designer genius an ethical investigation of cognitive enhancement

8/6/2019 Designer Genius an Ethical Investigation of Cognitive Enhancement

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Designer Genius: An Ethical Investigation of Cognitive

Enhancement

Kenny Moran

Ms Wu

AP English Literature and Composition

Los Altos High School


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April 29, 2011

"Adderall makes me feel like I'm superman; it makes me feel like I can get

anything done, and I can do it in the best way humanly possible. Like, every

single action I take is so finely tuned to perfection that there's absolutely no

way I could be doing any better at anything, and that's really just an

incredible feeling . . . the things you can do on Adderall are just incredible

just incredible. By taking Adderall, the papers that Im putting out, the things

that Im learning, the things that Im remembering are just so much

better . . . so, I mean, if everybody was taking Adderall . . . wed all be doing

so much better, wed all be so much smarter and the things that humanity

could get done if everybody took Adderall it would be incredible. It would

be incredible. I cant even begin to describe the kind of world that were

missing out on.

The short, dark-haired, alluring young woman that well call Danielle is not a

very good student or at least, she wasnt born that way. Throughout high school,

Danielle often wouldnt do her homework and wouldnt study for tests. Whenever

she did try to succeed in school, she never found herself doing above-average work,

and she barely managed to pull off the C average she needed to keep playing on

her schools varsity softball team. After graduating, Danielle enrolled in community

college and decided that she wanted to get her life back on track. When she

started college, she still found herself struggling to overcome her lackluster study

habits and her problems remembering all the information that her college classes

threw at her but that hasnt stopped her from coming out at the top of all of her

classes and performing well enough during her first two years of college to be

accepted as a transfer student at UCLA.


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Danielles life turned around when she met Jeff, a peer at community college

two years her elder. Jeff is prescribed Adderall, a powerful psychostimulant

composed of a number of amphetamine salts. Adderall is approved for the

treatment of narcolepsy and Attention Deficit Hyperactivity Disorder, more

commonly known as ADHD. Jeff is diagnosed with ADHD, but he soon found that,

without much effort, he could easily convince his doctor to prescribe him twice the

dose he needed to function normally, allowing him to make a sizable profit selling

his extra pills to peers. Danielle is a regular customer of Jeffs, and, with the help of

Adderall, she has transformed herself from a below-average, apathetic student to a

highly motivated, studious scholar who consistently receives excellent marks. What

happened?

Adderall is what neurologists would call a cognitive enhancer in other

words, a smart pill. Many would immediately call Danielles decision to use a

cognitive enhancer immoral and contemptible. Danielle has managed to get

admitted into a prestigious university, despite the fact that her past history in high

school would indicate that she clearly doesnt belong there. How could

manipulating the system in this way be acceptable, let alone dignified?

The question of whether or not Danielles actions are acceptable may seem

like a simple one, but if we evaluate it on a deeper level, we see that it is far from

simple, and it brings up a number of complex questions about the ethics of

cognitive enhancement. We know that Danielle was performing below average

before taking Adderall. Its also true that Jeff struggled in school before he was

diagnosed with ADHD and prescribed Adderall. If its okay for Jeff to use Adderall to

fix his problems in school, why isnt it okay for Danielle to do the same thing? Some

might say that because Jeffs use is therapeutic and has the purpose of correcting a


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disorder, it can be distinguished from Danielles use, which only has the purpose of

making her smarter. As it turns out, though, figuring out where to draw the line

between therapeutic cognitive enhancement and non-therapeutic cognitive

enhancement is a very difficult task.

So how do we distinguish between therapy and enhancement? Should we

even have to? Is therapeutic enhancement morally objectionable, permissible, or a

moral obligation? Most importantly, what implications does cognitive enhancement

have for fairness and equality, and what should we do about it?

What is Cognitive Enhancement?

Before we can define exactly what is meant by cognitive enhancement, we

must first define what it is that cognitive enhancement techniques aim to enhance:

cognition. The term cognition is often used to refer to many different things by

different researchers in different fields, but in general, it is agreed that cognition

refers to a number of different psychological skills that are necessary for humans to

think and live. These include skills like perception (the ability to ascertain

information from ones environment), attention (the ability to control what

information is perceived and what is not), memory (the ability to retain

information), reasoning (the ability to manage, analyze, and synthesize

information), motor skills (the ability to effectively and efficiently control ones

movement in the manner that is most in accordance with the information managed

by the aforementioned skills), and cognitive executive functioning, a term for the

brains ability to effectively and efficiently allocate the brains energy among the

five other cognitive abilities. (Bostrom/Sandberg), (Bostrom/Roache).


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The collection of specific skills that depend on one or more of the six aspects

of cognition is massive; in fact, its extremely difficult to come up with a skill that

humans use that doesntdepend on cognition in one way or another. As such, it is

no surprise that researchers and customers are enthusiastic about the prospect of

enhancing cognition; in theory, cognitive enhancement alone could drastically

improve ones performance in every aspect of life. In practice, however, it is not

that simple. The scientific community has not developed a bona fide smart pill

that substantially improves all six aspects of cognition, and it is unlikely that it ever

will. Cognitive enhancers instead tend to target one or two aspects of cognition in

particular. For example, some of the popular modern cognitive enhancers that are

often used treat Attention Deficit-Hyperactivity Disorder target attention and

cognitive executive functioning, whereas the forms of cognitive enhancement that

are being developed to slow or stop the onset of Alzheimers Disease tend to target

memory exclusively. Different types of cognitive enhancers can affect the brain in

many different ways, and each form of cognitive enhancement has a unique set of

ethical implications. Though it may be tempting to do so, to make a

comprehensive, sweeping judgment about the moral value of cognitive

enhancement would ignore the significant differences in efficacy, permanence,

effects, and ethical implications between the different types of cognitive

enhancement.

With a definition of cognition and the six cognitive abilities in place, we can

now turn to cognitive enhancement itself. Like cognition, the term cognitive

enhancement can entail a number of different types of treatments with varying

degrees of efficacy and feasibility. The safest and least effective form of cognitive

enhancers available today is found in a number of substances that fall into the


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category of nootropic agents. The term nootropic, derived from the Greek words

nous, meaning mind, and trepein, meaning to bend, was coined in 1972 by

Romanian chemist Corneliu Giurgea. Although the definition has changed

substantially since it was coined, Girugeas original definition is a fairly accurate

description of what is characteristic of modern nootropics. Girugea defined a

nootropic drug as one that (1) enhances learning and memory, (2) enhances the

brains ability to resist conditions that tend to disrupt memory and learning such as

oxygen deprivation or intoxication, (3) protects the brain against physical or

chemical injuries, (4) improves the brains control of psychological and somatic

processes (i.e. improves cognitive executive function), and (5) has no substantial

side effects and very low toxicity. (Malik).

