24 Jun 2014

Can a pill make you harder, better, faster, stronger?

Pills, electrical stimulation, cell swaps and computer chips: all devices scientists are beginning to show can make people smarter, or even more moral. But should we go down this road?

“Humans have tried to use technology and tools to enhance themselves since time immemorial… today it seems that science and medicine are on the cusp of being able to provide tools not only to treat disease and ameliorate suffering, but to optimise and perhaps enhance human functioning.”

That is the verdict of Imre Bard from the London School of Economics, an academic who is researching the ethics of neuroenhancement.

He and many of his colleagues believe humanity is at a turning point in evolution, where we can begin to manipulate our brains in ways we barely even understand at this point.

“This might have seemed like science fiction, but in the last decade it has moved from the fringe to the mainstream,” he said.

Pills and computer chips

There are a number of areas where major advances have recently been made. Perhaps the most mainstream are smart pills: tablets like ritalin and modafinil, developed for patients with conditions like attention deficit hyperactivity disorder, which are now being used by healthy people to improve their cognitive abilities.

Scientists continue to debate how effective the pills actually are, as well as how many people are using them, but pills of this type have forced their way into the public consciousness.

Following not far behind, though, is what leading academic Professor Alex Quintanilha, from the University of Porto, described as the “brain-machine interface”.

He said: “There is a video of a tetraplegic woman with a chip in her brain who is able, through thinking, to command a computer connected to a mechanical arm and give it orders to pick up the coffee, bring it to her lips, and put it back on the table.

“I was shocked by this – I didn’t know it was possible yet.”

Speaking at a special neuroenhancement session at the EuroScience Open Forum in Copenhagen, Professor Quintanilha said it was frightening because at this point scientists do not know where this could end. The computational power of the brain is expected to be reached by machines by 2020.

“It’s nice to think you can tell machines what to do, not machines telling you what to do. Imagine people or machines from outside controlling your chip and telling you what to think,” he said.

Currents and cells

Many of the experiments in this field begin in the area of therapy, treating those who have brain problems whether through injury or illness. For example, a major European study has recently begun looking into whether the dopamine producing cells in the brain can be replaced with stem cells able to fulfil the same function.

This would help people with Parkinson’s disease, who lose these cells. But the potential is much wider, argues Professor Quintanilha.

It’s nice to think you can tell machines what to do, not machines telling you what to do. Professor Alex Quintanilha

“Your retina has cells which are sensitive only to visible light. How about changing these cells so they are also sensitive to ultraviolet or infrared? We do this now with binoculars – but one day it could be with our own cells,” he said.

Research into what could be done with electrical stimulation is perhaps even more advanced.

Dr Roi Cohen Kadosh from the University of Oxford has done work into whether transcranial electrical stimulation (TES) – low-current, non-painful currents to the appropriate part of the brain – can boost intelligence. The short answer? It seems like it can.

“When coupled with cognitive training, transcranial electrical stimulation can improve skill learning, basic numerical skills and arithmetic,” he said.

In Dr Cohen Kadosh’s experiment, subjects played a maths computer game over several sessions. With TES and training, their reactions and scores improved, both in the short and long-term. In subjects with learning difficulties, the results were even more profound.

But there’s a warning note.

“Before you go home and test your brains – because you can buy these things on the internet although I am not recommending that – we are at the tip of the iceberg,” Dr Cohen Kadosh cautioned. For example, the results of the research changed depending on whether people were worried about their mathematical ability or not. If they were concerned, with TES they performed better. If not, it actually made them perform worse.

Social beings

All of the experiments and treatments so far focus on either repairing or improving cognitive ability: a kind of Flowers for Algernon scenario, like the classic science fiction story. But the brain does more than just arithmetic. It also makes choices, shapes our personality, drives our morality. Can pills or electric currents affect this?

Absolutely, say the scientists, and it goes further than anti-depressants or electro-shock therapy.

