Skip to main content

Advertisement

SpringerLink
Log in

Regulating the Use of Cognitive Enhancement: an Analytic Framework

  • Original Paper
  • Published:
Neuroethics Aims and scope Submit manuscript

Abstract

Recent developments in neuroscience have enabled technological advances to modulate cognitive functions of the brain. Despite ethical concerns about cognitive enhancement, both individuals and society as a whole can benefit greatly from these technologies, depending on how we regulate their use. To date, regulatory analyses of neuromodulation technologies have focused on a technology itself – for instance, the U.S. Food and Drug Administration regulation of a brain stimulation device – rather than the use of a technology, such as the use of a brain stimulation device at work or school. Given that some forms of cognitive enhancement have already started to penetrate the general public’s everyday life, we should begin our discussion on potential regulatory issues regarding their use in various real-world situations. The goal of the article is to fill the gap by providing an analytic framework to examine these regulatory issues. More specifically, it aims to illustrate the issues around respecting autonomy and preventing coercive use of cognitive enhancement. The proposed framework categories the real-world settings where a neuromodulation technology can be used for cognitive enhancement based on two criteria – who is subjected to cognitive enhancement and who imposes cognitive enhancement. Based on this framework, the article analyzes regulatory issues arising out of every combination of subject/imposing party by taking one example case. Focusing on the regulations in the U.S., this analysis shows the current lack of adequate safeguards against the coercive use and calls for more attention from government agencies and researchers to develop sound policies regarding current and potentially more widespread use of cognitive enhancement.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. 21 C.F.R. § 882.5805 (2018).

  2. Parham v. J.R., 442 U.S. 584 (1979).

  3. Meyer v. Nebraska, 262 U.S. 390 (1923).

  4. This is a claim that has generated disagreement among scholars. In the context of genetic engineering, there has been an extensive discussion about whether there is a normative difference between parental genetic selection (or enhancement) of an embryo and parental environment shaping for an existing child (i.e., education) (Gheus A. 2017. Parental genetic shaping and parental environmental shaping. The Philosophical Quarterly 67(267): 263–281. https://doi.org/10.1093/pq/pqw064; Agar, N. 2004. Liberal Eugenics: In defense of human enhancement. Oxford: Blackwell). On the other hand, with respect to the types and uses of neuromodulation technology discussed in the paper, others have argued that the use of these technologies is not essentially different from traditional methods of enhancement (Greely, H. T. 2010. Enhancing brains: what are we afraid of? Cerebrum 2010:14; Buchanan, A. 2011. Cognitive enhancement and education. Theory and Research in Education 9(2):145–162. https://doi.org/10.1177/1477878511409623).

  5. 42 U.S.C. §5106 g (2012).

  6. Cal. Fam. Code § 7507, § 7824 (West 2008).

  7. Cal. Penal Code §273a (West 2008).

  8. Cal. Penal Code §273d (West 2008).

  9. Hoadley v. Allen, 291 Cal. App. 468 (1930).

  10. Cal. Educ. Code § 49,000–49,001(West 2008).

  11. Cal.Welf. & Inst. Code § 725 (West 2008).

  12. Cal.Welf. & Inst. Code § 727 (West 2008).

  13. Cal.Welf. & Inst. Code § 731(1) (West 2008).

  14. Cal.Welf. & Inst. Code § 729.10 (West 2008).

  15. In re Anthony M., 116 Cal. App. 3d 491 (1981).

  16. E.g. Civil Rights Act of 1964, Pub. L. No. 88–352, 78 Stat. 241 (codified as amended in scattered sections of 2 U.S.C., 28 U.S.C., and 42 U.S.C.); Age Discrimination in Employment Act (ADEA) of 1967, 29 U.S.C. §§ 621–634 (2012); Americans with Disabilities Act (ADA) of 1990, 42 U.S.C. §§ 12,101–12,213 (as amended) (2012); Cal. Gov’t. Code §§ 12,900–96 (West 2008).