Since Girugea coined the term, many have neglected the fifth aspect of this

definition, declaring any pharmacological cognitive enhancer to be a nootropic,

even those that have profound side effects and risk factors associated with them.

Still others use the term only to refer to those substances that only increase the

availability of existing chemicals (e.g. Oxygen, enzymes, hormones, and

neurotransmitters) in the brain, rather than drugs that introduce a new chemical to

the brain in order to have an effect on cognition. For our purposes, we can discount

the second and third requirements of Girugeas definition, because the brains

physical and chemical resistance to damage does not is not an aspect of cognition

as we have defined it. Thus, we can consider nootropics to include all substances

that improve cognition in some way, however marginal, without any substantial or

noticeable side effects or risk factors.


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The idea of a pill that can enhance cognition without any side effects may

seem romantic and appealing to many, but the reality is that all nootropics that are

currently available only very marginally improve cognition. Examples of modern

nootropics include supplements, herbs, and vitamins that already enjoy widespread

use. The most common and popular nootropics are B-vitamin supplements and

Omega-3 fatty acids found in many supplements such as fish oil capsules as well as

herbal remedies such as ginseng and Gingko biloba. Although these nootropics

improve cognitive function, they will not dramatically turn an average human into a

genius, and their effects on cognition are typically not significant enough to be

noticeable.

More significant cognitive enhancement can be found in the (usually illegal)

use of pharmaceuticals initially developed to treat mental disorders as a means of

temporarily improving cognition. Most of these pharmaceuticals were initially

developed to treat dementia, Alzheimers Disease (e.g.donepezil, ampakines),

Attention Deficit Hyperactivity Disorder (e.g. amphetamine, methylphenidate,

atomoxatine, pemoline), narcolepsy (e.g. amphetamine, modafinil), depression (e.g.

fluoxetine), hypertension (e.g. propanolol), or mental retardation. (Whitehouse).

Just as these drugs were found to bring those with cognitive deficits up to a normal

cognitive level in other words, to cognitively enhance such individuals many

have found that taking such drugs can bring an individual with normal cognitive

capacities to enhanced levels. Besides nootropics and caffeine, pharmaceutical

treatments for cognitive limitations are the most prominent and most widely

discussed class of cognitive enhancers today. Most cognitive enhancers that are

being developed today are emerging from efforts intended to effectively treat

severe mental disorders but among the bioethical community, these kinds of


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cognitive enhancers are less interesting than hypothetical future forms of

enhancement that are more powerful and more permanent.

The forms of enhancement we have discussed so far are a far cry from the

dramatic, futuristic, and powerful forms of enhancement depicted in films such as

Flowers for Algernon, in which a revolutionary form of neurosurgery enhances a

mentally retarded adult into a genius whose intelligence comes to exceed that of

even the researchers who enhanced him and the 2011 thriller Limitless," in which

a failing writer begins taking a pill that allows him to access 100% of his brain,

rather than the usual 20%. (It should be noted that it is an urban myth that humans

only use 20% of their brains; brain imaging techniques have in fact demonstrated

that no significant part of our brain goes unused. To only use 20% of a brain as

complex as ours would constitute a very inefficient allocation of ones energy, and

such inefficiency is almost always selected against by evolutionary pressures. The

mechanism of cognitive enhancement depicted in Limitless is not the way that

any of the forms of enhancement we are discussing here enhance cognition. This

mechanism of enhancement has different ethical implications about identity and

fairness, but we need not consider it.) The disappointing reality is that no such

wonder drugs exist today, and it will be a long time before we come close to these

fantasies. Cognitive enhancement technology is rapidly advancing, though, and

although more profound modes of enhancement are not yet available, ethicists are

obligated to consider what cognitive enhancement could mean to us in the coming

decades; current trends in the field indicate that someday, enhancement

technology could enable us to permanently alter our brain chemistry and cognitive

capacities, either through more advanced pharmaceutical agents or by way of

neurosurgery or genetic engineering. In this way, we might be able to someday


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fundamentally alter the way an individual thinks and functions. This is a profoundly

novel concept that raises a number of fascinating ethical issues, and the majority of

the debate surrounding cognitive enhancement in the neuroethical community is

futurological in nature; that is, it is concerned principally with ethical questions as

they apply to possible futures for humanity. We should be grateful that this is the

case, for it is far preferable to the alternative scenario, where new technologies and

scenarios must be confronted without any substantial ethical background with

which moral judgments can be made.

We cannot examine the implications of technologies that aim to permanently

change the way our brains work without also making some mention of the

intellectual and cultural movement known as transhumanism. In the strictest

sense, transhumanists affirm that humanity will someday have the technology

available to fundamentally alter the human condition by eliminating aging and

greatly enhancing physical and cognitive capacities and that when this technology

is available, we ought to embrace it and make it widely available. Transhumanists

seek to facilitate humanitys transition into a posthuman future in which some or

all descendents of todays humans have been so profoundly altered that they no

longer resemble normal humans and can be more accurately be classified as a new

species of posthumans. Transhumanism is concerned with much more than just

the prospect of powerful and lasting cognitive enhancement techniques, but a

significant portion of philosophical debates about the merits of transhumanism are

important to developing an ethics of cognitive enhancement, because as humanity

approaches the transhumanists ideal future, the relevant questions will be less

concerned with the ethics of enhancement in general and more concerned with the

implications of crossing species boundaries and relations between humans and


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posthumans. It would be nave of us to make sweeping judgments about cognitive

enhancement in a general sense, for to do so would be to ignore the massive

differences in efficacy, permanence, and effects of different kinds of cognitive

enhancement. At the same time, we cannot neglect any of the different levels of

cognitive enhancement if we are to conduct a comprehensive ethical analysis of the

topic. Each different form of cognitive enhancement compels us to ask different

ethical questions about what we should be able to do to enhance our own

capacities, and each deserves its own thorough ethical evaluation.

At what point does cognitive enhancement cease to be therapeutic?

A distinction that is of great relevance in defining and ethically evaluating

cognitive enhancement is the distinction between therapy and enhancement. We

generally define therapeutic treatment as treatment that fixes a problem, disorder,

disability or disease in an individual to bring him or her back to normal function.

