CMF raise concerns on the risks and moral dilemma

Philippa Taylor

Memory-boosting drugs may keep students awake, alert and achieving top marks, but they bring with them a range of moral dilemmas. Seen by some ambitious students as the winner's edge and maybe their ticket to a top job, so-called 'brain steroids' or 'smart dugs' can be bought for a few pounds to enhance focus, concentration or memory. But, Philippa Taylor, CMF's Head of Public Policy, argues they could be seen in the same vein as athletes feeling under pressure to take steroids. Emily Graves spoke with Philippa to find out more.

Emily: Please could you start by telling us about yourself and the work you're involved in?

Philippa: I'm head of public policy at the Christian Medical Fellowship. I work on behalf of Christian doctors and I do quite a lot of research work and writing and then also briefing in parliament, or for public consultations. I generally focus on the beginning of life issues and new technologies. Those are my main areas.

Emily: Can you tell us about these memory-boosting drugs?

Philippa: It's a fascinating area. It's the kind of issue that I think we're going to be facing in the future more. You can get on the internet, for not too much money, so called smart drugs or brain steroids. They are supposed to improve concentration and alertness and help people perform better and at a higher level. They were developed mainly to help people who have narcolepsy, to help them stay awake and concentrate. However they are obviously attractive to other people as well and they're becoming increasingly used across different parts of society, but particularly popular amongst students and young people.

Emily: How long have these drugs been around for?

Philippa: They've been in development for 20 or so years; but at the moment it's still early days. Many people would say that the effect that they have is not that great; perhaps the affect is only a small percentage, but even a small percentage increment in performance can still have a significant impact. I think what's going to happen is that as more money is put into researching them for treatments, for narcolepsy and other things, then the drug's effectiveness will certainly improve more and more. For the moment I would suspect that their effect is like taking a strong double espresso or a few Pro-Plus pills, but just slightly stronger and it may be a bit longer lasting. It's that kind of effect at the moment, but it's undoubtedly going to improve.

Emily: What are some of the moral questions that are thrown up because of this drug?

Philippa: There are quite a few questions that it raises. I've said it's probably not too dissimilar to having some pro-plus or strong coffee. One immediate question is, is there any real difference here between having some pills and having a really strong coffee? Another question is, is there a real difference between someone taking a memory-enhancing pill, who has a poor memory, perhaps an elderly person and a young person who just wants a temporary boost. You can see the fine line from one to the other.

Let's focus on the young people and students for the moment. Let's take this scenario; I have a daughter and she's 16. She will be doing A-Levels in a couple of years and then going to university. If she wants to get into one of the top universities and she's border line, her chances are sort of marginal, but she knows that these memory boosting pills are available off the internet, they could significantly increase her ability to concentrate when she's revising and could perhaps even boost her memory. If she knows that lots of her classmates are taking them to help revise for exams, what's the difference between that and a strong coffee, which she'll only take for maybe for a few days, so it's not going to lead to long-term harm and it could get her the difference between Oxford and another university. That could affect her whole career. What should she do? That's the question that a lot are facing.

Emily: Could you also look at this as cheating?

Philippa: It could be argued as that, but it could also be argued that there's only a small difference, as I've said, like several coffees in an evening; but there is a dilemma. People are taking something that is going to give them an added advantage. Let's go back to my daughter; say she gets in and she passes the exams with flying colours and gets into a great university; this is where the questions start raising; has she got in fairly and will she be able to maintain that? If she got in through an extra boost, will she be able to maintain that? Will she then feel under pressure to keep taking it to help her to carry on doing better? Will she, if she gets in, feel that she's got in off her own achievements, or does she feel that actually her achievement is meaningless, because she doesn't know whether it's due to certain technology, the pills, or her own striving. You can immediately see it's not necessarily a straightforward answer.

Emily: Does this drug have physical affects as well?

Philippa: That's another good question. We don't really know, but I would say that the young human brain, the developing human brain, is going to be very sensitive and it could have profound effects long term. Unfortunately those aged 18 to 25 are the most common non-medical users and we know that the brain continues to mature into the late twenties and beyond. No-one really understands the consequences of long-term use of stimulants on the developing brain. There's one big problem and there's very little data about off label use; obviously there's a lot of research being done on those who are given it for medical reasons, but if you're not using it for medical reasons there's very little data on the physical risk. I could counteract that though and say that many people may accept the risk of perhaps a bit of damage against the benefits that it will get, but I think there are very real concerns about the long-term affects on the brain and about potential addiction and about the damage these strong drugs could have on people.

Emily: Where do you stand at Christian Medical fellowship, as to whether or not it's good having these drugs?

Philippa: I've raised some of the problems and I think another one is the peer pressure and the fact that if a few people start using these drugs, then there's going to be an awful lot of pressure on other people. Although people might say it's a free choice as to whether we take it, if all your classmates are taking it, then it's suddenly not a free choice because you feel under pressure to compete and keep the level playing field. That's a big concern that we have and it isn't really dissimilar to the pressure on athletes using drugs; not necessarily to get an edge, but just to stay in the game. That's one very big concern that we have. I also have a concern about regulation. It's not possible to regulate a lot of these because they are so easily available off the internet. I also think we need to look at some of the issues like what are people trying to achieve? They're trying to achieve academic enhancement in some way; but that's not necessarily going to mean a better or a happier life. I think as Christians we should have a different perspective on achievement and performance and not just look at academic achievement and doing the best in exams, but look at our all rounded development and what is going to make us as people. Sometimes that involves feelings and working through failure; it involves discipline and perseverance and those are the kind of qualities that I think we need to ask are these smart drugs enhancing, or are they hindering other qualities? I think as a Christian the warning here is that any of these new technologies, or many of these new technologies, have huge advantages and they may bring benefits, but I think every one of them also comes with some costs attached. I think it's really important that people understand that these are not straightforward and there will be costs that come with it whether it's physical, safety costs, or whether it's to do with achievement; whether it's to do with priorities and flourishing and that kind of thing and we really need wisdom in weighing up the costs and the benefits much more than we have been doing at the moment.

Emily: What are your hopes then for the future in raising awareness on this?

Philippa: At the moment there's a push amongst students to take these. It's very easy to get hold of them; in fact one in five university students and academics are using them for non-medical reasons. There is a lot of pressure on young people and businesses, as well as business people, to use them. My hope is that we'll start raising some of these concerns; let's say this is not a straightforward answer, that you may find yourself under pressure to carry on taking this; you may find that these have real safety concerns. You may find that your achievements are not down to yourself and are you really looking at just academic performance, or are you looking at developing your whole person as well and developing much broader characteristics and things like perseverance and discipline and other things where we can be valued. I suppose my purpose is really to start talking about this; raise some of these concerns in young people's minds; warn people before they become students who are under pressure, to really think through these issues and think, hang on, do I want to go down this path, because it's not that beneficial necessarily?

Emily: If people want to find out more about the different arguments in and around this how can they find out more?

Philippa: Unfortunately there's very little written on it. I've done an article for our journal Triple Helix which is available on our website, called the Smart Drugs Dilemma; that's www.cmf.org.uk. There's one other website called www.bioethics.ac.uk that has a few articles on this looking at it from an ethical perspective, but these are so new that there's not a lot been written on it.