Sleep better than medicine? Ethical issues related to “wake enhancement”

The hopes and fears expressed in the debate on human enhancement are not always based on a realistic assessment of the expected possibilities. Discussions about extreme scenarios may at times obscure the ethical and policy issues that are relevant today. This paper aims to contribute to an adequate and ethically sound societal response to actual current developments. After a brief outline of the ethical debate concerning neuro-enhancement, it describes the current state of the art in psychopharmacological science and current uses of psychopharmacological enhancement, as well as the prospects for the near future. It then identifies ethical issues regarding psychopharmacological enhancements that require attention from policymakers, both on the professional and on the governmental level. These concern enhancement research, the gradual expansion of medical categories, off-label prescription and responsibility of doctors, and accessibility of enhancers on the Internet. It is concluded that further discussion on the advantages and drawbacks of enhancers on a collective social level is still needed.

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“…on our working schedules and on the 24/7 economy. It is not obvious that this will be an overall benefit for society (or individuals) [42].…”

Section: Should the Government Prohibit Or Promote Enhancement Research?mentioning

confidence: 99%

The Future of Psychopharmacological Enhancements: Expectations and Policies

et al. 2009

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“…This principle differs significantly from general conceptions of moral responsibility which weigh in whether or not the cause of harm lies within the moral agent. Generally, it is presumed that a person is blameworthy if in a unique position to contribute significantly to the existence of harm and/or to effectively enable control of its occurrence [49]. While we have outlined the ways in which physicians are in a particular position to contribute to social norms and values, the cause of the social injustice underlying the enhancement requests is not (necessarily) rooted within Dr. B's actions or inactions.…”

Section: Diagnosing a Social 'Evil'mentioning

confidence: 99%

‘Cosmetic Neurology’ and the Moral Complicity Argument

et al. 2009

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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

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“…A version of the "pharmaco-optimist" line of argument was mooted by An Ravelingien and Anders Sandberg in a 2008 paper that considers the possibility of minimising our need for sleep. Noting that "[o]ur society is becoming one of around the clock services and needs and it increasingly demands that we adapt our circadian rhythms to altered production schedules" 8 , they suggest that a (technologically) optimistic scenario is that we may one day be able to diminish our need for shuteye to a few hours a night, or to delay it for several days, while the lengthened vigilance is still equivalent to the effect of normal sleep. 9…”

Section: An End To Tiredness?mentioning

confidence: 99%

Perchance to Dream: Pathology, Pharmacology, and Politics in a 24-Hour Economy

Brassington

2018

Camb Q Healthc Ethics

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The lack of sleep is a significant problem in the modern world. The structure of the economy means that 24 hour working is required from some of us, sometimes because we are expected to be able to respond to share-price fluctuations on the other side of the planet, sometimes because we are expected to serve kebabs to people leaving nightclubs, and sometimes because lives depend on it. The immediate effect is that we feel groggy; but there may be much more sinister long-term effects of persistent sleep deprivation and disruption, the evidence for which is significant, and worth taking seriously. If sleeplessness has a serious impact on health, it represents a notable public health problem. In this article, I sketch that problem, and look at how exploiting the pharmacopoeia (or a possible future pharmacopoeia) might allow us to tackle it. I also suggest that using drugs to mitigate or militate against sleeplessness is potentially morally and politically fraught, with implications for social justice. Hence, whatever reasons we have to use drugs to deal with the problems of sleeplessness, we ought to be careful.

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Sleep better than medicine? Ethical issues related to “wake enhancement”

Cited by 9 publications

References 39 publications

The Future of Psychopharmacological Enhancements: Expectations and Policies

The Future of Psychopharmacological Enhancements: Expectations and Policies

‘Cosmetic Neurology’ and the Moral Complicity Argument

Perchance to Dream: Pathology, Pharmacology, and Politics in a 24-Hour Economy

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