In psychiatry, pharmacological research has played a crucial role in the formulation, revision, and refinement of neurobiological theories of psychopathology. Besides being utilized as potential treatments for various mental disorders, pharmacological drugs play an important epistemic role as experimental instruments that help scientists uncover the neurobiological underpinnings of mental disorders (Tsou, 2012). Interventions with psychiatric patients using pharmacological drugs provide researchers with information about the neurobiological causes of mental disorders that cannot be obtained in other ways. This important source of (...) evidence for the biological causes of mental disorder is often overlooked in philosophical analyses of psychiatry, especially in skeptical analyses that debase the biological aspects of psychopathology (e.g., Szasz, 1960; Scheff, 1963; Laing, 1967). In discussing pharmacological interventions as a form of evidence for the physical basis of mental disorders, this paper aims to clarify the nature, reliability, and limitations of this evidence. In addition, it illustrates the central role that pharmacological findings in applied clinical contexts play in the acquisition of neurobiological knowledge in research contexts. (shrink)

There are numerous ways people can improve their cognitive capacities: good nutrition and regular exercise can produce long-term improvements across many cognitive domains, whilst commonplace stimulants such as coffee temporarily boost levels of alertness and concentration. Effects like these have been well-documented in the medical literature and they raise few ethical issues. More recently, however, clinical research has shown that the off-label use of some pharmaceuticals can, under certain conditions, have modest cognition-improving effects. Substances such as methylphenidate and modafinil can (...) improve capacities such as working memory and concentration in some healthy individuals. Unlike their more mundane predecessors, these methods of “cognitive enhancement” are thought to raise a multitude of ethical issues. This paper presents the six principal ethical issues raised in relation to pharmacological cognitive enhancers —issues such as whether: the medical safety-profile of PCEs justifies restricting or permitting their elective or required use; the enhanced mind can be an “authentic” mind; individuals might be coerced into using PCEs;, there is a meaningful distinction to be made between the treatment vs. enhancement effect of the same PCE; unequal access to PCEs would have implications for distributive justice; and PCE use constitutes cheating in competitive contexts. In reviewing the six principal issues, the paper discusses how neuroscientific research might help advance the ethical debate. In particular, the paper presents new arguments about the contribution neuroscience could make to debates about justice, fairness, and cheating, ultimately concluding that neuroscientific research into “personalized enhancement” will be essential if policy is to be truly informed and ethical. We propose an “ethical agenda” for neuroscientific research into PCEs. (shrink)

Recent studies have shown that pharmacological treatment may have an impact on aggressive and impulsive behavior. Assuming that these results are correct, would it be morally acceptable to instigate violent criminals to accept pharmacological rehabilitation by offering this treatment in return for early release from prison? This paper examines three different reasons for being skeptical with regard to this sort of practice. The first reason concerns the acceptability of the treatment itself. The second reason concerns the ethical legitimacy of making (...) offers under coercive conditions. The third relates to the acceptability of the fact that those criminals who accepted the treatment would be exempted from the punishment they rightly deserved. It is argued that none of these reasons succeeds in rejecting this sort of offer. (shrink)

A good part of the explanation for differences in happiness has to do with genetics. This chapter reviews the scientific data relevant to a heritable component to happiness, and the prospects for using current and future technologies to alter those who have not won the genetic lottery. The chapter looks at the concept of heritability, and then at the heritability of happiness. The notion of heritability is typically seen as a composite of two factors: genetics and the environment. Three promising (...) technologies could be used to change the biological basis of happiness: pre‐implantation genetic diagnosis (PGD), genetic engineering, and advanced pharmacology. Unfortunately, on enhancing the moods of healthy individuals, there is limited research. The fact that two thirds of these “normal and healthy” volunteers felt “better than well” sounds like good news for happy‐people‐pills. The chapter touches upon the paucity of studies of the effects of antidepressants on healthy individuals. (shrink)

Digital technologies induce organised immaturity by generating toxic sociotechnical conditions that lead us to delegate autonomous, individual, and responsible thoughts and actions to external technological systems. Aiming to move beyond a diagnostic critical reading of the toxicity of digitalisation, we bring Bernard Stiegler’s pharmacological analysis of technology into dialogue with the ethics of care to speculatively explore how the socially engaged arts—a type of artistic practice emphasising audience co-production and processual collective responses to social challenges—play a care-giving role that helps (...) counter technology-induced organised immaturity. We outline and illustrate two modes by which the socially engaged arts play this role: 1) disorganising immaturity through artivism, most notably anti-surveillance art, that imparts savoir vivre, that is, shared knowledge and meaning to counter the toxic side of technologies while enabling the imagination of alternative worlds in which humans coexist harmoniously with digital technologies, and 2) organising maturity through arts-based hacking that imparts savoir faire, that is, hands-on knowledge for experimental creation and practical enactment of better technological worlds. (shrink)

