Ethical Dissonance
Arguments about safety, fairness and coercion aside, demand is indeed high for cognitive enhancers that are otherwise prescribed for conditions such as ADHD. Based on government data gathered in 2007, more than 1.6 million people in the U.S. had used prescription stimulants nonmedically during the previous 12 months. Legal medicines in this category include methylphenidate (Ritalin), the amphetamine Adderall, and modafinil (Provigil). On some campuses, one quarter of students have reported using the drugs. And an informal online reader survey by Nature last year showed 20 percent of 1,427 respondents from 60 countries polled about their own use said they had used either methylphenidate, modafinil or beta blockers (the last for stage fright). Overall, a need for improved concentration was the reason cited most frequently. People often manage to acquire the drugs on the Internet or from doctors, who can prescribe medicines approved for one purpose to treat something else (drugmakers, however, cannot legally promote such “off label” uses).
The recent push for ethical guidelines, of course, presumes that these drugs are better than placebos and do in fact improve some aspect of cognition, be it attention, memory or “executive function” (planning and abstract reasoning, for instance).
