Ethics of neuroenhancement: A phantom debate

Abstract

psychiatrists, the practice of psychotherapy has been on a steady decline since at least the mid-1980s. For problems of living, we depend, as do more and more of our children, on prescription drugs. Our contemporary debates have suffered from insufficient historical perspective. These two fine books meet an important need. Schö ne-Seifert, Davinia Talbot, Uwe Opolka, and Johann S. Ach have delivered a collection of articles providing a cross-section of the ongoing debate over cognitive and mood enhancement in Germany. As a pharmacopsychologist working on the neurochemis-try of cognition and emotion, I have followed this debate for several years now and I have felt uneasy about it from the start. What follows might rather be a perspectival response to the presented volume than a classical book review. But considering the current proliferation of publications on the ethics of neu-roenhancement it seems about time to call into question some of the pharmacological and epidemio-logical presumptions on which this emergent body of literature – including the book at hand – is based. The volume Neuro-Enhancement was developed from papers presented at a 1-week conference organized by the editors at the Hanse-Wissenschafts-kolleg in Delmenhorst, Germany in 2005. All contributors are established experts in the field of medical ethics, but they come from different dis-ciplines such as philosophy, political science and medicine. The chapters are divided into four thematic sections. The first provides a conceptual framework distinguishing neuroenhancement of healthy subjects from the medical treatment of patients. Here, Saskia Nagel and Achim Stephan, for example, draw a normative map of conceivable enhancement options. And Joel Anderson discusses whether the use of imaginable future neuroprotheses providing music lovers with super hearing would be ethically legiti-mate. The second section illustrates the problems and chances of cognitive enhancement in particular. For instance, Sabine Mü ller poses the question whether, from idealist and utilitarian perspectives, respectively, the enhancement of intelligence would be morally obligatory – if it became possible. The third section reviews issues of emotional enhancement addressing the challenge posed by drugs such as Prozac to authenticity. And the final section discusses the ethical implications of neuroenhancement for society at large. As most of the preceding contributions, Bernward Gesang's consideration of the social risks and benefits of different kinds of enhancement or Petra Schaper-Rinkel's discussion of the political consequences of thinkable further developments of neuroimplants con-necting people in new ways presuppose that, as the editors put it, neuroenhancement 'will actually turn out to be efficient, agreeable and therefore, from an individual perspective, attractive'. From a pharmacological point of view, however, this presupposition is questionable. In my discussion, I will focus on what the book has to say about the enhancement of cognitive performance (although similar critiques could be developed with respect to emotional enhancement, biological and technical brain implants, and genetic manipulations). I will not engage with the ethical, social and political consequences of enhancement discussed by the authors (as one could usually expect from a book review) as I believe that already their pharmacologi-cal and epidemiological premises are unrealistic. Boris B. Quednow, is Assistant Professor of Experimental and Clinical Pharmacopsychology at the University Hospital of Psychiatry in Zurich. His main research interests are the neurotoxicology of illegal drug use as well as the neurochemistry of cognition and disturbed information processing in psychiatric diseases.