The neurologist of the future will become a “quality of life” consultant as well as a doctor, says a University of Pennsylvania doctor in the leading journal Neurology. Gazing into a crystal ball, Dr Anjan Chatterjee says that because medical technology will make it possible for people to have “better brains” and better bodies, neurology is bound to move from therapy to enhancement. People will demand drugs to make them more alert, to give them better powers of memorisation, to help them to work longer and harder or to dampen their disturbing memories.

The ethics of such developments has been widely discussed, but in Dr Chatterjee’s view, resistance is futile. “Restraint by government regulation, journalistic consternation and religious admonition are likely to be overwhelmed by a relatively unrestrained market and the military.” If social pressures make “quality of life” medication common, drug companies stand to make substantial profits and are likely to encourage such pressures. Doctors will also support it. Scientific leaders who discover new therapeutic possibilities are quick to stake biotech claims. Prospecting for better brains may be the new gold rush.”

Although a commentary in the same issue of the journal was more optimistic and contended that “there is nothing inevitable about the course of our society or of neurology as a profession”, a leading cosmetic surgeon warned that medicine was under pressure to slip its moorings from disease. “The minute technology comes along, it will be used,” says Dr Robert Goldwyn, the editor of the Journal of Plastic and Reconstructive Surgery. “If doctors won’t do it, other people will do it.”

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