Brandon Turner Neuroethics April 18, 2012 Cognitive Enhancement: From Drugs to Genetics One of the most essential methods of survival known to the human race has been thedevelopment of technology to alter the way we interact with the environment. In fact, technologyhas hit a staggering rate of exponential growth as new advances lead to even better ones, with thepromises of perhaps being able to one day alter our own bodies and minds in order to circumventthe use of external gadgets and medication. Although this idea may seem unfathomable, thisprocess of self improvement is already in practice, though in much subtler ways. Yet with the constant advance of technology and the steady rise in the amount ofinformation about ourselves that scientific research is giving us, improving ourselves at the localclinic may not be as grounded in science fiction as we had once believed. What is even moreintriguing is the problem it poses to the most fundamental part of what we use to identify ashumans and persons: the brain. With the rapid expansion of the field of neuroscience, more andmore of the brain, from the physiological to the molecular level, is being discovered every day,making vast advances in pharmacology that seeks to alter the way our brain works in order tocure or treat neurological disorders. But what happens when this desire to cure evolves into thedesire to alter seemingly healthy, normal minds, pushing them to levels that evolution could notreach without centuries of random mutations? Advances in modern science have given us drugs to boost performance in the classroomand to help alleviate painful memories, many of which are available with little effort. Drugs suchas Ritalin and Adderall are already taken by students across the nation to increase the fruits oflong nights studying and help get through those difficult classes, even when they have noprescription based need for such a drug (Carley, 2008; Anderson, 2012). What’s more, advances
2in genetic screening and microbiological techniques have made processes such as in vitrofertilization (IVF) and pre-implantation genetic diagnosis (PGD) possible for many familiesplanning to have children. These processes allow parents to view the genomes of their potentialchildren while they are still embryos and choose which they would like to have. Although theseprocedures are mainly used by parents with incurable genetic disorders, such as Huntington’sdisease or dwarfism, it is not impossible to imagine a time when not only are negative traitsselected against but can be removed directly from the embryo (Silver, 1997). Also, consider theopposing situation when genes are not simply removed and a healthy one put in its place but asuperior version of the gene, allowing parents to enhance their progeny in a way that their owngenomic makeup would otherwise be impossible to generate. These issues seem mild for the way in which these technologies are in place today, butwhat of the future? How do we prevent situations such as those depicted in the films Equilibriumand Gattaca from coming about? I doubt many would argue for repressing emotions with drugsto conform to society or want that are bred as much by computers as their parents (Limitless,2011; Gattaca, 1997). In order to prevent such events from taking place, the ethics of suchmatters must be taken into account now such that law makers, and society itself, can preventsuch outcomes. The alteration of our bodies and minds may prove useful to those who are able tofreely choose such treatments, however, forcing those unwilling to undergo such a procedure oruse such a drug violates the ideals of personhood. Yet despite the possible drawbacks at anindividual level, the societal benefits from such alterations can prove beneficial to all and rest onprecedents of cognitive and physical enhancements available today. Because of this, I see noreason why the progression of research into such drugs and treatments should be discontinued.
