Moving Too Fast: Ethics of Enhancement Drugs
Psychopharmacology is defined as "the ability to achieve specific psychological changes by targeted neurochemical interventions" (3). While psychopharmacological drugs can be used to treat illness, their ability to improve neurological and psychological function in individuals who are considered normal is the subject of much of pharmaceutical research (3). In fact, neurocognitive enhancement is playing an increasingly large role in American society. Types of neurocognitive enhancement include Ritalin for elementary school children, and its off label use as a study aid in high school and college students (3). In the United States, supplements that claim to aid in memory and other areas for older individuals have become a large part of the culture (3). Drug companies are looking for ways to treat normal individuals who wish to increase their capacity for memory (3). Many pharmaceutical companies are looking to enhance memory function by developing aids that will erase unwanted memories and keep pleasant memories (3). The pharmaceutical industry is already developing drugs that have the purpose of blocking memories in normal individuals who have not experienced any type of severe trauma. Research is also being done to improve memory function in normal individuals (3). In individuals with ADHD, drugs that target the dopamine and noradrenaline neurotransmitter systems are effective in improving memory and task function; studies have shown that these capabilities can also be improved in healthy individuals through the same pathway (3). Studies have shown that normal individuals are able to perform tasks more accurately when taking these types of enhancement drugs when compared with a placebo (2).
"Lifestyle drugs" are also becoming more widespread and have similar effects to psychopharmacological drugs (4). The term lifestyle drugs is contested, but it can generally be defined as drugs that are used to satisfy a non-medical or non-health related goal (4). Examples of lifestyle medicines are Viagra, and medication to treat male pattern baldness (4). Lifestyle medicines also include medication to treat conditions that might be healed with changes in lifestyle (4). These include treatments for nicotine addiction, and alcoholism. Lifestyle medicines are not limited to pharmacological drugs, and can often times include recreational drugs (4).
The use of enhancement drugs in our everyday lives raises a number of ethical issues. In the case of lifestyle drugs, the lines between sick and healthy seemed to be blurred (4). Can an individual who self medicates in order to fix a minor cosmetic problem be considered a patient? Are these individuals, who consume lifestyle drugs actually suffering from an illness, or does the illness lie in the fact that they are trying to fill unfulfilled needs and desires with medication (4)? Is there a line to be drawn between an aspiration or need and an actual therapeutic and health related goal (4)? While these pharmacological drugs and lifestyle drugs may seem to have a quick fix solution, it seems as though they are causing a cultural revolution in America. Pharmaceutical companies have taken advantage of these unfulfilled needs and desires of the American public, and have found solutions for them (3). It seems that these types of medications can help with two types of issues; they can help to fix a normal "problem" such as aging or minor memory less; or they can help an individual to get out of a lifestyle choice problem such as drug and alcohol addiction (4). Does the fact that these "fix-all" drugs are available drive our thirsts and propensity towards addiction and obsession?
In the case of neurocognitive enhancement drugs, safety is an issue. It is unclear how these types of drugs will affect the brain in the long term. (3). Will individuals who use Ritalin now have unanticipated effects from the medication in the future (3)? It is difficult to assess long term effects of medication on those who are seemingly normal. The use of neurocognitive enhancers also provides undue pressure on the population (3). Individuals will feel pressure to increase their cognitive abilities in the classroom or at the workplace, which could in some cases cause some individuals to have an advantage over others (3). How would educators and employers evaluate individuals who have the ability to access those neurocognitive enhancers in relation to those who do not (3)? The pressure to perform at exceedingly high rates from a young age is increasing, and many are driven to use these types of drugs.
What is the solution? Outlawing these types of drugs is irrational, and takes away freedom of choice from individuals, but perhaps a cultural change is needed (3). While work ethic is an invaluable quality, it should be stressed that perfection is ideal. The increasing availability of these psychopharmalogical drugs and lifestyle drugs has psychological effects beyond their means; they compromise the perception of what a "healthy" and "normal" individual looks like, and takes away from the fact that human beings are imperfect (3). While self improvement is valuable, it should not dominate over the risk of safety and psychological well being. As each generation depends more and more on these psychopharmalogical and lifestyle drugs, it sends the message to the next generation that any imperfection can be fixed, and almost fuels the false image of human immortality (1). In some ways these drugs may fuel the mentality that immaturity is desirable and can be extended for as long the drug supply exists (1). Rather than seeing wisdom gained in old age as a desirable quality, we will forever be seeking the fountain of youth (1).
1. "Beyond Therapy: Biotechnology and the Pursuit of Happiness". President's Council on Bioethics. Bethesda, Maryland, Oct. 2003. www.bioethics.gov
2. D. Gilbert et al., Lifestyle medicines. Br. Med. J. 321 (2000), pp. 1341-1344
3. Farah, M. J., Illes, J., Cook-Deegan, R., Gardner, H., Kandel, E., King, P., Parens, E., Sahakian, B. J., and Wolpe, P. R. (2004). Neurocognitive enhancement: What can we do? What should we do? Nature Reviews Neuroscience, 5: 421-425.
4. Flower, R. (2004). Lifestyle drugs: pharmacology and the social agenda. Trends in Pharmacological Sciences, 25:182-185.