Enhancement, on the other hand can be defined as treatment that improves the

positive health of individuals who would have otherwise functioned at normal levels.

(McMahan). Very few ethicists have the audacity to question the belief that the

severely disabled are entitled to therapeutic enhancement and that society is

obligated to provide it to them. As our thinking goes, the severely disabled do not

have the same opportunity and potential for success that the rest of the population

has, and therapeutically enhancing such individuals, if not a moral imperative, is at

least morally defensible on the grounds that such therapeutic enhancement is

necessary to preserve the principle of equality of opportunity that is integral to

Western culture. On the other hand, moral critiques of cognitive enhancement

beyond the societal norm are abundant in the neuroethical community. Whereas


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therapeutic enhancement restores fairness and equality, enhancement beyond the

norm, it is said, undermines these principles.

It is tempting to accept this dichotomy at face value, as evidenced by the fact

that the two of the most notable cultural assessments of cognitive enhancement,

Flowers for Algernon and Limitless, come out decidedly against cognitive

enhancement and associate it with greed, arrogance, and the allegedly impersonal

and dehumanizing nature of modern science. Some scholars would even go so far

as to claim that this distinction between therapy and enhancement alone gives us

the only relevant moral constraint on cognitive enhancement. Therapeutic

enhancement, they claim, is inherently noble, and enhancement of the healthy is

inherently wrong, regardless of the circumstances. Such a view is expressed by

bioethicist Karen Bramstedt, who concludes her paper analyzing childrens use of

caffeine as a cognitive enhancer by declaring that she has figured out the answer to

all our questions about cognitive enhancement:

The test for whether or not cognitive enhancement is cheating is the

concurrent presence or absence of a clinically diagnosed cognitive deficit. In

the presence of such a deficit, drug-mediated cognitive enhancement is not

cheating but rather correction of a medical problem. In the absence of such a

deficit, drug-mediated cognitive enhancement is a form of cheating because

it circumvents the honest way of attaining excellencethat is, diligent

study. (Bramstedt).

In other words, Bramstedt claims that therapeutic enhancement is okay because

(by definition) it is a correction of a medical problem, but enhancement beyond the

norm is cheating, because it circumvents the necessity to study and work hard to

achieve excellence. Theres a reason why this reasoning seems so intuitive and


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taking fish oil capsules every morning? We cant avoid the fact that different forms

of cognitive enhancement require different ethical analyses, and we cannot wrap up

all of the hairy ethical issues that the topic brings up in a simple and intuitive

statement.

Most importantly, though, we cannot rely on the therapy-enhancement

distinction, as Bramstedt does, in order to construct a robust set of ethical

standards concerning cognitive enhancement, because the line that separates

therapy from enhancement turns out to be a very blurry one, and its difficult to

decide exactly where this line should be drawn. Consider the following scenario: A

man who in most respects can be considered normal begins to feel depressed.

After undergoing a psychiatric evaluation, he learns that he does not meet the

diagnostic criteria for clinical depression. For simplicity, let us assume that his

depression cannot be attributed to any other psychiatric disorder, and he just

happens to be experiencing low-grade, sub-clinical depression, an everyday reality

for countless people. Unable to obtain a treatment for his depression from a

psychiatrist, he goes about illegally securing prescription antidepressants, which

eliminate all traces of his depression, and enable him to approach everyday

challenges with a newfound enthusiasm and positive attitude. Are we to consider

the mans nonmedical use of antidepressants as treatment or enhancement, and to

what extent are his actions morally justifiable?

Bramstedts ethical standard specifically defined the permissibility of

enhancement to be contingent upon the presence of a clinically diagnosed

cognitive deficit, which would classify the mans actions as enhancement, not

therapy, making them morally objectionable in Bramstedts view. Many would

agree that, since antidepressants are intended to treat those who are clinically


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depressed, one should not take them without being diagnosed as such. There is an

important difference, however, between the competitive academic setting in which

Bramstedt discusses the therapy-enhancement divide and the setting of our

thought experiment. Bramstedt objects to cognitive enhancement of the healthy

because it circumvents the honest way of attaining excellencethat is, diligent

study. Her argument rests on the judgment that there is virtue inherent in the

non-enhanced experiences that enhancement avoids: in this case, diligent study

as a means of attaining academic excellence. Although this is a relatively

unsupported normative statement, such statements cannot be avoided entirely in

any meaningful ethical argument, and, more importantly, the virtue of hard work is

a significant element of Western culture that is espoused by many. Bioethicist D.

Gareth Jones, however, questions whether we can assign virtue to the non-

enhanced experiences that the sub-clinically depressed man avoided by enhancing

himself:

If [sub-clinical depression] is not an illness, are some of the treatments

illustrations of enhancement? If this concerns us, it follows that if some forms

of depression are normal, then we should refrain from treating them.

However, is there any virtue in living with sub-clinical depression if it can be

treated? What we are beginning to encounter here is the very fine line

between the normal and the pathological. (Jones).

There is no apparent reason to believe that living with sub-clinical depression is

virtuous, and it is doubtful that anyone holds such a view. It may seem like this

thought experiment concerning depression doesnt apply to our analysis of

cognitive enhancement as we have defined it; after all, mood is not one of the six

aspects of cognition we are looking at. However, a strong case can be made


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arguing that mood is intimately entwined with cognitive executive functioning, if

they are not the same thing. Regardless of whether or not we accept this

argument, though, this thought experiment has some unexpected implications if we

apply the same reasoning to enhancements of other aspects of cognition. What if

the man suffered not from depression but instead from poor reasoning skills? Let

us assume, as we did before, that the man does not meet diagnostic criteria for any

psychological disorder, and that the man is just dull, as are countless others. Would

he be justified in nonmedically securing a (hypothetical) treatment for mental

retardation that substantially increases intelligence and reasoning skills? Here, it is

even more intuitively appealing than it was in the last scenario to conclude that the

mans actions in enhancing himself were unethical. If we reflect on this though,

such a conclusion turns out to be just as irrational; are we really prepared to claim

that it is virtuous to live life as a fool?

Since treatment and enhancement are both defined in terms of notions of

normalcy and pathology, the very fine line between health and disease is

accompanied by an equally fine line separating therapy from enhancement, and

such a distinction is not a good foundation from which to develop an ethics of

enhancement especially considering the fact that the bioethical community seems

to be wholly unable to come to a consensus on where the line between disease and

health should be drawn:

. . . it is not necessary, and indeed it is probably fruitless, to try to draw a

conceptual line between legitimate treatment and nonmedical

enhancements by trying to limit the former to curing diseases and the latter

to improving positive health. The concept of disease is notoriously elastic . . .


