Commentary: Cognitive Enhancement: Are the Claims of Critics "Good Enough"?

Abstract

The motif of performance enhancement has played a long and important role in humanity`s cultural heritage. Aspiring to transcend what nature has endowed has been a prime motivator for many scientific achievements. At the same time, warnings about the dangers of hubris have inspired themes for artists, philosophers, and poets. As the public becomes more aware of how advancing technologies are expanding the repertoire of what is possible, issues surrounding performance enhancement will play an increasingly significant role in the clinical setting. As Dr. Cefalo faces the dilemma of whether or not to grant his patient’s request for pharmaceutical cognitive enhancers (PCEs), he must do so against the background of the physician’s duty to balance the benefits for his patient against possible harms. With that standard in mind, I suggest that Dr. Cefalo frame his deliberation by examining the main objections proffered against enhancing pharmaceuticals: (1) The drugs are unnatural, (2) use of the drugs is a form of cheating, 3) although it is not necessarily cheating, use of the drugs still place users at an unfair advantage over those who do not use them, and (4) the safety of the drugs is in question. In what follows, I argue against objections 1 and 2, and offer qualifications for 3 and 4.