Racine Eric, Martin Rubio Tristana, Chandler Jennifer, Forlini Cynthia, Lucke Jayne
Neuroethics Research Unit, Institut de recherches cliniques de Montréal (IRCM), 110 Avenue des Pins Ouest, Montreal, QC, H2W lR7, Canada,
Med Health Care Philos. 2014 Aug;17(3):325-37. doi: 10.1007/s11019-013-9539-4.
In the debate on the ethics of the non-medical use of pharmaceuticals for cognitive performance enhancement in healthy individuals there is a clear division between those who view "cognitive enhancement" as ethically unproblematic and those who see such practices as fraught with ethical problems. Yet another, more subtle issue, relates to the relevance and quality of the contribution of scholarly bioethics to this debate. More specifically, how have various forms of speculation, anticipatory ethics, and methods to predict scientific trends and societal responses augmented or diminished this contribution? In this paper, we use the discussion of the ethics of cognitive enhancement to explore the positive and negative contribution of speculation in bioethics scholarship. First, we review and discuss how speculation has relied on different sets of assumptions regarding the non-medical use of stimulants, namely: (1) terminology and framing; (2) scientific aspects such as efficacy and safety; (3) estimates of prevalence and consequent normalization; and (4) the need for normative reflection and regulatory guidelines. Second, three methodological guideposts are proposed to alleviate some of the pitfalls of speculation: (1) acknowledge assumptions more explicitly and identify the value attributed to assumptions; (2) validate assumptions with interdisciplinary literature; and (3) adopt a broad perspective to promote more comprehensive reflection. We conclude that, through the examination of the controversy about cognitive enhancement, we can employ these methodological guideposts to enhance the value of contributions from bioethics and minimize potential epistemic and practical pitfalls in this case and perhaps in other areas of bioethical debate.
在关于健康个体非医疗使用药物以提高认知能力的伦理辩论中，对于“认知增强”在伦理上是否存在问题，存在明显的分歧，一方认为其在伦理上没有问题，另一方则认为这种做法充满伦理问题。然而，另一个更微妙的问题，涉及到学术生物伦理学对这场辩论的贡献的相关性和质量。更具体地说，各种形式的推测、前瞻性伦理学以及预测科学趋势和社会反应的方法，是如何增强或削弱了这种贡献的？在本文中，我们利用对认知增强伦理的讨论，来探讨推测在生物伦理学学术研究中的积极和消极贡献。首先，我们回顾并讨论推测是如何依赖于关于兴奋剂非医疗使用的不同假设集的，即：（1）术语和框架；（2）诸如疗效和安全性等科学方面；（3）流行率估计及随之而来的常态化；（4）规范反思和监管指南的必要性。其次，提出了三个方法指南，以减轻推测的一些陷阱：（1）更明确地承认假设，并确定赋予假设的价值；（2）用跨学科文献验证假设；（3）采用广泛的视角以促进更全面的反思。我们得出结论，通过审视关于认知增强的争议，我们可以运用这些方法指南，来提高生物伦理学贡献的价值，并在这种情况下以及可能在生物伦理学辩论的其他领域，将潜在的认知和实践陷阱降至最低。
