Give students drugs if they can’t afford them.

Last year an informal survey in Nature found that 20% of scientists used mind-enhancing drugs to cope with their work. The drugs of choice were not yesteryear’s nicotine or caffeine, but Ritalin and Adderall. More and more American college students are using these prescription drugs as well. According to one survey 7% of all students at some stage, and up to 25% on some campuses, have used them in the past year.

But despite the popularity of cognition-enhancing drugs, off-label use is illegal and viewed with suspicion. This is a mistake, say the editor of Nature, Philip Campbell, in a commentary, written in conjunction with several other prominent bioethicists and neuroscientists. "Safe and effective cognitive enhancers will benefit both the individual and society," they argue. Since people cannot be stopped from using enhancement drugs, society ought to regulate their use instead of banning them.

What are their main arguments? First, drugs (and brain stimulation and prosthetic brain chips, too) are essentially no different from traditional ways of improving intellectual performance such as education, good health habits, and information technology. They are "morally equivalent to other, more familiar, enhancements". While some bioethicists have expressed reservations, notably Leon Kass, in the President’s Council on Bioethics report, Beyond Therapy: Biotechnology and the Pursuit of Happiness, these have been "persuasively rejected" (albeit only by one of the authors, John Harris, the radical British utilitarian bioethicist).

They recognise that some ethical concerns exist: safety, freedom from coercion, and fairness. The last is the most difficult to deal with. If drugs cost money, won’t poor students be left in the dust academically? Not if "every exam-taker [is given] free access to cognitive enhancements, as some schools provide computers during exam week to all students. This would help level the playing field."

Four areas need to be dealt with to implement a drug-friendly society: research into the benefits of cognitive enhancement; guidelines by professional organisations; public education about their benefits; and relaxed legislation for safe drugs.

The article is sure to ignite the smouldering debate over drugs in education and work. One area which is already being debated is whether drugs should be required in some jobs. "A hypothetical example is an extremely safe drug that enabled surgeons to save more patients. Would it be wrong to require this drug for risky operations?" ask the authors.

Since the editor of Nature is obviously a fan of enhancement, we may be reading more studies about its benefits and none too many about the ethical reservations raised in Beyond Therapy. ~ Nature, Dec 11

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