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Consideration of Context and Meanings of Neuro-Cognitive Enhancement: The Importance of a Principled, Internationally Capable Neuroethics

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A JOB Neuroscience
ISSN: 2150-7740 (Print) 2150-7759 (Online) Journal homepage:
Consideration of Context and Meanings of Neuro-
Cognitive Enhancement: The Importance of a
Principled, Internationally Capable Neuroethics
John R. Shook & James Giordano
To cite this article: John R. Shook & James Giordano (2019) Consideration of Context and
Meanings of Neuro-Cognitive Enhancement: The Importance of a Principled, Internationally
Capable Neuroethics, AJOB Neuroscience, 10:1, 48-49, DOI: 10.1080/21507740.2019.1595778
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Published online: 09 May 2019.
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Open Peer Commentaries
Consideration of Context and Meanings
of Neuro-Cognitive Enhancement: The
Importance of a Principled,
Internationally Capable Neuroethics
John R. Shook, University at Buffalo
James Giordano, Georgetown University Medical Center
Conrad, Humphries, and Chaterjee (2019) have examined
and analyzed public opinions about cognitive enhance-
ment (CE) for various purposes. They gather good evi-
dence that framing metaphors and contexts of discourse
have significant influence on social attitudes toward the
use of CEs in varied circumstances. We support this sort
of empirical study, and find its main results to be plaus-
ible and unsurprising. Judgments about CEs are formed
within both personal and social contexts, and assess-
ments of CEs must take contexts of capability and per-
formance into account (Mihailov and Savulescu 2018;
Shook and Giordano 2014; Shook et al. 2014).
As regards public policy, much formative work on
the roles of metaphor and framing language has been
done by George Lakoff (Lakoff and Johnson 1980; Lakoff
2008). Briefly, Lakoff explains how framing establishes
and thus enables the contextual application oflanguage
that fits a particular worldview. He notes both that
value-laden metaphors are pervasive in all languages,
and that much of public discourse is somewhat
preframedin terms of a given moral viewpoint.
Lakoff rebuts the notion that moral viewpoints are
subjective and apart from the social context of ongoing
public discourse. Likewise, what is heard in public dis-
course is not simply the aggregate of personal view-
points, as if the public and private spheres do not
continuously affect each other. Rather, public discourse
and personal opinion are intermingled in ongoing trans-
actions, dynamically exerting mutual and reciprocal
effect(s). Personal opinions can seem firmly established
and stable in the short term, and this can be reflected in
data from restricted temporal sampling. But such per-
sonal views can change with time and effect. Indeed,
Conrad and colleagues affirm that metaphorical
discourse can shift individual opinion: Metaphors may
be more likely to sway peoples opinion toward public
policy even if they do not change individual behavior
(Conrad, Humphries, and Chaterjee 2019, 43). Thus, one
take-awayfrom their study is that morality-laden
metaphors can and do influence peoples judgments, at
least to certain degrees. The authors conclude by provid-
ing the straightforward stance that (a) policies toward
CEs should be socially responsive by reflecting public
attitudes about CE use; (b) public attitudes toward CEs
can be ascertained through surveys applying frameworks
to distinguish various attitudes; and (c) surveying with
frameworks can assist efforts to craft policies that take
distinct public attitudes into account.
This straightforward stance about public attitudes is
not the whole story, and we wish to explore some
important considerations for neuroethics. First, we do
not feel confident that the authors offer a fully warranted
conclusion about the significance of their study for set-
ting policies towards CEs. Second, we suggest that neu-
roethical discourses must both be aware of the effects of
framing metaphors on public attitudes, and should be
proactive toward managing and resisting such framings,
as when seeking to formulate and standardize ethical
positions about CEs.
We agree with the authors that public attitudes
surely should not be ignored. However, socially
responsivepolicies are not necessarily socially
responsibleby promoting what is good and right for
the public. Eliciting public attitudes on an issue may not
always measure what the public already regards as being
best.To be sure, a greater lesson from this article,
apropos the work of Lakoff, argues against such a
naive stance.