The pharmacological literature on negative dream experiences is reviewed with respect to Revonsuo's threat rehearsal theory of dreaming. Moderate support for the theory is found, although much more work is needed. Significant questions that remain include the precise role of acetylcholine in the generation of negative dream experiences and dissociations between the pharmacology of waking fear and anxiety and threatening dreams. [Revonsuo].

BackgroundSocial cognitive impairments adversely affect social functioning in patients with schizophrenia. Although pharmacological interventions have been suggested to provide some benefits on social cognition, little information is available on the comparative efficacy of pharmacotherapy. Thus, the aim of this planned systematic review and network meta-analysis is to perform a quantitative comparison of the effects of various psychotropic drugs, including supplements, on social cognition disturbances of schizophrenia.MethodsThe literature search will be carried out using the PubMed, Embase, Cochrane Central Register of Controlled (...) Trials, PsycINFO, ClinicalTrials.gov, and International Clinical Trials Registry Platform databases from inception onward. Randomized controlled trials that examined the efficacy of drugs in social cognitive disturbances will be included, based on the most recent studies and the broader literature than previously searched. This protocol defines a priori the methods that will be used for study selection, data collection, quality assessment, and statistical syntheses.DiscussionThe findings this work are expected to help promote the development of better therapeutics of social cognitive impairments in schizophrenia and related psychiatric conditions.Systematic Review Registration[www.crd.york.ac.uk/prospero], identifier [CRD42021293224]. (shrink)

By drawing on the philosophy of Bernard Stiegler, the phenomena of mechanical (a.k.a. artificial, digital, or electronic) intelligence is explored in terms of its real significance as an ever-repeating threat of the reemergence of stupidity (as cowardice), which can be transformed into knowledge (pharmacological analysis of poisons and remedies) by practices of care, through the outlook of what researchers describe equivocally as “artificial stupidity”, which has been identified as a new direction in the future of computer science and machine problem (...) solving as well as a new difficulty to be overcome. I weave together of web of “artificial stupidity”, which denotes the mechanic (1), the human (2), or the global (3). With regards to machine intelligence, artificial stupidity refers to: 1a) Weak A.I. or a rhetorical inversion of designating contemporary practices of narrow task-based procedures by algorithms in opposition to “True A.I.”; 1b) the restriction or employment of constraints that weaken the effectiveness of A.I., which is to say a “dumbing-down” of A.I. by intentionally introducing mistakes by programmers for safety concerns and human interaction purposes; 1c) the failure of machines to perform designated tasks; 1d) a lack of a noetic capacity, which is a lack of moral and ethical discretion; 1e) a lack of causal reasoning (true intelligence) as opposed to statistical associative “curve fitting”; or 2) the phenomenon of increasing human “stupidity” or drive-based behaviors, which is considered as the degradation of human intelligence and/or “intelligent human behavior” through technics; and finally, 3) the global phenomenon of increasing entropy due to a black-box economy of closed systems and/or industry consolidation. (shrink)

Pharmacological cognitive enhancements nontherapeutically improve cognitive functioning, though recent critics have challenged their use by claiming that cognitive success, aided by the use of cognitive enhancement, is less valuable than otherwise. We criticize two recent responses to this objection, due to Carter and Pritchard and Wang, and propose a different response on behalf of proponents of cognitive enhancement that is shown to be more promising.

It is a commonplace of the critical innovation literature that experiment has replaced mass production as the driving force of accumulation. But while many theorists have explored the politics and dynamics of such economies of experiment under the rubric of ‘immaterial’, cognitive or affective labour, few have examined the intersection of labour, experiment and the speculative in the clinic. Taking the clinic as representative of contemporary transformations in the commodity-form, labour and innovation, this article will look at recent attempts to (...) reform the clinical trial, arguing that these developments represent a far-reaching shift in our understanding of medicine. First, I investigate recent efforts (associated with the discourse of ‘translational medicine’) to rethink the interface between experimental lab-based science and the clinic. I also look at closely associated efforts to reintroduce an element of experimental surprise into the clinical trial process itself, through the adoption of novel trial designs. If the randomized controlled trial was conceived essentially along the lines of a product testing procedure, recent efforts have attempted to reintroduce surprise into the testing process itself – in other words, to invent a trial process capable of producing unexpected events as leads for further innovation. I then move from the experimental clinic to what I call the distributed experiment. Here I focus on efforts to outsource pharmacological innovation to a distributed public of patients through the use of social networking software. These platforms allow drug developers to escape the limits of the conventional clinical trial by tracking the experimental practices taking place in the distributed clinic of unregulated drug consumption. (shrink)

