Robert Ranisch

“Clock Shock,” Motivational Enhancement, and Performance Maintenance in Adderall Use

The article by Scott Vrecko (2013) contributes toward the elucidation of a neglected issue in the debate on cognition enhancement drugs, namely, the exact nature of the effects experienced by users...

Germline Genome Editing and the Functions of Consent

Recent advances in the area of genome editing with tools such as CRISPR are generating a controversial discussion whether clinical research on human germline interventions should ever be endorsed (...

Jahrestagung des Deutschen Ethikrats 2016: Zugriff auf das menschliche Erbgut. Neue Möglichkeiten und ihre ethische Beurteilung

Mit dem Titel „Zugriff auf das menschliche Erbgut – Neue Möglichkeiten und ihre ethische Beurteilung“1 widmete der Deutsche Ethikrat am 22. Juni im Ellington Hotel Berlin seine Jahrestagung einem der gegenwärtig meistdiskutierten Themen der Biound Medizinethik. Seitdem jüngere molekularbiologische Verfahren wie CRISPR-Cas9 überraschend effiziente Eingriffe in Gene und Erbgut ermöglichen, häufen sich bemerkenswerte Forschungsereignisse und -visionen von genetischer Veränderung sowohl pflanzlicher als auch tierischer Zellen, und mit ihnen die Veröffentlichung von Stellungnahmen zum verantwortungsbewussten Umgang mit dieser Technologie.2 Die in diesem Zusammenhang frappierendsten Vorstöße unternahm kürzlich eine chinesische Forschergruppe mit der Manipulation des Erbgutes (nichtlebensfähiger) menschlicher Embryonen (Liang et al. 2015). Entsprechend überraschte nicht, dass auch der kürzlich neu zusammengesetzte Ethikrat dem wissenschaftlich-öffentlichen Austausch über diese Entwicklungen ein

Clinical Ethics Consultation and the Challenge to Implement What Is Right

The target article by Magelssen, Pedersen, and Forde (2016) contributes toward the elucidation of a neglected issue in ethics consultation: that is, the exact merits of normative ethical theories i...

Cognitive Enhancement to Overcome Laziness: Ethically Wrong or Just Stupid?

The article “Enhancing Motivation by Use of Prescription Stimulants: The Ethics of Motivation Enhancement” by Torben Kjærsgaard (2015) argues that bioethical debates on cognitive enhancement (CE) should rather focus on the question of motivational enhancement than performance enhancement. After all, available CE drugs only show modest performance-enhancing effects in healthy individuals, but significant performance maintenance effects. The latter issue, however, is frequently neglected in current bioethical debates (Ranisch, Garofoli, and Dubljevic 2013). His article discusses ethical questions concerning these neglected effects of motivational enhancement. He focuses on (self-) reported effects of Adderall use by healthy students and discusses ethical issues concerning accomplishment and effort. Kjærsgaard concludes that in most cases people should not use CE drugs to enhance motivation. While Kjærsgaard’s article offers an insightful contribution to bioand neuroethical questions, it fails to clarify the status of the normative claims he makes. In most cases, bioethical analyses focus on moral questions of enhancement technologies, such as liberty, justice, and harm. While Kjærsgaard makes clear that these aspects are important for an analysis of CE drugs, he is more interested in raising “some ethical questions beyond” these concerns. He identifies these as “individual issues,” that is, “what contributes to” and what “constitutes a good life.” I follow Kjærsgaard by terming these questions “ethical” rather than “moral” questions. It has sometimes been suggested that even though human enhancement technologies are innovative, they do not really pose new moral questions. The extended possibilities to modify, enhance, or even transform our nature rather confront us with questions about the human condition, how we want to live and how we should live well. Thus, possibilities of changing essential aspects of our psychological, emotional, and physiological constitution make it necessary to confront questions that are ethical by their nature, rather than moral. In this respect, Kjærsgaard’s article is an important contribution to the ethics of human enhancement. Nevertheless, his approach faces a difficulty if it wishes to be of practical relevance or to even guide policymaking: Liberal societies are distinguished by a “reasonable pluralism” (the term used by Rawls), and we find a legitimate diversity of concepts of the good life. For this reason, it is widely believed the one key element of liberalism is state neutrality: Policies should not be justified by a controversial and contested concept of the good. Reasons for neutrality are different. Sometimes it is maintained for epistemic reasons that state policies should not be guided by a particular concept of the good since we are unable to prove its superiority. Other positions hold that neutrality is the best mean to guarantee social and political stability or human flourishing. Regardless of justification of neutrality, there is a consensus in liberal societies: While the state must not be neutral concerning some moral questions, for example, questions of injustice or harm to others, citizens should be free to live their life according to their will, as long as no harm is caused to others. Concerning the case of enhancement technologies, this implies that regulation is not legitimate by reference to a controversial concept of a good life alone (Basl 2010). From the commitment to state neutrality, however, it would be wrong to conclude that there is nothing to be said about the possible contribution of CE to a good life (Fr€ oding 2010). While such questions are delicate from a liberal perspective, a public discourse is necessary. In a society where people are confronted with extended possibilities to enhance their cognitive capacities, guidance is needed and it is reasonable to consider whether or not a certain practices of CE could contribute to a particular ideal of a good life. To bluntly declare a certain practice as “ethically problematic,” as Kjærsgaard does, is neither helpful nor convincing for people who embrace such practice or find it even desirable. After all, to argue that motivation enhancement by means of CE drugs is “the wrong solution from an ethical point of view” (8) suggests a putative power of ethical reasons, which Kjærsgaard is not able to justify. Having excluded moral questions (e.g., harm, justice) from his analysis, Kjærsgaard is left with his intuition on what constitutes a good life, and I believe that he fails to make a convincing case against CE drugs. Apart from stressing that relying on stimulants is “ethically problematic,” he is not able to explain what this means or why this is the case. The lack of theoretical foundation becomes