  17. U.S. Dep’t of Army, Reg. 350–1, Army Training and Leader Development §1–10(1) (2014) [hereinafter AR 350–1].

  18. AR 350–1 §3–56.

  19. AR 350–1 §3–57.

  20. Id.

  21. U.S. Dep’t of Army, Reg. 600–20, Army Command Policy §4–2 (2014) [hereinafter AR 600–20].

  22. AR 600–20 §4–6.

  23. 10 U.S.C. § 815 (2012); U.S. Dep’t of Army, Reg. 27–10, Military Justice §3–9 (2011) [hereinafter AR 27–10].

  24. AR 27–10.

  25. 10 U.S.C. § 938 (2012).

  26. AR 600–20 §5–4. f(2)(a), f(2)(b).

References

  1. SubreddittDCS. https://www.reddit.com/r/tDCS/. Accessed May 10, 2017.

  2. Chatterjee, A. 2013. Chapter 27 - The ethics of neuroenhancement. In Handbook of Clinical Neurology, eds. James L. Bernat, and H. Richard Beresford, 323–334. Elsevier.

  3. Greely, H.T. 2010. Enhancing brains: What are we afraid of? Cerebrum 2010: 14.

    Google Scholar 

  4. Bostrom, N., and A. Sandberg. 2009. Cognitive enhancement: Methods, ethics, regulatory challenges. Science and Engineering Ethics 15 (3): 311–341. https://doi.org/10.1007/s11948-009-9142-5.

    Article  Google Scholar 

  5. Sandel, M.J. 2007. The case against perfection: Ethics in the age of genetic engineering. Cambrige: Harvard University Press.

    Google Scholar 

  6. Fukuyama, F. 2002. Our posthuman future : Consequences of the biotechnology revolution. 1st Aufl. New York: Farrar, Straus and Giroux.

    Google Scholar 

  7. Furger, F., and F. Fukuyama. 2007. Beyond bioethics: A proposal for modernizing the regulation of human biotechnologies. Innovations: Technology, Governance, Globalization 2 (4): 117–127. https://doi.org/10.1162/itgg.2007.2.4.117.

    Article  Google Scholar 

  8. Sandler, R.L. 2014. Ethics and emerging technologies. New York: Palgrave Macmillan.

    Book  Google Scholar 

  9. Sandel, M. J. 2002. What's wrong with enhancement. https://bioethicsarchive.georgetown.edu/pcbe/background/sandelpaper.html.

  10. Presidential Commission for the Study of Bioethical Issues. 2015. Gray matter: Topics at the intersection of neurosicenc, ethics, and society. https://bioethicsarchive.georgetown.edu/pcsbi/sites/default/files/GrayMatter_V2_508.pdf.

  11. Hughes, J. 2004. Citizen cyborg : Why democratic societies must respond to the redesigned human of the future. Cambridge: Westview Press.

    Google Scholar 

  12. Illes, J., and S.J. Bird. 2006. Neuroethics: A modern context for ethics in neuroscience. Trends in Neuroscience 29 (9): 511–517. https://doi.org/10.1016/j.tins.2006.07.002.

    Article  Google Scholar 

  13. Farah, M.J. 2012. Neuroethics: The ethical, legal, and societal impact of neuroscience. Annual Review of Psychology 63: 571–591. https://doi.org/10.1146/annurev.psych.093008.100438.

    Article  Google Scholar 

  14. Maslen, H., N. Faulmuller, and J. Savulescu. 2014. Pharmacological cognitive enhancement-how neuroscientific research could advance ethical debate. Frontiers in System Neuroscience 8: 107. https://doi.org/10.3389/fnsys.2014.00107.

    Article  Google Scholar 

  15. Fitz, N.S., and P.B. Reiner. 2013. The challenge of crafting policy for do-it-yourself brain stimulation. Journal of Medical Ethics 41 (5): 410–412. https://doi.org/10.1136/medethics-2013-101458.

    Article  Google Scholar 

  16. Shook, J.R., L. Galvagni, and J. Giordano. 2014. Cognitive enhancement kept within contexts: Neuroethics and informed public policy. Frontiers in Systems Neuroscience 8: 228–228. https://doi.org/10.3389/fnsys.2014.00228.

    Article  Google Scholar 

  17. Wexler, A. 2015. A pragmatic analysis of the regulation of consumer transcranial direct current stimulation (TDCS) devices in the United States. Journal of Law and Biosciences 2 (3): 669–696. https://doi.org/10.1093/jlb/lsv039.

