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Hendriks S, Li X, Grady C, Kim SY. Public Views on Whether the Use of Pharmaceutical Neuroenhancements Should Be Allowed. Neurology 2024; 103:e209681. [PMID: 39042847 PMCID: PMC11271391 DOI: 10.1212/wnl.0000000000209681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 05/15/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Some individuals are using drugs to try to enhance cognitive and social-affective functioning and asking physicians for off-label prescriptions for neuroenhancement (e.g., stimulants). Several medical societies released guidance on prescribing neuroenhancers, some of which refer to potential societal effects of neuroenhancement (e.g., distributive justice), besides risks and benefits to users. Which institutions (e.g., medical societies, government, universities) should make decisions on allowing neuroenhancement and whether they should consider potential societal effects are unclear. We examined whether and how much support for allowing pharmaceutical neuroenhancers was influenced by the institution and potential individual and societal effects of neuroenhancers. METHODS We conducted a discrete-choice experiment using a constructed representative sample of the US adult public. Multinomial logit models were used to analyze the data. RESULTS Participants (n = 927) demographically resembled the US population. Risks of serious side effects (OR 0.20, CI 0.18-0.22) and a lack of benefits for users (OR 0.31, CI 0.26-0.38) had the largest negative effect on participants' support for allowing neuroenhancers. A risk of mild side effects had a moderate negative effect on participants' support for allowing neuroenhancers (OR 0.67, CI 0.62-0.74) and the prospect of more meaningful, long-lasting benefits for users a moderate positive effect (OR 1.74, CI 1.61-1.87). Positive or negative effects of neuroenhancers on the average well-being of people in society and on equality had moderate effects on participants' support for allowing neuroenhancers. For example, the odds of participants' support for allowing enhancers with a negative effect on societal well-being were around half (OR 0.45, CI 0.40-0.50) and the odds of allowing enhancers that worsen inequality were approximately 40% lower compared with enhancers without such effects (OR 0.62, CI 0.55-0.71). The odds of participants allowing neuroenhancers were slightly (10%) lower if enhancers reduced users' authenticity (OR 0.90, CI 0.84-0.97). The institution regulating neuroenhancers and neuroenhancers providing users with an unfair advantage did not affect participants' decisions. DISCUSSION When presented with both individual and societal considerations, the public seems to support medical societies and other institutions making policy decisions about neuroenhancers based on risks and benefits for users, as well as, but to a lesser extent, effects on equality and societal well-being.
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Affiliation(s)
- Saskia Hendriks
- From the Department of Bioethics (S.H., C.G., S.Y.K.), Clinical Center, National Institutes of Health; and Biostatistics and Clinical Epidemiology (X.L.), NIH Clinical Center, Bethesda, MD
| | - Xiaobai Li
- From the Department of Bioethics (S.H., C.G., S.Y.K.), Clinical Center, National Institutes of Health; and Biostatistics and Clinical Epidemiology (X.L.), NIH Clinical Center, Bethesda, MD
| | - Christine Grady
- From the Department of Bioethics (S.H., C.G., S.Y.K.), Clinical Center, National Institutes of Health; and Biostatistics and Clinical Epidemiology (X.L.), NIH Clinical Center, Bethesda, MD
| | - Scott Y Kim
- From the Department of Bioethics (S.H., C.G., S.Y.K.), Clinical Center, National Institutes of Health; and Biostatistics and Clinical Epidemiology (X.L.), NIH Clinical Center, Bethesda, MD
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Ishida S, Nishitsutsumi Y, Kashioka H, Taguchi T, Shineha R. A comparative review on neuroethical issues in neuroscientific and neuroethical journals. Front Neurosci 2023; 17:1160611. [PMID: 37781239 PMCID: PMC10536163 DOI: 10.3389/fnins.2023.1160611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
This study is a pilot literature review that compares the interest of neuroethicists and neuroscientists. It aims to determine whether there is a significant gap between the neuroethical issues addressed in philosophical neuroethics journals and neuroscience journals. We retrieved 614 articles from two specialist neuroethics journals (Neuroethics and AJOB Neuroscience) and 82 neuroethics-focused articles from three specialist neuroscience journals (Neuron, Nature Neuroscience, and Nature Reviews Neuroscience). We classified these articles in light of the neuroethical issue in question before we compared the neuroethical issues addressed in philosophical neuroethics with those addressed by neuroscientists. A notable result is a parallelism between them as a general tendency. Neuroscientific articles cover most neuroethical issues discussed by philosophical ethicists and vice versa. Subsequently, there are notable discrepancies between the two bodies of neuroethics literature. For instance, theoretical questions, such as the ethics of moral enhancement and the philosophical implications of neuroscientific findings on our conception of personhood, are more intensely discussed in philosophical-neuroethical articles. Conversely, neuroscientific articles tend to emphasize practical questions, such as how to successfully integrate ethical perspectives into scientific research projects and justifiable practices of animal-involving neuroscientific research. These observations will help us settle the common starting point of the attempt at "ethics integration" in emerging neuroscience, contributing to better governance design and neuroethical practice.
