YES

The progress of science has made cosmetic psychop- harmacology, or the administration of medication to improve personality and intellect, a conceivable possibility for the future of self-enhancement. However, the conception of cosmetic psychopharmacology inspires a new debate over the advisability of the use of such medications in psychologically healthy individuals. Of course, society has always embraced the idea of self-enhancement. The societal emphasis on perfection has fostered the promotion of a myriad of procedures for the individual’s convenience. The field of self-improvement is not new. Thus, cosmetic psychopharmacology only serves as a possible, albeit significantly life-altering, convenience for individuals in pursuit of personal change. Why, then, does the very idea of cosmetic psychopharmacology trouble critics?

Moral implications aside for the moment, critics also charge the potentially harmful side effects that may result from the administra- tion of psychotropic medication in healthy individuals. Such psychotropic drugs were only recently developed. As is frequently pointed out, the long term consequences of their use, even as intended, remain unknown by experts. However, it must not be assumed that the effects of current and future neuro-enhancing drugs will be unduly harmful to individuals before they are studied. Such drugs should be reviewed on a case by case basis, under the purview of the FDA. Given that the drugs are found to be safe for public consumption, why should these drugs not be accessible to the public?
It must also be noted that the societal emphasis on individual autonomy has led to the continued and legal existence of other drugs, such as tobacco and alcohol, despite their proven detrimental effects upon the individual’s health. That is not to say that neuroenhancing drugs should be accepted, regardless of proven harm.

However, it is necessary to understand that the concern of critics on this point seems oddly misplaced, considering all the legal and validly harmful technologies and substances currently in existence as a consequence of the societal encouragement of individual autonomy.

Societal precedents would seem to suggest that cosmetic psychopharmacology should rightfully be considered as an acceptable means of self- enhancement. Critics such as Kass may argue that the effortlessness and appealing convenience of cosmetic psychopharmacology will result in the cheapening of identity by making everything too easy. ⁵ However, as Chatterjee points out, this “no pain, no gain” mentality does not seem to have deterred society’s utilization of other conveniences and luxuries such as central air conditioning and Tylenol®. ²

And what of modern innovations like liposuction? Society dictates that an individual has the freedom to make the decision to cosmetically enhance themselves; they do not require universal approval in order to undergo such a procedure. If they are unhappy about their appearance, they have the means to change their appearance in a way that satisfies them. If societal values allow this, then it can be argued that cosmetic psychop- harmaceutical drugs should be accessible to the public. Society emphasizes autonomy and authenticity insomuch that authenticity can be pursued if individuals are permitted to be autonomous.

Contrary to critics’ assertions, authenticity is possible with cosmetic psychopharmacology. ⁴ After all, psychotropic medications act upon what is already there. Current psychotropic drugs enhance the concentration of existing neurotransmitter molecules in the brain. These drugs amplify existing, if hidden, personality traits. Rather than the creation of an artificial personality, the original personality is simply changed, without the possible restrictions imposed by less desirable characteristics. ³ According to Bublitz and Merkel, “…it is patently implausible to consider traits originating from specific neurotransmitters, say serotonin, as not an agent’s own.”

As such, neuroenhancements do not replace a natural biological system with an artificial, alien system. They simply work with the pre-existing system.

It is also important to note that one’s identity is also subject to other environmental factors. ⁶ Abuse and tragedy can repress and inhibit. Difficulty fosters depression. Psychotropic medications have the potential to remediate the oppression bred by external circumstances and allow the individual to experience their true identity, as nature dictated. Critics may still dismiss this as artificial on the aforementioned basis that pain “builds character, and eliminating that pain undermines good character.” ²

However, if an individual were in physical pain, no reasonable man would withhold a means to alleviate that pain from the individual on the grounds that ‘it will build character.’

However, this source of alleviation will not, as critics do contend, be available to the general public. It is highly unlikely that psychotropic drugs will be an affordable option for everyone. But this does not mean a future reminiscent of Huxley’s Brave New World. The creation of cosmetic surgery, after all, did not result in a significant aesthetic disparity between the wealthy and the poor. It is highly likely that cosmetic psychopharmacology will follow suit. This still does not mean that cosmetic psychopharmacology should not be offered as an option in the world of self-enhancement. It is still a plausible method of self-transformation.

It is society’s responsibility to create a more equitable system that would not encourage such a distinction between the poor and the wealthy. This cannot be accomplished by merely withholding cosmetic psychopharmacology and other similar technologies from individuals.

