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Ethics in America II

A Better Brain: The Ethics of Neuro-Enhancement

Maria and her daughter Camilla are meeting with several challenges in this difficult time in their lives, from the exhaustion of working two jobs, to the pressure and loneliness of being an average, unpopular kid at school. Yet it appears that some new pharmaceuticals may help each of them — if they choose to use them. New drugs have also found a place in the university setting where students find that Hype Pharmaceuticals' Alzheimer's drug, Rememberall, helps them study better, work faster and remember much more. By enhancing their performance this way, are they cheating? Are they possibly endangering themselves?

As our story begins, Maria, a teacher, sits at a school assembly, where a graduate who now works at Hype Pharmaceuticals describes a new drug called Alerta. Developed for people with narcolepsy, it allows someone to forego sleep for extended periods of time. Maria doesn’t have narcolepsy—she is perfectly healthy, in fact—but she does have two jobs, and could use the drug to work late into the night. She goes to her physician for a prescription. Should the doctor give it to her?

Time passes, Maria is back to one job, but she still is not sleeping at night, because she is worrying about her daughter, Camilla. Eight-year-old Camilla has no friends at school; the kids call her a “weirdo” although she doesn’t know what she is doing that’s weird. The school counselor suggests that Camilla might be helped by a medication called Amikind. Amikind was originally developed to treat autism and Asperger’s, conditions that Camilla does not have. But the drug also improves the ability of otherwise unimpaired individuals to interact with others, somehow making them better at picking up social cues. Should Maria consider giving her child a drug to solve her social problems?

As parent and child ponder their options, we move from the playground to Strivers University, where a new “study-buddy” has become quite popular: a drug called Rememberall, made by Hype Pharmaceuticals. Developed for Alzheimer’s patients, one can take Rememberall, study one’s schoolwork, and remember much more, much faster. Are the students who take Rememberall, and other drugs to enhance their performance, cheating? Are they endangering themselves?

As time passes, Hype Pharmaceuticals develops one more medication—one that helps you forget instead of remember. Traumagone dulls the memory of a traumatic experience; one will still remember what happened, but the emotional trauma surrounding the memory will be taken away. Among those who seek to take this drug is a soldier who wants to dull the memory of all the killing he did for his country. Should he be able to take the drug?

Credits

EXECUTIVE PRODUCER
Richard Kilberg

WRITER/ PRODUCER
Joan Greco

SENIOR EDITORIAL DIRECTOR
Ruth Friendly

EXECUTIVE DIRECTOR
Barbara Margolis

BROADCAST PRODUCER/DIRECTOR
Mark Ganguzza

EDITOR
Rob Forlenza

ASSOCIATE PRODUCERS
Jason Steneck
Ann Yoo

SCENIC DESIGN
H. Peet Foster

LIGHTING DESIGN
Dan McKenrick

SENIOR AUDIO ENGINEER
Bob Aldridge

ETHICS CONTENT ADVISOR
Lisa H. Newton, Ph.D.

AUDIENCE COORDINATOR
Rachel Ward

SPECIAL THANKS
The Hastings Center
Thomas H. Murray
Erik Parens
Josephine Johnson

Eric Cohen
Ahmad Corbitt
Michael J. Goldblatt
Amy Laura Hall
Lynn Jansen
David A. Lowe
Ramez Naam
Joyce M. Raskin
Tania Simoncelli
Ginger C. Simor
Laurence R. Tancredi
Jeff Vandam

Meet the Participants

John Hockenberry (Moderator)
John Abramson
Art Caplan
Lawrence Diller
Martha Farah
Joshua Foer
Michael Gazzaniga
William B. Hurlbut
Peter Augustine Lawler
Gary Lynch
Michael Sandel
Sally Satel
Antonin Scalia
Tim Tully

Moderator

John Hockenberry John Hockenberry
Television Correspondent and AuthorContributing Editor
WIRED Magazine
John Hockenberry has received numerous awards and honors for his work in broadcast journalism, including an Emmy and three Peabody Awards. Previously, Mr. Hockenberry served as a correspondent for the ABC newsmagazine Day One, and as a reporter, correspondent, and host of several programs on National Public Radio. Mr. Hockenberry is also the author of Moving Violations: War Zones, Wheelchairs and Declarations of Independence, his memoir of life as a foreign correspondent. In 1996, he performed “Spokeman,” the one-man, off-Broadway show, based on his book. He has also written for the New York Times, the New YorkerI.D. Magazine, the Columbia Journalism Review, and the Washington Post. He is also a contributing editor to WIRED magazine. Hockenberry moderated the Fred Friendly Seminar “Who Cares: Chronic Illness in America,” “Making Better Babies” in the Our Genes/Our Choices series and “Failure to Protect.”