    Article  Google Scholar 

  18. Maslen, H., T. Douglas, R. Cohen Kadosh, N. Levy, and J. Savulescu. 2014. The regulation of cognitive enhancement devices: Extending the medical model. Journal of Law and Biosciences 1 (1): 68–93. https://doi.org/10.1093/jlb/lst003.

    Article  Google Scholar 

  19. Sulzer, D., M.S. Sonders, N.W. Poulsen, and A. Galli. 2005. Mechanisms of neurotransmitter release by amphetamines: A review. Progress in Neurobiology 75 (6): 406–433. https://doi.org/10.1016/j.pneurobio.2005.04.003.

    Article  Google Scholar 

  20. Repantis, D., P. Schlattmann, O. Laisney, and I. Heuser. 2010. Modafinil and methylphenidate for neuroenhancement in healthy individuals: A systematic review. Pharmacological Research 62 (3): 187–206. https://doi.org/10.1016/j.phrs.2010.04.002.

    Article  Google Scholar 

  21. Smith, M.E., and M.J. Farah. 2011. Are prescription stimulants "smart pills"? The epidemiology and cognitive neuroscience of prescription stimulant use by normal healthy individuals. Psychological Bulletin 137 (5): 717–741. https://doi.org/10.1037/a0023825.

    Article  Google Scholar 

  22. Greely, H.T. 2008. Neuroscience and criminal justice: Not responsibility but treatment. Kansas Law Review 56 (5): 1103–1138. https://doi.org/10.17161/1808.20016.

    Article  Google Scholar 

  23. Valenstein, E.S. 1986. Great and desperate cures: The rise and decline of Psychosurgery & Other Radical Treatments for mental illness. New York: Basic Books Inc.

    Google Scholar 

  24. Fountas, K.N., and J.R. Smith. 2007. Historical evolution of stereotactic amygdalotomy for the management of severe aggression. Journal of Neurosurgery 106 (4): 710–713. https://doi.org/10.3171/jns.2007.106.4.710.

    Article  Google Scholar 

  25. Hall, W. 2006. Stereotactic neurosurgical treatment of addiction: Minimizing the chances of another 'great and desperate cure. Addiction 101 (1): 1–3. https://doi.org/10.1111/j.1360-0443.2005.01363.x.

    Article  Google Scholar 

  26. Jobst, B.C., and G.D. Cascino. 2015. Resective epilepsy surgery for drug-resistant focal epilepsy: a review. Journal of the American Medical Association 313 (3): 285–293. https://doi.org/10.1001/jama.2014.17426.

    Article  Google Scholar 

  27. Chan, A.H., S. Vaezy, and L.A. Crum. 2003. High-intensity focused ultrasound. https://doi.org/10.1036/1097-8542.YB031005.

    Book  Google Scholar 

  28. Jagannathan, J., N.K. Sanghvi, L.A. Crum, C. Yen, R. Medel, A.S. Dumont, J.P. Sheehan, L. Steiner, F. Jolesz, and N.F. Kassell. 2009. High intensity focused ultrasound surgery (HIFU) of the brain: A historical perspective, with modern applications. Neurosurgery 64 (2): 201–211. https://doi.org/10.1227/01.NEU.0000336766.18197.8E.

    Article  Google Scholar 

  29. Burgess, A., S. Dubey, S. Yeung, O. Hough, N. Eterman, I. Aubert, and K. Hynynen. 2014. Alzheimer disease in a mouse model: MR imaging-guided focused ultrasound targeted to the hippocampus opens the blood-brain barrier and improves pathologic abnormalities and behavior. Radiology 273 (3): 736–745. https://doi.org/10.1148/radiol.14140245.

    Article  Google Scholar 

  30. Rohani, M., and A. Fasano. 2017. Focused ultrasound for essential tremor: Review of the evidence and discussion of current hurdles. Tremor and Other Hyperkinet Movements (NY) 7: 462. https://doi.org/10.7916/D8Z89JN1.

    Article  Google Scholar 

  31. Baek, H., K. Pahk, and H. Kim. 2017. A review of low-intensity focused ultrasound for neuromodulation. Biomedical Engineering Letters 7 (2): 135–142. https://doi.org/10.1007/s13534-016-0007-y.

