Hot off the presses! This month marks the publication of Neuroethics in Practice, a collection of articles on neuroethics in healthcare settings edited by the CNS’ own Anjan Chatterjee and Martha Farah. I won’t give an overview, since the editors have done that already. But from the book’s major topics — which include brain enhancement, competence and responsibility, imaging, brain damage and new treatments — one issue jumped out to demand more screen time: the regulation of neuroenhancement among young people.
Though enhancement among youth is a popular topic, the discussion rarely involves specific policy recommendations. But those are exactly what Ilina Singh and Kelly Kelleher offer in their article for Neuroethics in Practice. Their argument: given that neuroenhancement is already being used, it should become a clinical option for young people that is regulated by primary care providers.
The details can be found in a version of the paper printed here. More broadly, two aspects of this position stand out.
First, regardless of whether it is “correct,” this stance is an unusually practical response to concerns over the inevitability of some enhancement — concerns stemming from the simple fact that as long as these medications exist, some unimpaired individuals will get them. Singh and Kelleher move beyond the instinctual reaction of fretting to ask, how can we deal with this problem in everyday health care?
Second, addressing neuroenhancement in primary care could have implications for a key subtlety of this topic: as of now, neuroenhancement is not equally available to all young people. As Singh and Kelleher point out, enhancement is at least initially more likely to spread throughout well-resourced families and communities, particularly where students attend competitive secondary schools. And reports on collegiate use of stimulants in the U.S. have found it to be more common in the northeast and at schools with more competitive admissions standards.
In other words, current neuroenhancement among young people seems tied to cultures of competitive academics, certain definitions of success and expendable money to put toward pills. But primary care is a different story — all young people should be able to get check-ups, not just those at elite schools. In that sense, these proposals raise important questions and new possibilities for the cultural context of neuroenhancement.
So, the final takeaway on the Singh and Kelleher paper? As part of the conversation on enhancement, it adds something new. As a peek into Neuroethics in Practice, it should make you curious about the whole book.