Recent discussions of cognitive enhancement often note that drugs and technologies that improve cognitive performance may do so at the risk of “cheapening” our resulting cognitive achievements Arguing about bioethics, Routledge, London, 2012; Harris in Bioethics 25:102–111, 2011). While there are several possible responses to this worry, we will highlight what we take to be one of the most promising—one which draws on a recent strand of thinking in social and virtue epistemology to construct an integrationist defence of cognitive enhancement.. (...) According to such a line, there is—despite initial appearances to the contrary—no genuine tension between using enhancements to attain our goals and achieving these goals in a valuable way provided the relevant enhancement is appropriately integrated into the agent’s cognitive architecture. In this paper, however, we show that the kind of integration recommended by such views will likely come at a high cost. More specifically, we highlight a dilemma for users of pharmacological cognitive enhancement: they can meet the conditions for cognitive integration at the significant risk of dangerous dependency, or remain free of such dependency while foregoing integration and the valuable achievements that such integration enables. After motivating and clarifying the import of this dilemma, we offer recommendations for how future cognitive enhancement research may offer potential routes for navigating past it. (shrink)

Beginning with a review of Michael Pollan's latest book about the renaissance of research into the use of psychedelics to treat addiction, depression, and end-of-life anxiety, this essay considers wisdom and insight that might be gained by examining the psychedelic practices of primitive people. Pollan finds that almost all who begin using psychedelics to treat the ill eventually come to the conclusion that they should be made available for the broader purpose of 'the betterment of well people'. By considering both (...) scientific and spiritual perspectives on these compounds, the book offers insight into the toxicity not only of our mental environment, but at the same time our relationship to fellow humanity and Mother Nature. However, Pollan does not consider what is perhaps the greatest source of wisdom regarding the pharmacological potential of psychedelics: primitive societies who have long incorporated these compounds into their ways of being. By casting anthropological accounts of primitive psychedelic practices against those of contemporary research, this essay seeks to deepen enquiry into the pathologies of modern personhood as they bear upon the ecological crisis, together with the potential value of entheogens for understanding and responding to these problems. (shrink)

Objectives To understand the ethical principles guiding college students’ abstention from pharmacological cognitive enhancement, and to determine the correlates associated with endorsing different principles. Design One-stage cluster sampling was used to implement a paper-based survey among undergraduate students attending one university in the U.S. Thematic analysis was used to explore the ethical principles guiding PCE abstention. Multivariate logistic regression analyses were used to examine sociodemographic correlates associated with endorsed ethical principles. Participants Of the 499 eligible students who completed the survey, (...) 259 students had a negative attitude towards PCE, did not engage in PCE, and provided reasons for abstention. Results The thematic analysis resulted in the identification of eight themes, with respondents often endorsing more than one theme per response. The three themes most endorsed were non-malfeasance, disapproval of drugs and dosage beneficence. The sociodemographic correlates associated with endorsing each theme varied across themes. Conclusions Students abstain from PCE for a multitude of reasons, many of which are guided by ethical principles. These findings may be incorporated into future prevention programming messages. (shrink)

ObjectivesTo understand the ethical principles guiding college students’ abstention from pharmacological cognitive enhancement, and to determine the correlates associated with endorsing different principles.DesignOne-stage cluster sampling was used to implement a paper-based survey among undergraduate students attending one university in the U.S. Thematic analysis was used to explore the ethical principles guiding PCE abstention. Multivariate logistic regression analyses were used to examine sociodemographic correlates associated with endorsed ethical principles.ParticipantsOf the 499 eligible students who completed the survey, 259 students had a negative (...) attitude towards PCE, did not engage in PCE, and provided reasons for abstention.ResultsThe thematic analysis resulted in the identification of eight themes, with respondents often endorsing more than one theme per response. The three themes most endorsed were non-malfeasance, disapproval of drugs and dosage beneficence. The sociodemographic correlates associated with endorsing each theme varied across themes.ConclusionsStudents abstain from PCE for a multitude of reasons, many of which are guided by ethical principles. These findings may be incorporated into future prevention programming messages. (shrink)

