Abstract
This paper examines the claims in the debate on cognitive enhancement in neuroethics that society wide pressure to enhance can be expected in the near future. The author uses rational choice modeling to test these claims and proceeds with the analysis of proposed types of solutions. The discourage use, laissez-faire and prohibition types of policy are scrutinized for effectiveness, legitimacy and associated costs. Special attention is given to the moderately liberal discourage use policy (and the gate-keeper and taxation approaches within this framework), as many authors presuppose that this type of policy would best serve public interest. Different more or less articulated models in the taxation approach (Tobacco regulation analogy, Coffee-shop system, Regulatory Authority for Cognitive Enhancements and Economic Disincentives Model) are analyzed from the point of view of justificatory liberalism. The author concludes that prohibition and laissez-faire types of policy would neither be effective nor justified. A moderately liberal public policy shows more promise, but not all approaches within this type of policy would be legitimate and effective. The “gate-keeper” approach and related models could not be justified whereas approach based on taxation with suitable models might be legitimate and effective.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
According one study [12], 34 % of student participants admitted that they were using ADHD stimulants illegally. Most illegal users reported using ADHD stimulants primarily in periods of high academic stress and found them to reduce fatigue while increasing reading comprehension, interest, cognition, and memory. Furthermore, most had little information about the drugs they used and found procurement to be both easy and stigma-free.
It should be noted here that the modeling strategy has to be qualitative. Namely, currently available data on prevalence varies greatly among different surveys and ranges from 5 % to 35 % (see [17]). Furthermore, the lack of adequate information on long term effects and even short term benefits (the issue how laboratory findings of improvement in cognition relate to everyday performance is far from clear) further complicates the matter. A purely quantitative rational choice modeling strategy would require reliable data, which is not available. Bearing all this in mind, numerical payoffs in the design of dilemmas could not be assigned, and we have to make do with a qualitative analysis. This also points toward the conclusion that regulatory models which could provide the missing information would be more effective, even if their preliminary assumptions turn out to be incorrect in the long run.
In this and next paragraph I draw on [20].
I am grateful to an anonymous reviewer for these two points.
In this paragraph I draw on [21].
Bearing this in mind, a prolonged discussion of positions that advocate legalization of “illicit” drugs for recreational use (e.g. [22, 23]) would be misleading, as associated social problems are very different. Namely, there might be peer pressure to consume say cannabis for recreational purposes or as a life-style choice, but pressure to use CE would be felt in entirely different social milieus—competitive work and educational settings.
Rawls’s principles of justice state that: 1. Each person has an the same indefeasible claim to a fully adequate scheme of equal basic rights and liberties, which scheme is compatible with the same scheme of liberties for all; (the equal liberty principle); and 2. Social and economic inequalities are to satisfy two conditions: first, they are to be attached to positions and offices open to all under conditions of fair equality of opportunity (the principle of fair equality of opportunity); and second, they are to be to the greatest benefit of the least advantaged members of society (the difference principle) [24], pp. 42–43. Although these principles have had a great impact in Bioethics (see e.g. [26]), there are dissenting voices on applicability of justice to bio-medical issues (e.g. [27]).
This particular requirement (as well as other requirements in EDM) could be perfectly legitimate and acceptable to citizens. A similar requirement is accepted worldwide in the case of vehicles: in order to use them a person must pay fees for a training course and pass an exam as proof of competence. Then when the vehicle is bought, taxes should be paid. In order to use the vehicle, an appropriate insurance must be taken and both the vehicle and the driver should be registered by a government agency. Finally, while using the vehicle, taxes on fuel, tolls and appropriate fees for regular technical check-ups must be paid. Since all these measures are readily accepted there is no reason to doubt the acceptability of similar measures in EDM.
References
Racine, Eric. 2010. Pragmatic neuroethics: Improving treatment and understanding of the mind-brain. Cambridge: MIT Press.
Gazzaniga, Michael S. 2005. The ethical brain. New York: Dana Press.
Greely, Henry, Barbara Sahakian, John Harris, Ronald C. Kessler, Michael Gazzaniga, Philip Campbell, and Martha J. Farah. 2008. Towards responsible use of cognitive-enhancing drugs by the healthy. Nature 456(7223): 702–705.
Appel, Jacob M. 2008. When the boss turns pusher: A proposal for employee protections in the age of cosmetic neurology. Journal of Medical Ethics 34(8): 616–618.
