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Physician Attitudes towards Pharmacological Cognitive Enhancement: Safety Concerns Are Paramount

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  • Opeyemi C Banjo
  • Roland Nadler
  • Peter B Reiner

Abstract

The ethical dimensions of pharmacological cognitive enhancement have been widely discussed in academic circles and the popular media, but missing from the conversation have been the perspectives of physicians - key decision makers in the adoption of new technologies into medical practice. We queried primary care physicians in major urban centers in Canada and the United States with the aim of understanding their attitudes towards cognitive enhancement. Our primary hypothesis was that physicians would be more comfortable prescribing cognitive enhancers to older patients than to young adults. Physicians were presented with a hypothetical pharmaceutical cognitive enhancer that had been approved by the regulatory authorities for use in healthy adults, and was characterized as being safe, effective, and without significant adverse side effects. Respondents overwhelmingly reported increasing comfort with prescribing cognitive enhancers as the patient age increased from 25 to 65. When asked about their comfort with prescribing extant drugs that might be considered enhancements (sildenafil, modafinil, and methylphenidate) or our hypothetical cognitive enhancer to a normal, healthy 40 year old, physicians were more comfortable prescribing sildenafil than any of the other three agents. When queried as to the reasons they answered as they did, the most prominent concerns physicians expressed were issues of safety that were not offset by the benefit afforded the individual, even in the face of explicit safety claims. Moreover, many physicians indicated that they viewed safety claims with considerable skepticism. It has become routine for safety to be raised and summarily dismissed as an issue in the debate over pharmacological cognitive enhancement; the observation that physicians were so skeptical in the face of explicit safety claims suggests that such a conclusion may be premature. Thus, physician attitudes suggest that greater weight be placed upon the balance between safety and benefit in consideration of pharmacological cognitive enhancement.

Suggested Citation

  • Opeyemi C Banjo & Roland Nadler & Peter B Reiner, 2010. "Physician Attitudes towards Pharmacological Cognitive Enhancement: Safety Concerns Are Paramount," PLOS ONE, Public Library of Science, vol. 5(12), pages 1-8, December.
  • Handle: RePEc:plo:pone00:0014322
    DOI: 10.1371/journal.pone.0014322
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    References listed on IDEAS

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    1. Arthur Caplan & Carl Elliott, 2004. "Is It Ethical to Use Enhancement Technologies to Make Us Better than Well?," PLOS Medicine, Public Library of Science, vol. 1(3), pages 1-1, December.
    2. Henry Greely & Barbara Sahakian & John Harris & Ronald C. Kessler & Michael Gazzaniga & Philip Campbell & Martha J. Farah, 2008. "Towards responsible use of cognitive-enhancing drugs by the healthy," Nature, Nature, vol. 456(7223), pages 702-705, December.
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    Cited by:

    1. Sebastian Sattler & Cynthia Forlini & Éric Racine & Carsten Sauer, 2013. "Impact of Contextual Factors and Substance Characteristics on Perspectives toward Cognitive Enhancement," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-12, August.

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