Neuroethics

, Volume 8, Issue 2, pp 83–92 | Cite as

Knowledge, Experiences and Views of German University Students Toward Neuroenhancement: An Empirical-Ethical Analysis

  • Cynthia Forlini
  • Jan Schildmann
  • Patrik Roser
  • Radim Beranek
  • Jochen Vollmann
Original Paper

Abstract

Across normative and empirical disciplines, considerable attention has been devoted to the prevalence and ethics of the non-medical use of prescription and illegal stimulants for neuroenhancement among students. A predominant assumption is that neuroenhancement is prevalent, in demand, and calls for appropriate policy action. In this paper, we present data on the prevalence, views and knowledge from a large sample of German students in three different universities (n = 1,026) and analyze the findings from a moral pragmatics perspective. The results of our study indicate that neuroenhancement is a well-known phenomenon among German students, but not prevalent. 2.2 % of our sample reported having used a prescription medication for neuroenhancement. Exams and competitive situations were predominant motivators of use. Students were unenthusiastic and critical about neuroenhancement in the academic context and disapproved of neuroenhancement for professionals. The majority of respondents agreed that neuroenhancing substances should be regulated by the state. These stances were based on strong beliefs in resisting peer pressure, avoiding the creation of injustice and valuing of hard work. From a moral pragmatics standpoint, these results challenge the assumption that policy on neuroenhancement is necessary in academic environments.

Keywords

Neuroenhancement Empirical ethics Moral pragmatics 

Notes

Acknowledgments

Jan Schildmann, Patrik Roser and Radim Beranek are members of the Global Young Faculty II, an initiative of Stiftung Mercator in cooperation with the University Alliance Ruhr (UA Ruhr), coordinated by the Mercator Research Center Ruhr (MERCUR) in Essen. Cynthia Forlini conducted this work as part of an International Visiting Fellowship in Medical Ethics at the Institute for Medical Ethics and History of Medicine, Ruhr-University Bochum. We would like to thank Bettina Plum, Birte Dahmen and Antje Hütten for their support of data collection and management.