    Article  Google Scholar 

  32. Kringelbach, M.L., N. Jenkinson, S.L. Owen, and T.Z. Aziz. 2007. Translational principles of deep brain stimulation. Nature Review Neuroscience 8 (8): 623–635. https://doi.org/10.1038/nrn2196.

    Article  Google Scholar 

  33. Inman, C.S., J.R. Manns, K.R. Bijanki, D.I. Bass, S. Hamann, D.L. Drane, R.E. Fasano, C.K. Kovach, R.E. Gross, and J.T. Willie. 2018. Direct electrical stimulation of the amygdala enhances declarative memory in humans. Proceedings of the National Academy of Sciences of the United States of America 115 (1): 98–103. https://doi.org/10.1073/pnas.1714058114.

    Article  Google Scholar 

  34. Rossini, P.M., and S. Rossi. 2007. Transcranial magnetic stimulation: Diagnostic, therapeutic, and research potential. Neurology 68 (7): 484–488. https://doi.org/10.1212/01.wnl.0000250268.13789.b2.

    Article  Google Scholar 

  35. Luber, B., and S.H. Lisanby. 2014. Enhancement of human cognitive performance using transcranial magnetic stimulation (TMS). Neuroimage 85 (Pt 3): 961–970. https://doi.org/10.1016/j.neuroimage.2013.06.007.

    Article  Google Scholar 

  36. Woods, A.J., A. Antal, M. Bikson, P.S. Boggio, A.R. Brunoni, P. Celnik, L.G. Cohen, F. Fregni, C.S. Herrmann, E.S. Kappenman, H. Knotkova, D. Liebetanz, C. Miniussi, P.C. Miranda, W. Paulus, A. Priori, D. Reato, C. Stagg, N. Wenderoth, and M.A. Nitsche. 2016. A technical guide to tDCS, and related non-invasive brain stimulation tools. Clinical Neurophysiology 127 (2): 1031–1048. https://doi.org/10.1016/j.clinph.2015.11.012.

    Article  Google Scholar 

  37. Antal, A., I. Alekseichuk, M. Bikson, J. Brockmöller, A.R. Brunoni, R. Chen, L.G. Cohen, G. Dowthwaite, J. Ellrich, A. Flöel, F. Fregni, M.S. George, R. Hamilton, J. Haueisen, C.S. Herrmann, F.C. Hummel, J.P. Lefaucheur, D. Liebetanz, C.K. Loo, C.D. McCaig, C. Miniussi, P.C. Miranda, V. Moliadze, M.A. Nitsche, R. Nowak, F. Padberg, A. Pascual-Leone, W. Poppendieck, A. Priori, S. Rossi, P.M. Rossini, J. Rothwell, M.A. Rueger, G. Ruffini, K. Schellhorn, H.R. Siebner, Y. Ugawa, A. Wexler, U. Ziemann, M. Hallett, and W. Paulus. 2017. Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines. Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology 128 (9): 1774–1809. https://doi.org/10.1016/j.clinph.2017.06.001.

    Article  Google Scholar 

  38. Purves, Dale. 2013. Principles of cognitive neuroscience. Second edition. Aufl. Sunderland, Mass.: Sinauer Associates Inc. Publishers.

  39. Baker, J.M., C. Rorden, and J. Fridriksson. 2010. Using transcranial direct-current stimulation to treat stroke patients with aphasia. Stroke 41 (6): 1229–1236. https://doi.org/10.1161/STROKEAHA.109.576785.

    Article  Google Scholar 

  40. Fregni, F., P.S. Boggio, M.C. Lima, M.J. Ferreira, T. Wagner, S.P. Rigonatti, A.W. Castro, et al. 2006. A sham-controlled, phase II trial of transcranial direct current stimulation for the treatment of central pain in traumatic spinal cord injury. Pain 122 (1–2): 197–209. https://doi.org/10.1016/j.pain.2006.02.023.

    Article  Google Scholar 

  41. Fregni, F., P.S. Boggio, M.A. Nitsche, M.A. Marcolin, S.P. Rigonatti, and A. Pascual-Leone. 2006. Treatment of major depression with transcranial direct current stimulation. Bipolar Disorders 8 (2): 203–204. https://doi.org/10.1111/j.1399-5618.2006.00291.x.

