Abstract
BackgroundThe use of medical stimulants to sustain attention, augment memory and enhance intellectual capacity is increasing in society. The use of Methylphenidate for cognitive enhancement is a subject that has received much attention in the literature and academic circles in recent times globally. Medical doctors and medical students appear to be equally involved in the off-label use of Methylphenidate. This presents a potential harm to society and the individual as the long-term side effect profile of this medication is unknown.DiscussionThe implication of the use of Methylphenidate by medical students and doctors has not been fully explored. This article considers the impact of this use on the traditional role of medicine, society, the patient and suggests a way forward. We discuss the salient philosophy surrounding the use of cognitive enhancement. We query whether there are cognitive benefits to the use of Methylphenidate in healthy students and doctors and whether these benefits would outweigh the risks in taking the medication. Could these benefits lead to tangible outcomes for society and could the off label-use of Methylphenidate potentially undermine the medical profession and the treatment of patients? If cognitive benefits are proven then doctors may be coerced explicitly or implicitly to use the drug which may undermine their autonomy. The increased appeal of cognitive enhancement challenges the traditional role of medicine in society, and calls into question the role of a virtuous life as a contributing factor for achievement. In countries with vast economic disparity such as South Africa an enhancement of personal utility that can be bought may lead to greater inequities.SummaryUnder the status quo the distribution of methylphenidate is unjust. Regulatory governmental policy must seek to remedy this while minimising the potential for competitive advantage for the enhanced. Public debate on the use of cognitive enhancement is long overdue and must be stimulated. The use of Methylphenidate for cognitive enhancement is philosophically defendable if long-term research can prove that the risks are negligible and the outcomes tangible.
Highlights
The use of medical stimulants to sustain attention, augment memory and enhance intellectual capacity is increasing in society
Regulatory governmental policy must seek to remedy this while minimising the potential for competitive advantage for the enhanced
The use of Methylphenidate for cognitive enhancement is philosophically defendable if long-term research can prove that the risks are negligible and the outcomes tangible
Summary
Methylphenidate: efficacy and adverse effects Systematic review has shown that the expected effects of methylphenidate exceed its actual effects, as demonstrated in single or double-blind randomised controlled trials [9]. Regulatory governmental policy must seek to remedy this while minimising the potential for competitive advantage for the enhanced This will be achieved by disincentivising citizens from their use; while discouraging their use by personal taxation, the requirement of the acquisition of a license; .additional medical insurance, the participation in a long-term cohort study on their use; and a further corporate tax to act against the potential for coercion A public debate on the use of cognitive enhancement is long overdue and must be stimulated by new analysis and research. The use of Methylphenidate for cognitive enhancement has been shown to be defensible from: a utilitarian perspective in terms of enhancing personal utility for the potential good of society; a deontological perspective through the principle of autonomy as an inviolable right; virtue ethics where the pursuit of a virtuous life is suggested to be more achievable with the addition of cognitive enhancement; a perspective of justice. She is a member of the following: the HIV Preventive Research Data Safety Monitoring Board (DSMB) in the Division of AIDS, National Institutes of Health (NIH), Washington DC, USA; the Scientific Review Committee, European and Developing Countries Clinical Trial Partnership (EDCTP), The Hague, Netherlands; the Board of Directors, South African Medical Research Council (MRC), Cape Town; SAGE Working Group on Immunisation in Humanitarian Crises, World Health Organisation (WHO), Geneva, Switzerland
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