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Horizon 2020 and The Role of Lay People’s Perspectives in Bioethical Reasoning

By Kimberly Schelle & Nadira Faulmüller

Horizon 2020, the European Union’s 2014-2020 largest research programme ever, includes the call to pursue ‘Responsible Research and Innovation’ (RRI). RRI stands for a research and innovation process in which all societal actors (e.g. citizens, policy makers, business and researchers) are working together in the process to align the outcomes with the values, needs, and expectations of the European Society. In a recently published paper on the importance of including the public and patients’ voices in bioethical reasoning, the authors describe, although in other words, the value of the RRI approach in bioethical issues:

“A bioethical position that fails to do this [exchange with the public opinion], and which thus avoids the confrontation with different public arguments, including ones perhaps based in different cultural histories, relations and ontological grounds […], not only runs the risk of missing important aspects, ideas and arguments. It also arouses strong suspicion of being indeed one-sided, biased or ideological—thus illegitimate.”

Interestingly, it has been shown that the public’s opinion often matches normative analyses, for example on topics as sex selection of embryos and life extension technologies. We have found the same when looking at public opinions on ‘smart drugs’, i.e. pharmacological cognitive enhancement.

In an overview of 40 empirical studies on lay people’s opinion on the use of smart drugs, we found that people in general have three main concerns. The three themes largely reflect the main themes that are discussed in most normative academic literature on the topic, namely:

1) Medical safety, the substances’ pharmacological short- and long-term side effects

2) Coercion, the explicit and implicit pressures that can arise from the availability of smart drugs (e.g., employers potentially forcing employees to use an enhancing drug)

3) Fairness, covering several subthemes namely ‘equality of opportunity’ (the importance of an equal distribution of opportunities to obtain smart drugs and opportunities deriving from the use), ‘honesty’ (e.g., touching the question whether cognitive enhancement is cheating), and ‘authenticity’ (the question whether performance under the use of smart drugs is an authentic performance or not).

When looking more closely at the available studies, however, interesting aspects that hint to topics in need of further normative analysis arise. An example is the differences between the opinions of certain groups, such as parents, students and health care providers. A more striking discrepancy, however, is the one in the views of users and nonusers. Users think that the use of smart drugs is less dangerous and more (morally and socially) acceptable than nonusers believe it to be. For example, an online survey among 1765 Swiss students showed that only about 64 percent of the group that indicated to use smart drugs worried about the side effects, while for nonusers this was almost 82 percent. Furthermore, users state less doubts about the fairness of smart drugs, and feel less troubled by others gaining academic advantages of the use, than nonusers. In a large online survey amongst mostly nonusers in Germany, the use of cognitive enhancement was even seen as less fair than cheating or plagiarism.

The discrepancy between views of users and nonusers might be due to the – rather trivial – point that users are more willing to engage in the use of smart drugs because they have a more positive attitude towards it in the first place. However, the discrepancy might also be due to users adopting (or uttering) a positive attitude as a result of personal usage, based on a process called ‘reduction of cognitive dissonance’ – which means reducing the gap between what you do and what you think (and express), by changing what you think. It requires further research to examine which mechanism is at play here, to understand where viewpoints originate and to be able to better predict how they will develop in the future.

For a sound analysis of major bioethical topics, both the academic bioethical literature as well as empirical findings on the opinions of lay people matter. A more in depth analysis of lay people’s opinions could advance the ethical debate, for example by demonstrating the perspective of specific minorities and by adding to the examination of the human behaviour that underlies certain ethical arguments. Incorporating lay people’s opinions thus offers a more complete overview, leading to research and innovation that aligns with key societal values and needs.


Kimberly Schelle received her MSc in Behavioural Science from the Radboud University Nijmegen, focussing on the psychological mechanisms underlying the use of cognitive enhancers. During her MSc thesis (supervised by Nadira Faulmüller), she visited the Oxford Centre for Neuroethics. She currently performs a Professional Doctorate in Engineering on the topic of User System Interaction at the University of Technology Eindhoven. Her research interests focus on the augmented human and human – technology interaction.

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2 Comment on this post

  1. I am curious about how to test whether there is self-selection or cognitive dissonance in the users. An interventional study might perhaps be a good idea, where people are asked about their views, get to use the enhancer, and then asked again?

  2. Kimberly Schelle

    This is indeed an interesting question. Assuming that you mean to urge people to use the pharmacological cognitive enhancers for research purposes I believe this will not be allowed by any ethical committee in the upcoming years (rightfully). One might get permission for this kind of studies on certain substances when participation is fully voluntary, but then the attitudes of the group of participants are probably already biased towards the positive end from the beginning (the people with a positive attitude towards these substances will more easily join the research than others which makes it difficult to examine if a negative attitude could change to a positive attitude by the use of the smart drug).

    A (more passive) longitudinal study following participants over a period of time in which they might start using (let’s say during their student time) can perhaps be a better option. In this way Sattler & Wiegel (2013) examined the influence of cognitive test anxiety and other constructs on the prevalence of smart drug use. However, also this proposal can start discussions (e.g. would asking questions about attitudes towards the use of smart drugs trigger people to experiment with it, especially in countries or groups where smart drugs are less known and such research might be the first one to introduce it to a participant, and can researchers then examine the behaviour whithout keeping in mind that they asked certain questions first? This is related to an effect that is known in psychology as the question-behaviour effect). A good study proposal would ask for a more in depth analysis of the options.

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