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Cognitive Enhancement and the Principle of Need

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Abstract

In this article we argue that

(i) the principle of need, on some interpretations, could be used to justify the spending of publically funded health care resources on cognitive enhancement and

(ii) that this also holds true for individuals whose cognitive capacities are considered normal.

The increased, and to an extent, novel demands that the modern technology and information society places on the cognitive capacities of agents, e.g., regarding good and responsible decision-making, have blurred the line between treatment and enhancement. More specifically, it has shifted upwards. As a consequence, principles of need on their most reasonable interpretations can be used to support publically funded cognitive enhancement. At least this is so, if broader aims than curing and ameliorating diseases are included in the goals of health care. We suggest that it would be plausible to see health care as accepting such broader goals already today.

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Notes

  1. Walzer M., (1983), pp. 86–90 [2]

  2. We are interested in cognitive capacities, such as better focus, capacity to disregard irrelevant stimuli, fewer bias, risk assessment, compassion, and sense of fairness, rather than an improvement of general IQ.

  3. Daniels N., (2008), p 34–36 [1]

  4. DeGrazia D., (2005), p. 206 [24]; Juengst D., (2003), pp. 753–755 [25]

  5. For more on the conceptual distinction between enhancement and treatment, see Juengst 1998 [30].

  6. Crisp R., (2003), p. 758 [31]

  7. Since there will always be persons below the threshold (unless it is set unreasonably low, Juth N., (2013) [22]

  8. Although Daniels conceded that there may be situations where public health care could legitimately fund e.g., genetic enhancement that would boost our immune system [32]. So perhaps we are less in disagreement with Daniels than others of his texts would suggest. [1]

  9. For more detailed arguments, see Juth N., (2013) and Casal P., (2007) [21, 22].

  10. What previously has been called the minimise insufficiency version of the principle of need (Juth 2013).

  11. Juth N., (2003), p. 35 [32],

  12. Prioritarianism (or “the priority view”) is perhaps most famously formulated and defended by Parfit D., (1997, 2013) [33, 34].

  13. Tännsjö T., (2014), p 184 [35]

  14. Carlsson P., et al. (2012), p 896 [37]

  15. Carlsson P., et al. (2012), p 894 and 900–902 [37]

  16. Segall S., (2010), p. 121 [23]

  17. Segall S., (2010), p. 121 [23]

  18. Unless one would like to say that whatever health care decides to do makes it a medical goal—but then it would of course become a truism.

  19. http://en.strama.se/dyn/,84.html http://www.reactgroup.org/

  20. It should be noted that while we do not speak of specific methods for cognitive enhancements in this article we would, given today’s technology and that of the near future, suggest that the most plausible method would be a combination of drugs and life-style (in this we include diet, exercise and education—both classical and more specific e.g., memory training, meditation.

  21. Levy N. (2014), p. 293 [8]; Kahneman, D. and Tversky, A. (1984). “Choices, Values, and Frames”. American Psychologist 39 (4): 341–350. doi:10.1037/0003-066x.39.4.341 DOI:10.1037 %2 F0003-066x.39.4.341 . Kahneman D. (2011). Thinking, Fast and Slow. Macmillan. Bostrom, N., & Ord, T. (2006). The Reversal Test: Eliminating Status Quo Bias in Applied Ethics*. Ethics, 116(4), 656–679.

  22. One could even claim that the point of (or value in) respecting autonomy is derived from the value of living an autonomous life. This seems to be an underlying assumption in Levy’s text that he does not argue in favour of (he does not even seem to be very aware of the distinction between autonomy conceived of as a right and as a value). For such an argument see Lindley R., (1986). [443]

  23. Levy N., (2014), p. 293 [8]

  24. Levy N., (2014), p. 299 [8]

  25. Levy N., (2014), p. 295–97 [8]

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Authors and Affiliations

  1. Department of Philosophy, Royal Institute of Technology (KTH), Brinellvägen 32, 100 44, Stockholm, Sweden

    Barbro Fröding

  2. Stockholm Centre for Healthcare Ethics, Karolinska Institutet, LIME, 171 77, Stockholm, Sweden

    Niklas Juth

Authors
  1. Barbro Fröding
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  2. Niklas Juth
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Correspondence to Barbro Fröding.

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Fröding, B., Juth, N. Cognitive Enhancement and the Principle of Need. Neuroethics 8, 231–242 (2015). https://doi.org/10.1007/s12152-015-9234-7

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