Brave New World Or Same-Old, Same-Old?

An op-ed in today’s NYTimes discusses a commentary appearing in the December 11 issue of Nature.    The commentary’s authors, Henry Greely of Stanford University and others, brings into the open the use of cognitive enhancers by the healthy.

Cognitive enhancers are drugs that increase cognitive ability.  There are some drugs that are prescribed for cognitive enhancement, such as the reversible acetyl cholinesterase inhibitor, Aricept, used to treat Alzheimer’s dementia.  However, there are other drugs that are used “off label”, for their cognitive enhancing side-effects.  One of these is the commonly known stimulant Ritalin, used to treat attention deficit disorder.  

Greely, et al, assert that the use of off-label cognitive enhancers is wide-spread, should be legitimized and is a logical next step in human development.  In fact, the authors state that these drugs “…  along with newer technologies such as brain stimulation and prosthetic brain chips, should be viewed in the same general category as education, good health habits, and information technology — ways that our uniquely innovative species tries to improve itself”.

In the New York Times, Judith Warner, argues this stance from both sides without coming to a definite opinion.  However, what Warner does not do is discuss Greely et al’s proposition that the drugs be accepted and legitimized with the caveat that there be a policy put in place after evidence-based study.  In fact, the authors propose four mechanisms that should underlie such a policy.

The article is certainly worth reading as are the comments following the online version.  In my opinion, the article authors do a very good job of pleading their case.  Being a person who weighs the pros and cons before ingesting an over-the-counter pain reliever, I found myself moving from a stance of being totally appalled to being somewhat ambivalent.

What makes Greely et al different from Timothy Leary and his also learned followers is their proposal for study and policy.  Greely et al accept that the drugs are in current use and acknowledge a black-market on college campuses among other places.  They suggest that there is no going back and the next step is study and legitimization.

Science and innovation, medical or otherwise, have always stirred controversy.  And we have certainly come a long way since wise women were burned as witches for reducing the pain of childbirth.  At least Nature has allowed to be printed an article that is sure to stimulate discussion and, of course, dissension.

Would medicine-wary me take a cognitive enhancer?  For dementia, yes.  To stay awake more hours to write more blogs, no.


Mary Lou Bernardo, PhD, MSN


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