Humans are continuously pursuing perfection. This drive is what motivates scientific researchers and comic book authors to dream about the invention of bionic men. It seems inevitable that this quest has expanded to target humankind’s most prized possession: our brain. Cognitive enhancements are various technologies created in order to elevate human mental capacities. However, as scientists and entrepreneurs attempt to research and develop cognitive enhancements, society faces an ethical dilemma. Policy must help create a balance, maximizing the benefits of augmented mental processing while minimizing potential risks.
Cognitive enhancements are becoming increasingly prevalent and exist in numerous forms, from genetic engineering to brain stimulation devices to cognition-enhancing drugs. The vast differences between these categories make it difficult to generalize a single proposition that can effectively regulate enhancements as a whole. Overall, out of these types, prescription pills and stimulation devices currently have the largest potential for widespread usage.
Prescription pills exemplify the many benefits and drawbacks of using cognitive enhancements. ADHD medications like Ritalin and Adderall, which stimulate dopamine and norepinephrine activity in the brain, may be the most ubiquitous example of available cognitive enhancements. These drugs are especially abused among college students, who use these pills to stay awake for longer periods of time and enhance their attention while studying. In a collection of studies, 4.1 to 10.8% of American college students reported recreationally using a prescription stimulant in the past year, while the College Life Study determined that up to a quarter of undergraduates used stimulants at least once during college.1,2 Students may not know or may disregard the fact that prolonged abuse has resulted in serious health concerns, including cardiopulmonary issues and addiction. When these medications are taken incorrectly, especially in conjunction with alcohol, users risk seizures and death.3
In addition to stimulants, there are a variety of other prescriptions that have been shown to improve cognitive function. Amphetamines affect neurotransmitters in the brain to increase consciousness and adjust sleep patterns. They achieve this by preventing dopamine reuptake and disrupting normal vesicular packaging, which also increases dopamine concentration in the synaptic cleft through reverse transport from the cytosol.4 These drugs are currently used by the armed forces to mitigate pilots’ fatigue in high-intensity situations. While usage of these drugs may help regulate pilots’ energy levels, this unfortunately means that pilots face heavy pressure to take amphetamines despite the possibility of addiction and the lack of approval from the U.S. Food and Drug Administration.5
Besides prescription medications, various technological devices exist or are being created that affect cognition. For instance, transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) are devices currently marketed to enhance cognitive functioning through online websites and non-medical clinics, even though they have not yet received comprehensive clinical evaluations for this purpose.6 tDCS works by placing electrodes on the scalp to target specific brain areas. The machine sends a small direct current through electrodes to stimulate or inhibit neuronal activity. Similarly, TMS uses magnetic fields to alter neural activity. These methods have been shown to improve cognitive abilities including working memory, attention, language, and decision-making. Though these improvements are generally short-term, one University of Oxford study used tDCS to produce long-term improvements in mathematical abilities. Researchers taught subjects a new numerical system and then tested their ability to process and map the numbers into space. Subjects who received tDCS stimulation to the posterior parietal cortex displayed increased performance and consistency up to six to seven months after the treatment. This evidence indicates that tDCS can be used for the development of mathematical abilities as well as the treatment of degenerative neurological disorders such as Alzheimer’s.7
Regulation of cognitive enhancements is a multifaceted issue for which the risks and benefits of widespread usage must be intensively examined. According to one perspective, enhancements possess the ability to maximize human efficiency. If an enhancement can enable the acceleration of technological development and enable individuals to solve issues that affect society, it could improve the quality of life for users and non-users alike. This is why bans on anabolic steroids are not directly comparable to those on cognitive enhancements. While both medications share the goal of helping humans accomplish tasks beyond their natural capabilities, cognitive enhancements could accelerate technological and societal advancement. This would be more beneficial to society than one individual’s enhanced physical prowess.
While discussing this, it should be noted that such enhancements will not instantaneously bestow the user with Einsteinian intellectual capabilities. In a recent meta-analysis of 48 academic studies with 1,409 participants, prescription stimulants were found to improve delayed working memory but only had modest effects on inhibitory control and short-term episodic memory. The report also discussed how in some situations, other methods, including getting adequate sleep and using cognitive techniques like mnemonics, are far more beneficial than taking drugs such as methylphenidate and amphetamines. Biomedical enhancements, however, have broad effects that are applicable to many situations, while traditional cognitive techniques that don’t directly change the biology behind neural processes are task-specific and only rarely produce significant improvements.8
However, if we allow enhancement use to grow unchecked, an extreme possibility is the creation of a dystopian society led by only those wealthy enough to afford cognitive enhancements. Speculation about other negative societal effects is endless; for example, widespread use of cognitive enhancements could create a cutthroat work environment with constant pressure to use prescription pills or cranial stimulation, despite side effects and cost, in order to compete in the job market.
The possibility of addiction to cognitive enhancements and issues of social stratification based on access or cost should not be disregarded. However, there are many proposed solutions to these issues. Possible governmental regulation proposed by neuroethics researchers includes ensuring that cognitive enhancements are not readily available and are only given to those who demonstrate knowledge of the risks and responsible use of such enhancements. Additionally, the creation of a national database, similar to the current system used to regulate addictive pain relievers, would also help control the amount of medication prescribed to individuals. This database could be an integrated system that allows doctors to view patients’ other prescriptions, ensuring that those who attempt to deceive s pharmacies to obtain medications for personal abuse or illegal resale could not easily abuse the system. Finally, to address the issue of potential social inequality, researchers at Oxford University’s Future of Humanity Institute proposed a system in which the government could support broad development, competition, public understanding, a price ceiling, and even subsidized access for disadvantaged groups, leading to greater equalized access to cognitive enhancements.9
Advancements have made it possible to alter our minds using medical technology. Society requires balance to regulate these enhancements, an environment that will promote safe use while preventing abuse. The regulation of cognitive enhancement technologies should occur at several levels to be effective, from market approval to individual use. When creating these laws, research should not be limited because that could inhibit the discovery of possible cures to cognitive disorders. Instead, the neuroethics community should focus on safety and public usage regulations with the mission of preventing abuse and social stratification. Cognitive enhancements have the potential to affect the ways we learn, work, and live. However, specific regulations to address the risks and implications of this growing technology are required; otherwise the results could be devastating.
References
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- Maslen, H. et al. J. of Law and Biosci. 2014, 1, 68-93.
- Kadosh, R.C. et al. Curr. Biol. 2010, 20, 2016-2020.
- Ilieva, I.P. et al. J. Cogn. Neurosci. 2015, 1069-1089.
- Bostrom, N.; Sandberg, A. Sci. Eng. Ethics 2009, 15, 311-341.