Basics
It is likely that drugs created to treat illness will also be able to enhance our natural abilities. Medication to treat Alzheimer‘s disease is likely to improve considerably normal memory function as well. Stimulating medicines, now used to treat children with attention deficit hyperactivity disorder, also increase the ability of the ‘normal’ brain to concentrate. One‘s emotional state can also be improved. The new generation of pharmaceutical drugs to treat depression also have an effect on people who do not suffer from depression: people who take them are less concerned with small everyday worries and live life more optimistically and with more confidence.
Instead of being used for therapy, these drugs might one day be employed for enhancing the normal body, brain and psyche. With all the imagined benefits of taking these drugs and ‘enhancing’ ourselves, is it inevitable that they will be taken for this purpose? Can we, or even should we, try to limit this?
The question is certainly valid if it appears that these drugs are not harmful. What is wrong with increasing memory, intelligence, attention levels, ability to concentrate? Or even to enhance our creativity, empathy or sociability? We already take refuge daily in coffee, cigarettes or a glass of Chardonnay. Don’t we do this mainly for the effect of the caffeine, the nicotine or the alcohol on the brain? Is a pill different from a cup of coffee?
Info cards
20 years ago, scientists thought that the brain could not change after infancy, apart the loss of nerve cells during the ageing. Now we know that the brain constantly remodels itself throughout life, as a result of learning and adapting to the environment.
Scientists say by the time we’re conscious of doing something, in our brain it is already done. This means our brain controls how we act, and that consciousness doesn’t control our actions, but is a way for our brain to explain its actions.
In searching for a link between behaviour and anatomy or biology of brain, scientists discovered that 21 individuals with “antisocial behaviour” averaged 11% less volume in part of their brain.
Studying behaviours like addiction, aggression and parenting behaviour in animals, scientists discovered that they can be modified by using drugs. Some of this research is already applied to humans.
People suffering from Parkinson’s disease can’t control well their movements. The cause is the death of brain cells in a part of the brain which controls movement. Drugs are available to treat Parkinson’s but many people become resistent to them.
Deep brain stimulators have been used to treat Parkinson's disease and other movement disorders. They are now being trialed to treat psychiatric conditions, like depression and obsessive compulsive disorder (OCD).
Parkinson’s disease is a good candidate for stem cell therapy because the damaged area of the brain is small and easily identified. Replacing damaged cells with the help of stem cells could lead to improvement or even a cure.
Between 1930-1950 schizophrenic patients were treated by removing the front part of their brain, changing their personality forever. Modern deep brain stimulation techniques can act much more selectively on the brain, and can be reversible.
It seems that TMS can improve performance in memory and reasoning tasks, rouse people from the effects of severe fatigue, or teach them a new skill.
By giving non-medical conditions a medical or psychological label are we encouraging treatment through the use of prescribed medication?
Drug treatments can make normal people “better than normal”. Drug enhancements already exist for mood, memory, cognition, and essential functions like sleep, appetite and sex.
These are much safer than the previous ones, and this leads to a wider use. There is a trend for using them as “mood-brighteners” by perfectly healthy people wanting to feel “better than well”.
Depression can come and go, often with years between episodes. Patients today are likely to be treated with a new generation of antidepressants over a period of years, even when they show no symptoms.
In Aldous Huxley's 1930’s book Brave New World, a drug called Soma removed all feelings of pain. Today there is a variety of brain drugs available by consumer choice or upon prescription.
The World Health Organisation has identified depression as the major health hazard of this century. Mental disorders are one of the leading causes of disease and disability in Europe and beyond.
Many brain drugs are taken not just to treat diseases. Some people who take anti-anxiety drugs may not be particularly anxious.
Ritalin and similar psycho-stimulant drugs have been proved to improve vigilance, response time, problem-solving and planning. It is considered to be the most widely used recreational drug on American campuses.
Many drug companies are now directing enormous research efforts to the development of memory-boosting drugs. Memory-enhancing nutritional supplements are already a billon-dollar industry, despite little evidence that they work.
Drugs to treat sleep disorders can prolong wakefulness for days. Its use by healthy people has been investigated by the military.
The military is spending $20 million to investigate new ways to prevent tiredness and enable soldiers to stay awake, alert, and effective for up to seven days without suffering any effects.
The US military has suggested humans need an upgrade. They are researching ways to make soldiers smarter, tougher, faster, and stronger - in short, superhuman.
“Maybe it is not a good thing to have memory enhanced chronically every day for the rest of your life. Maybe that will produce psychological side effects, like cramp your head with too many things you can’t forget.”
Many brain enhancing drugs were originally designed to treat a medical condition, but have proved to be safe enough for wider use.
We don’t know the effect of the overflow of information from the media on maturing brains. It’s been suggested that media influence on the brain may be more dangerous than drugs.
Issue cards
Should brain imaging be allowed for purposes other than diagnosis or treatment of a disease? Who should be allowed to use it?
Is having an electrode in my brain different from taking a pill?
Is court-ordered drug treatment for aggressive or sexually inappropriate behaviour a violation of the individual’s freedom and human dignity? And what if the treatment consists of implanting electrodes?
Which of the following would I improve, if it were possible by artificial means (pill, electrode, TMS etc.):
• Memory?
• Intelligence?
• Mood?
Are some methods more acceptable than others?
Will brain enhancement have broad social effects? Will some social groups have an advantage over others if they use them?
Should we ask presidents and prime ministers, making decisions that might alter the world, to take brain enhancing drugs?
Will we change the evolution of humanity by artificially changing the human brain?
How can we know the long term risks of most psychoactive drugs, especially when people start taking them at a young age, and take them for a long time?
“Once a medicine is approved and accepted, other people will make use of it for other purposes.”
There is a danger that employers and schools seeking higher performing workers and students will force them into brain enhancement. This needs to be stopped.
Am I still the same person after taking a drug that acts on my brain?
Should depression be treated with a pill or by talking to a therapist?
If a problem is located in the brain, should the remedy be found only in the brain?
In the realm of mood disorders, how can we draw a clear limit between healthy and sick?
Is depression a disorder of the individual or a disorder of a society?
Is there a risk that the use of brain drugs could mask a social problem?
How much do we socially accept the range of variation of human behaviour?
“Most of us would love to go through life cheerful and svelte, focusing like a laser beam at work and enjoying rapturous sex each night. Yet most of us feel uneasy about the idea of achieving these things through drugs. Why?”
“Who defines behaviour and behavioural disorder, who should control treatment?”
“Is it ethical to use drugs to gain an advantage over others?”
“Education is a cognitive enhancer that is very inequitably distributed, but society is not against education. Conversely, neurocognitive enhancers might be relatively easy to distribute widely.”
If cognitive enhancement drugs are developed, what are the implications for people using them to pass competitive exams?
Is taking a stimulant before a test any different from gulping down a cup of coffee?
Courts can already force treatment on criminals. Is there a danger that treatment will be forced on anyone that society regards as ‘deviant’?
Story cards
Policies
If a substantial assessment of the potential negative effects is available, there should be no more controls on “brain enhancements” than there are today on alcohol and tobacco, letting the market decide.
“Brain enhancements” should in any circumstance be regulated under strict medical control – that is, they need to be prescribed by a medical doctor.
“Brain enhancements” should not be available to the general public but research should be carried on (with clinical trials, military use, etc.) in order to understand the long-term consequences, both medical and social.
It is morally unacceptable to use this kind of stimulants to enhance a normal behaviour, therefore the use of such substances should be a therapeutical one only - treatment of diseases, impairments and other disorders.
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