In the debate on the ethics of the non-medical use of pharmaceuticals for cognitive performance enhancement in healthy individuals there is a clear division between those who view “cognitive enhancement” as ethically unproblematic and those who see such practices as fraught with ethical problems. Yet another, more subtle issue, relates to the relevance and quality of the contribution of scholarly bioethics to this debate. More specifically, how have various forms of speculation, anticipatory ethics, and methods to predict scientific trends and societal responses augmented or diminished this contribution? In this paper, we use the discussion of the ethics of cognitive enhancement to explore the positive and negative contribution of speculation in bioethics scholarship. First, we review and discuss how speculation has relied on different sets of assumptions regarding the non-medical use of stimulants, namely: (1) terminology and framing; (2) scientific aspects such as efficacy and safety; (3) estimates of prevalence and consequent normalization; and (4) the need for normative reflection and regulatory guidelines. Second, three methodological guideposts are proposed to alleviate some of the pitfalls of speculation: (1) acknowledge assumptions more explicitly and identify the value attributed to assumptions; (2) validate assumptions with interdisciplinary literature; and (3) adopt a broad perspective to promote more comprehensive reflection. We conclude that, through the examination of the controversy about cognitive enhancement, we can employ these methodological guideposts to enhance the value of contributions from bioethics and minimize potential epistemic and practical pitfalls in this case and perhaps in other areas of bioethical debate.
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Our own reflection was part of a project examining the legal, ethical and social consequences of memory technologies in an effort to engage in meta-ethical questions about bioethics itself. Some of the authors of this paper have directly intervened in this debate and therefore take a reflexive stance on their own scholarship and the claims made in their contributions.
Throughout debates about the non-medical use of stimulants, a further complicating factor has been the evolving definition of the term “cognitive enhancement”. Ferrari et al. (2012) identify these shifts in meaning by looking at the history of human enhancement: “the term ‘cognitive enhancement’ was originally used to describe the treatment of disease-associated cognitive impairment…the meaning of the term was subsequently broadened to encompass the use of interventions for mild cognitive impairment (MCI) (…) More recently ‘cognitive enhancement’ has been applied to interventions in normal ageing processes and in ‘healthy’ people for non-medical purposes” (Ferrari et al. 2012).
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Support for this work comes from a catalyst grant of the Canadian Institutes of Health Research (CIHR; Jennifer Chandler, PI; Eric Racine co-PI), a University of Queensland Travel Award for International Collaborative Research (Jayne Lucke), the Canadian Institutes of Health Research (New Investigator Award, Eric Racine) as well as the Fonds de recherche du Québec—Santé (Career Award, Eric Racine). We extend our thanks to members of the Neuroethics Research Unit for feedback on a previous version of this manuscript and to Ms. Allison Yan and Mr. John Aspler for editorial support. Thanks to Brad Partridge who was a visiting researcher at the Neuroethics Research Unit in 2012 for feedback on the concept of this paper. Thanks also to Dr. Emily Bell and Dr. Veljko Dubljevic for comments on a draft version of this paper.
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Racine, E., Martin Rubio, T., Chandler, J. et al. The value and pitfalls of speculation about science and technology in bioethics: the case of cognitive enhancement. Med Health Care and Philos 17, 325–337 (2014). https://doi.org/10.1007/s11019-013-9539-4