3 Most everyone has probably thought or wished that there were some way to makethemselves better, beyond what they would be capable of at a normal functioning level even withlong hours of practice or study. As it turns out, this isn’t out of the realm of possibilities asmodern science has procured numerous drugs that rise to the occasion. From steroids in sportscompetitions to ‘study aids,’ which are often off the label use of medicines such as adderal,people are artificially enhancing themselves every day. But should they be allowed to continuethis? Some may argue that much of what they do, as far as negative side effects of such drugs areconcerned, that these constitute victimless crimes. Yet are they really so innocent? Gazzanigaargues that the use of drugs for mental enhancement is acceptable while use of drugs forenhancement in sports competitions constitutes cheating as the two apply to different sets ofrules. He argues that the use of steroids or other performance enhancers constitutes cheatingbecause “…the social contract with one’s competition is being broken (Gazzaniga, 2005).” Theuse of drugs for mental enhancement, however, is in a different spectrum, notably that of societyand culture. In American society, we strive for the best. Collegiate students under pressure toperform may often turn to such study aid drugs to help them through a difficult exam or write anengaging paper, and yet no one seems to hold this against them. Gazzaniga outlines ahypothetical situation involving a student, Joe, who graduates highschool at the top of his classto attend Dartmouth. “It is as if all of Joe’s peers at Glendale High had swallowed a ‘smart pill’and are now ready for quantum mechanics. Does the world become bizarre for our once-raresmart guy? Does he fret and feel inadequate in the face of all the competition? No. The answer,again, is rooted in how easily we adapt to our ever changing contexts (Gazzaniga, 2005).” In hismind, there will always be smarter people around us and allowing others to step up to that levelwill not change the norm. After all, if it raises the bar for the entire population, no one has gone
4up a peg in society. Martha Farah is in agreement with Gazzinaga, stating, “In academics,whether you’re a student or a researcher, there is an element of competition, but it’s secondary.The main purpose is to try to learn things, to get experience, to write papers, to do experiments.So in that case if you can do it better because you’ve got some drug on board, that would on theface of things seem like a plus (Carley, 2008).” In some sense, this may actually benefit societyas a whole. Imagine a country populated with smarter scientists, better businessmen, andenlightened lawmakers who saw more of the whole picture. In this sense, the use of these currentday drugs to boost performance of a person’s mental processes is accepted and could be appliedbroadly. A problem arises with these drugs, however, when taking them is out of our power ofchoice. Considering the above argument, these students and workers were taking these drugs toboost their own performance, but what happens if it is required? It is already considered immoraland unlawful to force someone to do something against their will, including forcibly alteringtheir mental state with drugs such as alcohol, GHB, or roofalin. But what if the whole worldjumps on the bandwagon of prescription brain enhancers and you’re forced to decide to take thepill or remain at the bottom of the barrel? Dr. Anjan Chatterjee, quoted in the New York Times,examines such a situation. “You can imagine a scenario in the future, when you’re applying for ajob, and the employer says, ‘Sure, you’ve got the talent for this, but we require you to takeAdderall.’ Now, maybe you do start to care about the ethical implications (Carey, 2008).” Itseems that a matter of choice has been removed for the would-be business man. But is it reallygone? I submit that the choice here still lies with the person in question, as he still has the abilityto act freely on his desire, namely that to be a successful business man. Every career surely hasits requirements and requires some sacrifice, and if business man wants to go forward with his
5career, he may have to make this sacrifice of taking adderall. Similarly, the world will alwaysneed service related workers: people to pump gas, run shops, cook, clean, etc. In this case, noindividual rights need to be impinged upon, as the choice to engage in medicated brainenhancement still exists. If all this is available now, where will we be in a few years? As neuroscience continues togrow and develop new treatments and enhancements for our mental abilities, new drugs willdoubtlessly be available in the future, and maybe sooner than we’ve expected. It may not be sofarfetched to imagine a drug such as NZT featured in the recent movie Limitless, a drug thatboosts the protagonist’s mental capacities to a super human state, allowing him to perform manytasks both faster and with better quality than before (Limitless, 2010). Yet with the possiblebenefits of the drug so vast, should we really postpone their creation now? The film Limitlessoutlines the benefits of a