Cognitive enhancement kept within contexts: neuroethics and informed public policy

Abstract

Neurothics has far greater responsibilities than merely noting potential human enhancements arriving from novel brain-centered biotechnologies and tracking their implications for ethics and civic life. Neuroethics must utilize the best cognitive and neuroscientific knowledge to shape incisive discussions about what could possibly count as enhancement in the first place, and what should count as genuinely “cognitive” enhancement. Where cognitive processing and the mental life is concerned, the lived context of psychological performance is paramount. Starting with an enhancement to the mental abilities of an individual, only performances on real-world exercises can determine what has actually been cognitively improved. And what can concretely counts as some specific sort of cognitive improvement is largely determined by the classificatory frameworks of cultures, not brain scans or laboratory experiments. Additionally, where the public must ultimately evaluate and judge the worthiness of individual performance enhancements, we mustn’t presume that public approval towards enhancers will somehow automatically arrive without due regard to civic ideals such as the common good or social justice. In the absence of any nuanced appreciation for the control which performance contexts and public contexts exert over what “cognitive” enhancements could actually be, enthusiastic promoters of cognitive enhancement can all too easily depict safe and effective brain modifications as surely good for us and for society. These enthusiasts are not unaware of oft-heard observations about serious hurdles for reliable enhancement from neurophysiological modifications. Yet those observations are far more common than penetrating investigations into the implications to those hurdles for a sound public understanding of cognitive enhancement, and a wise policy review over cognitive enhancement. We offer some crucial recommendations for undertaking such investigations, so that cognitive enhancers that truly deserve public approval can be better identified.

Research Domain Criteria as Psychiatric Nosology

“…48 Ethical issues related use of neuroscientific approaches for cognitive performance optimization and/or emotional modification (i.e., "cosmetic neuropsychiatry") will also arise. 49,50 The pace of neuroscientific research and the urgency of calls for its translation to improve neuropsychiatric diagnoses and treatment(s) mitigate a "wait and see" attitude, or the use of a simple precautionary principle to guide the use of brain science in clinical psychiatry. Rather, we have argued that such issues call for a preparatory neuroethical stance that can be used to (1) realistically assess the potential of objective measurements of neurotechnology to be used in clinical realms; (2) chart trajectories of their use and misuse; (3) identify potential problems and issues arising from their use and misuse; and (4) develop guidelines and approaches to address these problems and issues before or early in their development.…”

A randomized, double-blind, placebo controlled, parallel group, efficacy study of alpha BRAIN® administered orally

“…Much of the recent growth in popularity of nootropics and other cognitive enhancers has been documented among young, 18-to 35-year-old, cognitively healthy adults (McCabe et al, 2005;DeSantis et al, 2008;Maher, 2008;Tablot, 2009;Smith and Farah, 2011), and although the consumption and regulation of supplements, including nootropics, remains a controversial topic (Shook et al, 2014), there remains a considerable interest in the potential role of supplements, nootropics and other therapeutics in aiding the cognitive performance of adults (Zangara, 2003;Shineman et al, 2010;Dietz et al, 2013).…”

Pharmacological Human Enhancement: An Overview of the Looming Bioethical and Regulatory Challenges

“…Medicine's essential, commendable function in service of achieving a good, healthy life is not to be considered as automatically extendable to living a "great" life, or to attaining above average, excellent performances in a socially-sanctioned function or service (34). Hence, justifications for specialized enhancements meant to achieve extraordinary lifestyles or performances will not necessarily be obtained starting from and according to medical principles (35). Furthermore, as we argued before, cognitive enhancement is not the end of the line, far from it: unremitting scientific progress and advancements make it essential to move beyond it and toward a broader array of interventions, technologies, behaviors and environmental conditions that can affect many aspects of the human brain and nervous system.…”