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an appropriate line can be drawn simply by striving to allocate fairly medical

services within a population. (Whitehouse).

This system of bioethics, developed by James Sabin and Norman Daniels, does a

somewhat better job than Bramstedts generalization does in defining the line

between treatment and enhancement, and exploring cognitive enhancement

through this ethical lens sheds light on some of the deeper ethical issues

surrounding cognitive enhancement that Bramstedts model glosses over. Whereas

Bramstedts framework depends on a simplistic and relatively arbitrary assignment

of virtue to hard work and diligent study as a basis for her normative judgments,

Sabin and Daniels model relies on the principle of equality of opportunity as a

normative foundation. Although there is a case to be made that this principle is

arbitrary as well, it is nonetheless a more sophisticated, more agreeable, and more

universally accepted ethical foundation than is the virtue of hard work, which is why

Sabin and Daniels normal functional model of medical necessity is popular and

widespread among bioethicists. It turns out that Sabin and Daniels model does run

into problems, because it is exceedingly difficult to define the concept of species-

typical function on which the model is based, but this is beyond our concern.

Should the cognitively disabled be enhanced?

Until now, we have made the assumption that therapeutic enhancement is

always permissible due to the fact that such a view is held by an overwhelming

majority of bioethicists. However, Jeff McMahans Cognitive Disability and

Cognitive Enhancement introduces a novel way of looking at therapeutic

enhancement by evaluating it in the setting ofprenatal cognitive enhancement of a

cognitively disabled fetus, allowing him to persuasively argue that the virtue of

therapeutic enhancement, at least in this context, is nowhere near as strong as we


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might think it is, and other, stronger moral imperatives might take precedence over

therapeutic enhancement in certain situations. McMahan begins by establishing

what sort of conclusions we would come to about prenatal enhancement if we were

to assume that our intuitions about the difference between therapy and

enhancement were accurate, as Bramstedt does:

Most people . . . seem to believe that there is no moral reason to enhance

the future cognitive capacities of a cognitively normal fetus, and perhaps

even a reason notto, at least by genetic means. Yet even those who claim

that disabilities are not misfortunes tend to concede that there is a moral

reason, if possible, to enhance the cognitive capacities of a fetus that would

otherwise be cognitively limited, and to do so for its own sake. [his italics].

(McMahan).

The relevant difference between the conventional ethical evaluation of

enhancement and McMahans approach is that, whereas until now we have only

been forming judgments about the extent to which an individuals conscious choice

to enhance himself is morally defensible, we are now faced with the challenge of

actually making this choice for a cognitively limited fetus, and we thus have to

evaluate prenatal enhancement in terms of the desirability of the different possible

outcomes that could come about by enhancing such a fetus or refraining from doing

so.

There are three different interests we have to consider in this thought

experiment: the interests of the fetus, the interests of the individual that the fetus

would grow into, and impersonal, societal interests. Based on the fetuss interests

alone, it seems at first glance that we could quite easily develop an ethical

argument for enhancing a cognitively limited fetus: although it is debatable whether


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a life with cognitive disabilities is inherently worse than a cognitively normal life, it

is relatively noncontroversial to contend that the fetus would have more dimensions

of well-being accessible to it if it grew into a cognitively normal adult than it would

have otherwise. Therefore, the outcome of enhancing the fetus is better for the

fetus than the outcome of not enhancing it, and we can therefore conclude that it is

morally good to enhance the fetus to serve its own interests. McMahan does not

object to the conclusion that therapeutic enhancement is morally good but he

does object to conventional beliefs about how morally good it is.

It is difficult, if not impossible, to quantify the normative values that we

assign to different outcomes, but this does not mean that we cannot develop a

means for comparing moral obligations derived from future interests. McMahan

surmises that the difference in value between the two possible lives determines

the strength of the individuals present interest in the better of the two, which

would mean that the magnitude of the moral obligation to enhance a cognitively

limited fetus is proportional to the difference between the better outcome, a

cognitively normal life, and the worse one, a cognitively limited life but this way

of understanding the strength of the fetuss interest . . . is misleading. (McMahan).

McMahan contends that noting the difference in value between two outcomes is not

enough to fully evaluate how strong an individuals interest is in the better of two.

In order to more accurately model an individuals future interests, the difference in

value between outcomes must be measured based on what McMahan calls time-

relative interest.

McMahans model of time-relative interest essentially posits that any value

judgment about the appeal of a certain future to a certain individual should be. . .

discounted for the degree of psychological discontinuity between [the individual]


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now and [the same individual] in the future . . . (McMahan). In other words, the

more psychologically distant an individual is from the outcomes in question, the

weaker that individuals interests in that outcome are. Typical theories of rational

self-interest in economics and some fields of ethics assume that identity is constant.

With this assumption in place, the extent to which a thing will satisfy an individual

once he or she attains it can be measured by the magnitude of the individuals

current desire for that thing. In reality, though, identity is not constant, even if we

act and think under the assumption that it is. While this may not matter in

economics, it is of great importance both in evaluations of cognitive enhancement

and in ethical debates that concern the interests of unborn fetuses.

The notion of a variable identity may seem counterintuitive at first. Ask

yourself, though: can you really say with confidence that you are the exact same

person today as you were as a newborn? Of course, if we are to accept the

conventional view of identity at face value, then we certainly can say this but if we

consider identity to be defined by the sum of psychological characteristics, the

question becomes: can any of us say with confidence that he has the exact same

psychological characteristics today as he had as a newborn? We obviously cannot

say this, for if that were the case, we would have had the same memories, skills,

preferences, and perceptions when we were newborns as we have at the present

moment. If we abandon the conventional notion of identity, it is clear that we do

not have the same identity today that we had as infants. The psychological

discontinuity between a given individual as a baby and the same individual as an

adult is comparatively massive; we could perhaps even conclude that some of our

peers who are the same age as us are closer in identity to us than our present

selves are to ourselves as babies.