Address correspondence to John R. Shook, Department of Philosophy and Graduate School of Education, University at Buffalo, 135
Park Hall, Buffalo, NY, USA. E-mail:
48 ajob Neuroscience
AJOB Neuroscience, 10(1): 4861, 2019
#2019 Taylor & Francis Group, LLC
ISSN: 2150-7740 print / 2150-7759 online
DOI: 10.1080/21507740.2019.1595778
1. Per Conrad and colleagues, along with Lakoff, metaphors
can certainly effectively express moral judgments about
using CEs.
2. Per Conrad and colleagues, morality-conveying metaphors
are easily placed into frameworks that provide messages
to people in order to elicit their (positive, negative,
neutral) reactions.
3. Per Lakoff, morality-conveying metaphors are commonly
effective for framing policy issues in a positive or
negative manner to elicit public affirmation or rejection.
4. Combining Conrad and colleagues with Lakoff, public
attitudes about the morality of CEs can be influenced by
framed moral messaging accessible to the public.
5. Taking points 14 together, it appears that crafting framed
moral messaging can both elicit public views about CEs,
and potentially shape public judgments for/against CEs.
Neuroethical engagements and address must be sen-
sitive to the broader implications from that final conclu-
sion. Public judgments about the morality of policies can
be influenced by framed moral messaging accessed by
the public. Public attitudes about the morality of CEs
could shape policies for CE use, and preframed moral
messaging about CEs can shape policies for CE use. If
preframed moral messaging about CEs will be influen-
tial, as this line of reasoning suggests, then neuroethics is
confronted with a choice: Either follow current public
attitudes (as they shift and sway), or follow ethical
standards of its own for evaluating CE policies. And we
do not see this choice as a false dichotomy.
We doubt that a third alternative could be viable. If
there were one, it would start from the idea that society
could discern analogies between CEs and familiar drugs,
by which to morally judge each novel CE accordingly.
Yet society can just as easily select analogies according to
prior moral views (an ease in evidence with Conrad and
colleagues), so public attitudes would still prevail. In
fact, public verdicts about CEs may be mostly about
which preframed moral metaphor wins the meme race
within a society.
Neuroethical discourses could not be wholly impervi-
ous to moral metaphors, which may partly account for
the extant disagreement among neuroethicists when eval-
uating CEs. Neuroethical evaluations could consult nor-
mative standards apart from prevailing social views,
thereby raising above social relativism, if the field could
commit to a unified set of moral norms in the face of
powerful social attitudes and the moral metaphors that
sustain them. We believe that such commitment sustains
the second alternative: that neuroethics should apply eth-
ical standards of its own for evaluating CE policies.
These ethical standards for neuroethics need not be
invented anew. Ethics is intended to protect capacities
for autonomy, dignity, and morality. Scholars of neuro-
ethics have accordingly advocated ethical standards to
guide the quest for genuine enhancement (see, e.g., Clark
2014; Glannon 2011; Heinrichs 2012; Maslen et al. 2014;
Shook and Giordano 2014).
In this way, neuroethical discourses need not echo
whatever enjoys temporary public approval, nor partici-
pate in swaying public attitudes with moral framings, no
matter how academic in tone. Neuroethical considera-
tions of CEs and their appropriate uses can prescind sim-
ple social conventionality. Furthermore, deep
neuroethical analyses can afford a much-needed counter-
balance to one-sided moral framings for CEs. In this
way, we believe that both public discourses and policy
deliberations can benefit from the practical wisdom of
pragmatic neuroethical address.
The authors declare that they do not have any competing
Clark, V. 2014. The ethical, moral, and pragmatic rationale for
brain augmentation. Frontiers in Systems Neuroscience 8: 130. doi:
Conrad, E. C., S. Humphries, and A. Chatterjee. 2019. Attitudes
toward cognitive enhancement: The reole of metaphor and
context. AJOB Neuroscience 10(1): 3547.