    Article  Google Scholar 

  42. Kuo, M., and M.A. Nitsche. 2012. Effects of transcranial electrical stimulation on cognition. Clinical EEG and Neuroscience 43 (3): 192–199. https://doi.org/10.1177/1550059412444975.

    Article  Google Scholar 

  43. Mulquiney, P.G., K.E. Hoy, Z.J. Daskalakis, and P.B. Fitzgerald. 2011. Improving working memory: Exploring the effect of transcranial random noise stimulation and transcranial direct current stimulation on the dorsolateral prefrontal cortex. Clinical Neurophysiology 122 (12): 2384–2389. https://doi.org/10.1016/j.clinph.2011.05.009.

    Article  Google Scholar 

  44. Ross, L.A., D. McCoy, H.B. Coslett, I.R. Olson, and D.A. Wolk. 2011. Improved proper name recall in aging after electrical stimulation of the anterior temporal lobes. Frontiers in Aging Neuroscience 3: 16. https://doi.org/10.3389/fnagi.2011.00016.

    Article  Google Scholar 

  45. de Vries, M.H., A.C. Barth, S. Maiworm, S. Knecht, P. Zwitserlood, and A. Floel. 2010. Electrical stimulation of Broca's area enhances implicit learning of an artificial grammar. Journal of Cognitive Neuroscience 22 (11): 2427–2436. https://doi.org/10.1162/jocn.2009.21385.

    Article  Google Scholar 

  46. Bolognini, N., F. Fregni, C. Casati, E. Olgiati, and Gi. Vallar. 2010. Brain polarization of parietal cortex augments training-induced improvement of visual exploratory and attentional skills. Brain Research 1349: 76–89. https://doi.org/10.1016/j.brainres.2010.06.053.

    Article  Google Scholar 

  47. Jwa, A. 2015. Early adopters of the magical thinking cap: A study on do-it-yourself (DIY) transcranial direct current stimulation (tDCS) user community. Journal of Law and the Biosciences 2 (2): 292–335. https://doi.org/10.1093/jlb/lsv017.

    Article  Google Scholar 

  48. Juengst, E. T. 1998. What does enhancement mean? In Enhancing human traits: ethical and social implications, ed. E. Parens, 29–47. Washington D.C.:Georgetown University Press.

  49. Greely, H. 2008. Remarks on human biological enhancement. University of Kansas Law Review 56 (5): 1139–1157.

    Google Scholar 

  50. Savulescu, J., A. Sandberg, and G. Kahane. 2011. Well-being and enhancement. In Enhancing human capacities, ed. R.T. Meulen, G. Kahane, and J. Savulescu, 3–18. Hoboken: Blackwell.

    Chapter  Google Scholar 

  51. Wikipedia, the Free Encyclopedia. Lake Wobegon. https://en.wikipedia.org/wiki/Lake_Wobegon Accessed December 10, 2018.

  52. Earp, B.D., A. Sandberg, G. Kahane, and J. Savulescu. 2014. When is diminishment a form of enhancement? Rethinking the enhancement debate in biomedical ethics. Frontiers in Systems Neuroscience 8: 12. https://doi.org/10.3389/fnsys.2014.00012.

    Article  Google Scholar 

  53. Massie, C.F., E.M. Yamaga, and B.P. Boot. 2017. Neuroenhancement: A call for better evidencce on safety and efficacy. In Rethinking cognitive enhancement, ed. et.R.T. Meulen, A. Mohammed, and W. Hall, 57–68. Oxford: Oxford University Press.

    Chapter  Google Scholar 

  54. Hovarth, J.C., J.D. Forte, and O. Carter. 2015. Quantitative review finds no evidence of cognitive effects in healthy populations from single session transcranial direct current stimulation (tDCS). Brain Stimulation 8 (3): 535–550. https://doi.org/10.1016/j.brs.2015.01.400.

    Article  Google Scholar 

  55. Tremblay, S., J.F. Lepage, A. Latulipe-Loiselle, F. Fregni, A. Pascual-Leone, and H. Theoret. 2014. The uncertain outcome of prefrontal tDCS. Brain Stimulation 7 (6): 773–783. https://doi.org/10.1016/j.brs.2014.10.003.

