Drugs that reshape our character could become the defining industrial products of the century.
When Theodore Dalrymple practised psychiatry in Britain a few years ago he noticed that many of his indigent female patients lived sad lives, and looked rather sad, but never once complained of sadness. Instead, they told him they were depressed.
They had learned to speak the language. As he explained in one of his excellent magazine articles, his patients knew he had a pill to give them for depression whereas he could do nothing for sadness except suggest they re-organize their lives. In many cases he might have suggested they leave the abusive and neglectful men who were spreading melancholy in all directions. His patients didn't want to hear that.
They wanted pills, which he was able to provide.
In a sense, they understood the future of medicine better than he did. As a therapist, he imagined helping them work through life problems but science, public health services and pharmaceutical corporations were all moving elsewhere, away from talk therapy and toward the blossoming field of psychotropic drugs and the unfolding marvels of neuroscience.
Old-fashioned therapists still find good work to do but neuroscience has usurped the prestige that psychoanalysis and related forms of therapy possessed during the twentieth century. The neuroscientists have -- as C.P. Snow said about scientists in general in a famous lecture 50 years ago -- "the future in their bones." They have taught the world to regard joy as dopamine activity in the brain's reward centres and melancholy as serotonin deficiency.
The implications are large enough to reshape society and create a new economy, "Neurocapitalism." That's the title of a provocative article by Ewa Hess, a Zurich journalist, and Hennric Jokeit, a Zurich University neuropsychologist, in Merkur, a Berlin cultural review (kindly translated for those who don't read German by the excellent online Eurozine).
Psychotropic drugs are moving beyond curing the demonstrably sick. Increasingly, they are used by mainly healthy people to alter "character virtues," such as self-confidence and trust. Hess and Jokeit report that current medical journals go much farther, describing neuroscientific research into "love, hate, envy, Schadenfreude, mourning, altruism and lying." The expectation (and the reason for research funding) is that whatever neuroscientists identify can be modified by pharmaceuticals.
As Hess and Jokeit see it, psychotropic drugs could become the defining industrial products of this century. They choose the term "neurocapitalism" because the new drugs, in theory, answer the need of capitalism for more effective human beings and the need of individuals to make themselves successful in the marketplace.
Researchers are manipulating the nature of the human animal and challenging the very "self " at the core of human life. Almost everyone who touches this field understands that it raises delicate moral issues. Unfortunately, almost no one knows how to draw a line separating legitimate medical needs from purely frivolous desires. Where in the continuum would we place "neuro-enhancers" that propose to add years to a pilot's career or change someone from a B-to an A+ student? Drugs in this category can be rationalized as "compensatory" or "moderate enhancement," comparable to glasses worn to correct eyesight.
Even if medical ethicists could determine which drugs are legitimate and which are not, how would their judgment be enforced? Nation by nation? Through international treaties? It seems unlikely.
Hess and Jokeit, who have their misgivings about neuroscience and show no enthusiasm for capitalism, nevertheless point out that the freedom of individuals (as well as corporations) is involved. Pharmacological intervention expands the autonomy of people "to act in their own best interests or to their own detriment." That may turn out to be the most popular guiding principle; certainly it will have the drug companies behind it. It may be that medical ethics, confronted by unprecedented discoveries, lacking any relevant principles from the past, will never cobble together a moral structure it can apply to this largely unknowable science. Perhaps it is already happening much too fast.