ECC 2012-13 (Farah 2010) Spurred by the advent of functional magnetic resonance imaging (fMRI) in the 1990s, cognitive and affective neuroscience have finally come of age. We have learned enough about the neural bases of human thought and feeling to explain, predict, and even control some aspects of human behavior. This knowledge brings risks as well as benefits, and much of neuroethics is concerned with understanding the impact of neuroscience on society and assessing the inevitable trade-offs between risks and benefits.
ECC 2012-13 EN a1 (Roskies 2002, p. 21) For instance, in a liberal democratic society such as ours self- determination is highly prized, and hence the importance of informed consent is central to medical practice and medical ethics. But neurodegenerative diseases and psychiatric disorders may impair cognition so that in- formed consent, as generally conceived, may be impossible. What guidelines should be in place for treatment or experimental participation in these cases? We also take it for granted that when making medical decisions, patients will choose what is in their best interests. Some disorders of brain chemistry, such as depression, defy such an assumption. Who should wield executive power when the subject cannot be counted on to choose what is best for his or herself?
ECC 2012-13 EN a 2 Martinson et al 2005 Serious misbehavior in research is important for many reasons, not last because it damages the reputation of, and undermines public support for, science. Historically, professionals and the public have focused on headline- grabbing cases of scientific misconduct, but we believe that researchers can no longer afford to ignore a wider range of questionable behaviour that threatens the integrity of science. We surveyed several thousand early- and mid-career scientists, who are based in the United States and funded by the National institute of Health (NIH), and asked them to report their own behaviours. Our findings reveal a range of questionable practices that are striking in their breadth and prevalence.
ECC 2012-13 EN a-b 3 Farah 2005 The ethical issues surrounding brain enhancement can be grouped into three general categories. In the ﬁrst category are health issues: safety, side effects and unintended consequences. Of course, these are a concern with all medications and procedures, but our tolerance for risk is lower for enhancement than for therapy. Furthermore, in comparison with other comparably elective treatments such as cosmetic surgery, brain-based enhancement involves intervening in a complex and poorly understood system, and the likelihood of unanticipated problems is consequently higher. The second category of ethical issue concerns the social effects of brain enhancement: How will it affect the lives of all of us, including those who may prefer not to enhance our brains? For example, the freedom to remain unenhanced may be difﬁcult to maintain in a society where one’s competition is using enhancement. American courts have already heard cases brought by parents who were coerced by schools to medicate their children for attentional dysfunction . Indirect coercion is already likely to be at work in schools where 30% or more of the boys take Ritalin . The military has long used drugs such asIf we fall in love with someone who is on Prozac and then ﬁnd she is difﬁcult and temperamental off the drug, do we conclude we don’t love her after all? Then who was it we loved? Are we treating people (including ourselves) as objects if we chemically upgrade their cognition, temperament or sexual performance? People vary in how troubling they ﬁnd these scenarios, but at least some see a fundamental metaphysical distinction eroding, the distinction between things (even complex biophysical things), and persons.
ECC 2012-13 EN b 4 Racine et al. 2006 Research results are already permeating the public sphere. Neuroimaging data have been admitted in courts,1 and in one case, a homicide conviction was reversed because the state failed to provide brain scans (People v. Weinstein 1992). Studies of consumer preferences using fMRI to inform marketing strategies —“neuromarketing”—have been discussed by the neuroscience community and the wider public (“Brain Scam?” 2004; “ Open Your Mind” 2002). As the power of imaging technologies increases, novel studies may yield novel applications such as mind reading (Ross 2003). Some new imaging technologies, such as functional near-infrared imaging of the brain, promise to deliver inexpensive, reliable, and portable imaging neurotechnologies that are as accurate as the current costly and equipment-cumbersome functional imaging based on magnetic resonance technology. For example, a wearable headband functional near-infrared tool is being developed to investigate real-world behaviors, with possible uses such as lie detection (Izzetoglu et al. 2004). Hence, as the power of brain imaging technologies increases, so will the magnitude of the issues it raises. (Racine et al 2006).