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Now that we have established that a stricter definition of identity forces us to

conclude that identity changes as an individual grows, we can come to an intuitive

understanding of McMahans time-relative interest through another thought

experiment. Assume you are offered some large amount of money to spend

however you want with the condition that, if you accept this money, it is guaranteed

that you will die painlessly and instantly in ten years, no earlier and no later. This

offer will only be available for the next five minutes and will never present itself

again. How much money would have to be offered for you to accept it? Many

would say that no amount of money is enough to counteract such a shortening of

ones lifespan. What if, though, you were guaranteed to die not after ten years, but

instead after eighty years? Those who would have accepted a large amount of

money in the first scenario would probably accept the offer in the second scenario

for much less money, and those who refused the first offer would probably be much

more inclined to accept the second offer for some large sum of money. Indeed, it is

very likely that countless individuals would pay large sums of money to guarantee

an additional eighty years of life, even if in doing so they had to literally guarantee

their death at a certain point. The reason why we are much more inclined to accept

the second offer for a given amount of money than we are to accept the first offer

for the same amount is because, although our interests in not dying will be roughly

the same in ten years as they will be in eighty years, our present time-relative

interests in not dying are much stronger for the first offer than they are for the

second offer. Even on an emotional level, this phenomenon tends to hold true; our

fear of imminent death is one of the most powerful and profound emotions we can

ever experience, but our fear of eventual death is much more abstract and

detached, and is lesser in magnitude as a result.


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Despite the strength and philosophical utility of McMahans model, time-

relative interest is something of a misnomer. Factors other than time can cause

psychological discontinuity, such as cognitive enhancement. With this in mind, we

can return to McMahans thought experiment and apply the notion of time-relative

interest to evaluate the strength of the moral obligation to enhance a cognitively

limited fetus, if we can still say that one exists. We already determined that,

without taking into account psychological discontinuities, a cognitively normal life is

better than a cognitively limited one. The psychological discontinuity between any

fetus and any adult into which it will develop is great; it is for this reason that the

question of the permissibility of aborting a fetus is so much more complex and

controversial than the question of the permissibility of murdering an adult. This

psychological discontinuity diminishes a limited fetuss interests in a cognitively

limited life as well as its interests in a cognitively normal life, and the fetuss

interest in living a cognitively normal life is furtherdiminished by the psychological

discontinuity caused by cognitively enhancing the fetus. Because the psychological

discontinuity between the cognitively limited fetus and itself in the future with or

without enhancement is so large, McMahan is able to conclude that a cognitively

limited fetuss comparatively weak interest in having normal cognitive capacities as

an adult grounds only a weak moral reason to provide it with cognitive

enhancement.

McMahans model is a powerful one, but it does have one fatal flaw that could

invalidate our entire analysis. All of McMahans judgments about an individuals

interests in some action being taken have been evaluated in terms of that

individuals interests in the outcome of that action. What McMahan fails to answer

is this: when exactly is the outcome? McMahan makes the arbitrary decision to


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evaluate the fetuss interests in terms of the quality of the fetuss life after it has

developed into an adult, but what would happen to his conclusions if we instead

defined the outcome to be the moment right after childbirth? This would greatly

diminish the psychological discontinuity between the fetus and itself at the time of

the outcome that weakened the moral imperative to enhance the fetus, making the

resulting moral imperative to enhance the fetus much stronger. On the other hand,

if we extend the outcome far enough into the future, the outcome will be the

same no matter what: death. If this is where we define the outcome, this method

of analysis would find no discrepancies whatsoever between any two given future

timelines!

Fortunately, we can easily fix the model to avoid this problem. To do so, we

will not evaluate an individuals interest in a particular action being taken in terms

of the desirability of the outcome, but instead in terms of the sum of the

individuals interests in all moments in that individuals life in the timeline that is

brought about by taking a particular action, after diminishing each of the terms of

this sum by the appropriate amount due to psychological discontinuity. This way,

we avoid the ambiguity brought up by McMahans negligence to clearly define how

to determine when the outcome is, and our analysis takes into account the results

of defining the outcome at any moment in the rest of the individuals life.

Although McMahans model has allowed us to make a strong case against the

intuitive belief that there is a strong moral imperative to enhance a limited fetus,

our entire analysis thus far has been conducted in the context of McMahans original

thought experiment that aimed to determine the moral value ofprenatal

therapeutic enhancement. One might think that this would mean that we cannot

generalize the conclusions of our analysis to questions of therapeutically enhancing


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individuals who have already been born. Recall, though, that we have only been

evaluating the strength of the first of the three different interests that might ground

a moral imperative for prenatal therapeutic enhancement: the interest of the fetus,

as it exists at the present moment, in living a cognitively normal life. To figure out

how our judgments about prenatal therapeutic enhancement would apply to

cognitively disabled individuals after they have been born, we need only turn to the

second of the three interests that need to be considered: the interest of the

individual into whom the fetus will develop.

The two outcomes under consideration remain the same; the individual will

either live a cognitively normal life or a cognitively limited one. The magnitude of

the future adult individuals interest in the fetus receiving enhancement, then, is

measured in almost exactly the same way. As was the case when measuring the

fetuss interest, the magnitude of the adult individuals interest in prenatal

enhancement is proportional to the difference in value between the two outcomes.

Since the outcomes under consideration here are the same as before, this step in

the analysis does not reveal any distinctions between the interest of fetus and the

interest of the adult in prenatal therapeutic cognitive enhancement. Unlike the

fetus under consideration, the adult under consideration is not separated from the

outcomes we are considering by time or by biological development, and the adults

interests in prenatal enhancement are therefore not weakened by psychological

discontinuity in this respect. However, the psychological discontinuity caused by

cognitive enhancement still applies, and this discontinuity will also weaken the

adults interests in being enhanced. Thus, the adult into whom the fetus will

develop does have a weak interest in prenatal enhancement of the limited fetus,

but it is not as weak as the interests of the fetus itself in being enhanced.


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We will now concern ourselves with the question of how the interest in

therapeutic enhancement will change if the cognitively limited individuals under

consideration have already been born and now have the option of being

permanently enhanced. In order to approach this question with the same method

of analysis we have used to evaluate prenatal enhancement, let us make the

assumption that the individual under consideration is so severely cognitively limited

that we must make decisions for it, as we did for the fetus. As it turns out, there is

no difference whatsoever between the interest that the individual into whom a

cognitively limited fetus will develop has in prenatal cognitive enhancement and the

interest that a cognitively limited individual has in post-birth therapeutic cognitive

enhancement, because in the eyes of the ethical test we are using, the two

scenarios are exactly the same; the outcomes that we are deciding between are still

a cognitively limited life and a cognitively normal life; no significant psychological

discontinuity arises from differences in time or biological development between the

individual whose interests are under consideration and the individual who will

experience the outcomes under consideration, but the ultimate moral imperative to

enhance is weakened in both cases by the psychological discontinuity between a

cognitively limited and a cognitively normal mind. We can therefore conclude that

any moral obligation to enhance a cognitively limited individual will be a weak one

but how weak will it be?

