‘Cosmetic Neurology’ and the Moral Complicity Argument

Abstract

Over the past decades, mood enhancement effects of various drugs and neuromodulation technologies have been proclaimed. If one day highly effective methods for significantly altering and elevating one's mood are available, it is conceivable that the demand for them will be considerable. One urgent concern will then be what role physicians should play in providing such services. The concern can be extended from literature on controversial demands for aesthetic surgery. According to Margaret Little, physicians should be aware that certain aesthetic enhancement requests reflect immoral social norms and ideals. By granting such requests, she argues, doctors render themselves complicit to a collective 'evil'. In this paper, we wish to question the extent to which physicians, psychiatrists and/or neurosurgeons should play a role as 'moral gatekeepers' in dealing with suspect demands and norms underlying potential desires to alter one's mood or character. We investigate and discuss the nature and limits of physician responsibilities in reference to various hypothetical and intuitively problematic mood enhancement requests. Aims and ScopeOver the past decades, insight in the neurochemical basis of our cognition and emotion has increased significantly. This has driven the production of new drugs which outstrip former generations of psychotropic medication in terms of ability to modulate brain functions with greater precision. Expected progress in this area makes such drugs an attractive option for non-patients who do not suffer from a particular disorder, but who wish to elevate their baseline cognitive and affective functions without having to bear the side-effects related to most recreational drugs. Indeed, we have already witnessed soaring sales of methylphenidate, dextroamphetamine, modafinil and various selective serotonin reuptake inhibitors (SSRIs) once their enhancement effects were proclaimed.It is too early to predict if the current hype over psychopharmacological and neurotechnological enhancement is realistic. Nonetheless, if neuroscience does prove to provide highly effective methods for Neuroethics (2009) 2:151-162

Neuroenhancement in Young People: Proposal for Research, Policy, and Clinical Management

“…moedigemoeders.nl/index.php?module=news&cat id=21 &year=2008&item id=6741). A poll taken among 1500 students in Belgium suggested that 3% used stimulants as neuroenhancers (Ravelingien et al 2009). Indeed, while the evidence is at present mainly anecdotal, the use of stimulants as neuroenhancers appears to be a growing trend among university students around the world.…”

Empirical Support for the Moral Salience of the Therapy-Enhancement Distinction in the Debate Over Cognitive, Affective and Social Enhancement

“…Consensus about the propriety of brain enhancement is elusive [4,[8][9][10][14][15][16][17][18][19][20]. One way of approaching the issue is to query the public about their enthusiasms and concerns with regard to enhancement of human brains [21][22][23].…”

Emerging Therapeutic Enhancement Enabling Health Technologies and Their Discourses: What Is Discussed within the Health Domain?

“…This dynamics is seen to require an exchange of views “among researchers, healthcare practitioners, ethicists, the public, and those who influence and enact guidelines and policies” [ 76 ]. Another article highlights that various people, visible in the neuroenhancement discourse, have labeled neuroenhancement as legitimate health care [ 77 ]; another recommended that “health care systems and pharmacies should institute systems to monitor the quantity and location of requests for neuroenhancers to avoid abuse and monitor total dosage” [ 78 ].…”