ECC 2012-13 EN b 4 Farah 2005 Among the neuroscience technologies that present new ethical challenges of a practical nature is functional brain imaging ….In principle, and increasingly in practice, imaging can be used to infer people’s psychological states and traits. For example, in neuromarketing, brain imaging is used to measure limbic system response to a product that may indicate consumers’ desire for it. In one recent demonstration, brain activity related to soft drink preference was sensitive to both the taste of the drink and to the brain name, with Coke evoking more activity than Pepsi only when subjects knew which brain they were tasting. To the extent that neuroimaging can measure unconscious motivation to buy, it provides a valuable new kind of information for marketers. Another potential use for functional imaging of bran states is lie detection. Although fMRI-based lie detection is far from feasible in real-world situations, researchers have found correlates of deception in the laboratory. …Psychological traits also have physical correlates that are measurable with current brain imaging technology. Like genotyping, brainotypig may be able to reveal mental health vulnerabilities and predilection for violent crime. Unconsciuous racial attitudes care manifest in brain activation … (Farah 2005) Of course, none of these characteristics can be accurately inferred by imaging (or, for that matter, by genotyping) at present. Brain imaging is at best a rough measure of personality, … (Farah 2005) So, what is the problem? (see point b 6)
ECC 2012-13 EN b 4 Oullier 2012 France has tried to crack down on such rogue uses of neuroscience. With the help of myself and other neuroscientists, the French parliament has revised its 2004 rules on bioethics. The result, passed last year, is a section of the law that simply states: “Brain-imaging methods can be used only for medical or scientific research purposes or in the context of court expertise.” The revised law effectively bans the commercial use of neuroimaging in France, although neuromarketing companies have only to cross the border to continue their business. … French politicians call for neuroimaging to be used in courts even though no expert advocates the move speaks volumes about the excessive trust they have in this emerging technology. Perhaps we are seeing the consequences of the hype that surrounded the early studies and the fantasies promoted by companies who profit from the technology. Maybe this excitement, along with attempts by academic neuroscientists to interest policy-makers in the field, helped to convince the politicians that, although the brain sciences alone will not provide definitive answers to societal issues, it would be a mistake to ignore their insight and potential. We should support efforts in that direction, but is there yet enough evidence to give the green light to neuroimaging in the courts? Certainly not. (Ouillier, 2012)
ECC 2012-13 EN b 5 Farah 2005 Like the field of genetics, neuroscience concerns the biological foundations of who we are, of our essence. The relation of self to brain is, if anything, more direct than that of self to genome. … The idea that there is somehow more to a person than their physical instantiation runs deep in the human psyche and is a central element in virtually all the world’s religions. Neuroscience has begun to challenge this view, by showing that not only perception and motor control, but also character, consciousness and sense of spirituality may all be features of the machine. If they are, then why think there’s a ghost in there at all? The incompatibility between the intuitive or religious view of persons and the neuroscience view is likely to have broad social consequences. These are foreshadowed by the highly politicized controversy over evolution and creationism, resulting from the irreconcilable natures of the scientiﬁc and fundamentalist Christian views of our origins. Consider, still, that a literal interpretation of Genesis is held by only a minority of religious thinkers, whereas the existence of an immaterial soul is a near universal belief.
ECC 2012-13 EN b 6 Illes et al 2010 While translating and disseminating new knowledge is a fundamental responsibility for all scientists, neuroscience is among several scientific disciplines that are particularly prone to misinformation and inaccurate reporting. Sensational media headlines that evoke mind reading, a neurogenetic basis for fidelity or voting patterns, memory boosters for the healthy, and miracle cures for sensory and movement disorders are but a few examples. Without accurate and sufficient context, the public – who are naturally interested in diseases and cures, especially with regard to common and devastating brain disorders – may accept these simplistic messages uncritically4. The power of brain imaging techniques such as functional Magnetic Resonance Imaging further feeds into this problem, with the potential for brain scan images to create beliefs and biases in the laboratory, the clinic, and courtroom
ECC 2012-13 NE Roskies 2002 How are decisions made in the brain? How are values represented? How are ethical decisions similar to or different from other types of decisions? Many thinkers have assumed ethical reasoning to be a variety of rational thought. But recent evidence suggests that emotions play a central role in moral cognition (Damasio, 1995; Greene et al., 2001). Does this undermine the view of ethics as rational or instead undermine the long-cherished division between reason and emotion? How will a better understanding of the biological basis of moral cognition and behavior modify our philosophical ethical framework? How will it affect ingrained notions of rationality and its importance to human existence? (Roskies 2002, p. 22)