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Affiliation(s)
- Shu Ishida
- Graduate School of Life Sciences, Tohoku University, Sendai, Japan
| | - Yu Nishitsutsumi
- Center for Information and Neural Networks, National Institute of Information and Communications Technology, Suita, Japan
| | - Hideki Kashioka
- Center for Information and Neural Networks, National Institute of Information and Communications Technology, Suita, Japan
| | - Takahisa Taguchi
- Center for Information and Neural Networks, National Institute of Information and Communications Technology, Suita, Japan
| | - Ryuma Shineha
- Research Center on Ethical, Legal, and Social Issues, Osaka University, Suita, Japan
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What drives public attitudes towards moral bioenhancement and why it matters: an exploratory study. BMC Med Ethics 2021; 22:163. [PMID: 34886854 PMCID: PMC8656088 DOI: 10.1186/s12910-021-00732-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
The paper represents an empirical study of public attitudes towards moral bioenhancement. Moral bioenhancement implies the improvement of moral dispositions, i.e. an increase in the moral value of the actions or character of a moral agent. The views of bioethicists and scientists on this topic are present in the ongoing debate, but not the view of the public in general. In order to bridge the gap between the philosophical debate and the view of the public, we have examined attitudes towards moral bioenhancement. The participants were people from Serbia older than 15, who voluntarily completed an online questionnaire. The questionnaire consisted of a brief introduction to moral bioenhancement, seven general questions, 25 statements about participants’ attitudes towards moral bioenhancement, and five examples of moral dilemmas. The questionnaire also included questions which were used to reveal their preference of either deontology, or utilitarianism. Participants were asked to what degree they agree or disagree with the statements. The results showed that the means used to achieve moral enhancement, the level of education, and preference for deontology or utilitarianism do have an impact on public attitudes. Using exploratory factor analysis, we isolated four factors that appear to drive the respondents' attitudes toward moral bioenhancement, we named: general—closeness, fear of change, security, and voluntariness. Each factor in relationship to other variables offers new insights that can inform policies and give us a deeper understanding of the public attitudes. We argue that looking into different facets of attitudes towards moral bioenhancement improves the debate, and expands it.
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Revisiting Moral Bioenhancement and Autonomy. NEUROETHICS-NETH 2021. [DOI: 10.1007/s12152-021-09470-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Racine E, Sattler S, Boehlen W. Cognitive Enhancement: Unanswered Questions About Human Psychology and Social Behavior. SCIENCE AND ENGINEERING ETHICS 2021; 27:19. [PMID: 33759032 PMCID: PMC7987623 DOI: 10.1007/s11948-021-00294-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/10/2021] [Indexed: 05/23/2023]
Abstract
Stimulant drugs, transcranial magnetic stimulation, brain-computer interfaces, and even genetic modifications are all discussed as forms of potential cognitive enhancement. Cognitive enhancement can be conceived as a benefit-seeking strategy used by healthy individuals to enhance cognitive abilities such as learning, memory, attention, or vigilance. This phenomenon is hotly debated in the public, professional, and scientific literature. Many of the statements favoring cognitive enhancement (e.g., related to greater productivity and autonomy) or opposing it (e.g., related to health-risks and social expectations) rely on claims about human welfare and human flourishing. But with real-world evidence from the social and psychological sciences often missing to support (or invalidate) these claims, the debate about cognitive enhancement is stalled. In this paper, we describe a set of crucial debated questions about psychological and social aspects of cognitive enhancement (e.g., intrinsic motivation, well-being) and explain why they are of fundamental importance to address in the cognitive enhancement debate and in future research. We propose studies targeting social and psychological outcomes associated with cognitive enhancers (e.g., stigmatization, burnout, mental well-being, work motivation). We also voice a call for scientific evidence, inclusive of but not limited to biological health outcomes, to thoroughly assess the impact of enhancement. This evidence is needed to engage in empirically informed policymaking, as well as to promote the mental and physical health of users and non-users of enhancement.
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Affiliation(s)
- Eric Racine
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal (IRCM), 110, avenue des Pins Ouest, Montréal, QC, H2W 1R7, Canada.
- Department of Medicine and Department of Social and Preventive Medicine, Université de Montréal, 7101, Av du Parc, Montréal, QC, H3N 1X9, Canada.
- Departments of Neurology and Neurosurgery, Experimental Medicine, and Biomedical Ethics Unit, McGill University, 3801, University Street, Montréal, QC, H3A 1X1, Canada.
| | - Sebastian Sattler
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal (IRCM), 110, avenue des Pins Ouest, Montréal, QC, H2W 1R7, Canada.
