Exploring Some Challenges of the Pharmaceutical Cognitive Enhancement Discourse: Users and Policy Recommendations
The article explores some of the issues that have arisen in the discourse on pharmaceutical cognitive enhancement (PCE), that is, the use of stimulant drugs such as methylphenidate, amphetamine and modafinil by healthy individuals of various populations with the aim of improving cognitive performance. Specifically, we explore the presumed sizes of existing PCE user populations and the policy actions that have been proposed regarding the trend of PCE. We begin with an introductory examination of the academic stances and philosophical issues involved in defining PCE. We then focus on an examination of the population sizes of presumed current PCE users that have been listed in the academic literature on PCE, on presuppositions, which have been problematized by some authors as based on anecdotal or misinterpreted survey data. We follow this with an empirical examination of a potential PCE user population in a national context (students at the University of Ljubljana in Slovenia). We then proceed to examine the regulatory options proposed in the academic literature to address PCE, finally comparing them with an empirical overview of the policy recommendations on PCE produced in the multinational context of several national ethics advisory bodies (EABs) in Europe. Our main conclusion is that there is still little debate among the national EABs on what type of public policy responses, if any, are needed to address PCE in European countries, and that the issues they do address are similar to those discussed and proposed in the academic articles on PCE.
KeywordsPharmaceutical cognitive enhancement Drug use Students Ethics advisory bodies Neuroenhancement Public policy regulation
Part of the research presented in this article was conducted with the support of the European Commission FP7 Science in Society funded project, Ethics in Public Policy Making: The Case of Human Enhancement (EPOCH), grant number SIS-CT-2010-266660 (http://epochproject.com). We warmly thank all our partners and collaborators in the EPOCH project for their constructive cooperation.
We would also like to thank Steve Fuller for his insightful comments, as well as the two reviewers, whose suggestions were invaluable in improving an earlier version of this article.
- 1.Stehr, Nico. 2003. Wissenspolitik. Überwachung des Wissens. Frankfurt am Main: Suhrkamp.Google Scholar
- 3.Harris, John. 2007. Enhancing evolution: The ethical case for making better people. Princeton: Princeton University Press.Google Scholar
- 4.Bailey, Ronald. 2005. Liberation biology. The scientific and moral case for the biotech revolution. New York: Prometheus Books.Google Scholar
- 5.Hughes, James. 2004. Citizen cyborg: Why democratic societies must respond to the redesigned human of the future. Boulder: Westview Press.Google Scholar
- 6.Sandel, Michael J. 2007. The case against perfection: Ethics in the age of genetic engineering. Cambridge: Belknap Press of Harvard University Press.Google Scholar
- 7.Fukuyama, Francis. 2002. Our posthuman future: Consequences of the biotechnology revolution. New York: Picador.Google Scholar
- 8.McKibben, Bill. 2003. Enough: Staying human in an engineered age. New York: Henry Holt and Company.Google Scholar
- 9.Habermas, Jürgen. 2001. Die Zukunft der menschlichen Natur. Auf dem Weg zu einer liberalen Eugenik? Frankfurt am Main: Suhrkamp.Google Scholar
- 14.Mali, Franc. 2004. Recent dilemmas in the social and legal regulation of biotechnology in the European Union. Vest, Journal for Science and Technology Studies 17(3–4): 39–60.Google Scholar
- 15.Slob, Marjan, and Jan Staman. 2012. Policy and the evidence beast. A Dutch study of the expectations and practices in the area of evidence-based policy. Den Haag: Rathenau Institut.Google Scholar
- 16.Sauter, Arnold, and Katrin Gerlinger. 2012. Der pharmakologisch verbesserte Mensch. Leistungssteigernde Mittel als gesellschaftliche Herausforderung. Berlin: Sigma Verlag.Google Scholar
- 17.Coenen, Christopher, Mirjam Schuijff, Martijntje Smits, Pim Klaassen, Leonhard Hennen, Michael Rader, and Gregor Wolbring. 2009. Human enhancement. Brussels: European Parliament, DG Internal Policies STOA.Google Scholar
- 18.Savulescu, Julian, Ruud ter Meulen, and Guy Kahane (ed.). 2011. Enhancing human capacities. Wiley-Blackwell.Google Scholar
- 19.Brown, Nik. 2003. Hope against hype–accountability in biopasts, presents and futures. Science and Technology Studies 16(2): 3–21.Google Scholar
- 20.Kass, Leon R. 2003. Ageless bodies, happy souls: Biotechnology and the pursuit of happiness. The New Atlantis Spring 2003: 9–28.Google Scholar
- 21.Daniels, Norman. 2009. Can anyone really be talking about ethically modifying human nature? In Human enhancement, ed. Julian Savulescu and Nick Bostrom, 25–43. Oxford: Oxford University Press.Google Scholar
