancement purposes, might they decide it was too great a health risk?

Well, there's no question that strong catecholaminergics are highly effective in the short run. The catch is what DrugMonkey is talking about. Here the duration of the studies is far more salient than are the N, p, or effect size per se.

By Eric J. Johnson (not verified) on 12 Dec 2008 #permalink