Tuesday, June 13, 2017

Have I Been Cheating? Reflections of an Equestrian Academic

By Kelsey Drewry

Kelsey Drewry is a student in the Master of Arts in Bioethics program at the Emory University Center for Ethics where she works as a graduate assistant for the Healthcare Ethics Consortium. Her current research focuses on computational linguistic analysis of health narrative data, and the use of illness narrative for informing clinical practice of supportive care for patients with neurodegenerative disorders.

After reading a recent study in Frontiers in Public Health (Ohtani et al. 2017) I realized I might have unwittingly been taking part in cognitive enhancement throughout the vast majority of my life. I have been a dedicated equestrian for over twenty years, riding recreationally and professionally in several disciplines. A fairly conservative estimate suggests I’ve spent over 5000 hours in the saddle. However, new evidence from a multi-university study in Japan suggests that horseback riding improves certain cognitive abilities in children. Thus, it seems my primary hobby and passion may have unfairly advantaged me in my academic career. Troubled by the implication that I may have unknowingly spent much of my time violating the moral tenets upon which my intellectual work rests, I was compelled to investigate the issue.

The study in question, “Horseback Riding Improves the Ability to Cause the Appropriate Action (Go Reaction) and the Appropriate Self-control (No-Go Reaction) in Children,” (Ohtani et al. 2017) suggests that the vibrations associated with horses’ movement activate the sympathetic nervous system, leading to improved cognitive ability in children. Specifically, children 10 to 12 years old completed either simple arithmetic or behavioral (go/no-go) tests before and after two 10 minute sessions of horseback riding, walking, or resting. A large percentage of children demonstrated improved performance on the go/no-go tasks (which largely test impulse control) after 10 minutes of riding compared to children who walked or rested. No significant changes were seen in the arithmetic tasks.

"There are many possible effects of human-animal interactions on child development," study author Mitsuaki Ohta suggests. "For instance, the ability to make considered decisions or come to sensible conclusions, which we described in this study, and the ability to appreciate and respond to complex emotional influences and non-verbal communication, which requires further research to be understood" (Frontiers 2017).

So, have the horses I’ve ridden over my life (the number must be nearing 100) enhanced components of my cognitive abilities and perhaps even predisposed me to a career in bioethics? Have they given me unfair advantages over others by heightening my ability to think about and respond to moral problems? When I go to the barn before writing an exam or term paper (or this blog post) am I cheating via the highly controversial and purportedly unjust act of cognitive enhancement? After all, considered decisions and sensible conclusions are the hallmark of bioethics.

Image courtesy of Wikimedia Commons.
Though I initially—perhaps defensively—want to argue “no,” there seems to be a reasonable case that I have enthusiastically engaged in cognitive enhancement, and that my particular means of doing so is quite unjust. Though different in methodology and perhaps neurologic effect, pharmacological cognitive (or affective) enhancement seems to provide discourse that is surprisingly analogous to my circumstance.

Throughout diverse fields of literature, a host of arguments have been raised regarding the nature, moral and legal status of non-prescription use of stimulant “study drugs,” especially amid young people in academic settings (e.g. Aria 2011; Desantis et al. 2010; Terbeck 2013; Vrecko 2013). Among commonly advanced opposition to this sort of enhancement is the concern that it is unnatural and may result in inauthentic or non-rational choice. In his discussion of the issue, Torben Kjærsgaard writes, “We could risk losing our capacity to pull ourselves together, if we rely on motivation enhancers every time we face hard challenges... we may risk losing touch with ourselves in some sense. Thus, we should wonder how we would be doing if it were not for the enhancers, and ask ourselves how much we would have achieved if it were not for the motivation enhancers” (Kjærsgaard 2015). Now, at first blush riding may not seem to be motivational enhancement, but that is certainly a role it has played in my life. Not only has it become my go-to activity for coping with stress, anxiety, or any undesirable emotion in much the same way that some rely on drugs, my household rules growing up cemented its role as motivator. I was raised with academics as the priority—if I didn’t do well in classes, I didn’t get to ride. Though not ingested orally (rather aurally), I’d certainly say my love of horses, if not the riding itself, has significantly influenced my academic motivation. By this measure, my equestrian habit is at least ethically dubious if not entirely concerning.

Another commonly cited objection to the off-label use of stimulants is medical. In the most extreme cases, overdoses, “The primary clinical syndrome involves prominent neurological and cardiovascular effects… the patient may present with mydriasis, tremor, agitation, hyperreflexia, combative behavior, confusion, hallucinations, delirium, anxiety, paranoia, movement disorders, and seizures” (Spiller 2013). However, even the common “minor” equestrian injuries, which include soft tissue damage, fractures, and concussions (Bixby-Hammet 1990), are not negligible in comparison. I have suffered each category of riding injury multiple times—several broken ribs, a broken arm, an avulsion fracture in my foot, lung and liver contusions, and concussions are among my more certain traumas. Training and competing in the sport considered the most dangerous in the Olympics (van Gilder Cooke 2012) and leading the count in sports-related traumatic brain injuries (Mohney 2016), I’m considered lucky among my equestrian peers even with that list. Undoubtedly, anyone recommending participation in horseback riding could be accused of violating basic nonmaleficence. The risk-benefit ratio does not skew in favor of the saddle, and it seems unimaginable that a medical professional would recommend any intervention with a similar profile.

