Let’s talk about risks in Neuro-Enhancement

If we talk about Neuro-Enhancement it is important to remember the risks related to cognitive enhancing drugs or to the technologies that can improve performance.

Various current and putative future neuro-enhancement endeavors seem to offer promising perspectives: Who would not want to be smarter, to have a better memory, to be in a better mood, to be capable of doing more things in less time, or to be more focused in academic contexts or at work? Perspectives like these may seem fascinating. In particular, it is tempting to hypothesize that in the future there will be an ideal neuro-enhancer available which is effective in improving cognition or another mental ability without negative side effects.

This leads to the fact that in reports on neuro-enhancement technologies, which are fascinated by putative future technological development, the chances and possible future benefits tend to be stressed and the risks neglected.

However, the reality is far from this. Instead, issues concerning safety and effectiveness are crucial. It is questionable whether an effective biomedical enhancement of human brain functions will ever be possible without health risks.

At least in the current neuro-enhancement approaches, risks are an important and serious aspect. Most of the current neuro-enhancement attempts are premature uses of technologies which were originally developed for medical purposes, i.e. for treating patients with disorders. Prescription stimulants such as Ritalin®, for example, were tested and approved for the treatment of patients with attention deficit hyperactivity disorder (ADHD). Transcranial direct current stimulation (tDCS) has been used in clinical contexts in the treatment of severe depression or chronic pain. In the respective medical contexts, the benefits and risks for patients have been analyzed in a detailed way.

In contrast, there is a considerable lack of knowledge about the effects and side effects of these technologies in healthy individuals. In the use of prescription and illicit stimulants for enhancement purposes, for example, observed side effects in anecdotic reports include sleeplessness, restlessness, tachycardia, and tremor. In addition, the risk of addiction has to be taken into consideration. The information deficit is even more pronounced in the use of tDCS for self-enhancement. Furthermore, there is lack of empirical data concerning the long-term consequences of neuro-enhancement on the developing brains of children and adolescents.

Thus, pharmacological or device-based neuro-enhancement is fraught with considerable uncertainties. In general, it may be the case that one aspect of mental performance is enhanced, but at the cost of being detrimental to another one, which may lead to rather ambivalent results. In addition, it is plausible to assume that enhancements in mood, cognition, emotion or motivation may involve numerous implications on an individual’s behavior and life. Currently, the effects in real-life situations are far from known.

Whereas in clinical settings involving patients, there is a medical professional who adheres to medical standards concerning safety, risk-benefit-balancing and informed consent, in self-enhancement attempts the users are left to their own resources. These may include their own past enhancement experiences, advice from peers and friends, or media information. Reliable information on the risks and benefits being scarce, it cannot be excluded that current self-enhancers tend to overestimate putative benefits and underestimate the health risks involved.

To sum up, there is a clear need and responsibility for a balanced and scientifically informed picture of the chances, benefits and risks of current neuro-enhancement approaches. In dreaming about possible future enhancement scenarios, it is important not to disregard the current and putative future reality.