The moral imperative to enhance was weakened due to the significance of

the difference between the individuals psychological state before enhancement

and after enhancement. It follows, then, that the moral imperative will be

weakened more when this difference is greater. We must not forget, though, how

McMahan initially assigned normative value to a given action: . . . the difference in


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value between the two possible lives determines the strength of the individuals

present interest in the better of the two. Although more powerful forms of

enhancement yield greater psychological discontinuity between pre-enhancement

and post-enhancement states, weakening the moral imperative to enhance, they

also yield a greater difference in value between the two possible outcomes,

strengthening the moral imperative. I will not take on the task of determining which

of these effects is stronger, but it suffices to say that all forms of therapeutic

enhancement, regardless of efficacy, are especially limited in virtue and

relative importance, owing either to the insubstantial amount by which they

improve the lives of cognitively disabled individuals or to the psychological

discontinuity between the cognitively limited individual before and after

enhancement. It may seem that, in making this judgment, weve lost sight of the

precautions and standards for analysis that we deemed so important earlier: It

would be nave of us to make sweeping judgments about cognitive enhancement

in a general sense, for to do so would be to ignore the massive differences in

efficacy, permanence, and effects of different kinds of cognitive enhancement, but

notice that, unlike Bramstedt, we have considered the varying degrees of

enhancement in our analysis, and we have put forth an argument for why the same

judgment will hold true for all of them, so we are justified in making a generalized

conclusion about enhancement in the abstract.

Some might point out that although we have developed a very robust

argument against conventional beliefs about therapeutic enhancement, we have

only proved that the moral imperative to therapeutically enhance is weak, not that

it does not exist at all. Proving this may seem like a pointless exercise, but even

relative claims about the moral value of medical procedures can be very useful and


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can have important applications. As of now, our society makes a number of implicit

judgments about the extent to which we are morally obligated to help people with

disabilities, including the cognitively disabled. These judgments are manifested in

the amount of taxpayer money that we have decided to allocate to government

programs like Medicaid and Medicare, which have to treat many cognitively

disabled individuals, relative to other taxpayer-funded services. It is worth the

effort to work through this ethical analysis of therapeutic enhancement, because,

with a new understanding of the relative importance and virtue of therapeutic

enhancement, we might decide that we ought to re-evaluate the way we currently

allocate government resources to therapeutic enhancement relative to projects that

fulfill other societal goals. Our conclusion, like most bioethical conclusions, might

have comparably important applications for private insurance companies and

hospitals as well.

Should we want to enhance ourselves?

The power of McMahans model is apparent in the way that it allowed us to

generalize our conclusions about therapeutic enhancement to both fetuses and

grown humans and to all different forms of enhancement. If this analysis can cross

firm and substantial boundaries like the boundary between the interests of a fetus

and the interests of a person and the boundary between nootropics and

transhumanist, species-altering, cognitive enhancement technology, then perhaps it

can also traverse a boundary that we have shown at length to be blurry, thin,

ambiguous and elusive: the line between therapy and enhancement. If we are to

consider the same amount of cognitive enhancer being used both to bring a

cognitively limited person to a normal cognitive level and to bring an average

person to an enhanced level, then theres actually nothing whatsoever that


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distinguishes therapy from enhancement; although the outcomes being considered

are different, the difference in value between enhancing and not enhancing from

which the magnitude of interest in enhancement is being measured is the same for

therapeutic enhancement as it is for enhancement beyond the norm. Similarly, the

degree of psychological discontinuity between the unenhanced individual and the

enhanced individual, and thus the extent to which these interests are weakened is

the same for therapy as it is for enhancement. A cognitively normal individuals

interest in being cognitively enhanced is thus the same as a cognitively

disadvantaged individuals interest in being therapeutically enhanced. The average

persons interest in cognitive enhancement beyond the norm is not associated with

a proportionally strong moral obligation, as was the case with therapeutic

enhancement, because in this case we are not exploring what is best for others but

instead what is in our own best interest. Nonetheless, the conclusions we were able

to draw about what is in the best interests of a cognitively limited individual apply in

the same way to the best interests of cognitively normal individuals. This means

that although normal individuals do have an interest in being cognitively enhanced,

this interest is a weak one that is inferior to a number of other interests that the

cognitively normal may have to weigh as well in making decisions.

Those who find the idea of cognitive enhancement emotionally appealing

may dislike being told that their seemingly strong interests in enhancement are

actually relatively weak; for if this is the case, then why doesnt cognitive

enhancement only come off as weakly appealing? Before moving on, it would serve

us well to revisit why McMahans measure of time-relative interest is discounted by

psychological discontinuities. We have established that ones net psychological

state and, by extension, ones identity is not constant and will change as an


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individual grows. As a result, your identity a year from now may resemble your

identity today in most respects, but it will not be the same. Your identity in ten

years will be even less similar to your identity today, and this is why things that are

going to happen in a year tend to have more immediate emotional significance to

you right now than things that will happen in ten years. The more that the identity

of a future version of you differs from your current identity, the less you can

accurately call that person yourself. Any desire essentially comes down to an

interest in a future version of oneself experiencing some particular experience, for it

is impossible for us to satisfy our present desires in the past or in the present

(unless we are to act so fast that we instantly satisfy our desires the moment we

come up with them). This means that we pursue desires by trying to make

something happen for some future version of ourselves. Were not doing this out of

sympathy for our future selves, whom we have never met and might not know

anything about; if that was the case, wed be just as inclined to purchase a meal for

a person sitting on the opposite side of a restaurant at which we were eating as we

would be to purchase a meal for our (future) selves. We are still acting out of self-

interest, but our actions only fulfill our self-interest to the extent that the future self

psychologically resembles the present self. If one goes about trying to achieve

some goal at age 15, but by the time this goal is achieved, three years have passed

and 50% of the individuals brain has changed, then we might say the 15-year old

only experiences 50% of the satisfaction that would have been experienced if the

goal had been achieved instantly. The amount that an individual psychologically

changes before attaining a goal is inversely related to the extent to which that

individual enjoys the full benefits of attaining that goal.