so-called ‘normal’ functioning man engaging in mental enhancement,but what of those less of? It is possible that these drugs could serve a different purpose, namelyaiding those on the lower IQ spectrum who could function normally in society. Nootropes,another name for cognitive enhancers, have already been developed for patients suffering fromAlzheimer’s disease, a traumatic neurodegenerative disorder that causes retro and anterogradeamnesia (Gattinaga, 2005). This drug, of course, has been use for the same off-the-label purposesas Adderall, yet does this mean we should stop trying to help those worse off just because theymay put others at an unfair advantage by boosting performance beyond normal? As long as theadministration of such drugs is voluntary and can serve to bolster society as a whole, I see noreason why research into cognitive enhancers should not continue. Apart from medication to boost performance, a more permanent solution may be nigh athand, making such enhancements unnecessary. The continued advancement of molecular biology
6and neuroscience has lead to a massive increase in the genetic knowledge of how our nervoussystem is formed. Scientists are mapping new areas of the brain and correlating them to geneticfactors in hopes of finding traits that correspond to personality traits, athleticism, andintelligence. With processes such as PGD and IVF already available, it may become possible toinsert favorable traits into our children and mold them to what we want them to be. This idearests on several assumptions that are not necessarily true from a genetics standpoint. As it stands,the code in a person’s genome does not directly influence every bit of a person’s being in thefuture. Nature and nurture work in conjunction to form a person, an idea that has been modeledas genetics serving as the ‘potential’ or circuitry in the brain and environmental influencesshaping the formation of such framework (Silver, 1997). Yet one cannot deny the potentialinfluences of genetics on a person’s mentality. Brain scans and biochemical assays haveidentified ‘malformed’ regions and enzymatic deficiencies in criminals, indicating that geneticsmust surely have a role in who we are (Baily, 2005; Raine 2004). Could we really pull outdefective genes before a child is even born? As future research progresses, could we even swapin superior genes? Many people cringe at the notion of changing the genetic makeup of a child without themhaving the ability to chose it, but is it really so bad? Many parents would often make the claimthat they want what’s best for their child. If they could prevent their child from suffering from aterrible genetic disease, should they have the right? That is precisely what is going on today.Couples that have the possibility of having a child with genetic diseases can undergo PGD toscan a number of embryos for genetic traits that correspond to defective alleles and chose not tohave those embryos implanted, thus alleviating the possibility of their child suffering from such adisease (Silver, 1997). This is far from tampering with the genetic code of a child, but it serves
7an important precedent. If we’re ok with changing the chance occurrence of a genetically‘deficient’ child, why not alter his/her genome all together, and is this even possible? Recent findings have even shown that altering a person’s mind by genetic enhancementmay not require embryos at all. In fact, a company called Neurologix has developed a method forsending genes directly into the brain to treat Parkinson’s disease (Singer, 2009). This approachwould have the advantage of helping the gene pool in a population wide scale. Although somemay worry that these deficient genes have some hidden purpose, genetics says otherwise. AsSilver explains, “This point of view has no basis in reality. It results from a misunderstanding ofwhat the gene pool is, and why we should, or should not, care about it (Silver 1997).” In thissense, the idea of negative selection against disadvantageous genes seems like a great idea, aswell as one that seems permissible by moral standards and the drive for a better tomorrow. The difficult question arises when we begin to discuss positive selection in genomes.Positive selection would entail the swapping out or insertion of ‘better’ genes. While this isessentially the same negative selection when the targeted gene would be deleterious, it isdifferent when it starts to beget the enhancement of an embryo beyond what would normally beproduced by the parents. For example, if the genes for intelligence and athleticism werediscovered, parents could have doctors and molecular biologists insert superior versions of thosegenes, allowing their child to be a scholar athlete beyond what they would be by chance. This isnot entirely beyond the realm of possibilities. I myself perform such a procedure in my work inneuroscience, creating bacteria that have taken up external DNA and express the gene product tosuit the experiment. Although putting such a gene in a multi-cellular organism is more difficult,it too has been accomplished in mice and rats, along with other lab animals. But is it ethical forhumans to undergo such a treatment?
