What users think about the differences between caffeine and illicit,prescription stimulants for cognitive enhancement

Pharmacological cognitive enhancement (CE) is a topic of increasing public awareness. In the scientific literature on studentrnuse of CE as a study aid for academic performance enhancement, there are high prevalence rates regarding the use ofrncaffeinated substances (coffee, caffeinated drinks, caffeine tablets) but remarkably lower prevalence rates regarding the usernof illicit/prescription stimulants such as amphetamines or methylphenidate. While the literature considers the reasons andrnmechanisms for these different prevalence rates from a theoretical standpoint, it lacks empirical data to account for healthyrnstudents who use both, caffeine and illicit/prescription stimulants, exclusively for the purpose of CE. Therefore, wernextensively interviewed a sample of 18 healthy university students reporting non-medical use of caffeine as well as illicit/rnprescription stimulants for the purpose of CE in a face-to-face setting about their opinions regarding differences in generalrnand morally-relevant differences between caffeine and stimulant use for CE. 44% of all participants answered that there is arngeneral difference between the use of caffeine and illicit/prescription stimulants for CE, 28% did not differentiate, 28% couldrnnot decide. Furthermore, 39% stated that there is a moral difference, 56% answered that there is no moral difference andrnone participant was not able to comment on moral aspects. Participants came to their judgements by applying threerndimensions: medical, ethical and legal. Weighing the medical, ethical and legal aspects corresponded to the students’rnindividual preferences of substances used for CE. However, their views only partly depicted evidence-based medical aspectsrnand the ethical issues involved. This result shows the need for well-directed and differentiated information to prevent thernpotentially harmful use of illicit or prescription stimulants for CE.

Conceptual and normative issues of memory enhancement

Our growing understanding of human mind and cognition and the development of neurotechnology has triggered debate around cognitive enhancement in neuroethics. The dissertation examines the normative issues of memory enhancement, and focuses on two issues: (1) the distinction between memory treatment and enhancement; and (2) how the issue of authenticity concerns memory interventions, including memory treatments and enhancements. rnThe first part consists of a conceptual analysis of the concepts required for normative considerations. First, the representational nature and the function of memory are discussed. Memory is regarded as a special form of self-representation resulting from a constructive processes. Next, the concepts of selfhood, personhood, and identity are examined and a conceptual tool—the autobiographical self-model (ASM)—is introduced. An ASM is a collection of mental representations of the system’s relations with its past and potential future states. Third, the debate between objectivist and constructivist views of health are considered. I argue for a phenomenological account of health, which is based on the primacy of illness and negative utilitarianism.rnThe second part presents a synthesis of the relevant normative issues based on the conceptual tools developed. I argue that memory enhancement can be distinguished from memory treatment using a demarcation regarding the existence of memory-related suffering. That is, memory enhancements are, under standard circumstances and without any unwilling suffering or potential suffering resulting from the alteration of memory functions, interventions that aim to manipulate memory function based on the self-interests of the individual. I then consider the issue of authenticity, namely whether memory intervention or enhancement endangers “one’s true self”. By analyzing two conceptions of authenticity—authenticity as self-discovery and authenticity as self-creation, I propose that authenticity should be understood in terms of the satisfaction of the functional constraints of an ASM—synchronic coherence, diachronic coherence, and global veridicality. This framework provides clearer criteria for considering the relevant concerns and allows us to examine the moral values of authenticity. rn