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04/09/2015

Bioethics Commission Makes Recommendation on Equitable Access to Safe and Effective Neural Modifiers

The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) recently released Gray Matters: Topics at the Intersection of Neuroscience, Ethics, and Society. In this report the Bioethics Commission considered in depth ethical concerns raised by the development and use of novel forms of neural modification, including those designed to enhance cognition.

The Bioethics Commission described three goals of neural modification, including (1) maintaining or improving neural health and cognitive function within the range of typical or statistically normal human functioning, (2) treating neurological disorders, and (3) expanding or augmenting neural function. Although the third goal is sometimes associated with the pursuit of radical human enhancements, such as unyielding stamina or perfect recall, more realistically, expanding or augmenting neural function is associated with modest cognitive enhancement.

Novel forms of cognitive enhancement, such as the use of prescription stimulant drugs, are ethically controversial, and only limited evidence exists regarding their benefits and risks. In addition to recommending greater support for research on the prevalence, benefits, and risks of novel neural modifiers, the Bioethics Commission identified an area of particular ethical concern: the potential for cognitive enhancements to exacerbate existing inequalities between advantaged and disadvantaged groups, if they are available only to those who are already advantaged (for example by wealth, or social capital). However, the equitable distribution of cognitive enhancements could promote justice. Some evidence suggests that individuals with lower levels of baseline cognitive functioning experience a greater improvement from cognitive enhancements than those at a higher baseline level. If these results are borne out by future research, cognitive enhancement could be used to reduce inequities, for example, by reducing gaps in educational attainment.

The Bioethics Commission argued that limiting access to effective forms of cognitive enhancement to those who already enjoy greater access to other social goods would be unjust. It emphasized that the collective pursuit of neural modifications might help to close gaps in opportunity that are related to neural function and promote societal benefits of cognitive enhancement that might be lost if access is limited only to a privileged few. Specifically, the Bioethics Commission recommended that:

Policymakers and other stakeholders should ensure that access to beneficial, safe, effective, and morally acceptable novel neural modifiers to augment or enhance neural function is equitable so as not to compound or exacerbate social and economic inequities.

The Bioethics Commission emphasized the importance of assessing enhancement interventions to determine their potential to affect existing social and economic disparities. The ethical acceptability of these interventions will be determined in part by whether access to them is distributed so as to promote justice and fairness rather than create new, or exacerbate old forms of injustice.

Gray Matters: Topics at the Intersection of Neuroscience, Ethics, and Society and all other Bioethics Commission reports are available at Bioethics.gov.

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