Apathy and depression are frequently observed as behavioral and psychological symptoms of dementia, respectively, and are important for ensuring adequate care. This study aims to explore effective non-pharmacological interventions for apathy and depression with mild cognitive impairment and dementia. Five search engines including PubMed, Scopus, CINAHL, PsycInfo, and Web of Science were used to extract relevant studies. Inclusion criteria were studies that involved participants who were diagnosed with MCI or dementia, included quantitative assessments of each symptom, and employed randomized controlled (...) trials. Twenty studies were extracted, with interventions have been conducted in care facilities, the community, and hospitals. Participants in many studies had MCI or mild-to-moderate dementia but were not diagnosed with the subtypes of dementia. Few studies had set apathy and depression as the primary outcomes of non-pharmacological interventions. The findings suggested that emotional and stimulation-oriented approaches to apathy and depression would be useful for people with MCI or mild-to-moderate dementia. It would be helpful for therapists to assess the clinical features of the target symptoms for selecting suitable interventions. Additionally, increasing the number of randomized controlled trials focusing on apathy or depression as primary outcomes would offer a more definite conclusion for future systematic reviews. (shrink)

An engagement with Derrida's "Plato's Pharmacy." The paper addresses: where wordless things exist , Derrida's presentation of what he calls true morality , the son's replacement of the father in writing, , and "pharmacological therapeia ." The paper ends with an account of "sensible awareness" and the ways in which the functions of cultural sensibility both confirm and show limits in Derrida's pharmacological practices. The paper throughout addresses issues basic to how people live in the context of a pharmacological disposition.

This article offers the first edition and translation of two heretofore unpublished pharmacological treatises by Abū Bakr al-Rāzī, namely Fī ittikhādh māʾ al-jubn and Fī manāfiʿ māʾ al-jubn, which seem to have formed part of a lost volume on dairy products. As it demonstrates, al-Rāzī’s examination of whey is connected to his philosophical interest in the complex nature of simple substances such as milk. The article also highlights how these two treatises built on the Greek pharmacological tradition by incorporating ingredients (...) from Persia and India. (shrink)

This is a commentary piece on Marco Pavanini's article ' ‘Multistability and Derrida’s Différance: Investigating the Relations Between Postphenomenology and Stiegler’s General Organology' in which I critically extend upon his comparative analysis of postphenomenology''s notion of multistability and Stiegler's conception of organology, focusing in particular on the pharmacological nature of Stiegler's organology and the latter's most recent re-interpretation of it in terms of entropy and negentropy. Among other things I show, and both are more intended as additions than criticisms with (...) respect to Pavanini’s very helpful comparison, that the most important concern for Stiegler in theorizing technology is the fact that the transductive relations between the three organ systems distinguished in his pharmaco-organology of technology open up affective or libidinal circuits between these systems, i.e., circuits either of desire or drive depending on the way the pharmakon is adopted or not, and that these circuits are fundamentally noetic circuits vulnerable to denoetization; and that these libidinal-noetic circuits as conditioned by technology should be interpreted in terms of entropy and negentropy. Both insights are lacking in postphenomenology, which generally fails to consider the irreducibly destitutive character of all technology, rightfully emphasized by Pavanini, since it lacks a genuine pharmacological awareness. (shrink)

