Ever since graduate school, Dr. Martha Farah has loved cognitive neuroscience “for the questions it asks, the methods it uses, and the excitement of being able to understand how the brain works.” But the Penn psychology professor and director of Penn’s Center for Cognitive Neuroscience [“The Fragile Orchestra,” March 1998] had one big regret: “My field was so ‘ivory tower’ that it didn’t seem to have any relevance to the real world and its problems,” she says. Today that’s changed.

“The last few decades of research suddenly have made possible all kinds of interventions and methods of monitoring people’s brains that have some pretty serious social implications,” Farah says, acknowledging that she has mixed feelings about those methods. It’s “sobering to realize that the effect [my field has] could be good or not good, depending on how we use these new capabilities.”

One job for neuroethicists is to perform triage—separating imminent issues from more farfetched possibilities, she says. While implanting a computer chip in someone’s brain to control their mind is still a ways off, a growing number of people are starting to practice “neurocognitive enhancement” to improve their mood, attention, sleep, and sexual performance. Also on the horizon is the use of pharmaceuticals in the criminal-justice system. And though it’s currently impossible to put someone in a brain scanner and obtain a mental-health readout, says Farah, the increasing ability to mine the brain for “socially relevant” information raises very real questions about privacy in the new millennium.

Unless privacy protections are put in place, warns Caplan, this data easily could end up in the hands of employers, the courts, or government agencies.

Yourself, Only Better
If you think it’s tough to get your child into one of the top universities now, imagine the competition when the valedictorian and salutatorian have chips implanted in their brains to boost their academic performance. Art Caplan has no trouble envisioning a future world chock full of neuroenhancers for healthy individuals—nor predicting and putting down objections to it.

“Even people comfortable with the idea of fixing obvious brain defects become much prissier when it comes to mucking with brains to make them better than good,” he writes in the September issue of Scientific American. “Americans in particular believe that people should earn what they have. [But] Would it be bad if some innovation—say a brain chip implanted in the hippocampus—enabled a person to learn French in minutes or to read novels at a faster pace? Should we shun an implant that enhances brain development in newborns?”

To Caplan, brain engineering is no more unnatural than eyeglasses, artificial hips, plane rides, and vitamins. “It is the essence of humanness to try to improve the world and oneself.”

But does something get lost in the improving? “It’s probably one of the great worries we have,” Caplan responds in a phone interview. “If we eliminate the different and the unusual and the neurotic, will we wind up with less art and beauty and culture and zest in life? But I’m not sure that’s incompatible [with brain enhancement]. More to the point, you can still be neurotic and have a better memory and learn new languages faster.” It’s also unlikely that we’d end up the same if we had the option to improve our brains in different ways, Caplan says. “Not everyone is going to value the same things.”

If the French-facilitating chip sounds far-fetched, other examples of neuroenhancement are close at hand. U.S. fighter pilots took modafinil, originally developed for treating narcolepsy, to stay awake long hours during missions in Afghanistan. The advent of more powerful drugs with fewer side effects has led to a greater number of people using antidepressants. And Ritalin, prescribed for attention deficit disorder (ADD), has found its way into the hands of college students looking for an advantage at exam-time.

“My undergraduates tell me they’re easy to get,” says Farah of the latter drug. “And they do work for everybody.” A patient with ADD “will be able to focus on a project longer and work more effectively [on Ritalin], but it’s also the case that somebody with normal levels of attentional control will also be able to focus longer and work more efficiently with these drugs.”

Paul Wolpe points out that Ritalin use is bimodal: In inner-city schools, it’s pushed by administrators for classroom management; in suburban schools, parents seek it for their children as a “personal-enhancement” tool to improve their academic performance, he says.

“In our society, [ADD] is an illness, but what we have to remember is that in another society, it wouldn’t be.” In fact, Wolpe says, there is a theory that ADD developed in hunter-gatherer societies, because someone with the “scattered-” and “hyper-focus” of the disorder is a great hunter. “What you want to do when you’re hunting is be looking at your whole environment and then when you see the prey, put hyper-focus on it. A person with ADD can’t concentrate five minutes on their schoolwork, but they can sit with their Game Boy for 4 1/2 hours.”

Many people who currently take antidepressants would not have been prescribed these drugs 10 years ago, according to Farah. As more selective drugs are developed, “There is no reason to predict that their ranks will not continue to swell, and to include healthier and higher-functioning people,” she writes in an article that appeared in the journal Nature last November. Studies of short-term antidepressant use in normal subjects have found that it reduced “self-reported negative affect (such as fear and hostility) while leaving positive affect (happiness, excitement) the same.”

Pointing to the popularity and online-availability of drugs like Viagra, Wolpe says, “We will agonize over using [neuroenhancers] even as we use them.”

One concern over enhancement technologies is that the less wealthy or the less educated might be shut out of the opportunities they provide. Caplan argues that the problem “isn’t one of technology, it’s one of fairness.” And one need look only as far as private schools and the Kaplan SAT prep courses to find current inequities. “[It’s] a huge problem, but to me the [answer is figuring out] how to make things equitable.”

Though greater awareness of the brain and development of more sophisticated drugs may lessen the stigma of mental illness, Caplan acknowledges that someone who chooses not to medicate could experience discrimination. “I could imagine someone saying, ‘This is an apartment building where only the pharmacologically calm are allowed to live. We don’t want anyone yelling, screaming, or agitated.’”

Farah sees the potential for more indirect coercion. “Even the enhancement of mood, which at first glance lacks a competitive function, seems to be associated with increased social ability, which does confer an advantage in many walks of life,” she writes. But, she argues, “it would seem at least as much of an infringement on personal freedom to restrict access to safe enhancements for the sake of avoiding the indirect coercion of individuals who do not wish to partake.”

Beyond the moral objections to gain without pain, some forms of enhancement may backfire. Drugs developed for memory-loss in Alzheimer’s patients, for example, might some day improve the memories of healthy adults. But the ability to forget is sometimes crucial to our survival, she says, noting that studies have linked “prodigious memory” to “difficulties with thinking and problem solving.”

Wolpe points to a study in which mice with genetically enhanced memories showed more aversion to pain. “We have this assumption that ‘if I take this memory pill, my brain is going to be enhanced in areas which I want it to be,’” he says. “And yet the balance of memory and forgetting in our brains is very delicately programmed. Who knows what the impact would be? If the brain didn’t forget pain, women wouldn’t have more than one baby.”

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2004 The Pennsylvania Gazette
Last modified 01/19/04

FEATURE:
Who’s Minding the Brain?
By Susan Frith
Illustration by Jon Sarkin

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