This month’s British Journal of Psychiatry has a fascinating essay by psychiatrist Sean Spence who argues that while most attention has been focused on ‘smart drugs’ and cognitive enhancement, medication is already been subtly used to improve ethical behaviour and we should prepare for a revolution in ‘moral pharmacology’.
Spence argues that the cognitive enhancement debate has an undertone of smarter = better, but that people with high IQs can still conduct atrocities, so perhaps we need to start thinking about focusing on ‘humane drugs’ rather than ‘smart drugs’.
Crucially, the argument does not concern medicating people against their will, an area of constant moral debate. Spence is talking about people taking medication willingly, knowing that it will improve their future behaviour towards others and improving their social responsibility.
Recent considerations of the ethics of cognitive enhancement have specifically excluded consideration of social cognitions (such as empathy, revenge or deception), on the grounds that they are less amenable to quantification. Nevertheless, it would be regrettable if this limitation entirely precluded consideration of what must be an important question for humanity: can pharmacology help us enhance human morality? Might drugs not only make us smarter but also assist us in becoming more ‚Äòhumane‚Äô?
When voiced in such a way, this proposal can sound absurd, not least since we may suspect that such mental manipulation would render us ‚Äòartificially‚Äô moral. Where would be the benefit of being kinder or more humane as a consequence of medication? This is an understandable (though reflexive) response. However, if we stop to consider what is actually happening in certain psychiatric settings, then we may begin to interrogate this proposal more systematically. I shall argue that within many clinical encounters there may already be a subtle form of moral assistance going on, albeit one that we do not choose to describe in these terms. I argue that we are already deploying certain medications in a way not totally dissimilar to the foregoing proposal: whenever humans knowingly use drugs as a means to improving their future conduct.
For example, someone who may be prone to impulsive actions may take a medication to make them less likely to take irresponsible decisions, or perhaps decides on a drug that reduces their level of aggression.
Indeed, this is part of what psychiatrists assist with at the moment, but Spence suggests that the moral aspect is often couched purely in medical terms when it is clear we need to consider morality to fully make sense of the ethical implications.