The debate on “cognitive enhancement” has moved from discussions about enhancement in adults to enhancement in children and adolescents. Similar to positions expressed in the adult context, some have argued that pediatric cognitive enhancement is acceptable and even laudable. However, the implications differ between the adult and the pediatric contexts. For example, in the debate over cognitive enhancement in adults, i.e., those who have legal majority, respect for autonomy demands that personal preferences not be overridden in absence of strong arguments because competent adults are in the best position to recognize and protect their own interests. However, the concepts of best interest and autonomy provide a different picture in the case of pediatric enhancement. In the context of decision-making involving minors, it is assumed that the parents are in the best position to promote and protect the interests of their children and this is chiefly why they are granted the authority to make decisions on their behalf. However, we argue in favor of guarding the physical integrity of children from intrusive medical interventions without medical need and with clear and detrimental effects (e.g., suppressing growth). We also support leaving open other legitimate life trajectory and career choices, as this is in the best interest of the child, even if they are less in line with the expectations of parents or success in educational settings. In addition, parental decision-making in favor of cognitive enhancement suffers from a lack of information about cognitive enhancers (e.g., safety and efficacy) and potential biases. Thus, bearing in mind these issues and the development of volitional capacities of children, we argue that pediatric enhancement is not a morally acceptable practice and “inevitability” can be curbed with clear and fair rules that establish duties of state representatives, physicians, and public institutions. We conclude by canvassing evidence-based policy options that could protect the open future of minors and define the parameters of parental decision-making analogous to the cases of nicotine and alcohol.
This is a preview of subscription content, log in to check access.
Support for this work comes from the Banting Postdoctoral Fellowships Programme (Dubljević) and the Fonds de recherche du Québec—Santé for career awards (Racine). We extend our thanks to members of the Neuroethics Research Unit for feedback on previous versions of this manuscript. Special thanks to Matthew Sample for detailed constructive feedback on a previous version of this manuscript.
Austin MW (2016) Rights and obligations of parents. The Internet Encyclopedia of Philosophy, ISSN 2161-0002. http://www.iep.utm.edu/parentri. Accessed 26 Aug 2016
Dressler M, Repantis D (2015) Cognitive enhancement in humans. In: Knafo S, Venero C (eds) Cognitive enhancement. Elsevier, Academic, Amsterdam, pp 273–306CrossRefGoogle Scholar
Dubljević V (2012a) Principles of justice as the basis for public policy on pycho-pharmacological cognitive enhancement. Law Innov Technol 4(1):67–83CrossRefGoogle Scholar
Dubljević V (2012b) Toward a legitimate public policy on cognition-enhancement drugs. AJOB Neurosci 3(3):29–33CrossRefGoogle Scholar
Dubljević V (2013a) Cognitive enhancement, rational choice and justification. Neuroethics 6(1):179–187CrossRefGoogle Scholar
Dubljević V (2013b) Prohibition or coffee-shops: regulation of amphetamine and methylphenidate for enhancement use by healthy adults. Am J Bioeth 13(7):23–33CrossRefPubMedGoogle Scholar
Dubljević V (2013c) Autonomy in neuroethics: political and not metaphysical. AJOB Neurosci 4(4):44–51CrossRefGoogle Scholar
Dubljević V (2015) Neurostimulation devices for cognitive enhancement: toward a comprehensive regulatory framework. Neuroethics 8(2):115–126CrossRefGoogle Scholar
Dubljević V, Saigle V, Racine E (2014) The rising tide of tDCS in the media and academic literature. Neuron 82(4):731–736CrossRefPubMedGoogle Scholar
Durrant JE (1996) The Swedish ban on corporal punishment: its history and effects. Family violence against children: a challenge for society. Prevention and intervention in childhood and adolescence. Walter De Gruyter, Berlin, New York, pp 19–25Google Scholar
Racine E (2010) Pragmatic neuroethics: improving treatment and understanding of the mind-brain. MIT Press, CambridgeCrossRefGoogle Scholar
Ruxton CHS (2014) The suitability of caffeinated drinks for children: a systematic review of randomised controlled trials, observational studies and expert panel guidelines. J Hum Nutr Diet 27:342–357CrossRefPubMedGoogle Scholar