Cognitive Enhancement: Ethics and Policy Background: why should we care about enhancement uses? - There has been a large increase in stimulant sales ($8 billion) since 2002 - (Adderall) Amphetamines, (Ritalin) Methylphenidate, Modafinil (used by SA medical students), Ampakines (increased learning in rats), compare traditionIf you want to learn more check out What is an energy in the form of movement?
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al/legal stimulants (nicotine, caffeine) Mechanisms of action: Amphetamines and Methylphenidate - Ritalin binds to Dopamine transmitter and so Dopamine stays there - Adderall binds to Dopamine transporter and also reverse the action so it is pumping more Dopamine out (short term good >> focus, not sleep, long term = bad) - Way you consume them can affect the way they react - Swallow and goes to the stomach and then goes to liver and then the blood and then the blood brain barrier -- you take only around 15% to 20% - Some people crush it and mix it with water and inject it - OR some people could sniff it or smoke it/ mix it with another substance so it goes directly into brain - Dopamine = reward signal of the brain Molecular mechanism of modafinil’s action is unclear - Synthesized in 1991, we still don’t know much about it - Does affect dopamine, but not directly - Maybe creating cascade of effects on IPSP or EPSP - Most likely affecting a neuropeptide for sleep and wake cycle - Combats fatigue feeling - Orphan drugs treat rare diseases like narcolepsy or... sleep apnea, shift work sleep disorder - FDA sent pharma company cease and desist order - Can get Modafinil very easily in Germany from India Drug harm classification of UN and WHO - Higher schedule, the more riskier, dangerous the drugs are - Modafinil did not exist during the time of the convention - Schedule 1: substances like Heroin - Schedule 2: Amphetamine or Adderall - Schedule 3: Steroids - Schedule 4: Modafinil in some countries can easily be bought >> diversity in regulations - Harrison Narcotics Tax Act: propaganda like degenerate Mexicans, smoking marijuana, and Chinamen seducing white women w/ drugs Controversy over methodology and specific drugs - Problems: done by humans, socially situated humans w/ limited experiences Broad moral consensus is needed for public policyCognitive Enhancement: Ethics and Policy - Therapy/enhancement: distinction unclear - Focus on human nature: conflict and disagreement - Question of authenticity: too ambiguous - Doctrines of good life: paternalistic - Utility: sacrifices right - Justice? Policy options grounded in moral reasons: what can we do? - Mandatory (morally required) - Encourage use (morally desirable and permissible) - Laissez-faire (morally irrelevant) - Discourage use (bad but nevertheless still morally permissible) - Banned (morally impermissible) Point of view of public What principles of justice? John Rawls a. Each person has an equal claim to fully adequate scheme of basic rights and liberties, those w/ Narcolepsy = disadvantages so we need to give them Modafinil b. Why are healthy people taking these drugs? They want an edge over other people