Adderall for All: A Defense of Pediatric Neuroenhancement

The ubiquity of the fallacy of composition in cognitive enhancement and in education

Research into cognitive enhancement is highly controversial, and arguments for and against it have failed to identify the logical fallacy underlying this debate: the fallacy of composition. The fallacy of composition is a lesser-known fallacy of ambiguity, but it has been explored and applied extensively to other fields, including economics. The fallacy of composition, which occurs when the characteristics of the parts of the whole are incorrectly extended to apply to the whole itself, and the conclusion is false, should be addressed in the debate on cognitive enhancement and within education. Within cognitive enhancement, the premise that individual distinct cognitive processes can be enhanced by cognitive enhancers leads to the conclusion that they must enhance cognition overall, and this idea is pervasive in the literature. If the goal of cognitive enhancement is to enhance cognition or learning, and not merely individual cognitive processes, then this is a clear example of the fallacy of composition. The ambiguity of "cognitive," "cognition," and "enhancement" only perpetuates this fallacy and creates more confusion surrounding the purposes and goals of enhancement. Identifying this fallacy does not threaten the existing body of research; however, it provides a novel framework to explore new avenues for research, education, and enhancement, particularly through education reform initiatives. Education enhances and facilitates learning, and improvements to education could be considered cognitive enhancements. Furthermore, the same fallacy is ubiquitous in education; educators commit it by "teaching to the test" and prioritizing memorization over generalizable skills such as critical thinking and problem solving. We will explore these new avenues for research and highlight principles of learning success from other disciplines to create a clearer understanding of the means and ends of cognitive enhancement. Recognizing the pervasiveness of composition fallacy in cognitive enhancement and education will lead to greater clarity of normative positions and insights into student learning that steer away from fallacious reasoning.

Is Visiting the Pharmacy Like Voting at the Poll? Behavioral Asymmetry in Pharmaceutical Freedom

Jessica Flanigan argues that individuals have the right to self-medicate. Flanigan presents two arguments in defense of this right. The first she calls the epistemic argument and the second she calls the rights-based argument. I argue that the right to self-medicate hangs and falls on the rights-based argument. This is because for the epistemic argument to be sound agents must be assumed to be epistemically competent. But, Flanigan's argument for a constitutionally mandated right to self-medicate models agents as epistemically incompetent. For Flanigan, agents are different at the pharmacy than they are at the polls. I identify this behavioral asymmetry and advocate a symmetric and realistic behavioral postulate for both arguments. The result, however, is that the success of the epistemic argument becomes contingent which fails to justify a constitutionally mandated right. I proceed to raise skepticism about the rights-based argument as well. I conclude that there is reason to be skeptical that these arguments can justify a constitutionally mandated right to self-medicate. Ultimately, a bottom-up approach to pharmaceutical ethics is preferable.

Parents’ Perceptions on the Debated Parenting Practice of Cognitive Enhancement in Healthy Children and Adolescents

First evidence shows that some parents engage in the health-endangering practice of (mis-)using prescription drugs to boost their children’s school performance. But little is known about parental perspectives on this phenomenon. This study aims to better understand parents’ perspectives on the non-medical use of prescription drugs to improve healthy children’s cognitive functioning. We conducted twelve semi-structured face-to-face interviews with a diverse sample of parents in Germany, and applied qualitative content analysis to explore their perspectives on instrumentalizing prescription drugs for improving the performance of healthy children, including their underlying knowledge (gaps), moral evaluations, evaluations of accompanied risks and benefits, opinions on potential motivators, and wishes regarding policy-making. The results show that parents typically believed themselves knowledgeable about such prescription drug (mis-)use, although they were not aware of anyone in their social environment taking them for enhancement. Parents generally considered such behavior to be morally reprehensible, cheating, and similar to doping in sports, and they typically claimed that no situation or occasion could motivate them to administer prescription drugs to their healthy children. Health risks (including side effects or addiction) were a typical expectation of drug use. That doctors should give such drugs to healthy young people was seen as unjustifiable. The results suggest that morality and risk–benefit evaluations of parents play a major role in their decision-making concerning this potentially risky instrumentalization of non-medical drugs. These insights are of distinct importance, especially for future research and further discussions on this topic, such as an evidence-based public dialog and ethics debates.

Transcranial Electrical Stimulation to Enhance Cognitive Performance of Healthy Minors: A Complex Governance Challenge

An increasing number of healthy adolescents are consuming products that can enhance their cognitive performance in educational settings. Currently, the use of pharmaceuticals is the most widely discussed enhancement method in the literature, but new evidence suggests that other methods based on Transcranial Electrical Stimulation (tES) also have potential as cognitive enhancer. Just like pharmaceutical enhancers, the availability and education-related use of tES-devices raise a broad range of ethical, legal, and societal issues that need to be addressed by policy-makers. Few studies, however, have specifically explored these issues in relation to child wellbeing. In this narrative review with systematic search, we describe the issues for child wellbeing that could arise from the availability and education-related use of tES-based enhancers by healthy minors. We demonstrate that the issues form a complex web of uncertainties and concerns, which are mainly incited by two factors. First is the high level of factual uncertainty due to gaps in empirical evidence about the exact working mechanisms and efficacy of tES. Moreover, a lack of insight into the technique’s (long-term) effects on healthy developing brains, and uncertainties about potential cognitive trade-offs have fueled concerns about the technique’s safety and impact. The second factor that contributes to the complexity of issues is the presence of moral diversity in our society. Different opinions exist on whether a certain enhancement effect would be desirable and whether potential risks would be acceptable. These opinions depend on one’s moral perspective, and the way one interprets and weights values such as the child’s autonomy and authenticity. The challenge for proper governance resides in the design of an appropriate framework that is capable of balancing the different moral perspectives in society, while recognizing the uncertainties that still exist. We therefore argue for a responsible innovation approach, which encourages an adaptive attitude toward emerging knowledge and dynamic societal values, to deal with the identified issues regarding tES-based enhancement appropriately.