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Ask a Bioethicist: Limits on Neuroenhancement

Thursday, March 21, 2013

dark brain with yellow patch at supramarginal gyrus neuroimaging scan Brain scans showing areas in the brain where grey matter is more developed for bilinguals. (Dr. Cathy Price, University College London)

Continuing a weekly series where we tackle thorny bioethical issues, Nita Farahany, Professor of Law and Philosophy and Professor of Genome Sciences & Policy at Duke University, discusses the limits of neuroenhancement.

This complete interview originally aired live on March 21, 2013 as part of a month-long series. An edited version was re-aired on August 2, 2013 as part of a special hour of Ask a Bioethicist in a best-of episode of The Brian Lehrer Show.

Guests:

Nita Farahany

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Comments [42]

Lee from Greenpoint

It's even worse than the 20 or so people have noted here. WNYC's producers are actually re-broadcasting this segment as a "best of" and, under the same aegis, is re-broadcasting two other "bioethical" segments from this terrifying "expert." Rather than exploring anything approaching the concerns of the 20 of you, rather than reframing in any sense the very alarming aspects of this "bioethicist"'s very disturbing set of "positions"--they are retraumatizing every person of minimal sense in the listenership. More and more I'm moved to ask, of influencers all the way from our beloved NYC to Mr. Duke's castle in North Carolina: IS IT SOMETHING IN THE WATER? I quiver to suggest that, by now, the answer is a resounding YES. And not a Molly Bloom kind of yes either. Woe is all of us. But thank goodness for all of you. YOU are the ethicists here. I'm so grateful for you.

Aug. 02 2013 01:39 PM
Sredni Vashtar from the Shed Out Back

Glad I'm not the only one greatly disturbed by several of this person's comments. Glad also that I took my medical ethics courses from more principled people.

Maybe I'll be moved to rant at length later, but for now I'll just say this person seems to care only whether something has side effects for the individual, versus "side effects" for the society at large.

Aug. 02 2013 01:02 PM
u

i only heard a portion of the interview but as other listeners have pointed out there is something very irresponsible of the guest's talk she sounds like a totally dishonest and nonsensical hack forgive me for pointing out the layers of sugar coating she uses and how she tries to rename issues and effects to pass them off as harmless and positive what a joke. i support a much more lenient drug policy and am no stranger to prescription drugs but am shocked at the stupidity exhibited by the guest.

Aug. 02 2013 12:49 PM
Alex from TriBeCa

Here, here, KM! That was an inspired comment. To my list I should have added KM, Sarah, Olivia, Andrea, Beth, Susan, Tina, John, Maria, BrettG, Edward, Patricia. Megan, MikeinBrooklyn, and Taher. Those defending this drug nazi are clearly either astroturf industry plants or deranged themselves.

Aug. 02 2013 12:08 PM
MikeInBrklyn from Clinton Hill

I find this women rather scary. It is not the first time she has made statements on this program that shows a deep unethical side to her character. To encourage people to take medicines just because they might realize a boost of some sought, is unbelievable to me. Where does she draw the line? I guest a little cocaine, if you get a boost, is OK, too.

Aug. 02 2013 12:02 PM
Guy from NYC

"Incentives"? Actually, the more I listen to this woman, the more I am curious to see who endows her research. That she needs to be lectured on ethics by Brian indicates she might just be some kind of industry shill. Wow!

Aug. 02 2013 11:58 AM
Alex from Tribeca

Oh, well said, Smithsane and Guy. This guest sounds and reasons like a child, and her readiness to effectively normalize the doping of children with Adderal and Ritalin solely to "enhance" their competitive edge at test performance is depraved, idiotic, and deeply disturbing. Brian and producers, where is your pushback on this?

Aug. 02 2013 11:58 AM
Camille from NJ

ADHD medications for a person with ADHD is necessary to bring their neurochemicals within a more normal range. In the discussion of the use of these drugs made by non AHDH persons, the use by ADHD persons becomes tainted by the idea of trying to game the system in their favor.

Aug. 02 2013 11:55 AM
Shawn from Bergen County

This woman is just great. I have really enjoyed all her segments.

As she pointed out, I bet most of you out there use neuroenhancers. Coffee in the morning, maybe even a few throughout the day. If you think that sipping an espresso is any different than swallowing a pill, you are fooling yourselves. And relative to students from 75 years ago, we have many enhancers that allow for better learning (light at night, better nutrition, more access to information).

For anyone to draw a line in the sand and say "Ok, everything up to this point in 2005 is fine (caffeine, nutrition, etc) is fine, anything more (medication) is wrong" you are just like the Amish or the Orthodox who decide to freeze at some arbitrary point in time and say "This is right, everything else is wrong."

