The Neuroenhancement of Healthy Individuals Using tDCS: Some Ethical, Legal and Societal Aspects

Abstract

Over the past two decades there has been increasing scientific interest in Human Enhancement, that is, the possibilities of expanding and enhancing the capabilities of healthy individuals with direct technological interventions into the body. The (sub)field of neuroenhancement, which explores attempts to technologically increase attention, memory, perception, learning and other cognitive capabilities, as well as alter mood and emotions, has become especially prominent. Recently, transcranial Direct-Current Stimulation (tDCS) has emerged as a possible method for enhancing cognitive abilities in healthy individuals. The article provides a short overview of the concept of neuroenhancement and of the cognitive enhancement effects that tDCS has demonstrated in the scientific literature. It further focuses on the (neuro)ethical, legal and societal implications of such a practice, and points out issues and questions that especially require further research and investigation, both from a neuroscientific and from a social sciences and humanities perspective. tDCS could become another addition to the increasing set of Human Enhancement Technologies, but it requires further rigorous studies and trials in order to properly assess its potential risks and benefits.

tDCS for Memory Enhancement: Analysis of the Speculative Aspects of Ethical Issues

“…Table 1 (below) identifies seven distinct assumptions: prevalence, social acceptance, efficacy, ideological stance (bioconservative vs. libertarian), potential for misuse, long term side effects, and the delivery of complete and clear information. These are regularly featured in the literature to support the existence of ethical issues associated with tDCS (e.g., Hamilton et al, 2011; Hildt, 2013, 2014; Cabrera et al, 2014; Pustovrh, 2014; Schutter, 2014). For example, the existence of coercion that would impede autonomy (one of the four major issues) is contingent on a rather strong acceptance of tDCS (an example of an assumption) and significant prevalence of the use of tDCS for memory enhancement.…”

“…One of the first ethical preoccupations linked to the use of tDCS for enhancement purposes relates to safety (Cabrera et al, 2014; Hildt, 2014; Pustovrh, 2014). As tDCS is considered non-invasive and used in research settings on numerous people with only benign and transitory side effects, this device is usually considered to be relatively safe (Bikson et al, 2016).…”

“…However, additional unexpected risks could appear in cases of use outside of controlled laboratory settings, especially considering the potential repetitive and long-term use by healthy subjects facilitated by the online availability of tDCS (Hildt, 2014; Pustovrh, 2014) and risks associated with “transfer” of this technology to pediatric and other vulnerable populations (see e.g., Davis, 2014). Concerns about safety are related to the lack of knowledge and scientific uncertainty regarding unexpected or long-term side effects of tDCS enhancement uses (Hildt, 2013; Lapenta et al, 2014).…”

“…Some individuals might naively overestimate benefits and underestimate risks, an especially plausible scenario because tDCS is widely considered to be non-invasive, potentially leading to an unduly positive perception of safety (Davis and van Koningsbruggen, 2013; Fitz and Reiner, 2014; Hildt, 2014). Furthermore, many authors caution that promising enhancement of cognitive performance and memory is not advisable at this time, since more research is necessary to validate potential benefits (Hildt, 2013; Clark and Parasuraman, 2014; Coffman et al, 2014; Duecker et al, 2014; Pustovrh, 2014). There are worries that an accurate, evidence-based risk-benefit profile is difficult to obtain at this time, and that this leads to a breach of users’ informed consent (Hamilton et al, 2011; Cabrera et al, 2014; Hildt, 2014).…”

“…However, the mechanisms of action of tDCS likely involve different synaptic and non-synaptic effects on neurons and non-neuronal (e.g., glial) cells and tissues within the brain (Brunoni et al, 2011). Compared to other neurostimulation devices (such as TMS or DBS), tDCS devices are relatively small and affordable (about 80 dollars when purchased online), easily portable (battery operated) and less risky (only minor side effects in healthy adults reported to date; Hildt, 2014; Pustovrh, 2014; Bikson et al, 2016). Long-lasting effects appear to modulate longer-term protein synthesis, beyond a mere short-term electronic phenomenon associated with neurotransmission.…”