Depending on what news sources you follow, you may have heard a lot about it already: taking cognition-enhancing drugs to improve normal brain function. An editorial in Nature has just come out in favor of it, so although I wrote about this back in April, it’s time to talk over the issue again.
Let's define what we're talking about first. We really don’t have anything to selectively affect memory or general intelligence per se, but we do know something about how to affect attention span and wakefulness. So right now, cognition enhancement is mostly going to be found via the stimulants used for attention-deficit disorders, along with Cephalon’s Provigil (modafinil) for narcolepsy. These are the drugs of issue.
Nature started off this latest debate on this a few months ago, when they took an informal survey to see how many scientists used these. The results came in as “more than you might think”, although still a decided minority. One got the impression that these were reached for during grant-writing time in academia, for the most part, which would make their usage pattern similar to what you’d find among the student population. My guess is that the number of people using these in industrial research would be far smaller, for several reasons. For one thing, our work moves in different rhythms. As opposed to academia, we rarely have situations where a Big Creative Work has to be produced (or a huge pile of facts memorized) under time pressure. We do have big reports and presentations that come due, of course, but by the time the big ones are due there have been a lot of smaller ones, and the slides and material are largely summaries of those. It’s not to say that many of us couldn’t benefit from some extra attention to our work, it’s just that the opportunities for such aid aren’t as clear-cut.
Any discussion of this topic has to start with the question of how much good such drugs do. I’m willing to stipulate that for situations like the ones I’ve been describing – a need for long, sustained periods of focus and attention to detail – that these compounds do indeed help. They may be more beneficial for some people than for others, but yes, I think that their effect is real. (If anyone has evidence to the contrary, I’d be glad to hear it – I should also mention that I have no personal experience to draw on).
And that brings up another question, the second big one that always comes up in such a discussion: is it right to do this sort of thing? Now that’s a tangle, because a value judgment has come into the room. And anyone who wants to take a hard line has to deal with the fact that we already have a legal, well-known, widely used drug for cognitive enhancement: caffeine. If that doesn’t increase wakefulness, I’d like to know what does.
The comparison with steroid use in sports will also come up, although I regard that one as partially a red herring. The whole point of athletic competition is different from the point of achievement in the arts and sciences. All sports are essentially artificial constructs that we agree on rules for, and doping makes people worried and/or furious that these rules are being bent. Science, on the other hand, is the real world. If Barry Bonds did indeed break home run records with chemical aid – personally, I think he did – then a lot of people (including me) have a problem with that. But if someone comes up with, say, a proof of the Riemann Hypothesis with the use of modafinil and methylphenidate, well. . .a proof is a proof.
But there is a competitive aspect that the sports analogy does bear on: several junior faculty may all be vying for tenure at the same time, for example. If they’re all roughly equal in ability, does the appointment end up going to the one who uses pharmacological help most effectively? That’s where the same uneasy feeling starts to set in. It’s when you look at head-to-head, human-to-human cases that the arguing really gets going.
We’re going to have more and more of this to deal with in the future. I don’t expect it any time soon, but we’ll eventually be able to do more for memory – and, for all I know, for higher cognition. There are too many therapeutic reasons to investigate such things, and too many reasons for any useful drugs not to quickly escape to the population that doesn’t necessarily have anything wrong with it.
All of these issues are addressed by the authors of the latest Nature commentary, naturally. For example:
"Consider an examination that only a certain percentage can pass. It would seem unfair to allow some, but not all, students to use cognitive enhancements, akin to allowing some students taking a maths test to use a calculator while others must go without. (Mitigating such unfairness may raise issues of indirect coercion, as discussed above.) Of course, in some ways, this kind of unfairness already exists. Differences in education, including private tutoring, preparatory courses and other enriching experiences give some students an advantage over others.
Whether the cognitive enhancement is substantially unfair may depend on its availability, and on the nature of its effects. Does it actually improve learning or does it just temporarily boost exam performance? In the latter case it would prevent a valid measure of the competency of the examinee and would therefore be unfair. But if it were to enhance long-term learning, we may be more willing to accept enhancement. After all, unlike athletic competitions, in many cases cognitive enhancements are not zero-sum games. Cognitive enhancement, unlike enhancement for sports competitions, could lead to substantive improvements in the world."
The editorial comes down to several main points: that we need more solid data on the benefits and risks of such drugs for normal individuals, that competent adults should have to option to use them, and that policies should be worked out to deal with issues of fairness, coercion, and the like.
My own thoughts on this are deeply confused and divided. That’s partly because I’m a weirdo: I don’t drink alcohol, and in fact, I don’t even drink coffee. That goes back to what I’d have to classify as a deep reluctance to mess with the way my brain works through chemical means, a trait that was already well in place by the time I was a teenager, but which was only reinforced as I learned more and more biochemistry. So on one level, I have to think that we really don’t know enough about how the existing cognitive enhancing drugs work, let alone what we’ll know about future ones, and that alone would keep me away from them.
But I can come up with plenty of thought experiments that shake me up: imagine that the risks are better known, and that they're as much as, say, caffeine (but with more benefits). What then? What if such things turn out, many years in the future, to be necessary to work at any reasonably high level in science, since everyone else will be taking them, too? Is part of my problem with drugs that alter brain function a streak of Puritanism - would I feel better about using such things if I knew that they were guaranteed not to be enjoyable? And so on. . .I have to confess, I found such issues a lot easier to deal with inside the confines of old science fiction stories.