    Article  Google Scholar 

  56. Berryhill, M.E., D.J. Peterson, K.T. Jones, and J.A. Stephens. 2014. Hits and misses: Leveraging tDCS to advance cognitive research. Frontiers in Psychology 5: 800. https://doi.org/10.3389/fnsys.2014.00800.

    Article  Google Scholar 

  57. Galli, G., M.A. Vadillo, M. Sirota, M. Feurra, and A. Medvedeva. 2019. A systemic review and meta-analysis of the effects of transcranial direct current stimulation(tDCS) on episodic memory. Brain Stimulation 12 (2): 231–241. https://doi.org/10.1016/j.brs.2018.11.008.

    Article  Google Scholar 

  58. Santoni de Sio, F., N. Faulmuller, and N.A. Vincent. 2014. How cognitive enhancement can change our duties. Frontiers in Systems Neuroscience 8: 131. https://doi.org/10.3389/fnsys.2014.00131.

    Article  Google Scholar 

  59. Garasic, M.D., and A. Lavazza. 2016. Moral and social reasons to acknowledge the use of cogntive enhancers in competitive-selective contexts. BMC Medical Ethics 17: 18. https://doi.org/10.1186/s12910-016-0102-8.

    Article  Google Scholar 

  60. Allhoff, F., P. Lin, and J. Steinberg. 2011. Ethics of human enhancement: An executive summary. Science and Engineering Ethics 17 (2): 201–212. https://doi.org/10.1007/s11948-009-9191-9.

    Article  Google Scholar 

  61. de Jongh, R., I. Bolt, M. Schermer, and B. Olivier. 2008. Botox for the brain: Enhancement of cognition, mood and pro-social behavior and blunting of unwanted memories. Neuroscience and Biobehavioral Review 32 (4): 760–776. https://doi.org/10.1016/j.neubiorev.2007.12.001.

    Article  Google Scholar 

  62. Garner, B.A. 2009. Black’s law dictionary. Eagan: West.

    Google Scholar 

  63. Leo, R.J. 1999. Competency and the capacity to make treatment decisions: A primer for primary care physicians. Primary Care Companion to Journal of Clinical Psychiatry 1 (5): 131–141.

    Article  Google Scholar 

  64. Pape, T. 1997. Legal and ethical considerations of informed consent. Association of perOperative Registered Nurses 65 (6): 1122–1127.

    Article  Google Scholar 

  65. American Medical Association. 2018. Informed consent. In AMA Code of Medical Ethics. https://www.ama-assn.org/delivering-care/ethics/informed-consent. Accessed December 10, 2018.

  66. Shojania, K.G., B.W. Duncan, K.M. McDonald, R.M. Wachter, and A.J. Markowitz. 2001. Making health care safer: A critical analysis of patient safety practices. Evidence Report/Technology Assessment (Summ) 43 (i-x): 1–668.

    Google Scholar 

  67. Weithorn, L.A., and S.B. Campbell. 1982. The competency of children and adolescents to make informed treatment decisions. Child Development 53 (6): 1589–1598. https://doi.org/10.2307/1130087.

    Article  Google Scholar 

  68. Watts, C.D. 2004. Asking adolescents: Does a mature minor have a right to participate in health care decisions note. Hastings Women’s Law Journal 16: 221–250.

    Google Scholar 

  69. California Department of Education. Frequently asked questions. http://www.cde.ca.gov/sp/ps/rq/psfaq.asp Accessed December 10, 2018.

  70. Rabban, D.M. 1973. Judicial review of the university-student relationship: Expulsion and governance. Stanford Law Review 26 (1): 95–129. https://doi.org/10.2307/1227913.

    Article  Google Scholar 

  71. Gudeman, R. 2009. Consent to medical treatment for youth in the juvenile justice system: California law – A guide for health care providers. https://youthlaw.org/wp-content/uploads/2016/02/Juv._Justice_Consent_Manual_11-09.pdf. Accessed December 10 ,2018.

