Two Types of Pharmacological Cognitive Enhancement

It is suggested by Anders Sandberg that the use of cognitive enhancing drugs under medical supervision might achieve more overall learning and academic achievement and this is preferable to being driven into illicit use by bans, see practical ethics . In a previous posting I argued that the use of cognition enhancing drugs in examinations should be permissible subject to two conditions, see cognition enhancing drugs . In this posting I will firstly argue that there are two types of pharmacological enhancement. I will then consider such enhancement should be permissible, I will suggest that they should in some circumstances. Some of my conclusions might also apply to brain zapping, trans-crainial direct current stimulation, which might increase memory and as a result enhance cognition. I will not consider brain zapping directly.

Let us assume some drugs effectively enhances cognition. Any such drugs need to satisfy two further conditions for its use to be permissible.

1. Any cognition enhancing drugs must be safe to use without any major side effects. In certain circumstances some of these drug must be safe for long term use.
2. In certain circumstances the users of a cognition enhancing drugs must be prepared to continue using these drugs.

Commenting on Sandberg’s posting Dennis Tuchler worries about how long the effect of cognition enhancing drugs will last. He worries if cognition enhancers only work for a short time that their use will mislead employers and graduate schools about someone’s cognitive abilities. For instance let us assume someone gains a job in the diplomatic service due to her superb powers of concentration. Let us further assume that these powers are due to her taking cognitive enhancers. Lastly let us assume that once she gains this position she stops taking the enhancers and her powers of concentration fall away. In these circumstances someone else who failed to obtain the post due to the drug takers previous powers of concentration might feel he has been treated unjustly. Moreover the diplomatic service might be disappointed with the appointment. Whether Tuchler’s worries are justified depends on exactly what is involved with cognitive enhancement. Cognitive enhancement might occur in two ways. Firstly cognitive enhancement might be an ongoing process and secondly cognitive enhancement might be the end result of a process. It follows there are two types of cognitive enhancer. The first type of enhancers would result in an ongoing change in the user even after she has ceased to take the drug. Let us call such an enhancer type 1. An example of type 1 enhancer might be some drug which increases our ability to remember and what we remembered is retained even after we cease taking the enhancer. Type 1 enhancers might be likened to a scaffold round a building, the scaffolding supports the building during construction but once the building is finished there is no further need for the scaffolding and it can be removed. The second type of enhancers would require their ongoing use to be effective, let us call this type of enhancer type 2. An example of a type 2 enhancer might be some drug which helps our brains to concentrate. In the case of type 2 enhancer if use of the enhancer ceases the enhancement disappears, if the scaffolding is removed the building falls down.

Let us first consider the use of type 1 cognitive enhancers briefly. Let us assume that type 1 enhancers increase our power of memory. Sandberg believes memories enhanced by drugs will presumably endure regardless irrespective of whether the enhancer continues to be taken. Whether Sandberg’s belief is correct is open to experiment and cannot be answered by doing philosophy. However provided Sandberg’s belief is confirmed experimentally and a type 1 enhancer has no untoward side effects then philosophically there appears to be no reason why someone shouldn’t take such an enhancer. Indeed Nick Bostrom and Toby Ord’s reversal test seem to support this conclusion (1). According to this test if we accept that giving someone a drug to diminish her cognitive ability is wrong and we argue giving someone a drug to enhance her cognitive abilities is also wrong then we must be able to explain why enhancement is wrong or be accused of having a status quo bias. It appears to follow that provided a type 1 cognitive enhancer is safe that we have no reasons to prohibit the use of such an enhancer. Such a conclusion is premature and reasons might be found to support the status quo. If such an enhancer is prohibitively expensive and available only to a few due to cost then it might lead to social injustice. For instance if the use of cognition enhancing drugs was useful in the diplomatic service and these drugs were prohibitively expensive then people from disadvantaged backgrounds might be discriminated against in their attempts to join the service. The above conclusion might be amended as follows. If a type 1 cognitive enhancer is safe and not prohibitively expensive then we have no reasons to prohibit the use of such an enhancer.

