Mijail Alejandro Tapia Moreno

At the present time there is a boom in the use of pharmacological cognitive enhancers (PCEs) particularly within an academic and labor context. Numerous objections to the use of this medicines arise in the context of Neuroethics, being one of the most important, the principle of justice. Among the most prevalent arguments put forward it is noted the disturbance of distributive justice and competitive fairness. Succinctly it is established that hypothetical PCEs without adverse effects could promote the social fragmentation by favoring economically dominant classes. However, it has been experimentally observed that PCEs present benefits ruled by the inverted U phenomenon, where cognitive benefits given by these medicines are not dose-dependent and have dependence on the baseline performance. Producing bigger benefits in individuals that initially had a worst performance. In this way the use of PCEs, assuming a context of open-access, could contribute to social equity and distributive justice.

The use of cognition-enhancing drugs is a topic that currently requires special attention, particularly given the growing patient demand for their prescription. It is essential to examine the ethical aspects inherent to the use of these drugs, especially when they are not an innocuous intervention. The effectiveness of these cognition-enhancing drugs lacks the scientific evidence that supports the benefits attributed to them, such as more focus or better memory, as the results in studies show little consistency covering a spectrum from deleterious effects to beneficial effects in certain tasks. Considering this background, it is obvious that an assessment is required on how ethical it is to prescribe or recommend them. This assessment can be made based on bioethical principles of non-maleficence, beneficence, autonomy, and justice. Non-maleficence is a concern when reviewing potential adverse effects. Beneficence is unclear, particularly when it is doubtful that the benefits shown in some studies translate into improved performance in the real world. Although the current effectiveness of cognition-enhancing drugs suggests that they do not pose a problem to the justice principle, this should not be an aspect to be dismissed considering that this may change with the development of more effective cognition-enhancing drugs.