Defending cognition-enhancing drugs

A commentary in this week's issue of the journal Nature argues that cognitive performance-enhancing drugs should be made widely available, and sets out an ethical and legal framework for doing so in a way that maximizes the social good of being able to choose what state of mind you're in.

Contributors to the article include a Stanford law prof, a Cambridge research psychiatrist, a Harvard med-school prof, and other distinguished personages.

To wit:

Human ingenuity has given us means of enhancing our brains through inventions such as written language, printing and the Internet. Most authors of this Commentary are teachers and strive to enhance the minds of their students, both by adding substantive information and by showing them new and better ways to process that information. And we are all aware of the abilities to enhance our brains with adequate exercise, nutrition and sleep. The drugs just reviewed, along with newer technologies such as brain stimulation and prosthetic brain chips, should be viewed in the same general category as education, good health habits, and information technology — ways that our uniquely innovative species tries to improve itself.

Of course, no two enhancements are equivalent in every way, and some of the differences have moral relevance. For example, the benefits of education require some effort at self-improvement whereas the benefits of sleep do not. Enhancing by nutrition involves changing what we ingest and is therefore invasive in a way that reading is not. The opportunity to benefit from Internet access is less equitably distributed than the opportunity to benefit from exercise. Cognitive-enhancing drugs require relatively little effort, are invasive and for the time being are not equitably distributed, but none of these provides reasonable grounds for prohibition. Drugs may seem distinctive among enhancements in that they bring about their effects by altering brain function, but in reality so does any intervention that enhances cognition. Recent research has identified beneficial neural changes engendered by exercise10, nutrition11 and sleep12, as well as instruction13 and reading14. In short, cognitive-enhancing drugs seem morally equivalent to other, more familiar, enhancements.

Many people have doubts about the moral status of enhancement drugs for reasons ranging from the pragmatic to the philosophical, including concerns about short-circuiting personal agency and undermining the value of human effort15. Kass16, for example, has written of the subtle but, in his view, important differences between human enhancement through biotechnology and through more traditional means. Such arguments have been persuasively rejected (for example, ref. 17). Three arguments against the use of cognitive enhancement by the healthy quickly bubble to the surface in most discussions: that it is cheating, that it is unnatural and that it amounts to drug abuse.

Towards responsible use of cognitive-enhancing drugs by the healthy