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Panelists

John Abramson John Abramson
Clinical Instructor
Harvard Medical School
Author, Oversdosed America
John Abramson, M.D., has worked as a family doctor in Appalachia and in Hamilton, Massachusetts, and for seven years chaired the Department of Family Practice at Lahey Clinic. He was a Robert Wood Johnson Fellow and is currently on the clinical faculty of Harvard Medical School, where he teaches primary care. In 2002, Dr. Abramson left practice to devote himself full time to researching and writing Overdosed America (HarperCollins, 2004), with the goal of helping patients and doctors to reclaim the basic mission of medicine: optimizing health most effectively and efficiently.

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Art Caplan Art Caplan
Director
Center for Bioethics
University of Pennsylvania 
Art Caplan is currently the Emmanuel and Robert Hart Professor of Bioethics, chair of the Department of Medical Ethics, and the director of the Center for Bioethics at the University of Pennsylvania in Philadelphia. Prior to joining to Penn in 1994, Caplan taught at the University of Minnesota, the University of Pittsburgh, and Columbia University. He was the associate director of the Hastings Center from 1984 to 1987. He is the author or editor of 25 books and over five hundred papers in refereed journals of medicine, science, philosophy, bioethics, and health policy. His latest book The Case of Terri Schiavo: Ethics at the End of Life was published in March 2006.

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Lawrence Diller Lawrence Diller
Author, Running on Ritalin
Lawrence Diller is a behavioral-developmental pediatrician and family therapist. He has evaluated and treated more than 2,500 children and their families over the past 27 years. He is an assistant clinical professor of pediatrics at the University of California, San Francisco. He has written many articles on children’s behavior and psychiatric medication for the professional and lay literature that have garnered national and international notice. His book, Running on Ritalin: A Physician Reflects on Children, Society and Performance in a Pill (Bantam Books, 1998), was featured in a Time magazine cover story on Ritalin. He provided expert testimony on Ritalin before a U.S. congressional committee in May 2000 and the President’s Council on Bioethics in December 2002. His second book, Should I Medicate My Child? Sane Solutions for Troubled Kids with and Without Psychiatric Drugs (Basic Books), was published 2002. His latest book, The Last Normal Child: Essays at the Intersection of Kids, Culture and Psychiatric Drugshas just been released.

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Martha Farah Martha Farah
Director
Center for Cognitive Neuroscience
University of Pennsylvania 
Professor Martha Farah is an expert in many topics in cognitive neuroscience, including visual recognition, mental imagery, semantic memory, and more recently, ethical issues emerging from advances in the neuroscience of cognition and emotion. She is now the Walter H. Annenberg Professor in the Natural Sciences and director of the Center for Cognitive Neuroscience at the University of Pennsylvania. Her work spans many topics in cognitive neuroscience, including neuroethics. She is the author of Visual Agnosia (MIT Press, 2nd edition, 2004), Behavioral Neurology and Neuropsychology (McGraw-Hill, 2nd edition, 2003, with T. E. Feinberg), The Cognitive Neuroscience of Vision (Blackwell, 2000), and editor of Patient-Based Approaches to Cognitive Neuroscience (MIT Press, 2nd edition, 2005).

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Joshua Foer Joshua Foer
Freelance Science Journalist
Joshua Foer is a freelance science journalist in Washington, D.C. His writing has appeared in the New York Times, the Washington PostEsquireSlateDiscover, and the Nation. He is working on a book about memory.