References

  1. 1.
    Racine, E., and C. Forlini. 2010. Cognitive enhancement, lifestyle choice or misuse of prescription drugs? Ethical blindspots in current debates. Neuroethics 3(1): 1–14.CrossRefGoogle Scholar
  2. 2.
    Franke, A.G., C. Bonertz, M. Christmann, M. Huss, A. Fellgiebel, E. Hildt, and K. Lieb. 2011. Non-medical use of prescription stimulants and illicit use of stimulants for cognitive enhancement in pupils and students in Germany. Pharmacopsychiatry 44(2): 60–66.CrossRefGoogle Scholar
  3. 3.
    Lucke, J., S. Bell, B. Partridge, and W. Hall. 2010. Weak evidence for large claims contribute to the phantom debate. BioSocieties 5(4): 482–483.CrossRefGoogle Scholar
  4. 4.
    Farah, M.J. 2011. Overcorrecting the neuroenhancement discussion. Addiction 106(6): 1190.CrossRefGoogle Scholar
  5. 5.
    Arria, A.M., and R.L. DuPont. 2010. Nonmedical prescription stimulant use among college students: Why we need to do something and what we need to do. Journal of Addictive Diseases 29(4): 417–426.CrossRefGoogle Scholar
  6. 6.
    Farah, M.J., J. Illes, R. Cook-Deegan, H. Gardner, E. Kandel, P. King, E. Parens, B. Sahakian, and P.R. Wolpe. 2004. Neurocognitive enhancement: What can we do and what should we do? Nature Reviews. Neuroscience 5(5): 421–425.CrossRefGoogle Scholar
  7. 7.
    Greely, H., B. Sahakian, J. Harris, R.C. Kessler, M. Gazzaniga, P. Campbell, and M.J. Farah. 2008. Towards responsible use of cognitive-enhancing drugs by the healthy. Nature 456(7224): 702–705.CrossRefGoogle Scholar
  8. 8.
    Outram, S.M., and E. Racine. 2011. Developing public health approaches to cognitive enhancement: An analysis of current reports. Public Health Ethics 4(1): 93–105.CrossRefGoogle Scholar
  9. 9.
    British Medical Association. 2007. Boosting your brainpower: Ethical aspects of cognitive enhancement. London: British Medical Association.Google Scholar
  10. 10.
    Larriviere, D., M.A. Williams, M. Rizzo, and R.J. Bonnie. 2009. Responding to requests from adult patients for neuroenhancements. Guidance of the Ethics, Law and Humanities Committee. Neurology 73(17): 1406–1412.CrossRefGoogle Scholar
  11. 11.
    Graf, W.D., S.K. Nagel, L.G. Epstein, G. Miller, R. Nass, and D. Larriviere. 2013. Pediatric neuroenhancement: Ethical, legal, social, and neurodevelopmental implications. Neurology 80(13): 1251–1260.CrossRefGoogle Scholar
  12. 12.
    Commission de l’éthique de la science et la technologie. 2009. Position Statement on Psychotropic Drugs and Expanded Uses: An Ethical Perspective. Québec.Google Scholar
  13. 13.
    Nuffield Council on Bioethics. 2013. Novel neurotechnologies: Intervening in the brain. London.Google Scholar
  14. 14.
    President’s Council on Bioethics. 2003. Beyond therapy. Washington, DC: President’s Council on Bioethics/Harper Collins.Google Scholar
  15. 15.
    Lucke, J., Stephanie Bell, B. Partridge, and Wayne D. Hall. 2011. Deflating the neuroenhancement bubble. AJOB Neuroscience 2(4): 38–43.CrossRefGoogle Scholar
  16. 16.
    Schelle, K.J., N. Faulmuller, L. Caviola, and M. Hewstone. 2014. Attitudes toward pharmacological cognitive enhancement—A review. Frontiers in Systems Neuroscience. doi: 10.3389/fnsys.2014.00053.Google Scholar
  17. 17.
    Forlini, C., E. Racine, J. Vollmann, and J. Schildmann. 2013. How research on stakeholder perspectives can inform policy on cognitive enhancement. The American Journal of Bioethics 13(7): 41–43.CrossRefGoogle Scholar
  18. 18.
    Mazanov, J., M. Dunn, J. Connor, and M.-L. Fielding. 2014. Substance use to enhance academic performance among Australian university students. Performance Enhancement & Health 2(3): 110–118.CrossRefGoogle Scholar
  19. 19.
    Ott, R., and N. Biller-Andorno. 2014. Neuroenhancement among Swiss students—A comparison of users and non-users. Pharmacopsychiatry 47(1): 22–28.Google Scholar
  20. 20.
    Deline, S., S. Baggio, J. Studer, A.A. N’Goran, M. Dupuis, Y. Henchoz, M. Mohler-Kuo, J.B. Daeppen, and G. Gmel. 2014. Use of neuroenhancement drugs: Prevalence, frequency and use expectations in Switzerland. International Journal of Environmental Research and Public Health 11(3): 3032–3045.CrossRefGoogle Scholar
  21. 21.
    Salloch, S., J. Schildmann, and J. Vollmann. 2012. Empirical research in medical ethics: How conceptual accounts on normative-empirical collaboration may improve research practice. BMC Medical Ethics 13: 5.CrossRefGoogle Scholar
  22. 22.
    Birnbacher, D. 1993. Welche Ethik ist als Bioethik tauglich. In Herausforderungen der Bioethik, ed. J.S. Ach and A. Gaidt, 45–67. Stuttgart-Bad Cannstatt: Frommann-Holzboog.Google Scholar
  23. 23.
    Forlini, C., and E. Racine. 2012. Stakeholder perspectives and reactions to “academic” cognitive enhancement: Unsuspected meaning of ambivalence and analogies. Public Understanding of Science 21(5): 606–625.CrossRefGoogle Scholar
  24. 24.
    Partridge, B., J. Lucke, and W. Hall. 2012. A comparison of attitudes toward cognitive enhancement and legalized doping in sport in a community sample of Australian adults. AJOB Primary Research 3(4): 81–86.CrossRefGoogle Scholar
  25. 25.
    Sattler, S., and C. Wiegel. 2013. Cognitive test anxiety and cognitive enhancement: The influence of students’ worries on their use of performance-enhancing drugs. Substance Use and Misuse 48(3): 220–232. doi: 10.3109/10826084.2012.751426.CrossRefGoogle Scholar
  26. 26.
    Graff Low, K., and A.E. Gendaszek. 2002. Illicit use of psychostimulants among college students: A preliminary study. Psychology, Health and Medicine 7(3): 283–287.CrossRefGoogle Scholar
  27. 27.
