In its recently published report, Gray Matters: Topics at the Intersection of Neuroscience, Ethics, and Society (Gray Matters, Vol. 2), the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) focused on three controversial topics that illustrate some of the ethical and societal tensions that surround rapidly advancing neuroscience research and its applications. One of those topics was cognitive enhancement. The Bioethics Commission expanded the conversation about cognitive enhancement to include all forms of neural modification. It considered not only novel neurotechnologies like brain stimulation devices and brain training tools, but also any methods, behaviors, and conditions that alter the brain and nervous system.
For example, some lifestyle and public health interventions can benefit neural health and might be safer and more effective than novel neural modifiers such as transcranial direct current stimulation (tDCS) devices. The Bioethics Commission’s first recommendation addresses the prioritization of such existing strategies to maintain and improve neural health:
In addition to developing new drugs and devices to maintain and improve neural health, funders should prioritize and support research on existing, low-technology strategies, such as healthy diet, adequate exercise and sleep, lead paint abatement, high-quality educational opportunities, and toxin-free workplaces and housing.
Existing treatments for neurological disorders also are valuable and can be improved. Emerging neural modification interventions have the potential to reduce the burden of neurological disorders on individuals and society. Safe and effective treatments can help improve the lives of millions of individuals living with neurological disorders in the United States. The Bioethics Commission’s second recommendation is to prioritize treatment of neurological disorders:
Funders should prioritize research to treat neurological disorders to improve health and alleviate suffering. This research should consider individual, familial, and public health burdens as well as potential risks, benefits, and long-term effects of specific interventions.
Although the Bioethics recommended prioritizing the study of both traditional and novel interventions for the prevention and treatment of neurological disorders, it also recognized the need for research to better characterize novel neural modification techniques such as stimulant drugs and brain stimulation devices. Limited evidence exists for the benefits and risks of novel neural modifiers and more data is needed on the prevalence of use of these interventions for enhancement purposes. Therefore, the Bioethics Commission’s third recommendation is to study novel neural modifiers to augment or enhance neural functioning:
Funders should support research on the prevalence, benefits, and risks of novel neural modifiers to guide the ethical use of interventions to augment or enhance neural function.
Overall, the Bioethics Commission considered a variety of forms of neural modification and recommended that funders prioritize research on existing, low-technology and public health interventions and treatments for neurological disorders, and support research to better understand novel methods of cognitive enhancement and their use. By broadening the cognitive enhancement conversation to include all forms of neural modification, the Bioethics Commission aims to expand the scope of current dialogue.
Gray Matters, Vol. 2, and all other Bioethics Commission reports, are available at www.bioethics.gov.