Should we use drugs to enhance cognitive performance?
Maxine Clarke
Monday, 01 December 2008 17:40 UTC
There is a growing trend to take prescription stimulants (Adderall and Ritalin for example) in order to enhance cognitive performance – perhaps in attempt to obtain better grades or increase learning capacity. Nature has been reporting on developments in this controversial area and providing a forum for discussion. In a Commentary article published online today (_Nature doi:10.1038/456702a; 7 December 2008) Henry Greely and co-authors, who include Philip Campbell, Editor in Chief of Nature, say that society must respond to this demand. The authors call for:
- a presumption that adults should be able to use drugs for this purpose
- an evidence-based approach to evaluate the risks and benefits
- legal and ethical policies to ensure fair and equitable use
- a research programme
- broadly available information about risks and benefits
Do you agree with the authors that new methods of improving our brain function should be welcomed, to improve quality of life and extend lifespans? Will safe and effective cognitive enhancers benefit the individual and society? Or should these drugs remain illegal for these purposes?
The Nature Commentary is published online tonight (7 December) and will be in the 11 December 2008 print edition of the journal.
Previous Nature Network discussion responding to the question ‘would you boost your brain power?’
Updated 08 December 2008 08:27 UTC
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I thought about removing those first few comments, Steffi, when I posted the real post, but the only way to do that is to leave the statement “this post has been removed by the forum moderators” which also looks a bit strange – so in the end I decided it was best to leave it. Pity that Nature Network does not have a timer function on its posts.
Carol: it is very common for those who support homeopathic or other alternative approaches to describe one-off “miracle” anecdotes. Without a controlled trial of the variables, such stories have little conviction. See Snake Oil, a very good book by John Diamond, for example. Or Bad Science by Ben Goldacre. However, the comment you make is in any event not relevant to this partticular forum discussion, so if you return, may I suggest that you either stay on topic or make your remarks in some other venue? -
Ah yes, that would look strange. Never mind!
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The larger ethical question was raised by David Colquhoun and ignored by all other respondents—several of the authors of the article would benefit financially from pharma drugs being recommended for use by healthy people. This article on the heels of the recent assertion that statin drugs be marketed to healthy individuals to prevent heart attacks and stroke really emphasizes this much larger issue. While I believe in lively debate—we need to look at all the issues here. This was not even mentioned in the article. And this is a huge problem with our health care system: doctors, educators and scientists “on the payroll” of pharmacuetical companies setting health standards, making recommendations for and prescribing drugs to their patients.
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Of course, more research needs to be conducted into the long-term effects of taking these drugs, whether one is “healthy” or not. This goes for the vast majority of all drugs on the market, as anyone following the news has witnessed. I agree with a previous poster who said that this commentary was needlessly controversial in its language. Oh well, you guys have journals and ads to sell, after all.
However, I feel the authors are erroneous when they equate taking drugs to engaging in exercise or getting enough sleep. There is a clear difference between those things, although all of them may involve increased acetylcholine in the brain. Under the authors’ definition, masturbation could be considered cognitive enhancement. Such an assertion is similar to the following statement: “The Sun and incandescent light bulbs are essentially identical because they both emit light.”
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I was incorrect in stating that cognitive drugs require faith. Indeed, they require faith and motivation. How then is “a controlled trial of the variables” to be found? In the absence of unbiased science, and in light of more pressing social concerns; it is probably best for these drugs to be illegal.
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Anonymous
I commend the authors on what I think is a fair and insightful piece. I’m surprised by the seemingly overwhelming negative response to it so far. I suspect many commenter’s are guilty of default outrage without forcing careful thought from themselves first. There is clear history of this in response to many technological advances of the last century, and yet we seemingly always continue our progression.
I’d like to begin by voicing that I off-label ‘cognitively enhance’, as I find that occasional metered use can make astounding increases in my ability as a researcher – which results in tangible benefit to society. It’s not a competition, I’m not taking an exam. I’m doing research; research that I hope may one day improve the lives of many. Of course I exercise, sleep, eat well, and I drink coffee. And yet sometimes that significant extra boost allows me to spend 12 hours pushing through math I frustratedly found myself unequal too for weeks previous. Why is this the act of a social criminal?
Current social standing on such drugs seems to be that they are good if you need them to become equal, but wrong if you want to become more than equal. Can we really be so quick to condemn that crucial aspect of the human spirit that strives to better ourselves? It has brought us to where we are today. Should we also tell brighter students to hold back to the median? I think not. This issue is not black-and-white, it requires the careful greyscale considerations the authors recommend.