I love these segments.

Aug. 02 2013 11:52 AM
Guy from NYC

I'm glad it's not just me. This woman seems to lack both a certain moral sensibility and a learned reluctance to make problematic claims.

Aug. 02 2013 11:49 AM
John A

"A doctor who get to the operating room by doping..."
Or a doctor who gets to the WhiteHouse, Smithsane.

Aug. 02 2013 10:06 AM

I listened to all of the segments with Dr. Farahany, mostly because I try to force myself to listen points of view that differ from mine. This segment was by far the most appalling (and they were all quite terrible). As many commentators pointed out, the good doctor seems to have no moral compass. (I find this to be true for most "ethicists.") Any way just to point out one issue. I don't particularly care about doping in professional sports. These athletes are overpaid to live out the fantasies of the fan base. fans act surprised when they find out that -shock- my hero has been doping. Come on! The pressure to perform and outperform is like the pressure to create a busk out of thin air on Wall Street. But unlike Wall Street, sports are almost meaningless. The athlete does not have much impact on our lives. A doctor who get to the operating room by doping through undergrad and med school is not someone that I would want wielding a scalpel on me. Is the day of my operation the day that his/her brain enhancing drugs wear off? We've seen the effects on the world of people who feel they know it all. The world doesn't need more of this.

Apr. 24 2013 01:00 PM
Greg Liberatore from Auburn, NY

When the guest "pushed back" on the notion that we are an over-medicated society, I thought Mr. Lehrer could have challenged the guest's position more effectively. The example I thought of is our schools. Medications quite often seem to take the place of effective parenting these days.

Mar. 22 2013 04:15 PM

I only heard approximately the last 20 minutes of this interview but what I think some commenters have not taken into account is that Ms. Faharany, while appearing to advocate the use of neuroenhancers was also advocating the appropriate use in taking these drugs. She was not enforcing for kids to go out and get Adderall from their friends or local drug dealer in fact she made a very distinct point that she did not think children should use these drugs as they are not capable of making that decision and their brains have not be able to fully develop. What she did advocate was that if an individual who is informed of the risks and benefits of taking one of these neuroenhancers wants to do so, he or she should have the right to take it.
While I realize many drugs are still in testing processes of determining all their purposes and risks, Ms. Farahany did make mention of this. I don't see the major issue in advocating that people be allowed to make their own decisions regarding what they ingest. She was not enforcing people to go out and get pain medications or engage in illicit behavior she was simply putting out there that there are drugs that can help enhance individuals neurologically and I have to agree that in a more competitive and higher functioning society, if people's performance would be enhanced by use of certain drugs, with the benefits outweighing the risks, I see no reason why there should be restrictions. The US is still seventh in literacy, twenty-seventh in math, twenty-second in science and people are complaining that we shouldn't be using neuroenhancers? Maybe some Americans need to wake up to the twenty-first century.

Mar. 22 2013 01:38 PM
SUSAN BROWN from 07960

I only heard about the last 10 minutes of this interview, but this "bioethicist" was terrifying. Her entire point of view was that there is nothing unethical about drugged advantage as long as its in the mental/cognitive sphere and, basically, the more mind-stimulating meds the better! I don't think the woman (medicated as she giddily reported herself to be with her memory-enhancing off-label use of an Alzheimer's drug) has a functioning brain. She certainly has no moral fiber.

Mar. 21 2013 07:05 PM
Jim Quigley from East Orange, NJ

Your guest today was decidedly enthusiastic about further medication of our population. Granted that modern medicine has performed near miracles for so many and we should be mindful of its power for good, but we are all naive if we lose sight of the fact that it is in the best interest of the pharmaceutical industry to sell more of what the produce, medication in every imaginable form. Some of that will no doubt benefit patients and some of that will not. I did not hear in today's discussion any inkling from your guest that she shared this concern. On the contrary, she seemed to encourage more public use of medication.

Should this be the posture of an "ethicist?" I should think not. We have all heard our share of horror stories of people who have perished because the medication they were taking was inappropriate, incorrect, or simply badly manufactured.

The public at large is presently imperiled by a trend toward the non-therapeudic use of antibiotics in livestock production. In fact, the pharmaceutical industry sells more antibiotics for non-therapeudic use in livestock than in the human population. Through this ill-advised practice we are assuring the rapid growth of pathogenic organisms that will be increasingly resistant to antibiotic medications. How long will it be before widespread endemics decimate the human population because we as a society sacrificed safety for profitability?