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Putting this in terms of cognitive enhancement, we can conclude the efficacy

of the cognitive enhancer being used is inversely related with the extent to which

our present selves will enjoy the benefits of being enhanced. If Harold takes a weak

nootropic cognitive enhancer at 3:00 that only marginally enhances his cognition,

Harold at 3:01 will only be a slightlydifferent person than Harold at 2:59, and the

2:59 Harold enjoys almost all of the benefits from the nootropic that the 3:01 Harold

experiences. In contrast, if Sara undergoes a reconstructive neurosurgical

procedure from 3:00 to 4:00 that dramatically improves her memory, then Sara at

4:01 will be a substantially different person than Sara at 2:59. As a result, although

the 4:01 Sara will experience all of the benefits of the surgery, the 2:59 Sara

experiences significantly less of these benefits, and the fraction of the total benefit

(i.e. the benefit that the 4:01 Sara will experience) that the 2:59 Sara enjoys is less

than the fraction of the total benefit that the 2:59 Harold enjoys, because the

psychological discontinuity between 4:01 Sara and 2:59 Sara is greater than the

psychological discontinuity between 3:01 Harold and 2:59 Harold. It may seem

strange that we must be so insistent on evaluating what portion of the benefits 2:59

Harold and 2:59 Sara experience despite the fact that the treatments do not

begin until 3:00. Of course, the corporeal individuals that can be called Harold

and Sara at all times (We must make sure that we maintain a tone that

implements our stricter definition of identity, even though the conventional notion

of identity is so intimately tied with the use of names in our culture that doing so

seems a bit absurd and awkward at first.) will not literally experience the benefits of

their treatments at 2:59. To understand this, we need to think of 2:59 Harold, 2:59

Sara, 3:01 Harold, and 4:01 Sara to be four distinct individuals while simultaneously

assuming that 2:59 Harold and 2:59 Sara arepartially preservedbeyond their


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instantaneous moments of existence as distinct identities and incorporated into the

identities of 3:01 Harold and 4:01 Sara, respectively. We cannot simply evaluate

the treatments in terms the benefits that 3:01 Harold and 4:01 Sara experienced,

because we are not trying to figure out how cognitive enhancement will benefit

anyone at all we are trying to intuitively understand how cognitive enhancement

will affect the individuals that exist before enhancement. Since the ethical analysis

is conducted before any enhancement occurs, the 2:59 versions of Harold and Sara

are the only relevant individuals who actually exist, and the only individuals whose

interests in enhancement matter in our analysis. As we can see, our conclusion that

there are only weak reasons for a healthy individual to cognitively enhance himself

or herself does not disregard the emotional appeal of being cognitively enhanced.

This appeal is represented by 2:59 Harolds interest in experiencing what 3:01

Harold will experience and 2:59 Saras interest in experiencing what 4:01 Sara will

experience. The reason why the 2:59 individuals interests in deciding to enhance

themselves are not the same as their interests in experiencing what the post-

enhancement individuals will experience is because making this decision will not

bring about those experiences for the 2:59 individuals at least, not entirely. This

is the crucial point to understanding why McMahans model works on an intuitive

level, and it requires us to distance ourselves from the conventional notion of

identity as much as possible. Thus, the forms of enhancement that are effective

enough to be strongly emotionally appealing to you should actually be no more

rationally appealing to you than the weaker forms of enhancement, because the

extent to which you would get to see the benefit of this enhancement is much

less for more effective cognitive enhancers.

Is cognitive enhancement fair?


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We may have established that cognitive enhancement is desirable to us,

even if it is to a very weak extent. The strongest ethical problem cognitive

enhancement faces, though, is that of fairness. Our society is dedicated to

protecting the principle of equal opportunity for all, which was the moral principle

behind the imperative to provide therapeutic enhancement to the cognitively

limited. Does permitting cognitive enhancement undermine equality of

opportunity? After all, cognitive enhancement gives some individuals an

improvement in cognitive abilities that we could be expect to be accompanied by an

increase in opportunity. If some individuals are able to increase their opportunity

through enhancement, do we have a responsibility to ensure that everyone can

increase their opportunity by the same amount? To determine how the bioethical

community would approach this question, it benefits us to turn to a similar ethical

debate that has already been well-developed and well-publicized: that of the

permissibility of the use of anabolic steroids as athletic enhancement in professional

sports.

Those arguing that athletic enhancers should be allowed usually argued not

that athletic enhancement itself was morally permissible, but instead that individual

liberty should allow athletes to use anabolic steroids if they wish, or that a ban on

steroids is unenforceable or would have negative consequences. There is a case to

be made, though, that using athletic enhancers, even within competition, is in and

of itself morally justifiable. How could this be the case? Because, some argue,

athletic enhancement is already an important part of competitive sports. Most

runners would run a faster mile wearing running flats than they would barefoot.

Most baseball players would play a better game after weeks of training than they

would after a year of vacation. Hockey players who want to win often seek out the


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best brands of skates and sticks they can find. Anabolic steroids allow athletes to

transcend their biological limitations and perform better but isnt this exactly the

purpose of using better running shoes, better training techniques, and better

hockey sticks? In effect, tools, training, and dieting techniques all can be said to fall

under the label of athletic enhancement. Why should steroids be treated

differently?

To determine if there is any morally relevant distinction between standard

use of tools and training as enhancement and the use of anabolic steroids and other

pharmaceuticals as enhancement, we first have to decide whether we aim to

measure participants objective abilities or participants abilities relative to their

competitors. In competitions like the shot put and the long jump, players receive

objective scores which measure participants innate abilities. In competitions like

the SAT, however, a test which assigns participants a normalized score that

measures a participants location in the distribution of all participants scores on

that particular test, or in two-team competitions like baseball, basketball, and

football, we are not concerned with measuring innate ability, only relative ability.

Next we must determine whether the form of enhancement in question

fundamentally changes an individuals demonstration of competency in the respect

we which to measure it in. The introduction of fiberglass poles to pole-vaulting

dramatically increased the heights that vaulters could reach and forced them to

alter their technique, but they were permitted perhaps because they didn't

change the fundamentals of the sport. If somebody wanted to wear roller skates to

the Boston Marathon, however, it'd be hard to argue that the benefits provided are

analogous to those provided by air-cushioned running shoes or running flats,

because roller skates would dramatically change the fundamental meaning of the


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sport. Whether or not anabolic steroids change athletes demonstrations of

competency is still debatable, and is different for each sport, but the majority of

sporting institutions continue to prohibit them.