- Department of Sociology, University of Cologne, Universitätsstrasse 24, 50931, Cologne, Germany.
| | - Wren Boehlen
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal (IRCM), 110, avenue des Pins Ouest, Montréal, QC, H2W 1R7, Canada
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Dave AA, Cabrera LY. Osteopathic Medical Students’ Attitudes Towards Different Modalities of Neuroenhancement: a Pilot Study. JOURNAL OF COGNITIVE ENHANCEMENT 2020. [DOI: 10.1007/s41465-020-00163-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bard I, Gaskell G, Allansdottir A, da Cunha RV, Eduard P, Hampel J, Hildt E, Hofmaier C, Kronberger N, Laursen S, Meijknecht A, Nordal S, Quintanilha A, Revuelta G, Saladié N, Sándor J, Santos JB, Seyringer S, Singh I, Somsen H, Toonders W, Torgersen H, Torre V, Varju M, Zwart H. Bottom Up Ethics - Neuroenhancement in Education and Employment. NEUROETHICS-NETH 2018; 11:309-322. [PMID: 30220937 PMCID: PMC6132847 DOI: 10.1007/s12152-018-9366-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 04/18/2018] [Indexed: 10/28/2022]
Abstract
Neuroenhancement involves the use of neurotechnologies to improve cognitive, affective or behavioural functioning, where these are not judged to be clinically impaired. Questions about enhancement have become one of the key topics of neuroethics over the past decade. The current study draws on in-depth public engagement activities in ten European countries giving a bottom-up perspective on the ethics and desirability of enhancement. This informed the design of an online contrastive vignette experiment that was administered to representative samples of 1000 respondents in the ten countries and the United States. The experiment investigated how the gender of the protagonist, his or her level of performance, the efficacy of the enhancer and the mode of enhancement affected support for neuroenhancement in both educational and employment contexts. Of these, higher efficacy and lower performance were found to increase willingness to support enhancement. A series of commonly articulated claims about the individual and societal dimensions of neuroenhancement were derived from the public engagement activities. Underlying these claims, multivariate analysis identified two social values. The Societal/Protective highlights counter normative consequences and opposes the use enhancers. The Individual/Proactionary highlights opportunities and supports use. For most respondents these values are not mutually exclusive. This suggests that for many neuroenhancement is viewed simultaneously as a source of both promise and concern.
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Affiliation(s)
- Imre Bard
- Department of Methodology, London School of Economics, London, UK
| | - George Gaskell
- Department of Methodology, London School of Economics, London, UK
| | | | | | - Peter Eduard
- Experimentarium, Science Communication Centre, Copenhagen, Denmark
| | - Juergen Hampel
- Center for Interdisciplinary Risk and Innovation Studies, Stuttgart University, Stuttgart, Germany
| | - Elisabeth Hildt
- Center for the Study of Ethics in the Professions, Illinois Institute of Technology, Chicago, IL USA
| | - Christian Hofmaier
- Center for Interdisciplinary Risk and Innovation Studies, Stuttgart University, Stuttgart, Germany
| | - Nicole Kronberger
- Department of Social and Economic Psychology, Johannes Kepler University, Linz, Austria
| | - Sheena Laursen
- Experimentarium, Science Communication Centre, Copenhagen, Denmark
| | - Anna Meijknecht
- Tilburg Institute for Law, Technology, and Society, Tilburg University, Tilburg, The Netherlands
| | - Salvör Nordal
- Centre for Ethics University of Iceland, Reykjavik, Iceland
| | | | - Gema Revuelta
- Centre on Science, Communication and Society Universitat Pompeu Fabra, Barcelona, Spain
| | - Núria Saladié
- Centre on Science, Communication and Society Universitat Pompeu Fabra, Barcelona, Spain
| | - Judit Sándor
- The Center for Ethics and Law in Biomedicine Central European University, Budapest, Hungary
| | | | - Simone Seyringer
- Department of Social and Economic Psychology, Johannes Kepler University, Linz, Austria
| | - Ilina Singh
- Department of Psychiatry and Oxford Uehiro Centre University of Oxford, Oxford, UK
| | - Han Somsen
- Tilburg Institute for Law, Technology, and Society, Tilburg University, Tilburg, The Netherlands
| | - Winnie Toonders
- Institute for Science, Innovation and Society, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Helge Torgersen
- Institute of Technology Assessment Austrian Academy of Sciences, Vienna, Austria
| | - Vincent Torre
- Centre for Neurobiology, International School for Advanced Studies, Trieste, Italy
| | - Márton Varju
- The Center for Ethics and Law in Biomedicine Central European University, Budapest, Hungary
| | - Hub Zwart
- Institute for Science, Innovation and Society, Radboud University Nijmegen, Nijmegen, The Netherlands
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