I would urge you and your guest to explore the ethics of this dilemma. The agri-business and pharmaceutical industries have bridled against attempts by the Obama USDA to restrict non-therapeudic use of antibiotics in livestock despite growing calls from the medical profession to do so. Please consider this.

Mar. 21 2013 05:26 PM
Keith Malek from Brooklyn

First of all, when the food supply is poisoned with aspartame, high fructose corn syrup, and other garbage that causes brain damage, there should be NO limits to neuroenhancement because we need every advantage that we can get. Second, the constant comparison between neuroenhancements and athletes on steroids is ridiculous. Sports are the reenactment of outdated, five-thousand-year-old alpha male impulses, and they mean nothing. Your brain, on the other hand, is something that you NEED to use on a daily basis, just as long as you live outside of the United States.

Mar. 21 2013 05:09 PM
tina from Queens

Scenario for the future:
All members of the society took brain enhancers throughout school; they all graduated with PHD's.
Question:
Who is going to flip the burgers and wash the toilets?

Mar. 21 2013 02:45 PM
John from NYC

This 'expert' assertion and reasoning that is difference in the usage performance enhancing drugs in baseball and in the game of life is absolutely ridiculous.
This is an issue of safety - unless we have real long-term studies that show these drugs are safe, it should be approved for this kind of usage.

Mar. 21 2013 01:51 PM
maria

OF COURSE a professor from Duke is going to be touting that we all start popping "legal" neuroenhancers. She is being paid to do so. What happens when we are all popping this stuff, with no regard to , health side effects, effects on society, effects on natural mental stamina and many others. THis is irresponsible advertising from the pharma/biotech industry who as usual are willing to sell their souls to corporate greed to advance themselves. Lance Armstrong was wrong, it was cheating, as is the use of all steroid drugs to outperform other athletes. It is wrong to allow someone to take neuroenhancers to study for a test. At what cost? To have a nervous breakdown in the middle of the first semester? To go crazy and purchase a gun to kill your fellow students?THese drugs have bad side effects and someone better start taking responsibility before telling kids that they are "safe".

Mar. 21 2013 01:47 PM

As an older patient who has been treated with Provigil, Lyrica & others for shingles/PHN, the "bioethicist" is obviously unfamiliar & not up to date with the dangerous side effects associated with such drugs.

I recommend to ALL patients that have suffered bad side effects - report them not only to all your MDs but also directly to the FDA online, by mail or by phone. Excessive diarrhea, constipation, dry mouth/eyes, etc. can all have bad health effects.

The data that the FDA uses to OK drugs is often, if not always, inadequate to guessing the effects of the drugs on patients with multiple chronic ailments, multiple chronic Rx drugs & their interactions as well as dietary & other health effects.

Mar. 21 2013 11:56 AM
Edward from Washington Heights AKA pretentious Hudson Heights

Just watch commercials for drugs for treating various problems and listen for the warnings at the end for potential side effects (suicide) - that should dissuade most from trying these "enhancers".

Mar. 21 2013 11:41 AM
Patricia from BK

PLEASE do not invite Ms. Nita Farahany back. I am just blown away that she would identify herself as a bioethicist and that others would respect it!!! She has ZERO moral compass or even common sense.

This interview was on the level of yesterday's discussion about the show Girls and the depiction of condom use, or rather it's lack.

Please bring back quality, enlightening conversations.

Mar. 21 2013 11:18 AM
megan

I can't believe I'm hearing parents talking about buying their children addictive drugs so they can do better on a test, because make no mistake these ADD drugs are addictive. Just google "Adderall and high", and anyone who's ever taken these drugs, even for a day, knows they cause cravings when you stop.
I used to think people were smart enough to decide for themselves whether or not a drug was worth taking, but after hearing this conversation I'm not so sure.

Mar. 21 2013 11:07 AM
John A

What a horror it is to live in a world where our leaders, as this one, are so flawed.

Mar. 21 2013 11:05 AM
Taher from Croton on Hudson

Frank from Brooklyn, right you are. Who knows what pharma is funding this view.

Mar. 21 2013 11:04 AM
Andrea from NYC, NY

Is your so-called expert bioethicist a representative for the pharmaceutical industry??? All of her solutions involve taking more drugs, even simply by starting one's day with caffeine & sugar. Just because everyone else is taking the drug doesn't make it safe (take baseball's steroids controversy as an example). Her stance that with education (from the pharmaceutical companies, no doubt) will help people make informed choices about taking performance enhancing drugs is severely biased.