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Michael Gazzaniga Michael Gazzaniga
Director
SAGE Center for the Study of Mind
University of California,
Santa Barbara
Member
President’s Council on Bioethics
William B. Hurlbut is a physician and consulting professor in the Program in Neuroscience at Stanford University. In addition to teaching at Stanford, he currently serves on the President’s Council on Bioethics. His primary areas of interest involve the ethical issues associated with advancing biomedical technology, the biological basis of moral awareness, and studies in the integration of theology and philosophy of biology. Dr. Hurlbut has come to national prominence for his advocacy of a scientific method of obtaining totipotent stem cells which attempts to circumvent moral questions involved with the destruction of human embryos.

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William B. Hurlbut William B. Hurlbut
Neuroscience Institute
Stanford University Medical Center
Member
President’s Council on Bioethics
Michael Gazzaniga, Ph.D., is director of the Sage Center for the Study of Mind. He has published many books such as Mind Matters and Nature’s Mind and participated in the public television specials The Brain and The Mind. His many scholarly publications include the landmark 1995 book for MIT Press, The Cognitive Neurosciences, now in its third edition, which is recognized as the sourcebook for the field. Dr. Gazzaniga’s long and distinguished teaching and mentoring career has included beginning and developing Centers for Cognitive Neuroscience at the University of California Davis and Dartmouth, supervising the work and encouraging the careers of many young scientists, and founding the Neuroscience Institute and the Journal of Cognitive Neuroscience, of which he is the editor in chief. He is an advisor to various institutes involved in brain research, and is a member of the President’s Council on Bioethics.

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Peter Augustine Lawler Peter Augustine Lawler
Professor of International Studies
Department of Government
Berry College
Member
President’s Council on Bioethics
Peter Augustine Lawler, Ph.D., is Dana Professor and chair of the Department of Government and International Studies at Berry College. He teaches courses in political philosophy and American politics. He is executive editor of the acclaimed quarterly journal Perspectives on Political Science and has chaired the politics and literature section of the American Political Science Association. He also serves on the editorial board of the new bilingual critical edition of Alexis de Tocqueville’s Democracy in America and on the editorial boards of several journals. He is a member of the Society of Scholars at the Madison Center at Princeton University, the George Washington Professor on the American founding for the Society of Cincinnati for the state of Georgia, and he is a member of President Bush’s Council on Bioethics. He has written or edited ten books. Lawler has published more than 125 scholarly articles, chapters, and reviews.

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Gary Lynch Gary Lynch
Professor of Psychiatry
University of California Irvine 
Gary Lynch, M.D., is a cofounder of Cortex Pharmaceuticals and has been a scientific consultant since October 1987. He served as a director of the company from March 1988 to March 1989 and again from December 1994 to December 1995. Dr. Lynch was a professor in the Department of Psychobiology at the University of California, Irvine, from 1969 to 1997. He is currently professor above scale in the Department of Psychiatry and Human Behavior at UCI. Dr. Lynch is a member of the advisory board for the Cognitive Neurosciences Institute and JPL/NASA. Dr. Lynch has authored over five hundred articles and a number of books in the areas of neurobiology, cognition, and memory. He is a cofounder of Synaptics and the Thuris Corporation.

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Michael Sandel Michael Sandel
Professor of Government
Harvard University
Former Member
President’s Council on Bioethics
Michael Sandel, D.Phil., is the Anne T. and Robert M. Bass Professor of Government at Harvard University. Sandel has taught the famous Justice course at Harvard for two decades. Justice, conducted in Sanders Theater, is the first and only moral philosophy and reasoning class most Harvard undergraduates take. More than 10,000 students have taken the course, making it one of the most highly attended in Harvard’s history. It is also offered online for students nationwide through the Harvard Extension School. Sandel also teaches Ethics and Biotechnology, a seminar considering the ethical implications of a variety of biotechnological procedures and possibilities. His latest book, Public Philosophy, is a collection of essays published over the years, examining the role of morality and justice in American political life.

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Sally Satel Sally Satel
Coauthor, One Nation Under TherapyResident Scholar
American Enterprise Institute
Sally Satel is a resident scholar at the American Enterprise Institute in the W. H. Brady Program in Culture and Freedom. She is also the staff psychiatrist at the Oasis Clinic in Washington, D.C. Dr. Satel earned a B.S. from Cornell University, an M.S. from the University of Chicago, and an M.D. from Brown University. After completing her residency in psychiatry at Yale University School of Medicine, Dr. Satel was an assistant professor of psychiatry from 1988 to 1993. From 1993 to 1994, she was a Robert Wood Johnson Health Policy Fellow with the Senate Labor and Human Resources Committee. She is author of PC, M.D.: How Political Correctness Is Corrupting Medicine (Basic Books) and is coauthor, with Christina Hoff Sommers, of One Nation Under Therapy (St. Martin’s Press).

