Christopher Ng explores the notion of ‘authenticity’ within the context of treatment of psychiatric illness.
Cognition is the ability to organize information. This seemingly simple task, in actual fact, is complex. It requires the successful integration of several complicated neurobiological mechanisms. The ability comprises of the acquisition (perception), selection (attention), representation (understanding), and retention of information (memory) for further use to guide subsequent behaviour in the form of reasoning or motor output . Interventions that alter any of these processes are forms of cognitive enhancement.
With an increasing understanding of the neural underpinnings of brain function, we are able to manipulate and alter the natural processes in the brain to alleviate and possibly cure disease or even enhance our abilities. Already, drugs with some ability to enhance our cognition are avail- able today. However, these drugs are developed and approved for diseases like Attention Deficit Hyperactivity Disorder (ADHD), Alzheimer’s disease, and narcolepsy to name a few, under the existing, and rather traditional medical framework that aims to prevent, detect, and cure diseases, leaving no room for enhancement medicine. Pharmaceutical companies and research groups find it difficult or almost impossible to secure funding to study and develop potential cognitive enhancers. As a result, only data on therapeutic use and their effects are readily documented in comparison to the paucity of data on the enhancing effects of these compounds.
In 2008, an informal survey conducted by Nature reported that 69% of its 1400 respondents expressed interest in taking cognitive enhancers only if the side effects were minimal . 20% of the respondents self-reported having taken one or more cognitive enhancers for non-medical reasons: 62% of which reported methylpheni- date use, 44% reported modafinil use, and 15% reported beta-blocker use. Though these figures are from a select audience of the general public, the significance of these figures is two- fold. Firstly, the fact that a fifth of the respondents have already taken cog- nitive enhancers suggests that substantial enthusi- asm is present. Secondly and more importantly, it revealed that not every- one would take the drugs even if side effects were minimal. Why would individuals object to this opportunity? Even if no side effects existed, people would still opt to believe that disastrous consequences await the user, emphasizing the ingrained understanding that enhancing human capabilities does not come without a price . Other objections to using drugs may result from issues like fairness, coercion and autonomy to name a few . As unconventional methods for cognitive enhance- ment like pharmacologi- cal cognitive enhancers are still novel (compared to more conventional methods like schooling), the aforementioned is- sues need to be discussed thoroughly to ensure that future enhancement technologies are used ethically and responsibly. Though fairness and safety are important considerations, one of the primary objections for widespread use of enhancement technologies is that they may threaten our authenticity .
Authenticity refers to self-controlled consistency. It is the attempt to live one’s life according to the needs of one’s inner being without the input of societal demands or early conditioning; or simply put, doing things in one’s own way . Pharmacological cognitive enhancement may compromise one’s authenticity by producing alien states of mind, resulting in altered methods of completing tasks presented to individuals. An altered state of mind is not the only factor that can compromise authenticity. Another factor naturally comes to mind when one considers the education system. It requires work to merit achievement, suggesting that human effort is also a factor when consider- ing the authentic nature of one’s accomplishments.
Interventions aimed at processes in the brain may have the potential to alter our authentic states of mind, creating states of mind that may be alien to the people taking them [7,8]. An authentic state comprises of a higher order reflective capacity that controls which motivational state determines our actions [9-11]. Altering processes of critical reflection will distort the higher order reflective capacity and our subsequent actions. However, cognitive enhancers may not necessarily produce inauthentic states. Glannon reasons that the drugs are simply the means that the individual, the true agent of change, utilises to produce a change in mental states . As long as the individual retains the capacity to critically reflect on the reasons to take PCEs and voluntarily act on these reasons, it might not create inauthentic states. Even after taking drugs, one might remain the same person. However, the authentic nature of an individual’s state of mind after taking cognitive enhancers ultimately rests on how substantial the changes are effected on the individual.
Hard work and effort is another key component when considering the authentic nature of accomplishments. This refers to the aforementioned distinction between unconventional and conventional means of enhancement. Until recently, improving one’s cognitive ability primarily rests on the discipline and effort an individual devotes into perfecting their abilities. Drugs with the ability to increase attention and memory by altering processes in the brain quickly and efficiently may similarly improve one’s cognitive abilities without spending so much time and energy that could be otherwise spent doing different things. However, the attainment of those achievements via these methods seems to be ‘cheating’ or ‘cheap’ . There is an ingrained belief that people should work hard for their achievements as people admire those who overcome obstacles and try to achieve excellence. This is a matter of character that cannot be built by drug use.
The implications that widespread use of pharmacological cognitive enhancers will have on society are profound. Cognitive enhancers will play an especially salient role in education and employment. Use at school and work may provide unparalleled competitive advantage over those without drug use. With rising awareness of pharmacological cognitive enhancers, increasing numbers of people will be consider- ing them as an option to improve their cognitive abilities. Further discourse is required to determine the legitimacy of the use of cognitive enhancers in a multitude of different settings, as well as other issues including coercion, fairness, and autonomy for the ethical and responsible use of cognitive enhancers.
Bostrom, N. (2008). Smart Policy: cognitive enhance- ment in the public interest. Reshaping the Human Condi- tion Exploring Human Enhancement.
Maher B. Poll results: look who’s doping. Nature 2008 Apr 10;452(7188):674-675.
Cahill, M. (2005). The ethical consequences of Modafinil use. Penn Bioeth J.
Greely, H., Sahakian, B., Harris, J., Kessler, R. C., Gazzaniga, M., Campbell, P., & Farah, M. J. (2008). Towards responsible use of cognitive-enhancing
drugs by the healthy Nature, 456(7223), 702–705. doi:10.1038/456702a
The President’s Council on Bioethics. 2003. Beyond therapy: Biotechnology and the pursuit of happiness. Washington DC: The President’s Council on Bioethics. Wood, A., Linley, P., & Maltby, J. (2008). The authentic personality: A theoretical and empirical conceptualization and the development of the Authenticity Scale Journal of Counseling Psychology, 55(3), 385-399.
Elliott, C. 2003. Better than well: American medicine meets the American dream. New York: Norton.
Parens, E. 2005. Authenticity and ambivalence: Toward understanding the enhancement debate. Hastings Center Report 353: 35–41. (May–June).
Frankfurt, H. 1989. The importance of what we care about. New York: Cambridge University Press. Frankfurt, H. 1992. The faintest passion. Proceedings and Addresses of the American Philosophical Association 6: 5– 16.
Mele, A. 1995. Autonomous agents: From self-control to autonomy. New York: Oxford University Press.
Glannon, W. (2008). Psychopharmacological enhance- ment. Neuroethics, 1(1), 45-54.
Kass, L. (2003). Beyond Therapy: Biotechnology and the Pursuit of Human Improvement. Available from: http:// bioethics.georgetown.edu/pcbe/background/kasspaper. html