Nadira Faulmüller

Attitudes toward pharmacological cognitive enhancement-a review

A primary means for the augmentation of cognitive brain functions is “pharmacological cognitive enhancement” (PCE). The term usually refers to the off-label use of medical substances to improve mental performance in healthy individuals. With the final aim to advance the normative debate taking place on that topic, several empirical studies have been conducted to assess the attitudes toward PCE in the public, i.e., in groups outside of the academic debate. In this review, we provide an overview of the 40 empirical studies published so far, reporting both their methodology and results. Overall, we find that several concerns about the use of PCE are prevalent in the public. These concerns largely match those discussed in the normative academic debate. We present our findings structured around the three most common concerns: medical safety, coercion, and fairness. Fairness is divided into three subthemes: equality of opportunity, honesty, and authenticity. Attitudes regarding some concerns are coherent across studies (e.g., coercion), whereas for others we find mixed results (e.g., authenticity). Moreover, we find differences in how specific groups—such as users, nonusers, students, parents, and health care providers—perceive PCE: a coherent finding is that nonusers display more concerns regarding medical safety and fairness than users. We discuss potential psychological explanations for these differences.

Pharmacological cognitive enhancement—how neuroscientific research could advance ethical debate

There are numerous ways people can improve their cognitive capacities: good nutrition and regular exercise can produce long-term improvements across many cognitive domains, whilst commonplace stimulants such as coffee temporarily boost levels of alertness and concentration. Effects like these have been well-documented in the medical literature and they raise few (if any) ethical issues. More recently, however, clinical research has shown that the off-label use of some pharmaceuticals can, under certain conditions, have modest cognition-improving effects. Substances such as methylphenidate and modafinil can improve capacities such as working memory and concentration in some healthy individuals. Unlike their more mundane predecessors, these methods of “cognitive enhancement” are thought to raise a multitude of ethical issues. This paper presents the six principal ethical issues raised in relation to pharmacological cognitive enhancers (PCEs)—issues such as whether: (1) the medical safety-profile of PCEs justifies restricting or permitting their elective or required use; (2) the enhanced mind can be an “authentic” mind; (3) individuals might be coerced into using PCEs; (4), there is a meaningful distinction to be made between the treatment vs. enhancement effect of the same PCE; (5) unequal access to PCEs would have implications for distributive justice; and (6) PCE use constitutes cheating in competitive contexts. In reviewing the six principal issues, the paper discusses how neuroscientific research might help advance the ethical debate. In particular, the paper presents new arguments about the contribution neuroscience could make to debates about justice, fairness, and cheating, ultimately concluding that neuroscientific research into “personalized enhancement” will be essential if policy is to be truly informed and ethical. We propose an “ethical agenda” for neuroscientific research into PCEs.

How cognitive enhancement can change our duties

This theoretical paper draws the scientific community’s attention to how pharmacological cognitive enhancement may impact on society and law. Namely, if safe, reliable, and effective techniques to enhance mental performance are eventually developed, then this may under some circumstances impose new duties onto people in high-responsibility professions—e.g., surgeons or pilots—to use such substances to minimize risks of adverse outcomes or to increase the likelihood of good outcomes. By discussing this topic, we also hope to encourage scientists to bring their expertise to bear on this current public debate.

Beyond group-level explanations for the failure of groups to solve hidden profiles: The individual preference effect revisited

The individual preference effect supplements the predominant group-level explanations for the failure of groups to solve hidden profiles. Even in the absence of dysfunctional group-level processes, group members tend to stick to their suboptimal initial decision preferences due to preference-consistent evaluation of information. However, previous experiments demonstrating this effect retained two group-level processes, namely (a) social validation of information supporting the group members’ initial preferences and (b) presentation of the additional information in a discussion format. Therefore, it was unclear whether the individual preference effect depends on the co-occurrence of these group-level processes. Here, we report two experiments demonstrating that the individual preference effect is indeed an individual-level phenomenon. Moreover, by a comparison to real interacting groups, we can show that even when all relevant information is exchanged and when no coordination losses occur, almost half of all groups would fail to solve hidden profiles due to the individual preference effect.

The Indirect Psychological Costs of Cognitive Enhancement

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Cognitive biases can affect moral intuitions about cognitive enhancement

Research into cognitive biases that impair human judgment has mostly been applied to the area of economic decision-making. Ethical decision-making has been comparatively neglected. Since ethical decisions often involve very high individual as well as collective stakes, analyzing how cognitive biases affect them can be expected to yield important results. In this theoretical article, we consider the ethical debate about cognitive enhancement (CE) and suggest a number of cognitive biases that are likely to affect moral intuitions and judgments about CE: status quo bias, loss aversion, risk aversion, omission bias, scope insensitivity, nature bias, and optimistic bias. We find that there are more well-documented biases that are likely to cause irrational aversion to CE than biases in the opposite direction. This suggests that common attitudes about CE are predominantly negatively biased. Within this new perspective, we hope that subsequent research will be able to elaborate this hypothesis and develop effective de-biasing techniques that can help increase the rationality of the public CE debate and thus improve our ethical decision-making.

Do You Want to Convince Me or to Be Understood?: Preference-Consistent Information Sharing and Its Motivational Determinants

In two experiments, we provide evidence for a fundamental discussion asymmetry, namely, preference-consistent information sharing. Despite being in a dyadic situation requiring open information exchange and being given no incentive to do so, participants communicated more information that supported their individually preferred decision alternative than information that contradicted it. Preference-consistent information sharing was not caused by biased recall and occurred in written as well as in face-to-face communication. Moreover, we tested whether preference-consistent information sharing was influenced by statements by bogus discussion partners indicating that they held a congruent versus incongruent preference to the participants’ preference and that they understood versus did not understand the participants’ preference. We found that when partners stated that they understood the participants’ preference, subsequent preference-consistent information sharing was considerably reduced. This indicates that a motivation to be understood by others might be an important driving force underlying preference-consistent information sharing.

The consistency principle in interpersonal communication: Consequences of preference confirmation and disconfirmation in collective decision making.

Interpersonal cognitive consistency is a driving force in group behavior. In this article, we propose a new model of interpersonal cognitive consistency in collective decision making. Building on ideas from the mutual enhancement model (Wittenbaum, Hubbell, & Zuckerman, 1999), we argue that group members evaluate one another more positively when they mention information confirming each others preferences instead of information disconfirming these preferences. Furthermore, we argue that this effect is mediated by perceived information quality: Group members evaluate one another more positively when they mention information confirming each others preferences because they perceive this information to be more important and accurate than information disconfirming each others preferences. Finally, we hypothesize that group members who communicate information confirming each others preferences receive positive feedback for doing so, which, in turn, leads group members to mention even more of this information. The results of 3 studies with pseudo and face-to-face interacting dyads provide converging support for our model.

The Necessity of Objective Standards for Moral Enhancement

Addressing skeptical arguments from philosophy and neuroscience, John Shook (2012) claims that it is conceptually coherent to describe certain forms of mental intervention as “moral enhancement,” a...