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Over recent blogs I’ve been rehearsing some thoughts about what I call neurological reflexivity. The idea being that instead of a world in which what matters is what we think increasingly we are engaging with the question of how we think.

So it was timely to wake up this morning to hear on the Today programme about the report of the Academy of Medical Sciences’ report on Brain science, addition, and drugs. Following on from the Government Foresight project, Drugs Futures 20205, this commission was set up to investigate the societal, health safety and environmental issues raised by the Foresight report. It analyzes the scientific and ethical issues of drug development, use and abuse.

While there are some interesting findings about drug misuse and treatment, which are gratifyingly in line with the RSA Drugs Commission, what interests me here are the implications, both scientific and ethical, of using cognitive enhancement drugs on otherwise healthy individuals.

What the report argues is that because cognitive enhancement drugs are developed for use on unhealthy individuals (victims of stroke, Alzheimer’s or other degenerative neurological conditions) not enough is known about the long term side on healthy brains.

They argue that further research into this is necessary, particularly as the current drugs are increasingly available on the grey-market, and could be misused, for example, by students seeking to enhance exam results. Playing with brain chemistry must be an exact science given the scope for unpredictable and long term side effects.

There are major ethical implications of cognitive enhancement. John Harris, who spoke here last year,and others have powerfully attacked the superstition that we shouldn’t ‘unnaturally’ enhance our physical capacity. What he argues is the categorical difference between eye glasses and brain supplements? The more pressing dilemmas concerns equality of access and ‘devaluing unaided achievement’.

People who can afford to pay for their daily dose of cognitive enhancers will have an extra unfair advantage over those who cannot. These will probably tend to be the same people who already benefited from the environmental factors that seem to most enhance IQ.

The point about unaided achievement is that we have a strong – albeit complex and tacit – belief that achievement should result form the combination of talent and effort (we are also, according to opinion polls, happy to recognise the role that luck can play). But if performance in education, athletics, perhaps one day relationships, is dependent less on ability and effort than on access to drugs or on the interaction of these drugs with our personal physiology then, notwithstanding equity issues, this seems to challenge our most basic assumptions about human endeavour and status.

These are deep waters. They require a discourse that brings together scientists, social scientists, philosophers and policy makers. The public needs to understand and engage  with dilemmas that have quickly moved from science fiction to pharmaceutical reality. And these are some of the key purposes of the RSA cognition project that we will be launching in a few weeks.


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