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Antonin Scalia Antonin Scalia
Associate Justice
U.S. Supreme Court
Antonin Scalia is a jurist on the United States Supreme Court. He took his seat in 1986. Scalia went to Georgetown University, where he completed his undergraduate studies and received an A.B. summa cum laude in history. He also graduated from Georgetown as class valedictorian. Scalia went on to Harvard Law School. He served as editor of the Harvard Law Review and graduated magna cum laude. A formalist, Scalia is considered the Court’s leading proponent of textualism and originalism (he is careful to distinguish his philosophy of original meaning from original intent). These schools of jurisprudence emphasize careful adherence to the text of both the Constitution of the United States and federal statutes as that text would have been understood to mean when adopted.

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Tim Tully Tim Tully
Professor
Cold Spring Harbor Laboratory
Tim Tully, Ph.D., is a professor of genetics at the Cold Spring Harbor Laboratories on Long Island, New York. A native of Washington, Illinois, Tully attended the University of Illinois, where he obtained a B.S. in both biology and psychology and a Ph.D. in genetics. Tully investigates the genetic basis of memory. His research seeks to identify the genes involved in neural development as well as neural function. The goal of his work is to develop effective behavioral and pharmacological treatments for memory loss. His experiments on “photographic memory” in fruit flies was the first demonstration of genetically enhanced memory in history.

View Program and Text Highlights

The video highlight shows our panelists in action. The Discussion Guide frames their debates in contemporary terms, while the Ethics Reader grounds the discussion in the philosophy of the past.

Should students use memory-enhancing drugs to improve academic performance?

A father and college-age son, played by Justice Antonin Scalia and Joshua Foer, respectively, debate the son’s choice to use a memory-enhancing drug, Rememberall, to improve his performance on his final examinations. Scalia argues against taking the drug, arguing that there is a moral obligation to accept yourself as you are, even if you are not the smartest or the strongest. Foer counters by reminding his father that as a child he was always pushed to gain a competitive edge in academics. What is wrong with taking the memory-enhancing drug if it is deemed to be safe and everyone else is taking it?

Read Text Highlights

Framing This Discussion (from the Discussion Guide)

The goal of enhancement is nothing other than the betterment of human life—to make life more enjoyable for the one living it, more productive, more useful for self, family, and society. There are “natural” forms of enhancement that have always been approved. Indeed, simple practice can enhance natural abilities and, in the process, transform the human body to accommodate them. For example, practicing the piano, training at sports, or studying hard can lead to greater intellectual or physical dexterity and more success in the respective fields than not doing these things. But in certain competitive environments, simply studying hard, as recommended by Justice Scalia, may not be enough for Joshua Foer’s success if other students are taking legal and apparently safe stimulants to gain an edge. But, if everyone is enhanced, there is no more competitive advantage, the price of competing has been raised, and the competition made more dangerous for all participants.

For a deeper examination of the analysis abridged here, see the Discussion Guide.

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Philosophical Grounding of This Discussion (from the Ethics Reader)

John Stuart Mill’s Utilitarianism, excerpted below, urges those seeking neuro-enhancement to consider the “quality” of the happiness they may find and radiate to others.

According to the Greatest Happiness Principle . . . the ultimate end, with reference to and for the sake of which all other things are desirable (whether we are considering our own good or that of other people), is an existence exempt as far as possible from pain, and as rich as possible in enjoyments, both in point of quantity and quality; the test of quality, and the rule for measuring it against quantity, being the preference felt by those who, in their opportunities of experience, to which must be added their habits of self-consciousness and self-observation, are best furnished with the means of comparison. This, being, according to the utilitarian opinion, the end of human action, is necessarily also the standard of morality; which may accordingly be defined, the rules and precepts for human conduct, by the observance of which an existence . . . might be, to the greatest extent possible, secured to all mankind; and not to them only, but, so far as the nature of things admits, to the whole sentient creation. . . .

To read selections from philosophical texts relevant to this program, see Ethics Reader.

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