8 Some argue that the use of such treatments would put those children at an unfairadvantage over others as the procedure would be costly and available mainly to the rich. Filmssuch as Gattaca have already depicted such scenarios involving ‘designer babies’ that areenhanced to suit their parents needs. Silver outlines such a scenario in his book Remaking Eden,describing a distant future where the ‘gen-rich,’ or genetically enhanced subclass of humans,eventually becomes so advanced that they are becoming their own species and incapable ofmating with natural humans (Silver, 1997). Although such a society is of concern, the immediateeffects of such enhancements may be offset by the drug market which offers similarenhancements, mainly in the form of cognitive boosters. Allen Buchanan argues that althoughthese drugs may also be out of reach for some, other technologies that were thought to be onlyavailable to the wealthy have diffused widely across the population, such as cellular phones.“Right now if you go to Wal-Mart there are over one hundred and thirty drugs that used to be onpatent and have now gone off patent and gone generic, and a month supply of each of thesedrugs is only four dollars. Now thats a lot cheaper than the cognitive enhancement drug that youget at Starbucks (Andersen, 2012).” One could hope that such genetic advances would also spread throughout the populacevery rapidly, and perhaps it will given that with such advances in human intelligence, livingstandards across the board may increase, thus giving those on the lower end of the monetaryspectrum access to such procedures. Yet we must also be aware that, as said before, ‘better’genes does not necessarily make a better person. The fact that some genes are not completelypenetrant, i.e. they do not guarantee the desired phenotype, leaves room for such geneticexperiments to fail altogether. Many people probably know a person or two who has an amazingcapacity for learning, music, or athletics, but has chosen to squander those gifts due to, perhaps,
9a lack of determination or motivation. In this sense, our genes are no better than what we can dowith them, and failing to meet the full potential of those genes results in a normal person,genetically ‘rich’ or not. Those who also claim that those who are wealthier will have better access to suchtechnology, and thusly will have more success in life, seem not to have noticed that this isalready the case. Wealthier children can be afforded expensive boarding schools, advancedathletic training camps, personal assistants, musical tutors, etc., while those on the lower end ofthe spectrum cannot. It doesn’t seem like this had much to do with Oprah Winfrey’s success,however. Arguably one of the most successful TV hosts in America is also one of its best rags-to-riches success stories (Wikipedia, 2012). If she can get by on a normative education and adrive to succeed, it serves that even those who don’t have the enhanced gene package can do thesame. Evolution is geared towards survival, and an enhanced population free of genetic diseasesand super-smart, super talented athletes may well change selective pressures for those withoutthe treatment. Although I can’t speak to the speed at which this may occur, the drive to survivehas often won out for many in the past. As Gazzinaga states, “My own belief is that none of thisis threatening to our sense of self. The opportunities to enhance one’s mental state abound.Backstopping many of the ethical concerns about unleashing millions of really smart people onthe world is the fact that millions of really smart people are already here (Gazzinaga, 2005).”Perhaps it is time to stop fretting over how different people may become in realizing that we’realready different, and that enhancement of ourselves and our environment is part of what makesus human. Advancing technologies provide us with the ability to evolve outside of evolutionarybounds and allows societal and cultural constructs to shape what we become. In time, it may
10allow us to shape our own minds and bodies to what we wish it to be, which may be penultimatedesire of human science. This hyperagency, as it is termed, leads to many questions about howthese enhancements may affect both individuals and society as a whole. Yet, with pastprecedents to guide us, the future of cognitive enhancement with better science and betterpharmaceuticals is vast. The creation of drugs and gene therapies that directly target our mentalability may be both safer and more efficient that the over the counter drugs and expensivehospital bills that we pay for now. To solve the ethical quandaries of the future you, one needsonly to look at what is being done now to see that an improvement would be well received.
11 ReferencesAndersen, Ross. “Why Cognitive Enhancement Is in Your Future (and Your Past).” The Atlantic. 6 Feb 2012. Electronic.Bailey, Ronald. “Should We Cure Bad Behavior?” Reason.com. 1 June 2005. Electronic.Carley, Benedict. “Brain Enhancement Is Wrong, Right?” The New York Times. 9 Mar 2008. Electronic.Gattaca. Dir. Andrew Niccol. Perf. Ethan Hawke, Uma Thurman, and Jude Law. Columbia Pictures, 1997. DVD.Gazzaniga, Michael S. The Ethical Brain. New York: Dana Press, 2005. Print.Limitless. Dir. Neil Burger. Perf. Bradley Cooper, Anna Friel Robert DeNiro, and Abbie Cornish. Relativity Media, 2011. DVD.Raine, Adrian. “’Biological key’ to unlocking crime.” BBC News. 21 Dec 2004. Electronic.Silver, Lee M. Remaking Eden. New York: Avon Books, 1997. Print.Singer, Emily. “Sending Genes into the Brain: More-invasive therapies show promise for treating Parkinson’s.” Technology Review: Massachusetts Institute of Technology. 20 May 2009. Electronic.