Professor Christian Ruff from the Zurich Neuroscience Center has shown that gentle electrical currents applied to the lateral prefrontal cortex (LPFC), an area of the brain, can affect willingness to comply with social norms like fairness.

“With a bit of electricity, you can affect something as profound as human social behaviour,” he said.

In Professor Ruff’s research, two players are given different sums of money. Player one is given considerably more than player two, and asked how much he wants to transfer. If there are no repercussions to the decision, player one tends to keep more money, demonstrating what Professor Ruff called a weak adherence to the “fairness norm” of society. When a punishment is introduced, far more people adhere to this norm, and split the money more equally.

When the LPFC is stimulated with a current, Dr Ruff found, this changes. But do the players turn into better people and give more? No – the opposite. They keep more money for themselves.

The ‘morality pill’?

Perhaps that’s no surprise. Many would say humanity needs no electrical helping hand to become more Machiavellian. But what about the other direction – can we make ourselves more moral, better, perhaps by taking a pill?

“When I get this question it baffles me,” said neuroscientist Dr Molly Crockett from the University of Oxford. “Knowing how complex these processes are, I think it is very difficult if not impossible to create a morality pill. Nevertheless, there has been a lot of work in recent years into how different substances can influence moral behaviour.”

With a bit of electricity, you can affect something as profound as human social behaviour. Professor Christian Ruff

Firstly, oxytocin. Research has shown that enhancing oxytocin can make people more trusting and empathetic.

“But that’s not the whole story. Other studies have shown it can make you more envious, gloating, and more likely to favour people in your own group. So you could ignore the good stuff and call it the immoral molecule if you wanted,” said Dr Crockett.

Serotonin, a key ingredient in many anti-depressant pills, is the other hormone often cited. But it is oversimplified to call it the “happy” chemical. Manipulating serotonin levels also change social behaviour, said Dr Crockett. In a study where participants were asked to consider killing one person to save many others, increased serotonin levels made people much less likely to kill the one.

“So we can shift around people’s moral judgements by giving them a drug that affects serotonin,” said Dr Crockett, although she cautioned that the results are subtle and likely to be different on the healthy brains of her volunteers compared to those who take the drugs to treat depression.

The key problem with a morality pill is that drugs and hormones cannot be targeted to one area of the brain, and chemicals react and interact differently all over the brain and for a number of different reasons – as anyone who has ever drunk alcohol knows.

Then there are the ethical questions.

“It’s not clear exactly what is moral. And if we can’t agree on what is moral, it’s going to be very difficult to develop a pill that will enhance moral behaviour,” said Dr Crockett.

But is it right?

The moral and ethical question carries over into the entire field of neuroenhancement. Increasingly, we can – but should we? We don’t even fully understand how the brain works: is it really time to start tinkering with it?

There are profound ethical questions at every step. If these processes can be proved to work, who gets to benefit from them? Do we want machines in our heads? Who decides what a better person would look like? Fundamentally: is it acceptable at all to enhance human capabilities beyond their biological limitations?

For Imre Bard from the London School of Economics, these questions must be addressed – even if, as he argues, we have already been addressing them throughout human history.

It’s a quarrel with human limitation. Imre Bard

“You could argue that cultural evolution was nothing but a chance to overcome human limitations, the history of medicine nothing but testimony to our desire to overcome, cheat, and beat natural processes like decline, ageing and death. It’s a quarrel with human limitation,” he said.

Professor Quintanilha agreed that, in a way, neuroenhancement is part of an age-old process – the human desire to improve – historically through things like education, meditation or interaction. Or, more recently, through things as mundane as coffee.

But all of the scientists agree that the new technologies emerging now mean the questions need to be asked, and point to the EU-funded body, Neuroenhancement – responsible research and innovation (Nerri), as the space for this to take place.

“[Mid 20th century political philosopher] Hannah Arendt wrote prophetically about science and technology, and how it might be the case that with the newly gained technological powers humanity has, we can do things which we are not able to fully grasp the consequences of. There is a need to speak about these things before we start doing them,” said Mr Bard.