    Google Scholar 

  72. Feinman, J.M. 1976. The development of the employment at will rule. American Journal of Legal History 20: 118–135.

    Article  Google Scholar 

  73. Lord, R.A. 2006. The at-will relationship in the 21st century: A consideration of consideration. Baylor Law Review 58: 707–778.

    Google Scholar 

  74. Summers, C.W. 2000. Employment at will in the United States: The divine right of employers. University of Pennsylvania Journal of Labor and Employment Law 3: 65–86.

    Google Scholar 

  75. Noe, R.A. 2010. Employee training and development. 5th Aufl. New York: McGraw-Hill Irwin.

    Google Scholar 

  76. Center for Prevention and Health Services. 2008. An employer’s guide to employee assistance program: Recommendations for strategically defining, integrating, and measuring employee assistance programs. https://www.easna.org/documents/PS2-NBGRecommendationsforDefiningandMeasuringEAPs.pdf. Accessed December 10, 2018.

    Google Scholar 

  77. Society for Human Resource Management. How to establish performance improvement plan https://www.shrm.org/resourcesandtools/tools-and-samples/how-to-guides/pages/performanceimprovementplan.aspx. Accessed December 10, 2018.

  78. Fallon, N. 2016. How to create an employee performance improvement plan. https://www.businessnewsdaily.com/8997-performance-improvement-plan.html Accessed December 10, 2018.

  79. Moore, M. 2007. The collision of an employee’s work and personal lives: The role of the EAP referral,. http://www.lancasterlawblog.com/2007/09/articles/employment-law/the-collision-of-an-employees-work-and-personal-lives-the-role-of-the-eap-referral/ Accessed December 10, 2018.

  80. Perritt, H.H. 2017. Employee dismissal law and practice. Sixth ed. Aufl. New York: Wolters Kluwer.

    Google Scholar 

  81. Bonné, J. 2003. Go pills’: A war on drug. NBC News http://www.nbcnews.com/id/3071789/ns/us_news-only/t/go-pills-war-drugs/#.XA8nI6eZM6h. Accessed December 10, 2018.

  82. Caldwell, J.A., and J.L. Caldwell. 2005. Fatigue in military aviation: An overview of US military-approved pharmacological countermeasures. Aviation, Space, and Environmental Medicine 76 (7 Suppl): C39–C51.

    Google Scholar 

  83. Choe, J., B.A. Coffman, D.T. Bergstedt, M.D. Ziegler, and M.E. Phillips. 2016. Transcranial direct current stimulation modulates neuronal activity and learning in pilot training. Frontiers in Human Neuroscience 10 (34). https://doi.org/10.3389/fnhum.2016.00034.

  84. Sample, I. 2016. US military successfully tests electrical brain stimulation to enhance staff skills. The Guardian, https://www.theguardian.com/science/2016/nov/07/us-military-successfully-tests-electrical-brain-stimulation-to-enhance-staff-skills Accessed December 10, 2018.

  85. Roos, R. 2002. GAO: Military anthrax shots caused many reactions, prompted some pilots to quit. Center for infectious disease research and policy, http://www.cidrap.umn.edu/news-perspective/2002/11/gao-military-anthrax-shots-caused-many-reactions-prompted-some-pilots-quit Accessed December 10, 2018.

  86. Wadlington, W. 1994. Medical decision making for and by children: Tensions between parent, state, and child. University of Illinois Law Review 1994: 311–336.

    Google Scholar 

  87. Greely, H.T. 2006. Regulating human biological enhancement:Questionable justifications and Interantional complications. Santa Clara Journal of Interantional law 4 (2): 87–110.

    Google Scholar 

Download references

Acknowledgements

I am grateful to my advisor Professor Hank Greely for his guidance, encouragement, and comments on the earlier drafts of this paper.

Author information

Authors and Affiliations

  1. Stanford Law School, Stanford University, 559 Nathan Abbott Way, Stanford, CA, 94305, USA

    Anita S. Jwa

Authors
  1. Anita S. Jwa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anita S. Jwa.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jwa, A.S. Regulating the Use of Cognitive Enhancement: an Analytic Framework. Neuroethics 12, 293–309 (2019). https://doi.org/10.1007/s12152-019-09408-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12152-019-09408-5

Keywords

Search

Navigation