Common drugs can be dicey
Neuro-scientific research is rapidly expanding our knowledge of how we can alter brain function — for better or for worse. Most of this research is motivated by a desire to cure diseases or to slow down normal age-related decline. But some of it seems to hold out the hope of improving function in the already well-functioning brain. We might be able to enhance attention, for instance, or working memory, mathematical ability, and even the capacity to reason morally.
Some people welcome this prospect, while others fear it. Critics worry it threatens our sense of self, our authenticity, and that it might lead to a neglect of our proper attitude to nature and alter society in unexpected and unwelcome ways.
Most people would agree that, at the very least, we need to go slowly and cautiously here, ensuring that new technologies are not rolled out for general use until we have properly assessed their risks and benefits; established appropriate regulatory regimes; and thought through their ethical implications. But what if these technologies are already widely used, unbeknownst to those who use them?
This prospect is raised by a recent finding by researchers at University College London that normal people who take drugs commonly prescribed for the treatment of disease and dysfunction (Parkinson’s and depression) have their moral cognition altered—in a more selfish and a less selfish direction, respectively.
Whether either counts as moral enhancement is a very difficult question, most centrally because how selfish we should be remains contested. But that doesn’t seem to matter here: opposition to moral enhancement, and the counsel that we should proceed cautiously, depends more on worries about altering ourselves than on whether we’re actually altering ourselves for the better.
The study authors caution that we cannot conclude from the finding—that healthy people have their moral cognition modified by common pharmaceuticals—that sufferers from depression or from Parkinson’s are also subject to such modification.
The antidepressant used in the study (citalopram) seems to alleviate depression by changing the level of serotonin, a neurotransmitter, in the brain. Similarly, the Parkinson’s drug tested alters the level of dopamine. People who are properly prescribed these drugs have different baseline levels of these neurotransmitters to healthy controls.
As the study’s lead author Molly Crockett points out, this may mean the drugs have different effects on patients than on controls. In fact, the pharmaceuticals may be restoring patients’ former capacity for moral cognition. Or it may have no effect on their moral cognition at all; we cannot extrapolate from acute effects like these to long-term effects, given that brains are designed to adapt to persistent changes.
Still, we have at least a prima facie reason to test to see whether the drugs are having an effect on patients. What’s more, the antidepressant that Crockett and her colleagues tested is prescribed for a number of conditions besides depression and, in some of them, baseline serotonin levels are probably in the normal range.
Even more medicines
It’s not just these two drugs that affect moral cognition. In a recent paper that I published together with some Oxford University colleagues, we surveyed evidence that other drugs alter how people respond to moral dilemmas. At least one of these medicines, Propranolol, is sometimes prescribed for hypertension (it used to be very widely prescribed). Propranolol affects normal people’s memories, making them less likely to identify an item that was previously shown to them. There are circumstances in which this could matter a lot—in a court of law, for instance. Other drugs appear to make people more trusting. Whether this is a good or bad thing would depend on context: in some contexts, trust is a moral good that allows us to achieve shared ends (so-called “prisoner’s dilemmas” are one example). In other contexts, being trusting might leave people open to being exploited.
The drugs we surveyed have had their effects on cognition studied. Given that other medicines prescribed for physical conditions may also affect how we think (because the compounds that act as neurotransmitters also sometimes regulate bodily functions), there may be many more.
Just another unknown
So we may already be morally modified, and the time to ask ourselves whether we should change our cognition by taking medication has long passed. But it’s still important that we come to understand how we’re altering ourselves, to assess whether we ought to continue to do so. We need to understand the costs and benefits of these alterations.There’s no reason to panic; the effects of pharmaceuticals on moral cognition are likely to be subtle and it takes sophisticated statistical analysis to uncover them. But that doesn’t mean there’s reason for complacency either. A subtle effect at the level of individuals may make a dramatic difference at the level of a population, if enough people are taking the same compound.
And suppose we discover that we are morally modifying ourselves, should we worry? I think that depends on what the effects are. If they are generally beneficial (or, more realistically, more beneficial than costly - in a messy world, nothing comes without costs), then we should relax.
It’s worth bearing in mind that the differences between us are the product of physical forces—genes and various environmental influences—that we do not fully understand, and over which we exercise relatively little control. Moral modification by pharmaceuticals doesn’t look all that different from the kinds of influences that make us who we are.
(Neil Levy is professor at Macquarie University)