ECC 2012-13 NE Edge Seminar: The new science of morality Something radically new is in the air: new ways of understanding physical systems, new ways of thinking about thinking that call into question many of our basic assumptions. A realistic biology of the mind, advances in evolutionary biology, physics, information technology, genetics, neurobiology, psychology, engineering, the chemistry of materials: all are questions of critical importance with respect to what it means to be human. For the first time, we have the tools and the will to undertake the scientific study of human nature. This began in the early seventies, when, as a graduate student at Harvard, evolutionary biologist Robert Trivers wrote five papers that set forth an agenda for a new field: the scientific study of human nature. In the past thirty-five years this work has spawned thousands of scientific experiments, new and important evidence, and exciting new ideas about who and what we are presented in books by scientists such as Richard Dawkins, Daniel C. Dennett, Steven Pinker, and Edward O. Wilson among many others. In 1975, Wilson, a colleague of Trivers at Harvard, predicted that ethics would someday be taken out of the hands of philosophers and incorporated into the "new synthesis" of evolutionary and biological thinking. He was right. Scientists engaged in the scientific study of human nature are gaining sway over the scientists and others in disciplines that rely on studying social actions and human cultures independent from their biological foundation. No where is this more apparent than in the field of moral psychology. Using babies, psychopaths, chimpanzees, fMRI scanners, web surveys, agent-based modeling, and ultimatum games, moral psychology has become a major convergence zone for research in the behavioral sciences. So what do we have to say? Are we moving toward consensus on some points? What are the most pressing questions for the next five years? And what do we have to offer a world in which so many global and national crises are caused or exacerbated by moral failures and moral conflicts? It seems like everyone is studying morality these days, reaching findings that complement each other more often than they clash.
ECC 2012-13 B-B L Gazzaniga 2004 The term “neuroethics” was coined by William Safire, to refer to “the field of philosophy that discusses the rights and wrongs of the treatment of, or enhancement of, the human brain.” I would argue that it goes further. Neuroethics should not simply be bioethics for the brain. I define neuroethics as the examination of “how we want to deal with the social issues of disease, normality, mortality, lifestyle, and the philosophy of living, informed by our understanding of underlying brain mechanisms. It is not a discipline that seeks resources for medical cure, but one that rests personal responsibility in the broadest social context. It is—or should be—an effort to come up with a brain- based philosophy of life.” Farah 2010 It is here, at the juncture between psychology and the natural sciences, that neuroethics comes in. In principle, and increasingly in practice, we can understand the human mind as a part of the material world. This has profound implications for how we regard and treat ourselves and each other. It gives us powerful new ways to predict and control human behavior and a jarringly material view of ourselves. Neuroethics is the field that grapples with theses developments. (Farah 2010)
ECC 2012 Ethics of neuroscience communication neurophilia neuro-optimism The Foundation’s founder and namesake, Johnson O’Connor, had an abiding interest in the biological substrate of individual differences in aptitudes. In late 2006 at a professional research conference, David Ransom, exploring how our founder’s vision could be pursued by funding an outside researcher through the Johnson O’Connor Research Support Corporation, discussed with Dr. Richard Haier, a leading researcher on brain imaging and intelligence, the possibility of relating the volumes of defined brain areas measured with structural magnetic resonance imaging (sMRI) to performance on Johnson O’Connor aptitude tests. In the spring of 2007 Dr. Haier agreed to work on such a study, and in conjunction with Mt. Sinai Medical Center in New York, to conduct sMRI scans of 40 Foundation examinees, under the supervision of Dr. Cheuk Tang. brainhood
ECC 2012-13 Racine 2006 Neurorealism Our concept of ‘neuro-realism’ describes how coverage of fMRI investigations can make a phenomenon uncritically real, objective or effective in the eyes of the public. This occurs most notably when qualifications about results are not brought to the reader’s attention. For example, commenting on an fMRI study of fear, one article states, “Now scientists say the feeling is not only real, but they can show what happens in the brain to cause it.” Neuroessentialism The concept of ‘neuro-essentialism’ reflects how fMRI research can be depicted as equating subjectivity and personal identity to the brain. In this sense, the brain is used implicitly as a shortcut for more global concepts such as the person, the individual or the self. This is the case in many expressions where the brain is used as a grammatical subject. Headline examples of this phenomenon are: “Brain can banish unwanted memories”, “How brain stores languages” and “‘Brain stores perceptions into small meaningful chunks”. Neuro-policy ‘Neuro-policy’ describes attempts to use fMRI results to promote political and personal agendas, as in the case of interest groups that uphold the investigation of social problems using fMRI. For example, the Lighted Candle Society, a Utah-based non-profit organization that is dedicated to the enhancement of moral values, advocates the use of fMRI to prove that pornography is addictive.
