Jane McCredie: Do we need enhancement?

IN a competitive labour market, it’s increasingly important to have an edge, but how far should we be prepared to go to achieve that?

Could CVs soon include information on not just the degrees we have or our work experience, but also the cognitive enhancements we have undergone to improve our memory or processing speed?

A report released this month by a group of British institutions, including the Academy of Medical Sciences, investigates the likely future role of “human enhancement” in the workplace.

From shift workers taking modafinil to help them remain alert despite disrupted sleep patterns, to soldiers using auditory devices to boost their hearing beyond the normal range, the use of such enhancements raises complex ethical and policy questions.

Cognitive boosters used in healthy people are often a by-product of research originally designed to address a particular medical condition or impairment, as the report makes clear.

The attention deficit hyperactivity disorder (ADHD) drug methylphenidate has for example been shown to improve short-term memory and other cognitive measures in healthy volunteers, hence its popularity with students around exam time.

Similarly, studies suggest transcranial electrical stimulation might offer benefits in ADHD, Parkinson disease and schizophrenia, but also that it could enhance learning and cognition in healthy adults, with effects that might last for as long as a year after treatment.

The options for making ourselves smarter are only going to increase, as is the unregulated cyber-marketplace that spruiks them.

One site offering modafinil at $2.09 per pill, for example, promises the drug “helps to preserve workability and high level of intellectual activity with regular change of work shifts (schedules), and thereby contributing the stabilization of mental state and maintaining the ability to assimilate new information”.

The drug doesn’t appear to promote writing skills, but that’s cyberspace for you.

It’s hard to see how regulators can do much about this kind of promotion, but it does seem important that we at least consider the implications of these sorts of enhancements for our working lives.

If drugs — or devices — improve our ability to do our jobs, you could imagine a situation where those who didn’t take up the option, whether out of choice or a lack of financial resources, might be disadvantaged in the workplace.

It’s possible that employers could pressure workers into taking up enhancements that would boost productivity, or even possibly require them to do so especially in professions where public safety is an issue.

The report’s authors thought this could have implications for doctors among others: “It was clear that there would be pressure to permit, encourage or even obligate the use of enhancements if they could be shown to increase the safety of others, for example in the context of medical practitioners or transport workers”, they wrote.

Could future clinical guidelines mandate use of modafinil, or something like it, by doctors who had worked for a certain number of hours without a break?

Of course, coercion can be a great deal more subtle, and therefore more insidious, and it’s important that workers not be pressured into taking on the risks that accompany any medical intervention.

Mind you, cognitive enhancement is not a new phenomenon. I’m not sure how I’d get my neurones firing without my morning dose of caffeine …

Jane McCredie is a Sydney-based science and medicine writer.

Posted 12 November 2012