…I worry, however, that the focus on the exciting possibilities of present and future neuroscience obscures more pressing ethical issues. These more important issues should count as neuroethical issues.

Neuroethics has been especially concerned with cognitive and affective enhancement. A number of enhancement technologies are either in development or already available, including psychopharmaceuticals like methylphenidate (Elliott et al. 1997; Mehta et al. 2000) and modafinil (Turner et al. 2003), and also transcranial direct current stimulation (Kadosh et al. 2010), to name only the most prominent. Many ethicists are deeply worried about these developments. A range of arguments have been advanced purporting to show that the use of cognitive enhancements is impermissible or at least inadvisable.

Some ethicists have attempted to show that alterations produced by psychopharmaceuticals or electrical stimulation of the brain would be inauthentic (e.g. Elliott 1998). Others have focused not on the traits and capacities produced but on the means whereby they are produced: because these means are technological, they risk mechanizing our self-conceptions (Freedman 1998). Yet others have worried that cognitive enhancement might constitute cheating (Schermer 2008). Perhaps most pervasively, ethicists have worried about the social justice implications of cognitive enhancement (Sandel 2009); cognitive enhancement may well prove expensive, limiting access to those who are better off than average. Even if they are relatively cheap, they will almost certainly be out of reach of the roughly 10% of the world’s population living on less than US$2 a day, adjusted for purchasing power (World Bank 2015). Given that these enhancements are likely to be much more available to those who are already better off, they are likely to increase inequality, within and between countries.