Mar. 21 2013 11:01 AM
frank from Brooklyn

Wow, this woman on your show is such a rabid drug pusher. She won't even allow for any sane idea that maybe we just shouldn't be taking drugs unless it is essential for our health. The language she is using "enhancement" "side-effect profile" is coming right out of medical parlance and serves the purpose of bringing the debate above the common sense language of the rest of us. I wonder what self interest she has in wide-spread prescription drug use. What big pharma she is invested in.

Mar. 21 2013 10:59 AM
Taher from Croton on Hudson

Did I just hear that she admitted to being a “pill head?”

Mar. 21 2013 10:57 AM
Truth & Beauty from Brooklyn

Given the IQ bell curve, if EVERYONE partook of neuroenhancement (provided it actually works), the bell curve would remain the same. I can't see it not working the same way for everyone. Creating such a product would be pointless if it only worked for one segment of the IQ population. It would be discriminatory if it only worked for some people. Only drugs that treat specific deficits or illnesses or conditions should be targeted.

If there are such drugs as neuroenhancers, would people have to take them regularly for them to work or would they have a lasting effect after the initial dosage? And, if they are something that must be taken forever, would that really count as an IQ enhancement or would we be back at the Flowers for Algernon syndrome?

Mar. 21 2013 10:57 AM
John A

Gosh is this April 1? I'm sorry but your ethicist is totally out to lunch on this one.

Mar. 21 2013 10:57 AM
KM

Dr. Farahany, I think you are deep in competitive academia, like college students who are looking for an edge. What about honoring the human soul? Honoring the abilities we are born with for what they are? This relates to the work of Lawrence Diller, who laments the medicalization of deviance, childhood, education, ect.

Also, the NYT just featured an article on a young man who got addicted.

Mar. 21 2013 10:56 AM
Jon Booth

I've definitely seen this new normal in my university. If all the other students in your class are blasting through their papers in one night using Adderral, you don't seen any reason not to use it too. Plus, you have more time to party.

Mar. 21 2013 10:55 AM
Olivia from Manhattan

If the guest thinks that taking Aderall is the same as drinking coffee, she has either never tried it or is hiding her own addiction. Aderall is HIGHLY addictive, and the side effects are EXTREME. I say this as someone with experience with all categories of ADHD drugs. They are very serious. Anyone who willingly gives these drugs to their child when not medically necessary (and even in that case it is overprescribed) in order to 'get ahead', it doesn't take a specialist to know that that is not ethical.

Mar. 21 2013 10:55 AM
Sarah

Are we seriously talking about doping kids to enhance their academic performance? Does anyone else find this to be a sick concept? For who are we considering this? The parent or the kid? What is the message we are sending? You aren't smart enough so take this medicine? What are the psychological effects of this on children long-term?

Level the academic playing field - stop prescribing ADD medicine like its Tylenol. Respect the unique talents of children.

Mar. 21 2013 10:54 AM
Jim

@Bill said "Moreover how wouldn't it be an advantage to society overall for it to have more of its members performing at higher levels?"

Only if we can tax them at higher levels.

Mar. 21 2013 10:54 AM
Sally from Queens

Cab a teen who really wants to do well on a test genuinely understand the side-effect?

Mar. 21 2013 10:54 AM

Brian, like the steroids question, your over 20 years late.
When i started in a gym when i was 27, all the varsity and some JV high school athletes were using steroids, i am sure mickey mantel and all the players of that time, they were Russian vitamins.
The neuro enhancer were black beauties or other amphetamine.

Mar. 21 2013 10:54 AM
Olivier from The Bronx

What about good old fashion hallucinatory drugs like acid, mushrooms, mescaline and the such?

I, as an example , made 27 three pointers in a row while tripping. I am not that good of a shooter! I must have been in a state of "Satori" (intuitive illumination). : )

Mar. 21 2013 10:49 AM
Bill

Moreover how wouldn't it be an advantage to society overall for it to have more of its members performing at higher levels?

Mar. 21 2013 10:48 AM
Bill

Perhaps it only appears to be cheating if the advantage is viewed as leveraging an individual in competition with others, a point well-taken, because it's inescapable, even in education, where many students will eventually find themselves vying for post-graduate work or jobs with their academic resumes in hand; but from the standpoint of personal betterment, who wouldn't, and if available why shouldn't one, do what one can to improve his or her knowledge? As the guest said, in the end, that's life: some can afford, say, test preps while others can't, and naturally disparities of access will result in disparities of success.

Mar. 21 2013 10:46 AM
Suzy Allman from Rye NY

One of my favorite ideas was just echoed on this program: Let's hold The Human Performance Games I, an Olympic-like competition that encourages the maximum use of steroids without the occurrence of death or dropped limbs during its sporting events. Steroid use not optional, but integral. :0)

Mar. 21 2013 10:43 AM

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