- 22.President’s Council on Bioethics (ed.). 2008. Human dignity and bioethics: Essays commissioned by the president’s council on bioethics. Washington: US Independent Agencies and Commissions.Google Scholar
- 26.Galert, Thorsen, Christoph Bublitz, Isabella Heuser, Reinhard Merkel, Dimitris Repantis, Bettina Schöne-Seifert, and Davinia Talbot. 2009. Das optimierte Gehirn. Gehirn & Geist 11(2009): 40–48.Google Scholar
- 27.Jayne, Lucke, and Brad Partridge. 2012. Towards a smart population: A public health framework for cognitive enhancement. Neuroethics 6(2): 419–427.Google Scholar
- 29.Bostrom, Nick, and Rebecca Roache. 2008. Human enhancement: Ethical issues in human enhancement. In New waves in applied ethics, ed. Jesper Ryberg, Thomas S. Petersen, and Clark Wolf, 120–152. Palgrave Macmillan.Google Scholar
- 35.Wolbring, Gregor. 2008. Ableism, enhancement medicine and the techno poor disabled. In Unnatural selection: The challenges of engineering tomorrow’s people, ed. Peter Healey and Steve Rayner, 196–209. London: Earthscan.Google Scholar
- 39.Lieb, Klaus. 2010. Hirndoping. Warum wir nicht alles schlucken sollten. Dusseldorf: Artemis & Winkler.Google Scholar
- 42.Fuller, Steve. 2011. Humanity 2.0. What it means to be human past, present and future. Hampshire: Palgrave Macmillan.Google Scholar
- 44.Sandberg, Anders, and Julian Savulescu. 2011. The social and economic impacts of cognitive enhancement. In Enhancing human capacities, ed. Jualian Savulescu, Ruud ter Meulen, and Guy Kahane, 92–112. Wiley-Blackwell.Google Scholar
- 45.Lynch, Zack. 2005. Neuropolicy (2005–2035): Converging technologies enables neurotechnology, creating new ethical dilemmas. In Managing nano-bio-infocogno innovations: Converging technologies in society, ed. William Sims Bainbridge and Mihail C. Roco, 173–193. Dordrecht: Springer.Google Scholar
- 57.Bostrom, Nick, and Rebecca Roache. 2011. Smart policy: Cognitive enhancement and the public interest. In Enhancing human capacities, ed. Julian Savulescu, Ruud ter Meulen, and Guy Kahane, 138–149. Wiley-Blackwell.Google Scholar
- 60.Kass, Leon R. 2002. Life, liberty, and the defense of dignity. Encounter Books.Google Scholar
- 61.Mehlman, Maxwell J. 2003. Wondergenes: Genetic enhancement and the future of society. Bloomington: Indiana University Press.Google Scholar
- 64.Schuijff, Mirjam, Martijntje Smits, Christopher Coenen, Leonhard Hennen, and Michael Rader. 2009. A European approach to human enhancement. Background document for the STOA workshop. Brussels: STOA, European Parliament.Google Scholar
- 66.Bogner, Alexander. 2010. Let’s disagree! talking ethics in technology controversies. Science, Technology & Innovation Studies 6(2): 183–201.Google Scholar
- 67.Fuchs, Michael. 2005. Nationale Ethikräte. Hintergründe, Funktionen und Arbeitsweisen im Vergleich. Berlin: Nationaler Ethikrat.Google Scholar
- 68.Mortensen, Arne Thing, Jean-Christophe Galloux, Suzanne de Cheveigné, Agnes Allansdottir, Aigli Chatjouli, and George Sakellaris. 2002. The institutions of bioethics. In Biotechnology–the making of a global controversy, ed. Martin W. Bauer and George Gaskell, 129–149. Cambridge: Cambridge University Press.Google Scholar
- 69.EPOCH: Ethics in public policy-making: The case of human enhancement. 2012. http://epochproject.com. Accessed 30 January 2013.
- 70.Ahvenharju, Sanna, Mikko Halonen, Susanne Uusitalo, Veikko Launis, and Mari Hjelt. 2006. Comparative analysis of opinions produced by National Ethics Councils. Final report. Helsinki: Gaia Group Ltd.Google Scholar
- 71.European Conference of National Ethics Committees. 1998. Comparative study on the functioning of national ethics committees in 18 member states, COMETH 98 (13). Strasbourg. http://www.coe.int/t/dg3/healthbioethic/cometh/COMETH_98_13_fonctionnement_CNEs_bil.pdf. Accessed 23 June 2013.
- 72.European Conference of National Ethics Committees. 2012. http://www.coe.int/t/dg3/healthbioethic/cometh/national_ethics_committees/. Accessed June 30 2013.
- 73.National Ethics Committee Forum. 2012. http://ec.europa.eu/research/science-society/index.cfm?fuseaction=public.topic&id=1305. Accessed 30 June 2013.
- 74.World Health Organization. 2013. The global summit of national bioethics advisory bodies. http://www.who.int/ethics/globalsummit/en/. Accessed 30 June 2013.
- 76.Nuffield Council on Bioethics. 2002. Genetics and human behavior: the ethical context. London. http://www.nuffieldbioethics.org/genetics-and-behaviour. Accessed 10 March 2013.
- 77.Health Council of the Netherlands (in cooperation with the Center for Ethics and Health). 2003. Human enhancement. The Hague. http://www.gezondheidsraad.nl/sites/default/files/0308-04E.pdf. Accessed 15 March 2013.
- 78.Danish Council of Ethics. 2010. Recommendations concerning cyborg technology. Copenhagen. http://etiskraad.dk/en/Temauniverser/Homo-Artefakt/Anbefalinger. Accessed 17 March 2013.