Image courtesy of Pixabay.
Finally, let’s turn to justice and access. Core virtues of American medicine, just access and opportunity are morally idyllic, and often contribute to strong condemnations of pharmacological enhancement. The general argument is that drugs like Adderall are intended to “restore” normal cognitive (or affective) ability to individuals suffering from attention deficit disorders, and that use by “cognitively normal” individuals provides disproportionate benefit while unfairly disadvantaging those with medical need. Additionally, the high cost of the drugs, especially when purchased illegally, may widen the gap in academic achievement already created by socioeconomic factors (Sirin 2005). With these considerations, I must denounce my horse habit as undeniably unethical. Even more than expensive pills, the financial privilege required to participate in this sport is incontrovertible. Riding lessons cost from $25-$100+ an hour, and that is just instruction. Horseback riding is simply financially untenable for many, regardless of the purported cognitive benefits. Thus, if one accepts Ohtani’s conclusions, my equestrian activities have granted me access to a privileged means of enhancing cognition. I have improved my mental faculties without the effort and intention lauded by Kantian morality, and with disregard to the virtue of justice valued by my society (Timmons 2013).

The conclusion that by participating in a sport that I love, I may have inadvertently acted immorally by enhancing certain cognitive capacities is puzzling and likely provocative to many. My moral intuition suggests that since I neither intended to enhance my abilities, nor was I even aware that this outcome was possible, I did not act unfairly. There also seems to be something about the nature of the act, perhaps that it is physical instead of chemical, that excludes it from being one of the “immoral enhancements” denounced by bioconservative theorists. If we do deem this activity to be equestrian cognitive enhancement, why would this riskier, less accessible, and equally addictive methodology be less egregious than biomedical means? The readily paralleled discourse between cognitive enhancement via riding and the ethical issues of off-label nootropic drug use reveals that we have much more to discuss about what does and does not constitute enhancement. Perhaps after a bit more time in the saddle I’ll be able to come to a sensible conclusion.

References 

Arria, A. M. 2011. Compromised sleep quality and low GPA among college students who use prescription stimulants nonmedi- cally. Sleep Medicine 12(6): 536–537. Available here.

Bixby-Hammett, D., and Brooks, W.H. (1990) Common Injuries in Horseback Riding: A Review. Sports Medicine 9(1): 36-47.

DeSantis, A., S. M. Noar, and E.M. Webb. (2010) Speeding through the frat house: A qualitative exploration of nonmedical ADHD stimulant use in fraternities. Journal of Drug Education 40(2): 157– 171. Available here.

Frontiers. (2017, March 2). Horse-riding can improve children's cognitive ability: Study shows how the effects of horseback riding improve learning in children. ScienceDaily. Retrieved here.

Kjærsgaard, T. (2015) Enhancing Motivation by Use of Prescription Stimulants: The Ethics of Motivation Enhancement. AJOB Neuroscience 6(1): 4-10.

Mohney, G. (2016, April 1) Horse Riding is Leading Cause of Sport-Related Traumatic Brain Injuries, Study Finds. ABC News. Retrieved here.

Ohtani, N., Kitagawa, K., Mikami, K., Kitawaki, K., Akiyama, J., Fuchikami, M., Hidehiko, U., and Ohta, M. (2017) Horseback Riding Improves the Ability to Cause the Appropriate Action (Go Reaction) and the Appropriate Self-control (No-Go Reaction) in Children. Frontiers in Public Health. Published online 6 February 2017 here.

Spiller HA, Hays HL, Aleguas A Jr. (2013) “Overdose of drugs for attention-deficit hyperactivity disorder: clinical presentation, mechanisms of toxicity, and management,” CNS Drugs 27(7): 531-543.

Terbeck, S. 2013. Why students bother taking Adderall: Measurement validity of self-reports. AJOB Neuroscience 4(1): 20–22.

Timmons, M. (2013) Moral Theory: An Introduction. Lanham, Md.: Rowman & Littlefield Publishers.

van Gilder Cooke, S. (2012, July 28) Equestrian Eventing: The Olympics’ Most Dangerous Sport? Time. Retrieved here.

Vrecko, S. (2013) Just How Cognitive is “Cognitive Enhancement”? On the Significance of Emotions in University Students’ Experiences with Study Drugs. AJOB Neuroscience 4(1): 4-12.

Want to cite this post?

Drewry, K. (2017). Have I Been Cheating? Reflections of an Equestrian Academic. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2017/06/have-i-been-cheating-reflections-of.html

1 comment:

Unknown said...

The article cited seems as dubious as the text it inspired. Perhaps the brevity of the post increased its seeming illogical jumps. I had thought the go/no-go task was one of many tasks testing inhibition. Even if we were to take the study findings at face value, it is peculiar to me then that the next logical statement is that "[her] primary hobby and passion may have unfairly advantaged [her] in [her] academic career." Of course, ability to inhibit responses and to remain task-oriented will help in graduate school, but how might it "[predispose her] to a career in bioethics?" Should it be believed that every student in the cited study will too become bioethicists? Also, what, pray, are the moral tenets of her career such that it may inspire her to take arms against any person like herself who have dedicated time to a craft (e.g., horse riding, piano) and benefitted cognitively from its training? Is this really the moral and actionable equivalence of "stimulants"? The author finds similarities between the prohibitive costs and riskiness of her hobby and pills, but how does she differentiate between this hobby and the other sets of theoretically also cognitively enhancing hobbies that are less prohibitive and that she has not indulged in? And a prohibitive hobby necessitates the other cognitively enhancing comforts of a higher socioeconomic status, does it not? This includes a stable home environment, physical safety and protection from social disorder (e.g., violence) and drug use, richer academic curriculum, support from peers and teachers and parents, an environment in which academic success (and existential quandaries) are normative, etc. By that token, is her own existence not immoral?