Cognitive enhancers are set to change workplaces

BMJ 2012; 345 doi: (Published 07 November 2012) Cite this as: BMJ 2012;345:e7538
  1. Jacqui Wise
  1. 1London

Cognition enhancing drugs are increasingly being used by healthy people and could dramatically change how people work over the next decade, says a new report.1

The report, from the Academy of Medical Sciences, the British Academy, the Royal Academy of Engineering, and the Royal Society, examined a wide range of current and emerging technologies such as cognition enhancing drugs, bionic limbs, and retinal implants. It said that many of these technologies might improve performance in the workplace but that their use also raised many ethical, philosophical, and regulatory questions.

The report said that cognitive enhancers present the greatest immediate challenge for regulators and policy makers and called for further research into their use by healthy people. Modafinil, for example, is used to treat sleep disorders but can be bought over the internet fairly cheaply and is increasingly being used to improve performance. Up to 16% of students in the United States have used such cognitive enhancers to improve performance, said the report. There are no similar figures for the United Kingdom, but the proportion of prescriptions for stimulant drugs has doubled over the past 10 years, and they are widely used off label.

Speaking at a press briefing in London to launch the report, Barbara Sahakian, professor of clinical neuropsychology at the University of Cambridge, said that cognition enhancing drugs could potentially benefit some groups of people, such as bus drivers who drive long distances overnight. “Or imagine two surgeons, one who has been drinking coffee to stay alert and has hand tremors and the other who has been taking cognitive enhancing drugs and has no tremors and is alert. Which would you prefer to operate?”

The report quotes a 2011 study that found that modafinil reduced impulsive behaviour and improved cognitive flexibility in sleep deprived doctors without the side effects of tremor and heart palpitations.

The report said that enhancement technologies could improve a person’s ability to learn or perform tasks; enable people to work in more extreme conditions or into old age; and reduce work related illness or facilitate an earlier return to work after illness. Sahakian said, “There are real benefits to be had for people with brain injury, neuropsychiatric disorders, or mild cognitive impairment.”

But Genevra Richardson, professor of law at King’s College London and chairwoman of the committee that wrote the report, said, “There are not much data on the long term use of these cognitive enhancing drugs, and we need to have more research on their use in healthy individuals. There are also ethical considerations. It is one thing for an individual driver to decide to use modafinil, but it is different if a haulage company requires all their drivers to use modafinil.”

She added, “If a private individual is paying for the technology, then are the rich just going to get cleverer?”

Jackie Leach Scully, co-director of the policy, ethics, and life sciences research centre at Newcastle University, said, “There is a risk that employees will be under pressure to use technologies to enhance their work performance. They may not want to for religious, social, or health reasons.”

The report aimed to prompt debate and asked whether any form of self regulation would be appropriate or whether circumstances exist where such workplace enhancements should be encouraged or even made mandatory. For example, visual enhancement technologies such as retinal implants could improve the performance of bus drivers and airline pilots.


Cite this as: BMJ 2012;345:e7538