Glannon, W. 2011. Brain, body, and mind: Neuroethics with a
human face. Oxford, UK: Oxford University Press.
Heinrichs, J. 2012. The promises and perils of non-invasive brain
stimulation. International Journal of Law and Psychiatry 35(2):
121129. doi: 10.1016/j.ijlp.2011.12.006.
Lakoff, G. 2008. The political mind: A cognitive scientists guide to
your brain and its politics. New York, UK: Penguin.
Lakoff, G., and M. Johnson. 1980. Metaphors we live by. Chicago,
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Maslen, H., N. Faulm
uller, and J. Savulescu. 2014.
Pharmacological cognitive enhancementhow future
neuroscientific research could advance ethical debate. Frontiers
in Systems Neuroscience 8: 107. doi: 10.3389/fnsys.2014.00107.
Mihailov, E., and J. Savulescu. 2018. Social policy and cognitive
enhancement: Lessons from chess. Neuroethics 11(2): 115127.
doi: 10.1007/s12152-018-9354-y.
Shook, J. R., L. Galvagni, and J. Giordano. 2014. Cognitive
enhancement kept within contexts: Neuroethics and informed
public policy. Frontiers in Systems Neuroscience 8: 228. doi:
Shook, J. R., and J. Giordano. 2014. A principled and
cosmopolitan neuroethics: Considerations for international
relevance. Philosophy, Ethics, and Humanities in Medicine 9(1):
113. doi: 10.1186/1747-5341-9-1.
The Role of Metaphor and Context
JanuaryMarch, Volume 10, Number 1, 2019 ajob Neuroscience 49
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Full-text available
Should the development of pharmacological cognitive enhancers raise worries about doping in cognitively demanding activities? In this paper, we argue against using current evidence relating to enhancement to justify a ban on cognitive enhancers using the example of chess. It is a mistake to assume that enhanced cognitive functioning on psychometric testing is transferable to chess performance because cognitive expertise is highly complex and in large part not merely a function of the sum specific sub-processes. A deeper reason to doubt that pharmacological cognitive enhancers would be as significant in mind sports is the misleading parallel with physical enhancement. We will make the case that cognitive performance is less mechanical in nature than physical performance. We draw lessons from this case example of chess for the regulation of cognitive enhancement more generally in education and the professions. Premature regulation runs the risk of creating a detrimental culture of suspicion that ascribes unwarranted blame.
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We can say with certainty that our species would be unlikely to exist as it does today without augmentation. Cognitive- and neuroenhancements are just the latest in a long line of augmentations that have helped our species to survive and flourish. While there are some valid concerns, the benefits of brain augmentations like tDCS will likely far outweigh their costs when properly used. The continued pursuit of cognitive- and neuro-enhancement will help us to improve our quality of life, reduce suffering from brain and mental illness, and enhance our chances of survival long-term. Conflict of interest statement The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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THERE ARE NUMEROUS WAYS PEOPLE CAN IMPROVE THEIR COGNITIVE CAPACITIES: good nutrition and regular exercise can produce long-term improvements across many cognitive domains, whilst commonplace stimulants such as coffee temporarily boost levels of alertness and concentration. Effects like these have been well-documented in the medical literature and they raise few (if any) ethical issues. More recently, however, clinical research has shown that the off-label use of some pharmaceuticals can, under certain conditions, have modest cognition-improving effects. Substances such as methylphenidate and modafinil can improve capacities such as working memory and concentration in some healthy individuals. Unlike their more mundane predecessors, these methods of "cognitive enhancement" are thought to raise a multitude of ethical issues. This paper presents the six principal ethical issues raised in relation to pharmacological cognitive enhancers (PCEs)-issues such as whether: (1) the medical safety-profile of PCEs justifies restricting or permitting their elective or required use; (2) the enhanced mind can be an "authentic" mind; (3) individuals might be coerced into using PCEs; (4), there is a meaningful distinction to be made between the treatment vs. enhancement effect of the same PCE; (5) unequal access to PCEs would have implications for distributive justice; and (6) PCE use constitutes cheating in competitive contexts. In reviewing the six principal issues, the paper discusses how neuroscientific research might help advance the ethical debate. In particular, the paper presents new arguments about the contribution neuroscience could make to debates about justice, fairness, and cheating, ultimately concluding that neuroscientific research into "personalized enhancement" will be essential if policy is to be truly informed and ethical. We propose an "ethical agenda" for neuroscientific research into PCEs.
