The Myths, Realities, and Ethics of Neuroenhancement

When it comes to neuroenhancement (using drugs to improve your brain), the ethics are about as fuzzy as some of the science. A new initiative by the European Commission called the Neuroenhancement Responsible Research and Innovation project aims to get scientists and the public talking together to sort out the facts—and, more importantly, the feelings—about these emerging technologies.

This Monday, at the unlikely venue of a bar in east London, the first of those conversations got going during a panel discussion dubbed Brain Boosters. Speakers included neuroscientist Molly Crocket, neurotechnologist Aldo Faisal, and perhaps most notably neuropsychopharmacologist and controversial former UK government chief drug adviser David Nutt.

For the unititiated, neuroenhancement is the idea that if we can use neuroscience therapies to treat impaired patients, we can also use it to enable healthy humans to do things better somehow. Besides the alleged cramming qualities of the usual pills littering university libraries, claims range from being able to make you smarter, faster, more charming—and even more moral. From drugs to headsets to far more ambiguous “neuro drinks,” the American Psychological Association estimates that neuroenhancement is now a billion dollar industry.

But how much of this is capitalist-inflated sci-fi, how much of it is a reality, and how much is there to worry about? The Brain Boosters event was as much about setting the record straight about the state of the technology as it was about testing the waters to see how the audience—“enhanced” by their drinks in hand—felt about the ethical considerations about the course the research might take in the future.

Safe to say, the crowd was pretty enthusiastic.

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Enter the professors to offer their expert opinion on the drugs, hormones, and gadgets currently thought to boost brain function. Crockett started off her talk about the search for a “morality pill” with a takedown of the most-cited culprit, oxytocin—aka the “moral molecule.” In addition to being closely linked to increased levels of trust and intimacy, Crockett pointed out that oxytocin is also associated with greater incidence of envy, gloating, and in-group bias.

“Thus, you could also call it an ‘immoral molecule,’” Crockett said, arguing that, like many other molecules in the neuroenhancement debate, once oxytocin gets into the brain its effects are all over the place and hard to measure.

While the neurotransmitter serotonin has been shown to be potentially involved in moral decision-making, its effects are also little understood. Add that to the fact that morality itself is an incredibly hard concept to pinpoint, and the pretty obvious conclusion was that a “morality pill” is, at best, a far-off fantasy.

Unlike messy hormones, however, Nutt brought some more specifically-acting pharmacological agents to the table. Modafinil, a stimulant used to treat narcolepsy, is also well known for its off-label use promoting wakefulness. Nutt keeps some in his car’s dashboard for late night drives, and advises you to do the same (though you legally need a prescription to get it).

Another class of drugs called alpha 5 inverse agonists are implicated in memory. Tested against placebos with participants who, in a laboratory setting, had gotten “fairly drunk,” the drug enabled participants who took it to remember more than their placebo-consuming peers.

Other drugs fared less well in Nutt's assessment. As an example, he said acetylcholine-esterase inhibitors used to treat Alzheimer’s and thought by some to play a potential role in enhancing memory, “mostly just give you diarrhea.”

In the Q&A session that followed, the panel agreed that most media attention to date has blown both the technology’s capabilities and its risks out of proportion.

But what about ethics? According to Nutt, even the most common ethical argument about neuroenhancement giving people an unfair advantage is irrelevant. For him, the most important issues with the ethics of neuroenhancement concern situations where a user's consent may be fuzzy, such as patients with Down’s Syndrome or soldiers in the military.

But students popping modafinil before an exam are more likely to have a panic attack than outperform their peers, he argued. “The only drug that’s helped anyone win the Nobel Prize is LSD,” he said, referring to famed laureate Kary Mullis, who has spoken about LSD's role in his invention of PCR in DNA sequencing. Then there's the fact that, ethical or not, they're probably going to do it anyway. “My patients all tell me if you’re not going to prescribe it, I’ll just order it online,” he said.

That's unsurprising coming from Nutt, who has often been known to speak out on the issue of drug regulation. He finished with his usual appeals for openness: “Criminalizing people for drug use is like fighting for peace—it’s an oxymoron.”

The audience, a couple pints deep, burst into applause.