One of the most interesting stories of the 2012 olympics in London was that of Oscar Pistorius, the South African 400 meter sprinter who although running with two prosthetic legs competed in the standard event. The interesting part of the story, although controversial in it’s own right, is not this however, it’s that he also competed in the paralympics and found reason to complain about the winner’s unfair use of “longer” prosthetics
More recently we have seen Lance Armstrong admit that he cheated his entire career with performance enhancing drugs and techniques or, as he seems to see it, levelled the playing field.
This makes me wonder about where the line lies in human enhancement and particularly how it relates to our own work on non-invasive brain stimulation or transcranial direct current stimulation (tDCS) as it’s known.
Our own interests lie in medical applications such as stroke-recovery, depression or cognitive enhancement to offset mild cognitive impairment (MCI) in the elderly. Recent results however suggest that our technology can be used to enhance cognitive abilities in the healthy such as our ability to concentrate and carry out complex mental tasks or to improve our learning abilities in everything from piano to sharp-shooting (see links below for some examples).
If these results pan out where will it take us? Will it someday be considered commonplace to use a tDCS for a little mental boost? Is this cheating?
We can compare it to the use of Ritalin which is apparently widespread among students in some fields and academia in general. This is usually prescribed for ADHD but is a powerful aid to concentration in the healthy. Now some bioethicists such as Ilina Singh have argued that they could be prescribed for this purpose alone if we have appropriate safeguards in place. Julian Suvalescu, another ethicist that has written extensively on the subject of human enhancement writes about this here. From an ethical standpoint those that use it have an unfair advantage that would be eroded if it could be openly prescribed for enhancement. The argument here (and in sport) is also that people will find a way to do this anyway so better to keep it in the open so that it can be done safely.
So yes, it seems likely that tDCS might someday be used by the healthy. As to the question of cheating I think that for sure it may give an advantage to those that can afford this still expensive technology over those that can’t, but in that it does not differ from any technology in this digitally divided world.
We should also keep in mind that tDCS will drop in price quickly if it becomes massively popular. In the end, as with Ritalin, the question becomes one of representation and whether the user admits to it. I read somewhere recently the imaginary example of an interviewee using tDCS to get a job (however that might work…) and the company being fine with this as long as they agreed to use it everyday. Many technologies enhance our natural (and limited) mental resources and we are quite happy with the arrangement. If we assume that it is safe then tDCS is essentially no different.
In terms of acceptance it probably has a ways to go compared to carrying a smartphone around in your pocket but if it proves to be effective it could happen.
For our part the research community is very much aware of this aspect of our work and our responsibility in evaluating the ethical and social consequences. It’s a major component of all of our research projects. A recent report by Kadosh et al. at Oxford tackles this issue and calls for the community to address these concerns now before the applications mature. The growing neuroethics community is providing much needed support in this regard.