Die Posttraumatische Belastungsstörung (PTBS) ist ein schwerwiegendes psychisches Krankheitsbild, das Betroffene nach dem Erleben traumatisierender Situationen entwickeln. Im Zusammenhang mit den Auslandseinsätzen der Bundeswehr ist die PTBS bei Soldaten in den letzten Jahren verstärkt in den Fokus der deutschen Öffentlichkeit gerückt. Auch zivile Traumata bergen ein großes PTBS-Risiko. Seit einigen Jahren werden Methoden zur medikamentösen Prävention der PTBS erforscht. Die beiden wichtigsten Ansätze, die Prävention mit zentralnervös wirkenden Betablockern und Glukokortikoiden, basieren auf der Idee, durch den Eingriff in neuroendokrine Stressachsen (...) Einfluss auf die Art und Weise zu nehmen, in der die Erinnerung im Gedächtnis konsolidiert wird. Durch eine Entemotionalisierung und Abschwächung entsprechender Gedächtnisspuren soll das spätere Auftreten einer PTBS verhindert werden. Beide Ansätze zeigen in Pilotstudien vielversprechende Ergebnisse. Angesichts der herausragenden Bedeutung des Gedächtnisses für Individuum und Gesellschaft sollten Ansätze zur medikamentösen Gedächtnismodifikation (MGM) unter neuroethischen Gesichtspunkten diskutiert und bewertet werden. Der Text beleuchtet die MGM zur PTBS-Prävention entlang von fünf Problemachsen: 1) der Einflussnahme von MGM auf den Prozess der normalen psychischen Verarbeitung traumatischer Erlebnisse, 2) der Gefahr einer Entkopplung von Erinnerung und Realität, 3) der Bedeutung von emotionaler Erinnerung für die Moral, 4) der sozialen, juristischen und historischen Relevanz einer wahrhaftigen Erinnerungskultur und 5) der potenziellen Förderung eines gesellschaftlichen Medikalisierungsprozesses. Trotz ernsthaft zu diskutierender ethischer Bedenken ist – vor dem Hintergrund der Schwere des Krankheitsbilds – aus unserer Sicht eine MGM zur PTBS-Prävention grundsätzlich begrüßenswert, sollte jedoch derzeit nur im Rahmen klinischer Studien erfolgen. Hierfür stellen wir acht forschungsethische Aspekte zur Diskussion, die bei solchen Studien zu berücksichtigen sind. (shrink)

Clinical Pharmacology is a specialty with many attributes and our association with the subject has allowed us to acquire, apply and disseminate myriad aspects of research and practice. Though clinical pharmacologists are conspicuous by virtue of their small number, recent years have shown a growing need for the course. In the review below we navigate through several aspects of the subject as we encountered them from time to time. From critical appraisal of literature, to application of knowledge of drugs, (...) to clinical practice; moving on to clinical and basic research, to drug development process, to policy making - these are but a few of the many fields which constitute the scope of clinical pharmacology. The importance of the subject lies in allowing a trainee to develop a broad overview of the entire process, from drug generation to drug distribution to drug utilization, a process meant for the greater common goal of better health for all. We foresee a bright future for the subject though with a slight skepticism thrown in. In the present article, we make use of personal experiences and reference from literature to help you get a broad view of what clinical pharmacology means to us. (shrink)

Response to commentary. We are grateful to Crockett and Craigie for their interesting remarks on our paper. We accept Crockett’s claim that there is a need for caution in drawing inferences about patient groups from work on healthy volunteers in the laboratory. However, we believe that the evidence we cited established a strong presumption that many of the patients who are routinely taking a medication, including many people properly prescribed the medication for a medical condition, have morally significant aspects of (...) their cognition and behavior modified in a way that is unintended and may sometimes be unwelcome. Crockett notes that in some cases the effects of long-term drug use may differ, sometimes markedly, from the effects of short-term use. However, if acute use of a drug affects a neural system involved in mediating moral cognition or behavior, this nevertheless provides some evidence that chronic use of the drug may affect that same system and thus have morally significant effects. It is also plausible, in some cases, that an acute moral effect would give rise to a chronic moral effect via cognitive mechanisms. ... (shrink)

Pharmacoresistant schizophrenia is a significant impediment to the successful management of the disease. The expression and function of P‐glycoprotein (P‐gp) has recently been implicated in this phenomenon. P‐gp is a multidrug efflux transporter that prevents drug substrates from crossing the blood–brain barrier (BBB). Although the direct interaction between individual antipsychotic agents and P‐gp has been demonstrated, the effect of antipsychotic drug combinations used in disease management on P‐gp transport function remains to be elucidated. This could have important clinical implications in (...) some individuals as dosage adjustments based on plasma drug concentration changes may not always be appropriate if drug–drug interactions and the resulting changes in drug concentration in the brain are not considered. This paper introduces the potential impact that combination antipsychotic therapy may have on P‐gp function at the BBB and discusses the consequences of this in the prevention and circumvention of unfavourable therapeutic response in schizophrenic disorders. BioEssays 30:183–188, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

Bernard Stiegler’s theoretical and practical Internation Project called for a refoundation of theoretical computer science that would also put the fact of exchange back at the centre of the conceptualization and organization of the economy. This can be interpreted as a call to critique a form of capitalism that has arisen over the past 70 years through an ideology via which ‘information’ conjoins computation and economics into what becomes an absolute market. But another history of exchange unfolds contemporaneously with this (...) ideology: that pursued in responses to Marcel Mauss’s anthropology of the gift, by Claude Lévi-Strauss, Georges Bataille and Maurice Godelier, among others. Stiegler’s ‘neganthropology’ equally responds to and is informed by this other history of the fact of exchange but, by looking at these works more closely, it may be possible to pursue Stiegler’s project in fields such as kinship and sexuality, which were not his direct concern. (shrink)

