A prescription for smart pills

In response to the flood of prescription brain stimulants like Ritalin and Adderall on college campuses, a group of academics from Stanford, Harvard, Cambridge, Penn, and other schools say the time has come to allow such drugs to be prescribed to healthy people for “cognitive enhancement.” In a commentary published yesterday in Nature, they argue that such drugs, as well as future therapies like brain chips, should be viewed no differently than communications technologies or good sleep habits:

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 [cognitive-enhancement] 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.

They acknowledge but reject some of the more common ethical arguments that have been made against the prescription of smart pills:

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 exercise, nutrition and sleep, as well as instruction and reading. In short, cognitive-enhancing drugs seem morally equivalent to other, more familiar, enhancements … Given the many cognitive-enhancing tools we accept already, from writing to laptop computers, why draw the line here and say, thus far but no further?

While recommending further study of the effects of cognition-enhancing drugs as well as the laws controlling their use, the authors, led by Henry Greely of Stanford Law School, “call for a presumption that mentally competent adults should be able to engage in cognitive enhancement using drugs.” They go further to suggest, in terms that seem almost Swiftian (Jonathan, not Tom), that the government should actively support the distribution and use of amphetamines and other types of brain-boosting drugs: “If cognitive enhancements are costly, they may become the province of the rich, adding to the educational advantages they already enjoy. One could mitigate this inequity by giving every exam-taker free access to cognitive enhancements, as some schools provide computers during exam week to all students. This would help level the playing field.”

That’s the economic playing field. I worry more, though, about the possibility of leveling the cognitive playing field, as institutionally supported programs of brain enhancement impose on us, intentionally or not, a particular ideal of mental function. In a long list of questions for further research, the authors make a glancing reference to this concern: “Do [these drugs] change ‘cognitive style’, as well as increasing how quickly and accurately we think?” Something tells me that once the idea of artificial brain “enhancement” becomes accepted, through writings like this Nature commentary, that question will end up being pushed aside. Will people worry about the subtleties of “cognitive style” if they sense that the person in the next dorm or office is getting an edge on them by popping smart pills?

6 thoughts on “A prescription for smart pills

  1. Alex Tolley

    “I worry more, though, about the possibility of leveling the cognitive playing field, as institutionally supported programs of brain enhancement impose on us, intentionally or not, a particular ideal of mental function.”

    We know that clothes (e.g. a suit) and makeup also affect how people behave. But we don’t worry about this or restrict their sale. You’ve written previously about the effect of the web on cognition “Does Google make us Stoopid” but even though you lamented its effect, again you didn’t suggest we shouldn’t use the web.

    My sense is that you have some ill-defined worry about “drugs” and are using the possible changes in cognitive style as an ill-defined bogeyman.

    Perhaps you could be more specific about what cognitive styles you worry about and why brain enhancement by drugs differs from better nutrition, psychotherapy or education, especially MBA programs.

  2. Ryan Shaw

    The embrace of cognitive enhancement drugs is a logical extension of the emerging “neuroscientific consensus” in which everything from using the Internet to spending time with friends is reduced to various forms of brain customization and repair. Once you’ve accepted that human experiences are simply rearranging of brain cells, “why draw the line there?”

  3. chris Jangelov

    Some 50 years ago the goal was to free the mind from stress to become more human. Now it seems to be for coping with stress and (economic) achievment.

    The word is speeding up…

  4. David Evans

    We’re weirdly deterministic about these things, somehow assuming that doing X leads to Y, and not understanding that both the effects of scaling and more general second, third, fourth order effects are unpredictable. We simply don’t know what the long term effects on population would be for a mass-addiction to cognitive enhancement drugs. History tells us it wouldn’t be great. It’s the same logic that said formula milk was ‘scientifically’ designed to be ‘perfect’ for babies, not realising the extraordinary complexities and adaptation of breast milk. It’s also the same sort of approach that’s given us the singularity theory, and to me at least flies in the face of the human experience.

  5. marc farley

    As an aging self-medicator I want to know what the experience is like. Do you twitter faster, remember more phone numbers, “get” more inside jokes, have a calming effect on dogs, extend or shorten foreplay, operate the remote more adroitly, recognize when you have a cold coming on faster?

  6. Bob

    We humans are certainly tortured over this issue. There is widespread acceptance of male sexual enhancement drugs while a battle rages back and forth about the use of drugs to enhance physical performance among athletes. Almost the exact same arguments have been used with regard to sexual and sports related drug enhancements as have been put forth here with regard to drugs to enhance cognitive abilities. I tend to agree with the commentator who is concerned about the second, third and fourth order effects of these drugs, but there is an argument to be made to simply let evolution sort this out. Of course that could lead to our own extinction, but then again, so could not using every tool at our disposal to “advance” mankind.

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