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The American Academy of Neurology (AAN)'s Ethics, Law and Humanities Committee entered difficult terrain with its guidance for responding to adult requests for neuroenhancement.1 The Committee's emphasis on individual autonomy raises questions, especially regarding social and scientific issues.
First, the authors acknowledge that enhancement lies outside the traditional goals of medicine and they suggest an approach to addressing these requests. However, their guidance falls short of fully considering the social aspects of neuroenhancement and the unique responsibility of physicians who seek to protect the complex biosocial and psychosocial functions of the brain. By overlooking the full impact of social stressors and other factors that prompt individuals to request neuroenhancers in competitive environments, the authors' guidance allows neurologists to comply with potentially problematic social goals and contexts. Another option would have been to provide guidance that approaches individual well-being in a broader social context and emphasizes solidarity rather than accepting individual biologic coping strategies to these requests, which have social repercussions and unaddressed health policy implications.2
Second, the opinion that prescribing neuroenhancement medications is ethically permissible relies on a tacit favorable belief about the safety and efficacy of neuroenhancers. These beliefs are not supported by strong evidence such as large-scale randomized clinical …
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