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By Laura Y. Cabrera, Rachel McKenzie, Robyn Bluhm Image courtesy of the U.S. Airforce Special Operations Command . Treatments for psychiatric disorders raise unique ethical issues because they aim to change behaviors, beliefs, and affective responses that are central to an individual’s sense of who they are. For example, interventions for depression aim to change feelings of guilt and worthlessness (as well as depressed mood), while treatments for obsessive-compulsive disorder try to diminish both problematic obsessive beliefs and compulsive behaviors. In addition to the specific mental states that are the target of intervention, these treatments can also affect non-pathological values, beliefs, and affective responses. The bioethics and neuroethics communities have been discussing the ethical concerns that these changes pose for individual identity [1,2], personality [3,4], responsibility [5], autonomy [6,7], authenticity [8], and agency [9,10].  What we did Pharmacological interventi

By Michael N. Tennison  Image courtesy of Wikimedia Commons . Bioethicists and neuroethicists distinguish therapy from enhancement to differentiate the clusters of ethical issues that arise based on the way a drug or device is used. Taking a stimulant to treat a diagnosed condition, such as ADHD , raises different and perhaps fewer ethical issues than taking it to perform better on a test. Using a drug or device to enhance performance—whether in the workplace, the classroom, the football field, or the battlefield—grants the user a positional advantage over one’s competitors. Positional enhancement raises issues of fairness, equality, autonomy, safety, and authenticity in ways that do not arise in therapy; accordingly, distinguishing enhancement from therapy makes sense as a heuristic to flag these ethical issues.  These categories, however, do not capture the entire scope of the reasons for and contexts in which people use drugs or devices to modify their experiences. Consider psy

By John Banja  John Banja , PhD is a medical ethicist at Emory University’s Center for Ethics, a professor in the Department of Rehabilitation Medicine , and the editor of AJOB Neuroscience . In next month’s (December, 2014) issue of the American Journal of Bioethics , I’ll have an article appear on drug and alcohol use among health professionals. My paper is a counter-argument to one that appeared in JAMA in 2013, 1 which recommended that physicians who are involved in serious, harm-causing medical errors should be drug and alcohol tested on the spot. Now, I’ve studied the occurrence of medical errors for over a decade, and the more I thought about that proposal, the more I thought it was a bad idea. So I wrote the article, sent it to AJOB , and eventually it was accepted. 2 The point of this blog post is to discuss something that stems from what I learned from the literature on drug and alcohol abusing physicians: most of them can go years, even decades, without the drug or alc

By Ross Gordon In their recent paper on neuroenhancement, Brian Earp and his colleagues draw a distinction between “functional enhancement [and] enhancement of well-being,” arguing that the former, dominant construction cannot deal with the ways in which welfare is often enhanced by functional diminishment. On these grounds, the authors propose a “ welfarist ” paradigm, which defines enhancement as “any change in the biology or psychology of a person which increases the chances of leading a good life in a given set of circumstances.” On one level, I think Earp's welfarist approach both clarifies debates about enhancement and usefully broadens the set of interventions that could be understood as “enhancing.” On another level, however, I think his discussion of welfare begs a set of far more crucial questions: namely, what does it mean to talk about a “good life,” what “given set of circumstances” exist, and what is the relationship between individual welfare and broader social stru