Cognitive neuroenhancing drugs: Are they ethical?

A friend of plus15 on Twitter pointed out this article on BioEdge, which sums up the recent findings of a panel of ethicists:

Are cognitive neuroenhancing drugs ethical? German ethicists say no

The near frontier of human enhancement is coffee on steroids: the drugs of the future that will make you smarter, sharper and quicker. Even now, a quarter of American students are said to use psychostimulants. About 5% of workers in Germany use pharmaceutical drugs to enhance their cognitive functions. A survey in Nature once revealed that many American scientists regularly use ritalin and modafinil. This has led some bioethicists to advocate research into cognitive neuroenhancement as a matter of urgency.

This is misguided and risks being unethical, argue four German ethicists at the International Centre for Ethics in the Sciences and Humanities at the University of Tübingen in the latest issue of the Journal of Medical Ethics.

The ethicists cited contend that the two primary assumptions proponents of cognitive enhancers make are, in fact, incorrect.
First they refute the assumption that effective, safe neuroenhancers could exist. Instead, they declare that given the inextricable relationship between the neuronal mechanisms of cognition and addiction, any drug that could act to enhance function would inevitably incur a heightened risk of dependence.  The law of unintended consequences strikes again.
The second assumption they dismiss is that researching cognitive enhancement carries no moral ambiguity, that such research constitutes an inarguable good. To quote the paper’s abstract, “The potential for addiction, along with arguments related to research ethics and the potential social impact of neuroenhancement, could invalidate this assumption.”  In short, it could be unethical to expose study participants to the risk of addiction.
The BioEdge article sums up the panel’s conclusion boldly:

The danger of addiction is so great and so proximate and the potential benefits are so remote and hypothetical that on balance, it would be immoral even to conduct clinical trials.

Rather a definitive statement.  And considering the matter in the context of neuroenhancement for the neurotypical — the paper stipulates “already-healthy individuals,” so we extrapolate from there — that may be a fair argument to make.  To enhance a process that already works well enough is, after all, a luxury.
But from the plus15 perspective, where the issue is cognitive improvement for people with Down syndrome, the counterargument is that the potential benefit of enhancement is so great — so life-changing — that the prospect of dependence should be weighed differently in the balance.  For people with DS, neuroenhancement isn’t a question of being able to focus keenly on your job for nine hours instead of seven; it’s the difference between being able to live independently as an adult, for example, versus needing to remain under the care of your parents your entire life.  We believe that ability isn’t merely a luxury. We believe promoting it is an imperative.
That’s not to say we pursue progress heedless of the consequences it could have, or that we dismiss ethical questions about research — in fact, a vulnerable population demands greater care, not lesser, and the scientists we work with are deeply sensible of the obligation to proceed with exquisite caution and responsiveness.  We weigh these matters just as carefully as this panel of ethicists has.  But we consider different questions about a different population, and we come to a different conclusion.
Image courtesy of Calvero at Wikimedia Commons.