ECC 2012-13a. gulliblity Dihydrogen monoxide Habit Context: knowledge is not enough Authority Confirmation, Availability
ECC 2012-13 b. seductive allure of neuroscience http://mindhacks.com/ 2010/02/25/area- responsible-for- neuroscience-errors- Role ofvisual perception in reasoning located/ and understanding Illusion of reality Difficult but lloks easy Illusion of understandinghttp://mindhacks.com/2010/02/25/area-responsible-for-neuroscience-errors-located/
ECC 2012-13 Farah 2005 Another practical problem raised by progress in neuroimaging is that the public tends to view brain scans as more accurate and objective than in fact they are. Statements like ‘the brain does not lie’ crop up in popular writing on neuromarking and brain-based lie detection, reflecting a failure to appreciate the many layers of signal processing and statistical analysis that intervene between actual brain function and resulting image of reform, as well as the complex set of assumptions required to interpret the psychological significance of such images or waveforms. Brain-based measures do, in principle, have an advantage as indices of psychological states and traits over more familiar behavioral or autonomic measures, being one causal step closer to these states and traits than responses on personality questionnaires or polygraph tracings. For this reason imaging may eventually provide more sensitive and specific measures of psychological processes than are now available. At present, however, such uses must be approached carefully and with a healthy dose of skepticism.
ECC 2012-13c. misuse of neuroimaging studies Iacoboni et al. This is your brain on politics – The NY Times 11/11/2007
ECC 2012-13 Aron et al 2007 This Is Your Brain on Politics” (Op-Ed, Nov. 11) used the results of a brain imaging study to draw conclusions about the current state of the American electorate. The article claimed that it is possible to directly read the minds of potential voters by looking at their brain activity while they viewed presidential candidates. For example, activity in the amygdala in response to viewing one candidate was argued to reflect “anxiety” about the candidate, whereas activity in other areas was argued to indicate “feeling connected.” While such reasoning appears compelling on its face, it is scientifically unfounded. As cognitive neuroscientists who use the same brain imaging technology, we know that it is not possible to definitively determine whether a person is anxious or feeling connected simply by looking at activity in a particular brain region. This is so because brain regions are typically engaged by many mental states, and thus a one-to-one mapping between a brain region and a mental state is not possible. For example, rather than simply providing a brain marker of anxiety levels, as the article assumed, we know that the amygdala is activated by arousal and positive emotions as well. Such problems of interpretation with brain imaging studies can be avoided only by careful experimental design, and, as with any scientific data, the peer review process is critical to understanding whether the data are sound or based on faulty methodology. Unfortunately, the results reported in the article were apparently not peer-reviewed, nor was sufficient detail provided to evaluate the conclusions. As cognitive neuroscientists, we are very excited about the potential use of brain imaging techniques to better understand the psychology of political decisions. But we are distressed by the publication of research in the press that has not undergone peer review, and that uses flawed reasoning to draw unfounded conclusions about topics as important as the presidential election.
ECC 2012-13d. production of evidence Cargo cult science, or Producing good evidence is also a matter of ethics, not only of skills
ECC 2012-13 Feynman 1974 In the South Seas there is a cargo cult of people. During the war they saw airplanes land with lots of good materials, and they want the same thing to happen now. So theyve arranged to imitate things like runways, to put fires along the sides of the runways, to make a wooden hut for a man to sit in, with two wooden pieces on his head like headphones and bars of bamboo sticking out like antennas--hes the controller--and they wait for the airplanes to land. Theyre doing everything right. The form is perfect. It looks exactly the way it looked before. But it doesnt work. No airplanes land. So I call these things cargo cult science, because they follow all the apparent precepts and forms of scientific investigation, but theyre missing something essential, because the planes dont land.
ECC 2012-13 Feynman 1974 … there is one feature I notice that is generally missing in cargo cult science. That is the idea that we all hope you have learned in studying science in school--we never explicitly say what this is, but just hope that you catch on by all the examples of scientific investigation. It is interesting, therefore, to bring it out now and speak of it explicitly. Its a kind of scientific integrity, a principle of scientific thought that corresponds to a kind of utter honesty--a kind of leaning over backwards. For example, if youre doing an experiment, you should report everything that you think might make it invalid--not only what you think is right about it: other causes that could possibly explain your results; and things you thought of that youve eliminated by some other experiment, and how they worked--to make sure the other fellow can tell they have been eliminated. … In summary, the idea is to try to give all of the information to help others to judge the value of your contribution; not just the information that leads to judgment in one particular direction or another.
