NeuroEthicsWomen Leaders

Laura Cabrera, Ph.D. is a visiting postdoctoral research fellow at the Core where she is working on a project that explores the attitudes of the general public regarding cognitive enhancement. Laura Cabrera is a postdoctoral researcher in bioethics and emergent technologies in the Institute for Biomedical Ethics at Basel University. Laura received a BSc in Electrical and Communication Engineering from the Instituto Tecnológico de Estudios Superiores de Monterrey (ITESM) in Mexico City, and a MA in Applied Ethics from Linköping University in Sweden. She received a PhD in Applied Ethics from Charles Sturt University in Australia. Laura’s current research focuses on neuroethics and emergent technologies, especially those connected to uses of neurotechnologies and individual/societal implications and perspectives.

Human enhancement has become an umbrella term to refer to a wide range of existing, emerging and visionary technological interventions that blur the boundaries between interventions aimed at therapy and those beyond therapy and species typical features, as well as interventions targeting vulnerabilities, prevention, restoration, rehabilitation, and protection from harms.

Discussion of issues related to human enhancement is nothing new under the sun. We have always been working out how to improve ourselves and to overcome our limitations. As we have seen throughout history, the desire to enhance ourselves is all-too-human, and it exists even before we have developed any sophisticated technology. However, this desire has gained increasing attention over the last decade, and has taken a particular twist in many fields such as neuroscience (Elliott, 2003, Parens, 2009, President’s Council on Bioethics (U.S.), 2003).

Given the pervasiveness and the impact of the topic, it might not be far-fetched to say that we are indeed near the start of a human enhancement revolution (Allhoff, Lin, Moor & Weckert, 2009; Lin & Allhoff, 2008) or an “enhancement society” (Coenen et al., 2009: 39). That is why, the debate on technology and human enhancement has been regarded as one of the most crucial debates of our time.

One relevant area for neuroethics that seems to also cover a great deal of the general discussion around human enhancement is cognitive enhancement. While we often encounter newspapers or articles in the media talking about students using pharmaceutical cognitive enhancers (a.k.a. smart pills), during the past decades non-pharmaceutical methods to intervene in the brain have started to gain increased attention. One of these non-pharmaceutical methods is direct stimulation of the brain, which involves the application of electric or magnetic stimuli to neurons and/or nerves. Direct stimulation of the brain is quickly becoming an often used practice in research as well as clinical settings, but given the claims of its potential for improving certain areas of cognition (Chi and Snyder, 2011, Chi and Snyder, 2012, Kadosh et al., 2010, Hamani et al., 2008, Kirschen et al., 2006) it could become common practice outside the medical setting for enhancement purposes. Brain stimulation techniques are also gaining attention in the forensic setting, for instance for improving eye-witness memory (Vedder and Klaming, 2010), or as lie detection (Luber et al., 2009).

Let me mention now some of the techniques involved. A widely discussed type of brain stimulation in the scientific and philosophical (ethical) literature has been deep brain stimulation (DBS), however other less invasive techniques are also gaining attention, such as Transcranial Magnetic Stimulation (TMS) and transcranial direct current stimulation (tDCS). It is worth highlighting that both TMS and tDCS are minimally invasive, the patient remains conscious while undergoing the procedure and it is generally speaking safe and painless (except for perhaps some tingling). But more importantly, in contrast with pharmacological cognitive enhancers, some of these techniques can more easily be put together and with fewer costs involved. Is the convergence of these features of minimally invasive techniques likely to give rise to a more widely use of these techniques in the future than pharmaceutical cognitive enhancers? It is premature to say anything on this, however, one can already find groups of do-it-yourself enthusiast developing their own tDCS kits and some people who have tried tDCS on themselves (this of course raises questions relating to whether or not they are following proper safety protocols having to do with polarization and location of electrodes).

Now, let me go back to the idea of human enhancement. From the literature and the general discourse around the topic we can say that human enhancement touches upon a wide number of concerns, from philosophical and ethical approaches to the proper role of medicine and desirable human qualities (Wolpe, 2002). It has also been portrayed in extreme views, in one extreme it is seen as a liberating and exciting opportunity, and in the other as a disturbing and even frightening. In particular, when discussing interventions that directly affect the brain, the ethical issues involved seem to take a different degree, as the brain is generally associated with concepts of personhood and personal identity.

How much brain stimulation techniques will start playing a more central role in the cognitive enhancement arena? Will people reactions and acceptance towards these techniques be similar to those we have seeing in the pharmacological cognitive enhancement arena? While the answers to these questions are yet to be untangled, more work on the neuroethics of cognitive enhancement and brain stimulation techniques can help us to get some answers.

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