I rapidly admit that many doctors and bio-scientists have managed to place themselves in quite a tangled web of conflict-of-interest. And this has sometimes proved to be dangerous, when they advise what we should consume for their profit. These authors may have some stated conflict of interest, which thankfully Nature requires authors to confess. However, that possible conflict of interest does not alleviate you, the reader, from your obligation to rationally and carefully consider their argument. They are not wrong just because they consult for pharma.
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The commentary was restricted to cognitive-enhancing drugs, but every facet of their argument, point by point, holds relevance for a “presumption” that healthy individuals, not competing in drug-tested sports, should be able to engage in physical enhancement using anabolic steroids and other performance-enhancing drugs.
In the absence of a “context of sport”, pharmacological cognitive-enhancement AND pharmacological physical-enhancement are “morally-equivalent.”
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What really is a healthy brain?
Everyone’s brain works differently. People approach the same problem differently and some do better than others. Most of these types of brains could be considered “healthly” but one may not be as efficient as the other in solving certain kinds of problems.
If certain drugs can enhance certain functions and can be shown to be safe and without serious side effects then why not use them. I doubt it will turn an idiot into a genius.
I would take something if I thought it would make me better at my job and would not harm me in the process. I am not competing with others but just trying to make myself (and company) more successful.
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In principle, why not? As the authors points out, good nutrition, exercise, and all sorts of things enhance cognitive performance.
However, my concern is a very un-science-like sort of issue.
Just what would it say to kids if it was made clear to them from day one that they just aren’t good enough as they are, and need cognitive performance enhancers from day one?
The ‘evolutionary’ analysis of a competitive edge this could potentially give societies ultimately has to be balanced against the potential that this could undermine certain important factors of the social fabric in an undesirable manner.
Of course, such arguments as “undermining social fabric” are regularly used against things that you simply don’t like when unarmed with concrete arguments.
As I said, in principle, I don’t see why any individual should not be allowed to enhance their cognitive performance, but I’m not entirely comfortable with the signals this sends out about the inherent value of human capacity (whether said ‘inherent’ nature is a social construction or not).
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I believe human stupidity is a great evil, and I welcome technologies that can alleviate it. But the authors’ calls come at a time when the only technologies available work poorly, and society is unable to apply enhancement technologies in anything resembling a healthy manner. As such, their commentary is easily a decade premature, and will do much more harm than good.
Let’s get off the abstract plane: the only new enhancements anyone is talking about are drugs. Drugs are powerful, often like a sledgehammer on one’s neurochemistry. Adderall, a prominent example they use, is simply speed, amphetamine. German marching powder. Black beauties. Highly addictive, it frequently causes outbursts of anger, paranoia, and the disruption of eating and sleeping patterns. Not good for you at all. Similarly, modifinil: if we could safely get away with 1 hour of sleep per night, we definitely would have evolved that way. This drug will obviously cause serious health problems in long-term users. To compare these blunt instruments with the subtle and easily modulated exercise and reading, and claim moral equivalency, is absurd. To match them with caffeine, even, is to show a profound disconnect with real life.
Yet the authors are wrapped up in these intellectual arguments – their ivory tower – to such a degree that they can’t see how coercive and desperate the environment they drop their pro-doping argument into is. The idea that our “emerging social norms” are within spitting distance of moral or ethical behavior is absurd. This seems so obvious to me, I don’t know what evidence to use. The fact that some guy just got trampled at WalMart? The political and economic situation, and all the dirty, stupid efferents that fed into it? Growing inequality and declining social mobility? How can anyone be so oblivious: the authors’ many and well-argued calls for research and education will be largely ignored, while only their licensing of brain doping will get though and exacerbate a culture of sweaty desperation, oily conniving, and increasing spiritual and physical disease, a culture that is already plaguing our civilization and rapidly reversing the gains we have made since the Enlightenment.
As I said, I support the use of advanced biological technologies to help alleviate human stupidity. Heck, let’s cure ugliness and aging while we’re at it. I’m not being sarcastic: we will get there someday, and it will be wonderful. But we are not close enough, not by a long shot, for the changes called for in this article. Liberalizing the use of bad drugs in a sick society while ridiculously asserting they’re “just another technology — like reading! We’ll be careful…” is an idea that could only come from, as Curtis Mayfield once sang, “educated fools, from uneducated schools.” That’s harsh, but true. Rarely have I seen such a sterling example of how a logical argument can be wrong.
I hope the pro-dopers just get ignored: if this breaks into an argument in the public square, it may well hurt the chances of deploying good cognitive enhancement technologies when they’re ready.
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