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By Kelsey Drewry Kelsey Drewry is a student in the Master of Arts in Bioethics program at the Emory University Center for Ethics where she works as a graduate assistant for the Healthcare Ethics Consortium. Her current research focuses on computational linguistic analysis of health narrative data, and the use of illness narrative for informing clinical practice of supportive care for patients with neurodegenerative disorders. After reading a recent study in Frontiers in Public Health (Ohtani et al. 2017) I realized I might have unwittingly been taking part in cognitive enhancement throughout the vast majority of my life. I have been a dedicated equestrian for over twenty years, riding recreationally and professionally in several disciplines. A fairly conservative estimate suggests I’ve spent over 5000 hours in the saddle. However, new evidence from a multi-university study in Japan suggests that horseback riding improves certain cognitive abilities in children. Thus, it seems my pri...

By Shweta Sahu Image courtesy of Pexels . I was always an average student: I was good, just not good enough . I often wondered what my life and grades would be like if I’d had a better memory or learned faster. I remember several exams throughout my high school career where I just could not recall what certain rote memorization facts or specific details were, and now in college, I realize that if I could somehow learn faster, how much time would I save and be able to study even more? Would a better memory have led me to do better on my exams in high school, and would my faster ability to learn new information have increased my GPA? Such has been the question for years now in the ongoing debates of memory enhancement and cognitive enhancement , respectively. I’m not the only student to have ever felt this way and I’m sure I won’t be the last. Technology and medicine seem to be on the brink of exciting new findings, ones that may help us in ways we’ve never before thought imaginable. Th...

The 6.1 Issue of the American Journal of Bioethics Neuroscience ( AJOB Neuroscience ) is now hot off the presses with two target articles highlighting ethical issues behind the use of two very different therapeutic interventions: first-in-human trials to treat Parkinson’s disease using stem-cell based therapies and prescription stimulants to enhance motivation. The Target Article “Ethical Criteria for Human Trials of Stem-Cell Derived Dopaminergic Neurons in Parkinson’s Disease” 1 by Samia A. Hurst et al. discusses three specific considerations of a phase I(safety)-II (efficacy) clinical trial designed to test an experimental neurorestorative stem cell therapy for Parkinson’s disease. Parkinson’s disease is a result of the loss of dopamine-producing neurons in the substantia nigra, and significant depletion of dopamine leads to the tremors, rigidity, and difficulty initiating or halting movement that is often seen as the disease progresses. To compensate for the diminishing level...

We’ve all been there. It’s exam week of your junior year of college with two papers due the day after a final. You’re a new faculty member with a semester of lectures to prepare and a lab to get started. You’re a tax accountant and it’s early April. There is simply too much to do and not enough hours in the day to get it all done while sleeping enough to keep your brain working like you need it to. In that situation, where do you stand on cognitive enhancement drugs? Most of us wouldn’t hesitate to grab a cup of coffee but what about a caffeine pill, or a friend’s Adderall? Many discussions about cognitive enhancement eventually come down to this question: where do we draw the line? Currently most of the cognitive enhancers that create unease for ethicists and the general public alike are prescription drugs that were originally meant to treat conditions recognized as out of the realm of “normal” such as diseases or deficits. Therefore, a key step in deciding where we should stand on th...

Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders in the world. Its main symptoms consist of inattention (be easily distracted, miss details, and frequently switch from one activity to another or have difficulty organizing and completing a task or learning something new or trouble completing homework assignments), hyperactivity and impulsiveness (fidget and squirm in their seats or talk nonstop or be very impatient) 1 . These symptoms emerge mainly before seven-year old and approximately 75% of those children are male 2,3 . Two criteria are currently used to diagnose ADHD, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) and International Classification of Diseases, 10th edition (ICD-10). American psychiatrists follow the DSM-IV, which describes two primary categories of behavioral symptoms: inattention and impulsivity-hyperactivity; and three subtypes of ADHD: inattentive type, hyperactive-impulsive typ...

Over the past decade or so, there has been an alarming growth in the number of ADHD diagnoses, and, which is more disturbing, the prescription of stimulants for children with this condition. Concurrent with these increases has been a growing concern in the general public about the legitimacy of ADHD as a real disease and the repercussions and ethical issues of giving kids psychotropic drugs. A hundred years back, this was not a problem. Kids would come to class, be disruptive, not listen, misbehave… and get a whopping smack in the hand or bum with some kind of discipline ruler or other blunt object. The teacher found this behavior to be typical of kids, the parents shook their heads wondering “where did we go wrong?” and life went on. Today, however, there have been striking advances in science that have given us some insight into the factors that contribute to ADHD, tools for recognizing the symptoms of this disease, and yet others for treating it. Or so it seems. Do we indeed ...

There are many ethical concerns that are raised by the treatment of children with psychotropic drugs. This is especially relevant with the use of stimulants to treat ADHD because of the large number of children receiving stimulant medication. In 2008, 3.5% of children under 18 in the United States received stimulant medication. This was even higher in school age children and adolescents, with 5.1% of 6-12 year olds and 4.9% of 13-18 year olds receiving stimulant treatment. This data indicates that an estimated 2.8 million children received stimulant medication for the treatment of ADHD in 2008 1 . Are stimulants overused? ( Source ) The safety of stimulant medications in children is a large concern because there have not been many longitudinal studies on the effects of stimulant usage, especially for children beginning stimulant usage at a young age. There has been some evidence of serious side effects, including cardiovascular risk, growth suppression, and development or early onset ...

Victoria became pregnant at a young age. During her pregnancy, she was unable to consistently make responsible choices for herself and her developing child, often indulging in alcohol and drugs. As a result, her son Brian was born prematurely at 7 months. By the time Brian entered preschool, he became increasingly difficult for Victoria and his teachers to control, his interactions with other children at times violent and aggressive. Desperately trying to manage Brian’s outbursts, Victoria confides in a child psychiatrist who puts Brian on Ritalin. Within a couple of months, Brian’s outbursts subside, and much to everyone’s relief (Brian’s included), he is now able to sit through his preschool classes with limited distraction. He begins to enjoy relating with other kids and no longer receives negative attention at school. Several years later, Brian, now a very diminutive 9 year-old, writes a paper for a class assignment in which he suggests that everyone should have treatm...