Would you take a pill to make you smarter? Neuroscience is an emerging field in the biomedical sciences that encompasses numerous topics. Just one part of this fascinating topic is the tools used to interact with the brain; from fMRI scans that can practically read your mind to pharmacological neuroenhancers that can alter your mind. These tools are becoming gradually common with scientific development. As with any change seen in society that comes from scientific, or specifically, technological development, there are numerous bioethical questions that arise. It is especially important to address the idea of introducing neuroenhancing agents to the classroom. Neuroenhancers, in all its complexity, to someone who has attention deficit hyperactivity disorder (ADHD) is simply medication treated in order to improve their attention and concentration in class; however, is proper medication the sole purpose of these neuroenhancers? Maier et. al. claims, “neuroenhancement is the use of substances by healthy subjects to enhance mood or cognitive functions” [1]. Enhancing cognitive functions for people who have ADHD might be the intended purpose for the invention of these substances, but is that the only way they are being used in this world? Is there a justification for “healthy people” using them to enhance cognitive functions at necessary times? Before these questions are addressed, it is important to consider the background of these neuroenhancers.
Neuroenhancers, as Maier et. al. illustrates, is “defined as the use of prescription drugs or other psychoactive substances by healthy individuals who try to improve their cognitive function or mood” [1]. Cognitive function could include alertness, attention, concentration and memory, while mood or sleep falls under psychological function. If this definition is considered to be true, stimulants like Ritalin, Adderall, and even coffee aid in the improvement of cognitive capabilities [2], and substances like alcohol or marijuana are seen to ease psychological problems. Apart from their side effects, any of these substances help individuals be successful in improving their concentration, or relaxing when it gets too stressful. According to the Pharmaceutical Journal [3],
“Methylphenidate is a central nervous system stimulant. It binds to the dopamine transporter in the striatial presynaptic neurons, thus inhibiting dopamine reuptake and causing increased extracellular dopamine levels.”
Methylphenidate works with this dopaminergic activity to help children with ADHD, but if taken illegally as an off-label substance, it can have cognitive enhancing capabilities to “healthy people,” or people who do not have ADHD. To be clear, neuroenhancers simply helps people focus their attention better temporarily, which in broad terms could mean “smarter”. Studies have shown a greater use of these substances in college campuses where the need to be successful academically and the interrelated stress that comes with it influences how greatly these enhancers are used. More than 50% of the people who used these claimed to have done it for learning purposes, or for relaxation/sleep improvement [1]. The issue of attainability of these substances is a whole another debate, but to illustrate the issue, an economical perspective needs to be considered.
The fundamental question regarding the use of these neuroenhancers is access. Who is able to get them? What about the people that are not able to? It is clear that these neuroenhancers, to some extent, do help an individual to be able to retain information better, which could help at performances that need attention and concentration. To a great level, socioeconomic factors play a role. Who has the financial, cultural, and social capital to acquire these substances? In The Guardian, Talbot illustrates how a Harvard graduate manipulated his doctors to think he has ADHD so he could acquire Adderall in order to keep up with his school work [4]. Another person with the same level of stress as this Harvard graduate, besides not having a cultural capital of being knowledgeable enough to influence a professional, might additionally not have the financial capability of acquiring such medications. The success or failure in a competition between a person who takes neuroenhancers and a person who does not is highly skewed; there will absolutely be no place for fairness when it comes to college applications or even college grade distributions anymore. Greely in his article “Towards responsible use of cognitive-enhancing drugs by the healthy” argues, that “one could mitigate this inequity by giving every exam-taker free access to cognitive enhancements… this would help level the playing field” [5]. Greely’s solution could be useful if the students were simply using it for test taking, but a lot of the student life is focused on other academically competitive aspects as well, such as writing papers for class, as in the case of the Harvard student [4].
There is an understanding, however, that the world is already unfair, so would allowing students to get Adderall really change the already unjust world? Some argue that the introduction of neuroenhancers into the classroom would not influence the competitive nature of the classroom because inequalities already exist. Furthermore, there are claims that the use of these substances could help individuals improve the world. Greely claims there are “differences in education, including private tutoring, preparatory courses and other enriching experiences giving some students an advantage over others.” Greely, with this claim, is considering neuroenhancing agents the same as educational differences, or socioeconomic differences that plague our society. If taken simplistically, I completely agree with Greely, but Greely’s analogy should be the key reason to why neuroenhancers should not be introduced into the classroom. Introducing more inequalities simply polarizes society further. The regulation regarding who can receive these substances in addition to what circumstances an individual can use these enhancers for creates a whole new topic for debate. If the idea is to give it to everyone, how long will it last before supplies run out? There is little possibility for policy regarding neuroenhancing substances, for healthy people, to be written in a fair way to all members of community.
References
- Maier, Larissa J., Matthias E. Liechti, Fiona Herzig, and Michael P. Schaub. "To Dope or Not to Dope: Neuroenhancement with Prescription Drugs and Drugs of Abuse among Swiss University Students." PLoS ONE. November 13, 2013. Accessed March 29, 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3827185/.
- “Neuroenhancement.” John J. Reilly Center. University of Notre Dame. Accessed March 29, 2018. https://reilly.nd.edu/outreach/emerging-ethical-dilemmas-and-policy-issues-in-science-ad-technology-2014/neuroenhancement/
- “Cognitive Enhancers: what they are, how they work, and what is the pipeline. The Pharmaceutical Journal. February 19, 2013. Accessed March 29, 2018. https://www.pharmaceutical-journal.com/news-and-analysis/cognitive-enhancers-what-they-are-how-they-work-and-what-is-in-the-pipeline/11117394.article
- Margaret Talbot. “Can a Daily Pill Really Boost Your Brain Power?” The Guardian. September 19, 2009. Accessed March 29, 2018. https://www.theguardian.com/science/2009/sep/20/neuroenhancers-us-brain-power-drugs
- Henry Greely et. al. “Towards responsible use of cognitive-enhancing drugs by the healthy.” Nature 456, 702 – 705. December 11, 2008. Accessed March 29, 2018.