It is important to consider possible implications and consequences in the cosmetic psychopharmacology debate. We cannot rush to accept it just because it looks promising. We must proceed with caution. On the other hand, we cannot hold back because we are afraid of this new technology. Progress is inevitable, essential lest our society fall into stagnation. Cosmetic psychopharmacology offers the opportunity for a new possible self, a new avenue in the constant pursuit of personal perfection.

NO

Imagine a drug with which, for a reasonable you could permanently alter your per- sonality. You could be the individual you always wanted to be, constantly cheerful and always content with your well being. Just pop a pill every day and you could be the person you always dreamed of being. No, this is not a pitch for the newest science fiction movie. This is reality in the form of cosmetic psychopharmacology, a phrase coined by Brown University psychiatrist Peter Kramer in 1990 when describing a then newly developed antidepressant called Prozac®. ⁵ Cosmetic psychopharmacology “refers to taking someone from one normal, but less desired or less socially rewarded state to another normal, but more desired or more socially rewarded state,” explained Kramer. ⁴ Drugs such as Prozac® are typically taken as prescriptions for individuals with emotional or mental disorders, such as depression or schizophrenia. However, there is an increasingly large number of individuals who believe that it should be legal for “healthy” individuals (those who fail to meet the criteria of any emotional or mental disorder) to use drugs such as SSRIs (selective serotonin reuptake inhibitors) and Prozac® to change their personalities. This concept is bioethically immoral and individuals should never take psychopharmacological drugs to permanently alter their brain chemistry or personality.

Drugs that alter the chemistry of the brain and thusly one’s personality were not unheard of before the creation of Prozac®. Mental stimu- lants have been present in society in the form of nicotine and caffeine for centuries. ¹ Coffee makes an individual more alert for a period of time, but the difference between these mental stimulants and SSRIs is that drugs such as Prozac® are viewed as “mental steroids,” as Christopher Altman puts it. ¹ Prozac® alters cognitive functions by affecting the release rate of endorphins and of different neurotransmitters in the brain. ¹ These drugs can potentially alter what the human population defines as a healthy mind, thus it is better that they are only used to treat individuals who absolutely need them, rather than those who simply wish to “improve” their personality.

Mark Walters, a writer and researcher for CignaMedicare, explains that psychopharmacological drugs are supposed to improve the cognitive abilities of certain individuals suffering from conditions including depression and anxiety. ⁶ Walters makes an excellent point when he states that the consumerism of these products displays the naivety of the general public and a general lack of understanding regarding how these drugs will affect a perfectly healthy brain. ⁶ The average individual is never content with him or herself and wishes to change who they are. Companies can market drugs such as Prozac® by saying they will make you perfect, the person you always wanted to be. Philosophically speaking, a person should not feel the need to alter their personality using SSRIs because they believe they are inadequate or imperfect. Mankind is imperfect and that is perfectly fine.

An anonymous contribution to Perspectives: A Journal of Reformed Thought examines cosmetic pharmacology from a theological and philo- sophical perspective. Even if one does not believe in a deity figure, the following sentence is difficult to argue against: “By using drugs to ignore pain’s warning signs, we would multiply our injuries and let disease go untreated, and so hurt ourselves far more severely.” ³ One cannot simply take a drug to feel better about themselves; the individual will never mature or learn from his or her mistakes. Creating an “alter ego” so to speak by fiddling with personality traits and emotional states is a gross abuse of medicine. These psychopharmacological drugs are to be used for sick individuals who lack other options. Prozac® should never be viewed as a different form of cosmetic surgery, except instead of altering one’s outer appearance it alters one’s inner appearance.

Being unhappy is part of life. Nobody should be happy twenty four hours a day, seven days a week. Individuals need to learn from sadness in order to mature and become better individuals. Everyone learns this concept when they are young, yet very few people choose to accept it. Victor
Reus, a professor of psychiatry at the University of California San Francisco, has stated, “My sense is that there are a number of people who may not meet the full criteria for major depressive disorder but are still experiencing dysfunction in their lives, and in addition, they just don’t experience pleasure in many different activities where they might have at one time.” ⁴ These individuals can then hypothetically feel better about themselves by taking psychopharmacological drugs, but this action defeats the purpose of learning about oneself and finding what truly makes one happy. There are no “miracle drugs” that will make an individual content all of the time. The only way individuals can be happy is to take the time to find out what makes them happy, a method which no drug can ever replace.

Cosmetic psychopharmacology is one of the more bioethically immoral concepts currently present in the medical world. Bruce Charlton of the Department of Psychology at the University of Newcastle upon Tyne perfectly summarizes the purpose of these drugs: “These are drugs with the potential to give appetitive gratification, to give life more meaning. When they work, they are true ‘happy’ pills; where happiness is taken to be the legitimate goal of life.” ²