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Physical vs. Cognitive Alterations: Is All Fair in the World of Anti-Aging Enhancement?

On March 28, Dr. Rommelfanger, Assistant Director of Emory’s Neuroethics Program, gave a talk to the Nu Rho Psi group about the ethics of neuroenhancement technologies. These technologies can be anything from Adderall to interventions that raises IQ. This talk got me thinking about how the normal human aging process is critical in the way that a person views themselves and others. 

Aging now battled with complex technologies. Across the world, doctors routinely perform appearance altering operations, even to the point of giving someone an entirely new face (like this man), which certainly come with psychological consequences. While face transplants are an extreme example, other cosmetic procedures, like Botox injections to relax wrinkles, are performed millions of times a year.  But what about procedures to alter cognitive function? Is neuroenhancement technology ready to become mainstream, or is there some inherent feeling that altering the brain is off limits?
 In the view of Arthur Caplan (Director of the Center for Bioethics at UPenn), “Messing with the brain is unnatural because the brain is the seat of who we are. To change it is to change our identity.”1 Loss of identity is a frightening prospect. As the population ages (the median age in America jumped almost 2.5 years from 1990-2000)2 and technology progresses, the interest in brain enhancement for the purposes of retaining cognitive abilities known to decline with age will grow. Is altering our brain function really much bigger of a step from altering our physical bodies, or is it mostly fear of the unknown?
Francis Fukayama states, in a speech called “Our Post-human Future”, “Human rights are based on a certain understanding of human nature.”3 Neuroenhancements are often understood as bestowing an unfair advantage on those who are enhanced in ways that plastic surgery could not, to the point of potentially changing this “human nature”. But can’t physical features have profound effects on “human nature”? In a study done by Timothy Judge and Daniel Cable, it was found that taller people make more money at an average of almost $800 per year per inch above average.4 Isn’t this an unfair advantage?
  In terms of neuroenhancements, even caffeine could be seen as enhancing your brain function, yet coffee is a widely accepted and properly consumed substance. When I have a long paper to write, I can be seen in the library with a gigantic cup of coffee feverishly typing away – is keeping myself awake and alert giving me an advantage over others (or cheating), and if so, should it be banned? What if I were an executive in my 60s using supplements to keep my brain “young” to hold onto my career? As Fukuyama points out, society moves in a generational pattern, and if six generations of people are competing for the same jobs, this will seriously change the fabric of society and competition. But isn’t life in general full of unfair advantages (money, physical traits, etc.)…how do we say what is “fair” or “natural” and what is not?
Both plastic surgery (aesthetic) and neuroenhancements (cognitive) are used as a way to battle the aging process, a huge determinant of identity. Humans are mortal, and while we are all faced with this as reality, some prefer to think that mortality doesn’t have to limit our existence. There are even individuals, like Ray Kurzweil5, a leader of the transhumanism movement, who believe that the time is coming when people won’t have to die at all because computers will have progressed to a point where we can upload our minds onto them. 
This may seem extreme, but it is unsurprising that many would seek to slow the aging process, whether by appearing younger or attempting to keep the brain functioning at a high level.
We have all been bombarded with images of youth and beauty, urging us to buy the latest anti-aging products. Plastic surgery has a large client base of those seeking the latest in wrinkle treatment, and even something as simple as hair dye is a weapon in the fight to appear young. In the United States alone, over 119,000 facelifts were performed in 2011 (up 5% from 2010)6, and this and other age-defying procedures like Botox have been increasing rapidly throughout the world.7

In Western society, youth is highly valued, and age is often viewed as a sign of weakness or uselessness.9 However, East Asian cultures have traditionally revered their elders and looked to them as a source of wisdom.8 While many Asian countries, like South Korea and Japan, have been quick to embrace Western culture and anti-aging aesthetics like plastic surgery, it seems their reverence for the aged and the process of aging may lead to a decreased likelihood to try brain enhancements.10 Why would someone who already possesses the wisdom and respect that comes with age need an anti-aging upgrade?
Countless vitamins and supplements claim to boost brain function, and most advances in medicine are sought in the diseases of aging. Invasive surgical processes already being attempted for diseases like Parkinson’s (deep brain stimulation)11 and Alzheimer’s (implanting genetically modified cells into the brain)12. It may not be that much of a stretch to see a world in which all aging people, not just those with diagnosable diseases, may seek treatment to keep their brains “young”. Cognitive decline will no longer be seen as “normal”.
Neuroenhancement is simply unnatural, you may say. That it may be, but humanity has been fighting nature for a long time. Have no hair? Wear a wig. Vision poor? Here are some glasses. Can’t hear? Cochlear implants might be just the thing for you. The problem with this line of reasoning is that all of these things can be seen as technologies designed to grant a person “normal” abilities, even if they fit in the category of neuroenhancements. We assume that any given human will “normally” possess the ability to see; we do not assume that they will have a genius level IQ or the ability to live to age 200. With the development of neuroenhancements, might it be possible that we create a world in which non-enhanced people are considered abnormal or that enhanced older people are being “enabled”?
Many groups are quick to attack neuroenhancements as technology to be feared and censored. For instance, Leon Kass wonders whether we will doom future generations to become slaves to machines and whether we fully recognize the immense potential for evil that some of these technologies can create.13 In terms of brain-enhancing drugs, some doctors wonder whether or not the safety of long term use has been adequately tested.14 While these are legitimate concerns deserving of careful thought, I believe most of this skepticism can be largely attributed to a fear of the unknown. Most of us have seen the movies where robots or genetically engineered humans take over the world (Gattaca, I, Robot), leaving the “normal” people at best outcasts and at worst akin to some kind of lowly beast in the eyes of those in power. 
While some may be frightened by these prospects and the idea of enhancing technology, others might be tempted to run full speed ahead into the world of brain enhancements. The technologies with which humans can transform their bodies are major and varied, and many are already being employed; should enhancement of the brain really be off limits?

--Mia Michalak

Nu Rho Psi Member, Emory Neuroscience and Behavioral Biology Student

Want to cite this post?
Michalak, M. (2012). Physical vs. Cognitive Alterations: Is All Fair in the World of Anti-Aging Enhancement? The Neuroethics Blog. Retrieved on , from

References (1) (6) (8) (9) (11) (12) (13) (14)


  1. Thanks for your post Mia! I think you lay out the key issues very nicely.

    My own approach is to neither reject neuroenhancers as disrupting "natural" processes (as you point out, what does natural mean anyway) nor to celebrate neuroenhancers as perfect solutions to our problems. Rather, I think it is important to focus on structural issues. Some of the questions that I would ask include:

    1) who will have access to these technologies and will the availability of these technologies exacerbate existing inequalities?

    2) what kinds of social and economic pressures make these technologies so attractive? (i.e. is it the break-down of social safety nets that leads us to need to work into our late 70s, which therefore places pressure on us to maintain certain types of cognitive abilities through neuroenhancers)

    3) will certain types of cognitive and emotional abilities or styles be privileged at the expense of others? (for example, will the pressure to use neuroenhancers reduce "neurodiversity," possibility at the expense of the benefits that came come from having diverse cognitive and emotional approaches to the world)



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