To evaluate whether cognitive enhancement would be unethical in cognitive

competitions, like chess matches, spelling bees, and the SAT, we have to look at

what it is we value in the contest itself, and whether the use of enhancers changes

the participant's attempt at demonstrating competency in that respect. The use of

calculators as a means of effective cognitive enhancement on the SAT is not

prohibited, because the SAT aims to measure relative ability, and The College Board

has determined that, provided that all students taking the test have access to them,

calculators do not change students demonstration of relative ability.

In light of our analysis of the time-relative merits of cognitive enhancement,

we ought to point out a peculiar implication of enhancement in the competitive

context that must be considered when the contest measures cognitive abilities

rather than athletic abilities. Because athletic enhancement usually affects the

body rather than the mind, the psychological discontinuity between a cognitively

enhanced individual and the same individual without enhancement does not apply

to athletic enhancement. As a result, there is no difference in identity between an

unenhanced and an enhanced athlete (unless one considers the body to be an

element of identity, which we have not done). As a result, if the enhancement

fundamentally changes the athletes demonstration of competency, the legitimacy

of the competition is threatened. Athletic enhancement changes ability but not

identity; the competition therefore would therefore assess the same individual more

favorably than intended. As we determined earlier, though, the psychological

discontinuity associated with cognitive enhancement changes an individuals


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identity to an extent that is proportional to the strength of the enhancer. The

competition therefore does not judge the same individual more favorably than

intended it instead judges a differentindividual with the same name and body as

the unenhanced individual more favorably than it intended to judge the unenhanced

individual. So although at first glance it may look like cognitive enhancement

qualifies as cheating, the way that cognitive enhancement changes identity means

that, in the strictest sense, it does not diminish the legitimacy of the competition

like athletic enhancement does. Of course, cognitive enhancement only partially

changes an individuals identity, so we cannot give cognitive enhancement a free

pass. The extent to which the legitimacy of the competition is threatened is,

somewhat counter-intuitively, greater for the least effective forms of enhancement.

At the same time, though, the least effective forms of cognitive enhancement will

have the least significant effect on the results. For each sport, the significance of

the effect on the results, the significance of the psychological discontinuity between

an unenhanced individual and the same individual after enhancement, and the

extent to which the enhancement fundamentally changes participants

demonstration of the factor we wish to measure must all be taken into

consideration in determining whether using a particular cognitive enhancer is

unfair.

Examining the issue in this manner calls our attention to an interesting

question which we can evaluate through another thought experiment. Assume a

chemical is developed that drastically improved reasoning skills, but there are only

enough resources to synthesize enough of this chemical for one person. The

government decides that this chemical should be given to a person randomly

selected from all babies born in the next year. Tom, who has an identical twin


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brother named Tim, is selected and receives the enhancer in infancy, developing

into a hyper-intelligent individual with extremely powerful reasoning skills. Tim, on

the other hand, is average in all respects. While in high school, the two twins take

the SAT on the same day. Tom scores a 2400, the maximum possible score, and

Tom scores a 1500, the average score. If we make the assumption that the

psychological differences between Tom and Tim significantly outweigh their

differences in score, then, according to our analysis, Tom deserves to outscore Tim.

Now assume that fraternal twins Tod and Rod take the same SAT test on the same

day. Tod is naturally smarter than Rod, so much so that Tod scores a 2400 and Rod

scores a 1500. Societal morals would imply that Tod deserves to outscore Rod, and

it was because of these societal morals that we were able to conclude that Tom

deserved to outscore Tim but why exactly does either Tod or Tom deserve to

outscore his twin? Both of them did not receive their advantage through hard work;

there is nothing in particular that would indicate that Tod and Tom are entitled to a

cognitive advantage more than Tim and Rod are. Before coming into existence, Tod

and Rod had the same chance of having such an advantage over the other, and

before the smart pill was randomly assigned, Tom and Tim had equal chances as

well. Does the fact that the distribution of cognitive advantage is random really

make it fair that some individuals are naturally smarter than others? To answer this

question, or to develop an ethical model that did not assume that it is fair that

natural advantages are distributed by a genetic lottery would be a daunting

philosophical task that I will not take on here, but this question deserves to be

asked, and further research ought to be conducted in this area. If we can reject the

fairness of the genetic lottery, then we can conclude that cognitive enhancement is

without a doubt unfair in cognitive competitions, but as long as our society does not


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take issue with the genetic lotterys distribution of cognitive advantages, some

forms of cognitive enhancement will have to be permissible.

Conclusion

Answering ethical questions about cognitive enhancement is an exceedingly

difficult endeavor, and it seems that the only way to responsibly develop an ethics

of cognitive enhancement is on a case-by-case basis. Intuition would tell us that the

only relevant distinction determining whether cognitive enhancement is permissible

is the distinction between therapy and enhancement but as it turns out, finding a

satisfactory definition of where this distinction lies is almost impossible. Ethicists

ought to abandon their fruitless pursuit of a line that cleanly divides permissible

therapy from contemptible enhancement, for there are much more sophisticated

ways to ethically evaluate cognitive enhancement that hold true for both therapy

and enhancement. Factors that need to be taken into consideration include the

efficacy and permanence of the form of cognitive enhancement under

consideration, the nature of the competition whose legitimacy is allegedly

threatened by cognitive enhancers, and the magnitude of psychological

discontinuity that enhancement causes.

All of this analysis has been conducted within a moral framework that has

questionable implicit assumptions. Our society currently has no issue with

rewarding some people more than others simply because some are more

genetically lucky. Although religion may see this issue differently, the extent to

which this assumption holds in a secular society is extremely questionable. To

maintain a consistent moral frame, ethicists have two options. We must decide

between accepting the fact that cognitive enhancement will sometimes be


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permissible or confronting the fact that our societal morals might be largely

founded on a fallacious assumption. The latter task is a formidable one, but we

have a responsibility as human beings with moral integrity to undertake it, even if it

means we might have to drastically restructure the way our society works. The

intuition of the layman may fiercely oppose such a transition, but, as we have seen,

intuition often comes to deeply erroneous conclusions about what is best for the

individual and for society. Attempts to question societal moral norms will

undoubtedly be labeled as sinful, reprehensible, wicked, and vile but let us not

forget why we undertake these tough ethical endeavors in the first place: to make

the world a better place for all who inhabit it.

designer genius an ethical investigation of cognitive enhancement

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