Cosmetic Neurology

Cosmetic surgery is performed to improve appearance in otherwise healthy people. These aren't burn or trauma victims; they just want a tummy tuck or a nose job to look better, be more attractive, increase self-confidence. Whatever we think of cosmetic surgery, it's an accepted thing. If someone can pay for it, they can get it.

But what if there were medications or procedures that could improve cognitive capabilities in otherwise healthy people? What if you could take a smart pill to increase intelligence, memory, reflexes, attention, or even personality? Would we have a problem with this? Somehow, I imagine that society would frown upon people who had some surgery to get a perfect score on the SAT. Indeed, synthetic growth hormone isn't given to people with normal height who want it. But on the other hand, a cup of coffee might increase one's alertness and we have no objections with that.

This isn't science fiction. Modafinil ("Provigil") is a drug to treat narcolepsy, but it can be used by anyone to increase alertness despite sleep deprivation. You hear about Ritalin to improve attention in someone without ADHD. These drugs actually enhance the cognitive resources of normal, healthy people.

Ethically, how should we consider cosmetic neurology? It seems hard to argue that cosmetic surgery is intrinsically morally wrong, but there is an incredible urge to label cosmetic neurology as such. It seems abnormal to try to enhance intellectual attributes with medicine for some reason. Our test scores, how smart we are - we would like to think that these things are influenced by how hard we work rather than whether we can afford a pill. And indeed, what a skewed economy we could imagine if dollars could buy your way into medical school (wait, can't they already?) or get your kindergartener into that coveted academy. But why would it seem so repulsive to take a pill to learn more efficiently as opposed to hiring a tutor? On what grounds can we say that cosmetic neurology is morally wrong?