Tariq Nelson

More to gain that competitive edge

Brain research is accelerating, and a new era of “cognitive enhancement” - the use of brain-stimulating drugs and devices by healthy people - is approaching, the authors said.

While thorny ethical and medical questions must be addressed, pharmaceutical enhancement of inborn mental gifts is a trend to be welcomed, the seven co-authors from Harvard, Stanford and other prestigious institutions said.

“We call for a presumption that mentally competent adults should be able to engage in cognitive enhancement using drugs,” said the writers, who include Stanford law Professor Henry Greely and neuropsychology Professor Barbara Sahakian at the University of Cambridge in the United Kingdom. “From assembly line workers to surgeons, many different kinds of employee may benefit from enhancement and want access to it, yet they may also need protection from the pressure to enhance.”

Sahakian and another co-author, Ronald Kessler of Harvard Medical School, are consultants for pharmaceutical companies. Nature noted no conflicts of interest for the other five authors, who include the publication’s editor in chief, Philip Campbell.

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Even now, some college students are trying to boost their academic performance by obtaining such drugs, researchers say. While studies indicate that some academics obtain stimulants through legal off-label prescriptions from doctors, others order them via the Internet or buy a few pills from friends - both of which are illegal.

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Greely, who has been tracking policy issues in neuroscience for six years, said the article is not a clarion call for widespread use of brain-boosting drugs, free of legal controls. Instead, the authors wanted to debunk arguments that drug enhancement is immoral per se, compared to other means of strengthening mental performance, such as a double espresso or an expensive tutor. “Society shouldn’t reject them just because they’re pharmaceutical enhancements,” he said in an interview.

The Nature paper could escalate a debate set off in December 2007 when Sahakian and a colleague, in another Nature piece, said that some scientific colleagues were using sleep disorder drugs to enhance their productivity and that student use of stimulants seemed to be on the rise. Nature followed up with more articles and a survey. That raised a renewed flurry of blog posts, news stories and sensational monikers for the phenomenon, such as “brain doping” and “brain steroids.”

Effects on healthy people

Greely said the moral repugnance that is often focused on steroid use in sports should not be grafted onto cognitive enhancement drugs. “Better-working brains produce things of more lasting value than longer home runs,” he said.

However, Greely and his co-authors acknowledged that drug safety is a paramount concern. Too little is known about the benefits and risks for healthy people taking medicines approved to treat mental impairments, they said. The authors called for more research so that doctors and patients can balance the gains and the harms. Risks that would be tolerated to treat a severe illness might be unacceptable for a healthy young person, the authors noted.

No new wave of high-efficacy cognitive enhancement drugs has yet emerged for healthy individuals, Greely said. But society needs to prepare itself for the intricate ethical issues that would accompany such advances, he said. Doctors, educators, labor experts, employers and legislators should be thinking about it, he and his co-authors said.

Could the competitive advantages already enjoyed by rich students be unfairly amplified by purchases of expensive new brain enhancers that are out of reach to their less wealthy peers? Such objections need not lead to a ban, the Nature authors said. Instead, they suggested, schools could give every exam taker free access to the drugs.

There are also some neurotechnology brain enhancers coming down the pike

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