ECC 2012-13 Feynman 1974 Weve learned from experience that the truth will come out. Other experimenters will repeat your experiment and find out whether you were wrong or right. Natures phenomena will agree or theyll disagree with your theory. And, although you may gain some temporary fame and excitement, you will not gain a good reputation as a scientist if you havent tried to be very careful in this kind of work. And its this type of integrity, this kind of care not to fool yourself, that is missing to a large extent in much of the research in cargo cult science.
ECC 2012-13e. communicaiton of evidence Self-deception among scientists Blondlot (N rays) Benveniste (memory of water) Nature sends Wood and Maddox- Stewart-Randi Role of replication Role of publication in peer reviewed journals
ECC 2012-13 Clarke 2009 Peer review is a means of giving journalists confidence in new work published in scientific journals. Premature release of research results by scientists to the media denies journalists that confidence. It also removes journalists’ ability to obtain informed reactions about the work from independent researchers in the field. Although not all journalists and not all science bloggers (who write about scientific research on the internet) are supportive of this type of policy, this system of scientific communication has evolved for several reasons and serves multiple purposes for scientists themselves…
ECC 2012-13f. Adam Krumwiede’s syndrome Is there an alternative to peer-review publication? When should scientific results reach blogs, general public press, …? How should scientific results be managed by the general public’s press? How should they be communicated to laypeople?
ECC 2012-13 Suhr 2009 Science journalism is facing tough challenges today. The general public has a desire, and a right, to learn what new discoveries are being made and how these may affect everyday life, and they rely on science journals to bring them this information. However, the topics are often very complex and difficult to relay in terms that are understandable for the non-expert, and they can be politicized or pushed by different lobbies. Topics such as climate change or stem cell research affect humanity on an existential level, and the ethics involve in portraying these topics — how, orindeed whether to portray them — are complex. The responsibility for accurate science reporting lies, according to Halliday (2009, this TS), with journalists and researchers alike. She suggests that, ‘science graduate students should be required to take a course on writing for the public — not with the intentionof turning scientists into journalists, but to help them take a step back from the language they are immersed in.’ Halliday (2009, p. 27). The specialized language used in communications between scientists and a fear of being misrepresented may be the main reasons why scientists are reluctant to communicate what they do to the public. To change this, Halliday (2009) suggests courses in science communication to be taught during graduate school.
ECC 2012-13g. selling research Optimism about applications Illusion of straightforward application Pressures from laboratories for funding research
ECC 2012-13 Feynman 1974 I would like to add something thats not essential to the science, but something I kind of believe, which is that you should not fool the layman when youre talking as a scientist. Im talking about a specific, extra type of integrity that is not lying, but bending over backwards to show how you are maybe wrong, that you ought to have when acting as a scientist. And this is our responsibility as scientists, certainly to other scientists, and I think to laymen. For example, I was a little surprised when I was talking to a friend who was going to go on the radio. He does work on cosmology and astronomy, and he wondered how he would explain what the applications of this work were. "Well," I said, "there arent any." He said, "Yes, but then we wont get support for more research of this kind." I think thats kind of dishonest. If youre representing yourself as a scientist, then you should explain to the layman what youre doing--and if they dont want to support you under those circumstances, then thats their decision.
ECC 2012-13 Feynman 1974 So I have just one wish for you--the good luck to be somewhere where you are free to maintain the kind of integrity I have described, and where you do not feel forced by a need to maintain your position in the organization, or financial support, or so on, to lose your integrity. May you have that freedom.