Sixteenth century pharmacology was still very much under the influence of a distinction going back to ancient medicine: the distinction between effects of medicaments that were taken to be explainable by the elementary qualities, their mutual modification in mixture, and the combination of these modified elementary qualities on the one hand, and the effects of medicaments that were taken not to be explicable in this manner.1 Galen coined the expression that a medicament of the latter kind possesses the capacity (...) of acting "by its whole substance,"2 and the question of how actions of the whole substance could be explicated gave rise to heated controversies in early modern pharmacology. Did Galen just... (shrink)

Bernard Stiegler depicts technics as the human's tertiary memory retention generating a pharmakon with both curative and malignant potential. He additionally rues the posthuman epoch's depletion of a 'time of the question': revealed in the prevalent inaptitude for wisdom -scilicet long-term acuity. We offer Christian liturgy as an abeyant psychotechnique arcing the current pharmakon to cure through soliciting a 'time of the question'. Rejuvenating Christian liturgy as a psychotechnique can bolster a broader societal 'time of the question'. Firstly, we describe (...) technic's du jour mise on scène. Secondly, we constrain Christian liturgies as complex systems incorporating malleability, temporality, and instability. Thirdly, we imagine Christian liturgy as empty tradition allowing amateur repetition of ancient art enticing a 'time of the question'. (shrink)

The construction of the phenomenological project of psychopathology began in the 1920s. Husserl’s philosophical elaborations, which started to be drawn a few decades earlier, had a broad repercussion on the historical and cultural context of the time and was eventually incorporated into several disciplines, including psychopathology. Particularly in this field, phenomenology had a significant impact, because its epistemological foundations was a close match to the rigorous purposes of a scientific investigation of mental disorders.The phenomenological contribution has established an irrevocable and (...) unique conception of the psychiatric object. The innovation brought... (shrink)

abstract In this paper, we examine issues raised by the possibility of regulating emotions through pharmacological means. We argue that emotions induced through these means can be authentic phenomenologically, and that the manner of inducing them need not make them any less our own than emotions arising 'naturally'. We recognize that in taking drugs to induce emotions, one may lose opportunities for self-knowledge; act narcissistically; or treat oneself as a mere means. But we propose that there are circumstances in which (...) none of these concerns arise. Finally, we consider how the possibility of drug-regulation might affect duties to feel emotions. (shrink)

Academic performance enhancement or cognitive enhancement (CE) via stimulant drug use has received increasing attention. The question remains, however, whether CE solely represents the use of drugs for achieving better academic or workplace results or whether CE also serves various other purposes. The aim of this study was to put the phenomenon of pharmacological academic performance enhancement via prescription and illicit (psycho-) stimulant use (Amphetamines, Methylphenidate) among university students into a broader context. Specifically, we wanted to further understand students’ experiences, (...) the effects of use on students and other factors, such as pressure to perform in their academic and private lives. (shrink)

Pharmakologisches „cognition enhancement“ zielt auf die Verbesserung der geistigen Leistungsfähigkeit mithilfe von Präparaten, die primär als Medikamente eingesetzt werden. Der Beitrag befasst sich mit der ethischen Bewertung des Gebrauchs von Stimulanzien als „enhancer“ durch Kinder und Jugendliche. Am Beispiel von Diagnose und Behandlung der Aufmerksamkeitsdefizit-Hyperaktivitätsstörung (ADHS) werden die Schwierigkeiten der Abgrenzung von Therapie und Enhancement beschrieben und daraus auf verschiedenen Ebenen ethisch relevante Fragen bezüglich Cognition enhancement entwickelt. Diese betreffen z. B. die Wirkungen von Stimulanzien auf ein sich entwickelndes System (...) und eine mögliche grundlegende Änderung der Erziehungs- und Sozialisationssituation durch pharmakologisches Enhancement, aber auch das Problem der Normierung von Verhalten und der Einschränkung der Autonomie der Betroffenen. Die vorgestellten Überlegungen geben Anlass, Cognition enhancement durch Stimulanzien im Jugendbereich vorläufig kritisch zu beurteilen. (shrink)