Let us now examine the use of type 2 cognitive enhancers. If this type of enhancer is to be effective it must continue to be taken. Such an enhancer would affect one or more of our physiological processes and this affect would result in increased cognitive ability. Drugs that affect our physiological processes seem to require continuous use. For instance someone taking a drug to reduce his blood pressure must continue to do so. A drug which enhances someone’s ability to concentrate would be an example of a drug that has a temporary physiological affect which temporarily enhances her cognitive capabilities. It might be argued Bostrom and Ord’s reversal test gives us no reason to ban type 2 cognitive enhancers. However once again reasons might be found to support the status quo.

Perhaps the use of type 2 cognitive enhancers might mislead employers or universities about someone’s cognitive capabilities. For instance the examination grade obtained by a student taking a type 2 cognitive enhancer might not accurately reflect his cognitive abilities if he ceases taking the enhancer. However if he continues taking the enhancer then the examination should reflect his cognitive abilities in a similar way to how examinations reflect students abilities without the use of cognitive enhancers of any sort. It appears possible that the use of type 2 cognitive enhancers might be permissible subject to certain conditions. The first of these conditions is that the user of type 2 enhancers must continue taking the enhancer or else any supposed benefit will be illusory. The second condition is that the use of type 2 enhancers will not lead to social injustice.

I will deal with each of these conditions in turn. If we are to permit the use of type 2 cognitive enhancers we must be able to assure ourselves that users of these enhancers continue taking them. How might this be achieved? Let us consider this question in conjunction with safety. I will consider the question first in cases where the issue of safety is clear cut. If such an enhancer has major safety issues then its use should simply be prohibited. If such an enhancer is completely safe and the cost is reasonable then I would question if we need any such assurance. Someone with hypertension will take a safe drug to control his condition without a second thought because it benefits him and carries minimal risk. He has a reason to take the drug and no reason not to. It might be argued by analogy that much the same applies to someone taking completely safe cognitive enhancers. It seems safe to assume if someone has a reason to continue taking a cognitive enhancer and none not to that he will continue to do so. Unfortunately not all cases are so clear cut and most drugs have some side effects. In these circumstances Anders Sandberg suggestion that the use of cognitive enhancing drugs should only occur under medical supervision seems sensible. If the use of type 2 cognitive enhancers takes place under medical supervision then once again we have no reason to question their continued use. It appears to follow that provided type 2 cognitive enhancers are completely safe or only used under medical supervision that we have no reason to question their continued use.

I now want to consider whether the use of type 2 cognitive enhancers might lead to injustice? Someone opposed to cognitive enhancement might argue that the prohibitive cost of such enhancers might make them unavailable to some people leading to social injustice. I will consider this objection in two specific contexts, first jobs depending on good cognitive skill such as the diplomatic service and secondly in higher education. First let us consider type 2 cognitive enhancers in the context of jobs requiring high cognitive skills. It is in employers’ interests to provide employees with the tools to work efficiently. It seems probable that if type 2 enhancers increase efficiency in some contexts that in these contexts it is in the interests of employers to provide them for free. Of course some might not do so. If a significant number of employers do not provide type 2 cognitive enhancers for free when these enhancers have been proved to be safe and increase efficiency then some legislation might be necessary. A similar argument might be advanced with regard to higher education. Universities provide students with the tools to help them learn, libraries, lectures halls and lecturers. If type 2 cognitive enhancers are safe but too expensive for most students then provided they are a useful learning tool perhaps universities should supply them.

The above leads to some tentative conclusions which might need modifying in the light of experience. Firstly provided a type 1 cognitive enhancer is safe and not prohibitively expensive then we have no reasons to prohibit the use of such an enhancer. Secondly even if the cost of type 2 cognitive enhancers is high the use of such enhancers should be permissible in higher education and jobs requiring high cognitive skills. The permissibility of more widespread type 2 cognitive enhancers is dependent on the availability and price of these enhancers.

1. https://nickbostrom.com/ethics/statusquo.pdf