ECC 2012-13h. tell the truth about science Early publication Media coverage of fresh results Risk of confounding results and facts Risk for the perception of science
ECC 2012-13 Simons 2010 My concern is about media reporting and even blogging about new and provocative scientific findings, the very findings that tend to decline. Following a murder, the arrest of a suspect is broadcast on the front pages, but when that suspect is exonerated, the correction ends up on the back of the local section months later (if it appears at all). The same problem holds for flawed scientific claims. The thoroughly debunked Mozart Effect still receives media coverage, just as other unsupported findings remain part of the popular consciousness despite a lack of replicability. Part of the problem is the rush to publicize unusual or unexpected positive findings, particularly when they run counter to decades of established science. That excitement about a new result is palpable and understandable. Who wants to write about the boring old stuff? The media loves controversy, and new results that counter the establishment are inherently interesting. Scientists strive for such controversy as well—what scientist doesn’t relish the idea of overhauling an accepted theory? Scientists understand that initially provocative claims don’t always hold up to scrutiny, but media coverage rarely withholds judgment. If well-established ideas can be shot down by a single study, and that single study gets extensive media coverage, the public understandably won’t know what to trust. The result, from the perspective of a consumer of science, is that science itself appears unstable. It gives people license to doubt non-controversial claims and theories (e.g., evolution). To the public eye, a single contradictory study has the same standing as established theory.
ECC 2012-13 2 actions Enhance (neuro-) scienceEnhance communication skills in literacy in educators / theresearchers general public AAAS Mass Media Science Fondation La main à la & Engineering Fellows pâte Program
ECC 2012-13 Illes et al. 2010 Some steps towards the cultural shift can be immediately implemented, such as increasing the professional value of delivering public lectures, media work and the development of training activities designed specifically for neuroscientists. Other actions, such as the full integration of communication training into neuroscience curricula and graduate training, will require longer- range planning and a more fundamental culture shift, given already heavily laden schedules. For neuroscientists, the overall continued development of specialized training sessions, online course modules and ‘boot camps’ at professional meetings or local institutions will help to achieve this culture shift. Indeed, some actions have been taken and investments made towards this goal. For example, the American Association for the Advancement of Science (AAAS) sponsors a summer internship programme that places graduate and postgraduate students study- ing science, engineering and mathematics at media organizations nationwide; participants “come in knowing the importance of translating their work for the public, but they leave with the tools and the know-how to accomplish this important goal” (The AAAS Mass Media Science & Engineering Fellows program…
ECC 2012-13Issues also relevant for mind, brain,behavior and education Issues related to the realization of fair trials with control groups of learners that are “deprived” of a potentially effective interventions are often raised by educators and parents more generally: to the design of experimental protocols that count as “fair trials”
ECC 2012-13 Issues related to interventions based on neuroscience, in particular in relationship with treatments for ADHD and other forms of “smart pills” diagnostic tools for learning disorders privacy pre-diagnosis in the absence of a treatment or useful interventions do we have the right to ignore what we know works or cannot work in education?
ECC 2012-13 the fact of describing a learning difficulty as a “dys-” is sometimes perceived as a form of stigmatization,
ECC 2012-13 as the derogation of educational tasks to the physician (medicalization of learning issues)
ECC 2012-13 Issues related to “responsibility” are also present in the domain of education: e.g., what if girls were really bad at mathematics? Should we judge them differently when they fail a math score? fairness: e.g. what should we do with dyspraxic children that are disadvantaged by having to write during an exam? Should they have a computer or not? the effects of truth: e.g. it seems that learning is influenced by the image one has of oneself as a learner
ECC 2012-13 All the considerations about communication and literacy apply to educators and policy- makers, as well as to parents who might read about some new treatment or educational method or be caught by commercial vendors
ECC 2012-14Happy pills Medicalization ofAgainst human nature normal life
ECC 2012-13 Farah 2005 The past two decades have seen the introduction of new antidepressant and antianxiety drugs with fewer side effects. The greater tolerability of these medications, along with increased public awareness of mental illness and aggressive marketing of psychiatric medications to physicians and patients has led to the widespread use of psychopharmacology by people who would not have been considered ill twenty years ago. There is a substantial literature (which in fact includes literary genres such as essays and memoirs) on the ways in which Prozac and other selective serotonin reuptake inhibitors (SSRIs) have become a part of life for many. However, there is surprisingly little scientific research on the effects of SSRIs on people who are not depressed. It seems clear that they are not happy pills, shifting depressed people to normalcy and normal people to bliss. Rather, for most people they seem to leave positive affect unchanged but attenuate negative affect, for example reducing the subjectively experienced ‘hassle’ factor of life. They also have subtle effects on social behavior. In addition to mood, vegetative functions such as sleep, eating, and sex can be influenced pharmacologically and there is a large demand for ways of enhancing these functions. The wakefulness-promoting agent modafinil, approved in the US for treatment of certain sleep disorders, is prescribed off label for a panoply of other conditions and is said to be favored by some ambitious professionals as a way of packing more work into a day.