Capps, Benjamin. 2011. Libertarianism, legitimation, and the problems of regulating cognition-enhancing drugs. Neuroethics 4(2): 119–128.
Glannon, Walter. 2008. Psychopharmacological enhancement. Neuroethics 1(1): 45–54.
Glannon, Walter. 2011. Brain, body and mind: Neuroethics with a human face. New York: Oxford University Press.
Lieb, Klaus. 2010. Hirndoping: Warum wir nicht alles schlucken sollten. Mannheim: Artemis & Winkler.
Dubljevic, Veljko. 2012. Principles of justice as the basis for public policy on psycho-pharmacological cognitive enhancement. Law, Innovation and Technology 4(1): 67–83.
Dubljevic, Veljko. 2012. Toward a legitimate public policy on cognition-enhancement drugs. American Journal of Bioethics—Neuroscience 3(3): 29–33.
Maher, Brendan. 2008. Poll results: Look who’s doping. Nature 452(7188): 674–675.
DeSantis, Alan D., Elisabeth M. Webb, and Seth M. Noar. 2008. Illicit use of prescription ADHD medications on a college campus: A multimethodological approach. Journal of American College Health 57(3): 315–324.
Khushf, George. 2005. The use of emergent technologies for enhancing human performance: Are we prepared to address the ethical and policy issues? Public Policy and Practice 4(2): 1–17.
Khushf, George. 2008. The second stage enhancements. In Emerging conceptual, ethical and policy issues in bionanotechnology, ed. Fabrice Jotterand, 203–218. Dodrecht: Springer.
Schuijff, Mirjam. 2009. STOA: Human Enhancement Study. The Hague: Rathenau Institute.
Academy of Medical Sciences. 2012. Human Enhancement and the Future of Work. Joint report of the Academy of Medical Sciences, the British Academy, the Royal Academy of Engineering and the Royal Society http://royalsociety.org/uploadedFiles/Royal_Society_Content/policy/projects/human-enhancement/2012-11-06-Human-enhancement.pdf Accessed 10. November 2012
C.Ian Ragan, Imre Bard, and Ilina Singh. 2012. What should we do about student use of cognitive enhancers? An analysis of current evidence. Neuropharmacology 64: 588–595.
English, Veronica. 2007. Boosting your brainpower: ethical aspects of cognitive enhancements. A discussion paper from the British Medical Association. London: British Medical Association.
Institut für Gesundheits- und Sozialforschung. 2009. Gesundheitsreport 2009. Analyse der Arbeitsunfähigkeitsdaten. Schwerpunktthema Doping am Arbeitsplatz. Hamburg: DAK.
Euromonitor. 2011. Tobacco in Norway. Euromonitor International Market Research Report. http://www.euromonitor.com/tobacco-in-norway/report. Accessed 15 August 2012.
Staatsblad. 2002. Opium Act. Cannabis Bureau archive. http://www.cannabisbureau.nl/en/doc/pdf/Dutch%20Opium_Act_30556.pdf. Accessed 15 August 2012.
De Greiff, Pablo (ed.). 1999. Drugs and the limits of liberalism. New York: Cornell University Press.
Husak, Douglas. 2005. For drug legalization. In The legalization of drugs: For and against, ed. Douglas Husak and Peter De Marneffe, 3–108. New York: Cambridge University Press.
Rawls, John. 2001. Justice as fairness: A restatement. Cambridge: Harvard University Press.
Rawls, John. 2005. Political liberalism, expanded edition. New York: Columbia University Press.
Daniels, Norman. 2008. Just health: Meeting health needs fairly. Cambridge: Cambridge University Press.
Gert, Bernard, Charles M. Culver, and K.Danner Clouser. 2006. Bioethics—A systematic approach, 2nd ed. Oxford: Oxford University Press.
Nozick, Robert. 1974. Anarchy, State, and Utopia. New York: Basic Books.
Miller, David. 1999. Principles of social justice. Cambridge: Harvard University Press.
Gaus, Gerald. 2011. The order of public reason: A theory of freedom and morality in a diverse and bounded world. New York: Cambridge University Press.
Habermas, Jürgen. 2005. The inclusion of the other: Studies in political theory. Cambridge: Polity Press.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Dubljević, V. Cognitive Enhancement, Rational Choice and Justification. Neuroethics 6, 179–187 (2013). https://doi.org/10.1007/s12152-012-9173-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12152-012-9173-5