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The widespread use of stimulants among healthy individuals to improve cognition has received growing attention; however, public attitudes toward this practice are not well understood. We determined the effect of framing metaphors and context of use on public opinion toward cognitive enhancement. We recruited 3,727 participants from the United States to complete three surveys using Amazon’s Mechanical Turk between April and July 2017. Participants read vignettes describing an individual using cognitive enhancement, varying framing metaphors (fuel versus steroid), and context of use (athletes versus students versus employees). The main outcome measure was the difference in respondent-assigned level of acceptability of the use of cognitive enhancement by others and by themselves between the contrasting vignettes. Participants were more likely to support the use of cognitive enhancement by others than by themselves and more when the use of enhancement by others was framed with a fuel metaphor than with a steroid metaphor. Metaphoric framing did not affect participants’ attitudes toward their own use. Participants supported the use of enhancement by employees more than by students or athletes. These results are discussed in relation to existing ethical and policy literature.
The now-classic Metaphors We Live By changed our understanding of metaphor and its role in language and the mind. Metaphor, the authors explain, is a fundamental mechanism of mind, one that allows us to use what we know about our physical and social experience to provide understanding of countless other subjects. Because such metaphors structure our most basic understandings of our experience, they are "metaphors we live by"--metaphors that can shape our perceptions and actions without our ever noticing them. In this updated edition of Lakoff and Johnson's influential book, the authors supply an afterword surveying how their theory of metaphor has developed within the cognitive sciences to become central to the contemporary understanding of how we think and how we express our thoughts in language.
This book is a discussion of the most timely and contentious issues in the two branches of neuroethics: the neuroscience of ethics; and the ethics of neuroscience. Drawing upon recent work in psychiatry, neurology, and neurosurgery, it develops a phenomenologically inspired conception of neuroscience to explain the brain-mind relation. The idea that the mind is shaped not just by the brain but also by the body and how the human subject interacts with the environment has significant implications for free will, moral and criminal responsibility, and moral justification of actions. The book also examines the extent to which the use of drugs to enhance cognition will affect inequality and our sense of authenticity. In addition, it discusses brain imaging techniques to diagnose disorders of consciousness, deep-brain stimulation to treat neuropsychiatric disorders, and restorative neurosurgery for neurodegenerative diseases. By examining the empirical and normative factors that shape our knowledge of how the brain influences how we think and act, and by assessing the actual and potential effects of interventions in the brain, Brain, Body, and Mind offers a well-rounded discussion of the current state of neuroethics.
Non-invasive brain stimulation promises innovative experimental possibilities for psychology and neuroscience as well as new therapeutic and palliative measures in medicine. Because of its good risk-benefit ratio, non-invasiveness and reversibility as well as its low effort and cost it has good chances of becoming a widespread tool in science, medicine and even in lay use. While most issues in medical and research ethics such as informed consent, safety, and potential for misuse can be handled with manageable effort, the real promise of brain stimulation does raise one prominent moral worry: it may lay the foundation of reliable, precise and stable manipulations of the mind. This article addresses this worry and concludes that it is not the possibility of manipulation, but the shift in our understanding of our mind which stands in need of careful consideration.