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[bobf <bobford79 AT yahoo.com>]

Wendy, since you are active this am; what do you think about this article in 
this am NYT.  One of the scientists advocating cognitive enhancement through 
pharma is a writer from the journal 'Nature'.  

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Living the Off-Label Life 

By JUDITH WARNER


What if you could just take a pill and all of a sudden remember to pay your 
bills on time? What if, thanks to modern neuroscience, you could, 
simultaneously, make New Year’s Eve plans, pay the mortgage, call the 
pediatrician, consolidate credit card debt and do your job — well — without 
forgetting dentist appointments or neglecting to pick up your children at 
school?

Would you do it? Tune out the distractions of our online, on-call, too-fast 
A.D.D.-ogenic world with focus and memory-enhancing medications like Ritalin 
or Adderall? Stay sharp as a knife — no matter how overworked and 
sleep-deprived — with a mental-alertness-boosting drug like the 
anti-narcolepsy medication Provigil?

I’ve always said no. Fantasy aside, I’ve always rejected the idea of using 
drugs meant for people with real neurological disorders to treat the 
pathologies of everyday life. 

Most of us, viscerally, do. Cognitive enhancement — a practice typified by 
the widely reported abuse of psychostimulants by college students cramming 
for exams, and by the less reported but apparently growing use of 
mind-boosters like Provigil among in-the-know scientists and professors — 
goes against the grain of some of our most basic beliefs about fairness and 
meritocracy. It seems to many people to be unnatural, inhuman, hubristic, 
pure cheating.

That’s why when Henry Greely, director of Stanford Law School’s Center for 
Law and the Biosciences, published an article, with a host of co-authors, in 
the science journal Nature earlier this month suggesting that we ought to 
rethink our gut reactions and “accept the benefits of enhancement,” he was 
deluged with irate responses from readers.

“There were three kinds of e-mail reactions,” he told me in a phone interview 
last week. “ ‘How much crack are you smoking? How much money did your friends 
in pharma give you? How much crack did you get from your friends in pharma?’ ”

As Americans, our default setting on matters of psychotropic drugs — 
particularly when it comes to medicating those who are not very ill — tends 
to be, as the psychiatrist Gerald Klerman called it in 1972, something akin 
to “pharmacological Calvinism.” People should suffer and endure, the thinking 
goes, accept what hard work and their God-given abilities bring them and hope 
for no more. 

But Greely and his Nature co-authors suggest that such arguments are outdated 
and intellectually dishonest. We enhance our brain function all the time, 
they say — by drinking coffee, by eating nutritious food, by getting an 
education, even by getting a good night’s sleep. Taking brain-enhancing drugs 
should be viewed as just another step along that continuum, one that’s 
“morally equivalent” to such “other, more familiar, enhancements,” they write.

Normal life, unlike sports competitions, they argue, isn’t a zero-sum game, 
where one person’s doped advantage necessarily brings another’s disadvantage. 
A surgeon whose mind is extra-sharp, a pilot who’s extra alert, a medical 
researcher whose memory is fine-tuned to make extraordinary connections, is 
able to work not just to his or her own benefit, but for that of countless 
numbers of people. “Cognitive enhancement,” they write, “unlike enhancement 
for sports competitions, could lead to substantive improvements in the world.”

I’m not convinced of that. I’m not sure that pushing for your personal best — 
all the time — is tantamount to truly being the best person you can be. I 
have long thought that a life so frenetic and fractured that it drives 
“neuro-normal” people to distraction, leaving them sleep-deprived and 
exhausted, demands — indeed, screams for — systemic change. 

But now I do wonder: What if the excessive demands of life today are creating 
ever-larger categories of people who can’t reach their potential due to 
handicaps that in an easier time were just quirks? (Absent-minded 
professor-types were, for generations, typically men who didn’t need to be 
present — organized and on-time — for their kids.) Is it any fairer to saddle 
a child with a chronically overwhelmed parent than with one suffering from 
untreated depression? 

And, furthermore, how much can most of us, on a truly meaningful scale, 
change our lives? At a time of widespread layoffs and job anxiety among those 
still employed, can anyone but the most fortunate afford to cut their hours 
to give themselves time to breathe? Can working parents really sacrifice on 
either side of the wage-earning/life-making equation? It’s disturbing to 
think that we just have to make do with the world we now live in. But to do 
otherwise is for most people an impossible luxury.

For some of us, saddled with brains ill-adapted to this era, and taxed with 
way too many demands and distractions, pharmacological Calvinism may now be a 
luxury, too. 

Judith Warner writes Domestic Disturbances, a column at nytimes.com. Gail 
Collins is off today.

http://www.nytimes.com/2008/12/27/opinion/27warner.html?hp