- BIOETHICS FORUM ESSAY
Cognitive Enhancement on Campus: Taking Competition Seriously
For years, healthy students have taken prescription-only stimulants such as Ritalin and Adderall to improve their academic performance. While prescribed mostly to treat attention deficit hyperactivity disorder, these drugs are known to increase concentration and hold off fatigue in healthy people, allowing students to study more productively for longer or boost their performance on important exams. Scientific studies have recently confirmed the cognitive-enhancing properties of these drugs, reinforcing what students (and others) already know.
This last December, Henry Greely and six other prominent authors published a commentary in Nature titled “Towards Responsible Use of Cognitive-enhancing Drugs by the Healthy.” The authors argue in favor of allowing healthy adults to use drugs like Ritalin and Adderall for cognitive enhancement, and they foresee that the practice could lead to substantial benefits. In the course of their paper they address several ethical dilemmas and argue that carefully crafted policies can mitigate those concerns.
As a college student, I think Greely et al. do not accurately characterize and address the dilemma these drugs pose on college campuses — which is a significant problem, since use on college campuses is the most common real-world example of the practice the authors are advocating.
Greely and colleagues raise six possible moral concerns. I want to focus on two that are intertwined and particularly relevant to the college setting. The first is a concern about fairness. Is pharmaceutical cognitive enhancement unfair, or can policies be formulated to guard against any inequities? The authors begin by claiming that whether the use of drugs for cognitive enhancement is unfair depends on the nature of the effects those drugs have. They argue that if these drugs only improve exam performance, then they may be unfair, but if they also improve students’ ability to learn in the long run, then they may be acceptable.
But I think this sidesteps the real issue. It is not whether the drugs improve long-term learning that matters, but how students use the drugs. Students don’t buy these pills on the black market for learning’s sake; they take them to get better grades.
The authors also argue that the fairness of cognitive enhancement depends on the availability of the drugs. They argue that concerns about fairness relating to access can be adequately addressed. First, they note that there are already many other access-related fairness problems in education. Students who had access to elite high schools or private tutors may have an unfair advantage over other students. I have seen this argument made elsewhere; Randy Cohen, author of “The Ethicist” column in The New York Times Magazine, made it in an article last year. While it is certainly the case that there are inequalities based on access in the education system, the fact that inequalities already exist does not make the introduction of a new inequality acceptable. The argument seems to reduce to something like “Things are already unfair in significant ways, so what difference does it make if we introduce something else that might be unfair?”
The authors’ second argument about access-based fairness concerns is that policies can eliminate any unfairness brought about by access issues. They suggest, for example, that schools might provide free access to cognitive enhancements during exam week, in much the same way that some schools provide all students with computers during that time.
This argument leads to the second major concern particularly relevant to the college setting: the problem of freedom, “specifically freedom from coercion to enhance.” The authors ask, “Should schools and employers be allowed to require pharmaceutical enhancement… and if we answer ‘no’ to this question, could coercion occur indirectly, by the need to compete with enhanced classmates and colleagues?” The authors acknowledge that solving problems of fairness may lead to problems of indirect coercion, but they suggest that colleges should freely distribute cognitive enhancement. This is a terrible policy recommendation. It may solve the access-based fairness issue of the drugs being available to some students and not others, but surely it would cause an unprecedented level of indirect coercion. If colleges freely distributed cognitive enhancements during exam weeks, students would certainly feel coerced into taking them.
The authors seem to have an unrealistic view about the role and prominence of competition in college. In my experience, the unfortunate reality is that college academics are highly competitive, perhaps more competitive than they have ever been (and I go to a college that is known for having a far less competitive atmosphere than some of its peers). Increasing numbers of students are going to graduate school, and it is not uncommon for top programs to admit fewer than 10% of their applicants. Competition for plumb jobs is equally fierce, and the current economic downturn is only making matters worse.
Given this competitive environment, the concerns about fairness and freedom cannot be so easily set aside. Greely and colleagues offer a response to the fairness problem that would indirectly coerce students into taking enhancements because they felt they had no choice. They state that acceptable policies should discourage this kind of coercion, but they offer no good suggestions as to what these policies might be.
Benjamin Gould is a senior at Vassar College.