    White, B.P., K.A. Becker-Blease, and K. Grace-Bishop. 2006. Stimulant medication use, misuse, and abuse in an undergraduate and graduate student sample. Journal of American College Health 54(5): 261–268.CrossRefGoogle Scholar
  28. 28.
    Eickenhorst, P., K. Vitzthum, B.F. Klapp, D. Groneberg, and S. Mache. 2012. Neuroenhancement among German university students: Motives, expectations, and relationship with psychoactive lifestyle drugs. Journal of Psychoactive Drugs 44(5): 418–427.CrossRefGoogle Scholar
  29. 29.
    Babcock, Q., and T. Byrne. 2000. Student perceptions of methylphenidate abuse at a public liberal arts college. Journal of American College Health 49(3): 143–145.CrossRefGoogle Scholar
  30. 30.
    Repantis, D., P. Schlattmann, O. Laisney, and I. Heuser. 2010. Modafinil and methylphenidate for neuroenhancement in healthy individuals: A systematic review. Pharmacological Research 62(3): 187–206.CrossRefGoogle Scholar
  31. 31.
    Repantis, D., Peter Schlattmann, Oona Lainsey, and Isabella Heuser. 2008. Antidepressants for neuroenhancement in healthy individuals: A systematic review. Poiesis & Praxis 6(3–4): 139–174.Google Scholar
  32. 32.
    Repantis, D., O. Laisney, and I. Heuser. 2010. Acetylcholinesterase inhibitors and memantine for neuroenhancement in healthy individuals: A systematic review. Pharmacological Research 61(6): 473–481.CrossRefGoogle Scholar
  33. 33.
    Budney, A.J., and J.A. Emond. 2014. Caffeine addiction? Caffeine for youth? Time to act! Addiction. doi: 10.1111/add.12594.Google Scholar
  34. 34.
    Rosenfield, D., P.C. Hebert, M.B. Stanbrook, K. Flegel, and N.E. Macdonald. 2011. Time to address stimulant abuse on our campuses. CMAJ 183(12): 1345.CrossRefGoogle Scholar
  35. 35.
    Franke, A.G., C. Bonertz, M. Christmann, S. Engeser, and K. Lieb. 2012. Attitudes toward cognitive enhancement in users and nonusers of stimulants for cognitive enhancement: A pilot study. AJOB Primary Research 3(1): 48–57.CrossRefGoogle Scholar
  36. 36.
    Forlini, C., and E. Racine. 2012. Added value(s) to the cognitive enhancement debate: Are we sidestepping values in academic discourse and professional policies? AJOB Primary Research 3(1): 33–47.CrossRefGoogle Scholar
  37. 37.
    Bergstrom, L.S., and N. Lynoe. 2008. Enhancing concentration, mood and memory in healthy individuals: An empirical study of attitudes among general practitioners and the general population. Scandinavian Journal of Public Health 36(5): 532–537.CrossRefGoogle Scholar
  38. 38.
    Bell, Stephanie, B. Partridge, Jayne Lucke, and Wayne Hall. 2013. Australian university students’ attitudes towards the acceptability and regulation of pharmaceuticals to improve academic performance. Neuroethics 6(1): 197–205.CrossRefGoogle Scholar
  39. 39.
    Forlini, C., and E. Racine. 2009. Autonomy and coercion in academic “cognitive enhancement” using methylphenidate: Perspectives of a pragmatic study of key stakeholders. Neuroethics 2(3): 163–177.CrossRefGoogle Scholar
  40. 40.
    Sabini, J., and J. Monterosso. 2005. Judgments of the fairness of using performance enhancing drugs. Ethics & Behavior 15(1): 81–94.CrossRefGoogle Scholar
  41. 41.
    Banjo, O.C., R. Nadler, and P.B. Reiner. 2010. Physician attitudes towards pharmacological cognitive enhancement: safety concerns are paramount. PLoS ONE 5(12): e14322.CrossRefGoogle Scholar
  42. 42.
    Shaw, D. 2013. Neuroenhancing public health. Journal of Medical Ethics 40(6): 389–391.CrossRefGoogle Scholar
  43. 43.
    Franke, A.G., K. Lieb, and E. Hildt. 2012. What users think about the differences between caffeine and illicit/prescription stimulants for cognitive enhancement. PLoS ONE 7(6): e40047.CrossRefGoogle Scholar
  44. 44.
    Franke, A.G., C. Bagusat, P. Dietz, I. Hoffmann, P. Simon, R. Ulrich, and K. Lieb. 2013. Use of illicit and prescription drugs for cognitive or mood enhancement among surgeons. BMC Medicine 11: 102.CrossRefGoogle Scholar
  45. 45.
    Hotze, T., K. Shaw, E. Anderson, and M. Wynia. 2011. “Doctor, would you prescribe a pill to help me…?” A national survey of physicians on using medicine for human enhancement. American Journal of Bioethics 11(1): 3–13.CrossRefGoogle Scholar
  46. 46.
    Appel, J.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.CrossRefGoogle Scholar
  47. 47.
    Dubljevic, V. 2013. Cognitive enhancement, rational choice and justification. Neuroethics 6: 179–187.CrossRefGoogle Scholar
  48. 48.
    Sarewitz, D., and T.H. Karas. 2012. Policy implications of technologies for cognitive enhancement. In Neurotechnology: Promises, potential and problems, ed. James Giordano, 268–286. Boca Raton: CRC Press.Google Scholar
  49. 49.
    Strech D., J. Schildmann. 2011. Quality of ethical guidelines and ethical content in clinical guidelines: the example of end-of-life decision-making. Journal of Medical Ethics 2011 37: 390–6.Google Scholar
  50. 50.
    Dubljevic, V. 2013. Prohibition or coffee shops: Regulation of amphetamine and methylphenidate for enhancement use by healthy adults. American Journal of Bioethics 13(7): 23–33.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Cynthia Forlini
    • 1
  • Jan Schildmann
    • 2
  • Patrik Roser
    • 3
  • Radim Beranek
    • 4
  • Jochen Vollmann
    • 2
  1. 1.The University of Queensland Centre for Clinical Research, Royal Brisbane and Women’s HospitalUniversity of QueenslandHerstonAustralia
  2. 2.Institute for Medical Ethics and History of MedicineRuhr University BochumBochumGermany
  3. 3.Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University HospitalRuhr University BochumBochumGermany
  4. 4.Faculty of Chemistry and BiochemistryRuhr University BochumBochumGermany

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