More recently, the characters in "The Matrix" film series are shown
"downloading" knowledge into their brains nearly instantaneously. In
"Eternal Sunshine of the Spotless Mind" the lead character has the
uncomfortable memories of a love affair removed from his mind, with
unexpected results.
What used to be confined to speculative fiction is fast becoming
scientific fact. Brain boosting, or "neural enhancement," is already
being done - and much more powerful techniques are on the way. Some
observers say we're rushing into this brain-gain revolution without
sufficient thought or preparation.
"We're about to be handed a bunch of powerful new capabilities ...
to refashion ourselves, improve ourselves," notes Martha Farah, a
director of the Center for Cognitive Neuroscience at the University of
Pennsylvania, in an e-mail. "We should always think through the
ethical consequences of changing ourselves and our lives, for the
individual and for society."
While some may worry that we'll turn ourselves into a race of
Frankensteins, others look forward to new Einsteins. Optimists argue
that humans are only doing what they've always been doing: trying to
improve themselves, whether it's taking caffeine to stay alert or
undergoing cosmetic surgery to change their appearance.
The brain-enhancement revolution is already under way. The drug
Ritalin, first given to control hyperactivity in children, now is
routinely used by healthy high school and college students to sharpen
their thinking before taking exams. The long-term health effects are
unknown.
Modafinil was developed to treat narcolepsy, a rare condition
causing daytime sleepiness. But now it is used by those who simply
want to be wakeful and alert, and recently seven American track and
field athletes admitted to using it to boost their mental preparation.
Transcranial magnetic stimulation, used for nearly two decades to
treat depression, has also been found to enhance problem-solving
abilities in normal individuals.
Improved brain imaging, or mapping, is yielding new techniques such
as "brain fingerprinting," which purports to be able to locate
memories within the brain, raising troubling possibilities for
invasion of privacy. "There's nothing more private and personal than a
person's memories," says Richard Glen Boire, codirector of the Center
for Cognitive Liberty and Ethics in Davis, Calif.
Brave new ethics
Some scientists see a new field emerging they call "neuroethics,"
which would try to identify where the ethical land mines are buried
and how to deal with them. These judgment calls will be vital because
the revolution in the neurosciences "is just as important as the
genetic revolution, but no one is paying attention," says Arthur
Caplan, director of the Center for Bioethics at the University of
Pennsylvania.
As in the case of Ritalin, most of the current techniques for
enhancing mental abilities come from efforts to treat diseases. In the
2002 book "Our Posthuman Future: Consequences of the Biotechnology
Revolution," influential thinker Francis Fukuyama called for
governmental regulation of using such technologies for neural
enhancement.
But even others with ethical concerns say drawing such a "bright
line" between the use of a drug or other technology for therapy or for
enhancement is problematic.
Pharmaceutical companies are going to want to produce and market
drugs that appeal to 100 percent of the population, not just the
minority who are sick at any given time, Mr. Boire points out. After
all, many people would like a better memory, to be able to think a
little more quickly, or to forget troubling memories.
Yet a number of issues of personal liberty are being raised, he
says. "What rights does the person have to manage their own thought
processes?" Boire asks. "Thought is not just something that is changed
by reading a book or hearing a speaker. Now, and more and more, as
time goes on, thought will be changed by pharmacological agents."
How will we be able to say yes to therapy but no to enhancement?
Professor Caplan asks. He balks at the idea of telling someone "you
can take a pill if you have dyslexia, but you can't take a pill if
you're just a poor reader. It's very tough. It won't work."
Others see no need for making an ethical distinction between
therapy and enhancement. "There's better and worse. More life is good.
More smarts is good," says James Hughes, who teaches health policy at
Trinity College in Hartford, Conn., and is author of the forthcoming
book "Citizen Cyborg: Why Democratic Societies Must Respond to the
Redesigned Human of the Future."
"Sometimes I think I'm arguing for the plow" - a simple dramatic
upgrade in human technology, Professor Hughes says. In 100 years, he
predicts, "we'll have currently unimaginable cognitive abilities on
tap" through technology.
Playing it safe
Those who caution about a rush toward neural enhancement - such as
Professor Fukuyama; Bill McKibben, author of "Enough: Staying Human in
an Engineered Age"; and Leon Kass, the head of the President's Council
on Bioethics - are, in Hughes's assessment, "bio-Luddites," dragging
their heels against inevitable technological progress.
But in a recent National Science Foundation-sponsored report
entitled "Neurocognitive enhancement: What can we do and what should
we do?," a group of scientists, educators, and ethicists concluded
that "continuing our current laissez- faire approach [toward brain
boosting] risks running afoul of public opinion, drug laws, and
physicians' codes of ethics. The question is therefore not whether we
need policies governing neurocognitive enhancement, but rather what
kind of policies we need."
The report identifies a number of areas of concern, including
safety, fairness and equity, coercion, and "personhood and intangible
values" - and concentrates on the questions surrounding enhancement
drugs, stressing that they are leading the way in the field of
neuroscience.
Safety considerations should include "both the conventional medical
effects and the more subtle psychological effects that are likely to
accompany neurocognitive enhancement," says Dr. Farah, an author of
the study. "For example, will attentional enhancement become routine
and will we use it to become an even more workaholic society than we
are now?"
While patients might be willing to undertake some risk to use a
drug to treat a disease, enhancement drugs should meet a higher
threshold for safety, says Judy Illes, a senior research scholar in
biomedical ethics at Stanford University and the study's other author.
Might Ritalin use, for example, cause a loss of mental capacity in
old age? Our worry about possible hidden costs to brain boosting is
part "of our mistrust of unearned rewards," the sense that we may be
making a Faustian bargain, the study says.
Even enhancement advocate Hughes agrees that safety remains
important. The Food and Drug Administration needs to certify drug
safety "and it needs to be independent of the biomedical industry in a
way that it hasn't been," he says.
Mapping the brain brings its own set of concerns, Caplan adds. He
foresees brain scans someday being used at airports to screen
passengers. Do you have to give informed consent to have someone look
at your brain? he asks. What if it can be done at a distance without
your knowledge? And who's going to be allowed to keep information
about your brain?
Some kind of regulation will be needed. "You don't want people just
setting up machines on the sidewalk saying 'I'll tell you if your
spouse is cheating on you,'" Caplan says.
Defining identity
Perhaps most troubling - and most difficult to deal with from a
scientific basis - is the question of personhood. "Some people just
think messing with the brain is unnatural because the brain is the
seat of who we are," Caplan says. "To change it is to change our
identity."
"It's at the heart of what this new field of neuroethics is all
about," Dr. Illes says. That doesn't mean we must forestall research
"because it's getting too close to our personhood," she says, "but
rather to empower research with critical ethical thinking."
The concept of a "self" does not make much sense in the framework
of neuroscience, "where you and I are just big networks of neurons
that can be changed by a drug or other procedure," Farah adds. On the
other hand, she says, "I feel I have a self, I feel that other brains
are persons, and even though this may be an illusion, it is part of my
understanding of life that I am not ready to dispense with, no matter
what neuroscience tells me!
"I think the most challenging ethical issues in neuroscience have
to do with reconciling these two views of human life."
