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 

Cognition Enhancing Drugs

John Harris argues it would not be wrong to use cognition enhancing drugs such as Ritalin in order to obtain good grades in examinations (1). Prima facie it would appear the taking of such drugs, provided these drugs have no adverse side effects, would be an enhancement to the drug user as they appear to increase his cognitive abilities. It seems to me in practice the question as to whether it would be wrong to use cognition enhancing drugs in the context of examinations is not as straightforward as Harris believes. Let it be accepted that the use of cognition enhancing drugs to enhance someone’s cognition will allow him to obtain a better grade in an examination. I now want to question whether such an enhancement should be permissible.

Let it be accepted that an enhancement should not be permissible if it denies to others the goods they are rightfully entitled to. Does the fact that some candidate might improve his grade in an examination by the use of cognition enhancing drugs, whilst others do not take these drugs, potentially deny these others some goods they are entitled to? In order to answer this question we must first consider the purpose of an examination. This purpose is not simply to assess someone’s ability to pass an examination. The purpose of an examination might be defined as an attempt to assess someone’s proficiency in some subject which depends on his cognitive abilities in much the same way as a driving test tests someone’s proficiency to drive a car. An examination might be defined as a test of someone’s knowledge and cognitive abilities. The above definition still needs some further refinement. In an examination the attempt to assess someone’s proficiency takes place at time T. However the purpose of this assessment is not simply to gauge a candidate’s proficiency at time T. The purpose of an examination might be defined as an attempt to assess someone’s proficiency over an ongoing period of time. Examinations would clearly be pointless if candidates immediately lost all proficiency in the subject examined after the examination. Consider two candidates A and B taking some examination. Let it be assumed A takes cognition enhancing drugs in an attempt to improve his grade whilst B doesn’t. Let it be further assumed A is successful in obtaining a better grade in the examination than B and as a result obtains a better position than B. Let it be still further assumed that A’s stops taking the cognitive enhancing drugs after the examination and that his proficiency drops to below that of B. Prima facie it appears B has been deprived of some good he is entitled to. It follows that the possibility of using of cognition enhancing drugs in examinations might deny candidates who do not take these drugs the goods they are entitled to.

The above conclusion seems to depend on two factors. Firstly A’s use of cognition enhancing drugs in the examination does not enhance his proficiency in the subject examined in an ongoing way. Secondly his use similarly fails to enhance his cognitive abilities. Both these factors seem plausible. Taking aspirin after all only relieves pain for a limited period. Moreover it also seems reasonable to assume if someone stops taking cognitive enhancing drugs his cognitive abilities fall. If his abilities did not fall then it might be questioned whether the drugs concerned were really cognitive enhancing.

However even if both of these factors are true it does not automatically mean A’s use of cognition enhancing drugs denies B some goods he might be entitled to in all circumstances. Firstly A might continue to take cognition enhancing drugs after passing the examination. In these circumstances the fact he took these drugs in order to do well in the examination does deprive B of any goods he is rightfully entitled to. Furthermore provided someone’s continuing taking of these drugs has no long term adverse effects it again seems plausible A will continue to do so. After all some people after all continue to take a daily aspirin in order to reduce the possibility of heart attacks and strokes. It would seem in these circumstances the use of cognition enhancing drugs becomes a genuine enhancement and not one limited to the context of passing examinations. Secondly the taking of cognition enhancing drugs for a short period leads to cognition enhancement in the long term. I find this possibility unlikely. It follows that the use of cognition enhancing drugs in examinations ought to be permissible provided one or both of the two following conditions holds.

1. The short term use of cognition enhancing drugs by a candidate in an examination either increases his proficiency in the subject examined or his cognitive abilities in an ongoing way.
2.  Any candidate using cognition enhancing drugs in an examination must continue to use these drugs.

It might be objected that in practice the first condition is unlikely to hold. I accept this objection. It is also possible to object to my second condition. My objector might argue that it would seem to be impossible to ascertain whether someone would continue taking cognitive enhancing drugs after his examination. If someone fails to continue taking these drugs then the results of the examination will provide an inaccurate assessment of someone’s proficiency over an ongoing period of time. My objector might then conclude if cognition enhancing drugs are permitted in examinations that the value of examinations is devalued. However I would suggest that subject to the condition that the use of a cognition enhancing drug has no adverse side effects, it seems probable that anyone who benefits from this drug would continue to take it. To stop doing something which benefits someone and which does him no harm would seem to be illogical. It follows the second condition listed above should normally hold. It further follows Harris is correct to argue it should be permissible for someone to use cognition enhancing drugs in an examination provided those drugs benefit the users if taken in the long term and doing them no harm.

1. John Harris, 2007, Enhancing Evolution, Princeton University Press