Tagged: Anjan Chatterjee

Neuroethics in practice: Healthy youth seeks pill?

Adderall XR capsules. Image from webmd.com

Adderall XR capsules. Image from webmd.com

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.

Let’s talk about brain porn

Over the past few days, an op-ed from The New York Times Sunday Review has been causing a stir among anyone with an interest in the public role of neuroscience. In her piece, Alissa Quart — who has published books on gifted children and marketing to teenagers — celebrates the recent backlash against popular neuroscience. Otherwise known as “brain porn,” many popular works on neuroscience have claimed dubious links between the brain and everything from encounters with heaven to ways we should think about vaginas (whatever that means). The backlash has been bolstered by journalists like Quart, by writers who are also practicing scientists like the blogger Neuroskeptic*, and by straight-up research neuroscientists, as in the Neuron paper Quart mentions. Like most stories, this one’s got more than one side. And even beyond what it means for neuroscience and the media, an examination of this tit-for-tat should caution us against the reactionary approaches that can mark these kinds of debates.

Let’s start with the angrier camp, consisting of what Quart has dubbed the “neurodoubters.” In their broad criticism of neuroscience’s public role, neurodoubters make valuable points. They are right to demand quality and accuracy in the presentation of neuroscientific findings, standards that sometimes get lost in the appeal of self-help tinged popular headlines like “Tired of Feeling Bad? The New Science of Feelings Can Help.” It’s perfectly understandable to feel skepticism when faced with the growing cadre of “neuro-isms,” like neuroeducation, neuropolitics, neurosecurity, neuroeconomics and so on. These can paint a compelling (though incomplete) picture of neuroscience as a pushy discipline that sometimes worms its way into other fields without paying its dues. And Quart is right to note that it may be especially easy for the public to overestimate the value of neuroscience compared to other fields, since findings on the brain alter our views of the mind, which in turn touch on our most precious notions of human identity.

But the neurodoubting also gets some of the picture wrong. For one thing, Quart conflates all the brain porn out there with “mainstream neuroscience discourse,” when those two arenas of literature clearly differ. The Neuron article referenced in Quart’s op-ed criticizes media articles on neuroscience, not articles published in peer-reviewed journals like Neuron itself. This isn’t to say that all academic neuroscience discourse is equally credible and all popular articles equally shoddy. The key here is that the scientific field devoted to studying the brain should not be equated with media coverage of that field, which is what this intense backlash seems to be doing. If it’s overly simplistic to view neuroscience as the potential solution to every problem and a necessary complement to other fields, it’s equally simplistic to scold all neuroscience as misguided.

In other words, there’s just no reason to convey neuroscience in black-and-white terms as either a revelatory savior or a scientific demon come to pollute our newspapers and bookshelves primarily with crap. This sounds like an obvious point, but the vehemence of this backlash shows how easy it is to overlook the value of balance in such discussions. Public discourse on different disciplines, customs and other aspects of life tied to choice too often go like this: something (like neuroscience) becomes a trend, and then it becomes a trend to indiscriminately bash that trend. The cycle is easy to fall into, and it really doesn’t do much good.

So let’s recognize that when it comes to the public role of neuroscience, we can and should have it both ways. For every sketchy bit of brain porn we should criticize, there’s a line of research we should consider seriously, like Adrian Raine drawing connections between neurobiology and criminal behavior; like Martha Farah probing the relationship between childhood, brain development and our adult selves; like Anjan Chatterjee linking brain processes to aesthetics and language. Those examples might shamelessly promote CNS researchers, but I’ll defend that promotion with two points. One, unlike many popular publications, the work of these researchers undergoes rigorous scrutiny to confirm that it deserves the recognition. Two, I’m just highlighting the CNS as one group (which I happen to know better than others) that supports high-quality work connecting neuroscience to societal issues — while also remaining critical of ways the science can be misused.

In a funny way, all this fuss over neuroscience misses one of the points it’s trying to make: neuroscience is not necessarily that special. Like any field it’s got some good and some bad, and it’s up to anyone with a stake in it to separate the one from the other.

*Note: The elusive Neuroskeptic will be speaking at Penn next Thursday. See the CNS Talk Series page for details.