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08/04/2010

Putting Adderall in the Water–Irrestistible!

I have, from time to time, jokingly accused my neuro-enhancement colleagues about wanting to put cognition improving drugs in the water. All of them have resoundingly denied (publicly anyway) wanting to do it. Until now.

Oxford professor Julian Savulescu has advanced a claim, rooted deep public health origins, that much like fluorination of the water, society might be much improved by mass dissemination of neuro-enchancers. Well, sort of.

The argument, articulated in a 2008 paper discussed here, starts out with a simple argument about the virtues of fluorination. Then in a modified slippery slope fashion, he takes it a step further:

“once highly safe and effective cognitive enhancers are developed – as they almost surely will be – the question will arise whether they should be added to the water, like fluoride, or our cereals, like folate. It seems likely that widespread population level cognitive enhancement will be irresistible.”

adderall.jpg

Irresistible maybe. But is it ethical? We may all want to have our tap water make us alert longer or test a few points higher on a standardized test, but is that what we really ought to do as a society? Obvious justice questions raise red flags–will these drugs be put into the water supply in every city in the nation (or the world) or only those who can afford them? Will this simply exacerbate the gap between those who are cognitively enhanced and those who are not in terms of social or financial achievement?

Sure fluoridation may have been one of the top 10 public health achievements of the last century, but it was solving a public health PROBLEM. Applying a public health approach to an issue of enhancement is a separate thing altogether–and one that doesn’t work. The goal of public health is to improve the overall public’s health, not to enhance it beyond what is typical. Moreover, creating disparities (or exacerbating existing ones) would be contrary to the moral goals of public health.

So, would it be consistent with public health to put neuro-enhancers into the water supply? It could be, if it were done in the right way with transparency and public consultation and found to improve the health of entire populations rather than only a select few within a society. In principle, enhancement technologies are not inconsistent with public health, but these technologies should be pursued only after the basic public health needs of a society are met.

Summer Johnson, PhD

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