Why boost brains?

Reuters reports: Brain-boosting drugs: why not?, experts say (various follow ups in different media). The story is based on an opinion article in Nature, where a number of medical, legal and philosophical researchers argue that society must respond to the growing demand for cognitive enhancement. How and why should society respond?

The discussions of cognitive enhancement are heating up, partially driven by and partially motivating the field of neuroethics. Ronald Bailey has written a report from a neuroethics meeting that lists (and argues against) some of the main objections against cognitive enhancers. While some of his responses are a bit facile (any ethicist worth their salt could turn each objection into at least one paper), it is by no means easy to make a strong rational case against enhancement (c.f. Beyond Therapy). The kinds of arguments that often convince lay people (that it is unnatural, a threat to human authenticity or dignity) are notoriously slippery and often work well because they fit in with preexisting cultural or emotional preconceptions rather than any rational moral process. In many cases the arguments appear to be tied to a particular religious or secular worldview, making them unlikely candidates for any kind of generally acceptable public morality or policy. Arguments that enhancement would cause negative social effects (more competition, social inequalities or coercion) often hinge more on evoking dystopian scenarios than any plausible sociology, and seem vulnerable to social fixes (e.g. government subsidies or anti-discrimination laws) and in need for empirical testing. There are certainly plenty of potential problems that need to be dealt with, but none of these problems appear to be show-stoppers, ethically or practically. As far we know.

The Nature essay calls for a number of sensible actions:

  • The presumption that mentally competent adults should be able to engage in cognitive enhancement using drugs.
  • More research to evaluate the risks and benefits of cognitive enhancement in healthy people.
  • Setting up social policies to support fairness, protect individuals from coercion and minimize socioeconomic disparities.
  • Get doctors, educators and others to develop policies for the use of these drugs. Much of actual use will be determined by professional societies and their rules and guidelines rather than laws.
  • Legislative action to get cognitive enhancement technologies recognized and to channel them into useful paths.
  • Broad dissemination of the risks, benefits and alternatives to pharmaceutical cognitive enhancement.

I have little disagreement with this. The real problem may be timing: setting up social policies is probably best done when we have some experience with what works and what does not, and how it affects people socially. This would require a wait-and-see strategy for social policies, and that is seldom what politicians like. They are more likely to try to be proactive (especially if it can be done through "costless" legislation), which could saddle us with rules that are not evidence based.

Worse, there is a great deal of "science fact" thinking going on everywhere, making people think the field is more advanced than it is. The need for further studies on enhancement is actually very high. There are for example no studies showing that enhancers actually improve academic performance. But many people who have tried enhancers (or have heard others tell how well they worked) will be convinced they work well and reliably. But sadly, much of the enhancement effect people experience today is likely just placebo effects.

Most likely we are going to discover that enhancers are no panacea, but useful for certain specific things like focusing attention and improving learning abilities. Other activities such as exercise, nutrition, sleep, instruction and
reading can improve other mental faculties; they might turn out to be
complements or substitutes for certain enhancers. Still, managing one's neural resouces is just a part of education (or any other task). Without information, engaging teachers or the time to do a proper job we will not succeed.

However, if we can discover ways of improving general cognitive function the benefits can be profound. A healthier, brighter mind is useful for nearly all life projects. Smarter people are not just better off socially, they are healthier and live longer. A recent paper even shows that intelligence protects against homicide! Even when controlling for socioeconomic status, education and health the effect remained (the top half had just 27% of the risk of the lower 11%) The authors speculate that people with good verbal skills might be able to defuse disputes without having to resort to violence, or that low intelligence impairs risk perception (other possibilities include different levels of alcohol use, or that low-intelligence people associate more with dangerous people). In any case, the study suggests that having low cognitive functions is a bad thing. Any means, drugs or not, to help increase cognition is likely to be a good thing. It might even turn out that the real benefits will not be obvious on the individual level but on the societal level.

More research is definitely needed.

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