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Against The Grain: 'The benefits of brain-boosting drugs are huge'

Nick Jackson
Thursday 29 May 2008 00:00 BST
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Dr Nick Bostrom is the director of the Future of Humanity Institute at the University of Oxford. He argues that drug companies should be allowed to develop drugs that improve our lives rather than just cure diseases.

Cognitive-enhancement drugs, potentially enhancing cognitive capacity, memory, concentration and mental energy, would help people function more effectively and benefit individuals and society. But progress on developing effective cognitive enhancers, and on understanding their long-term effects, is being hampered by a shortage of focused research.

Prevailing patterns of medical funding and regulation are organised around the concept of disease. Every drug on the market with alleged cognitive-enhancing effects, such as Modafinil, was developed as a treatment for a pathology. Its good effects on healthy adults' brains were discovered as fortuitous side effects. This disease-centred framework impedes the development of safe and effective enhancing medicines.It makes funding hard to come by, and it makes it difficult to obtain regulatory approval for enhancement drugs.

To benefit from a cognitive enhancer, the user must first be classified as sick. This leads to the expansion of diagnostic categories and the invention of new pathological conditions. Take attention deficit hyperactivity disorder (ADHD). Some people find it very easy to concentrate, some find it very hard. At an arbitrary point, you draw a line and say beyond that point people are suffering from ADHD. That line shifts depending on how effective the drugs are and how effective the advertising is. In the US, between 5 and 10 per cent of boys in school are diagnosed with ADHD. That's a large number, and children diagnosed with a neurological condition are harmed by that diagnosis. The criterion should be whether this person benefits from a drug, not whether they suffer from a pathology.

Would this mean that funding was diverted from therapeutic drugs? No. Drug companies would just spend more money on research. And there is practically no research on cognitive enhancement right now, so you could quintuple the money on cognitive enhancement without any noticeable decrease on other research.

And it would be a mistake to ignore the leverage you could get from even a small cognitive enhancement. If someone makes a breakthrough in physics, even a huge one such as Einstein with relativity, it only helps a narrow domain. Relativity theory is of no use to a geneticist or a geographer or an accountant. But even a small advance in cognitive enhancement would have ramifications. Everybody could use that, facilitating research across the board and in other economic activities. The utility would be enormous.

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