Wednesday, June 27, 2012

What's Wrong With "Artificially" Enhancing Performance?

By Sherry Colb

In my Verdict column for this week, I examine the reported proliferation of drug use among high school students aiming to boost their academic performance.  By using medications like Ritalin and Adderall, students who do not technically suffer from Attention Deficit Hyperactivity Disorder (ADHD) (for which such drugs are prescribed) can -- like people with ADHD -- increase their ability to concentrate hard and learn efficiently.  Stimulants like these (and others) can enhance what psychologists call "executive function," including the brain's ability to self-regulate.  In my column, I discuss some of the risks  associated with the drug, including addiction and the related phenomenon in which many users of the drug find that it no longer enhances their abilities but has instead become necessary to maintain what had been their pre-drug-use baseline.

In this post, I want to focus on a different complaint that people have about the use of artificial means to enhance native capacities.  This particular complaint would be the same even if stimulants carried no harmful side-effects, was not addictive, and remained effective over the long term.  The complaint is that there is something unfair or akin to "cheating" in using artificial means to increase one's ability to achieve.

Consider a hypothetical example.  Say you have an easy time sitting down with a book and reading it cover to cover with great concentration.  Once having read the book, moreover, you are able, almost effortlessly, to remember what you have read and to apply it to new situations, even if the book is complicated and dense.  Say that I, by contrast, become easily distracted and frustrated when I begin reading the same book.  I can barely read two paragraphs without dozing off, heading to the kitchen to grab a snack, or daydreaming about my vacation.  Even if we come into the same course with the same background knowledge, you will likely earn an A on your exam on the book, and I will be lucky to scrape by with a B or a B-.  That is our baseline performance.  Your executive function is far superior to mine, even though I do not technically qualify for a diagnosis of ADHD.

Now imagine that there is a drug called "EasyThink" (ET) that supports greater executive function.  When I take the drug, I am suddenly able to concentrate effortlessly, just as you do without taking ET.  I can read the book in one sitting now, without feeling distracted or antsy and without becoming drowsy.  I too can get an A on the book exam, just as you can.  For many people, you will have succeeded "on the merits" in this example, and I will have benefited from a form of cheating -- chemically enhancing my "real" abilities.

In making this complaint, however, it is unclear why it would be accurate to describe what I have done as "cheating."  By hypothesis, I did not hire another person to take the test for me; I did not sneak answers into the exam.  What I did was to take a medicine that causes my brain to do what your brain does naturally, and -- as a result -- I honestly mastered the relevant material for the exam.  We put in the same amount of effort and received the same results, but many would consider your A more authentic than mine.  Why?

To state the problem differently, we can observe many inequities that yield difficult lives for some and easier lives for others.  Some of us are born to parents with means, and we receive the many benefits associated with financial security.  Others are born into more challenging or unsafe environments and find themselves with fewer benefits and opportunities.  Some people are sick, and others are healthy.  Some are strong, and others are weak.  Though hard work can make a huge difference in one's life prospects, even the ability to work hard is not evenly distributed in the population.  Some of us come into this world with more willpower than others, and those with little willpower may have no idea how to change themselves.

With all of these inequities, we pick and choose which ones we consider unfair and which ones we accept without question.  If a person is born with a terrible illness, no one says it would be unfair to treat the illness, because only those people who are healthy "on the merits" should be able to enjoy their authentic health.  On the contrary, we consider it a wonderful thing that someone who is born sick can be healed and enjoy the same life prospects as someone lucky enough to be born healthy.

With other inequities, however, we take a very different approach.  If a particular person who has a difficult time integrating dense material into his brain performs poorly at school (but not poorly enough to merit a diagnosis), many of us consider it "fair" that the person accomplishes only enough to earn a B- on an exam, while someone else can accomplish enough to earn an A, because she can integrate material far more easily than her classmate.  If we consider this inequity fair, then it is not surprising that we would regard it as unfair to artificially boost her classmate's performance so that he too can earn an A when he studies the book in question.

Consider an analogy from a very different area.  If a particular person remains young-looking and attractive as he ages, we consider him truly handsome.  If, on the other hand, he looks as good as he does because of plastic surgery or other artificial enhancements, we say that he has "had work done" and we dismiss his attractiveness as fake in some way.  This differential attitude toward an older person's good looks exposes the following view:  if someone looks like he is 35 when he is actually 70, then he either deserves to look that way (because his looks are unaffected by surgical intervention) or he has taken unfair advantage of surgery or other technology.  "Natural" good looks merit admiration, while "surgically enhanced" good looks merit contempt and gossip.

One could easily see things quite differently, however.  The person who naturally looks like he's 35 when he is 70 has been very lucky.  He was perhaps born with "young looking" genes -- something that he did not have to work to get.  His surgically enhanced analogue, by contrast, has had to undergo pain, risk, and difficulty to achieve the looks that he has.  In a sense, he has had to suffer for his looks, while the other man just had those looks fall into his lap.  Yet we manage somehow to consider the natural inequity legitimate, while the surgically generated equity is not.

Returning to executive function, a famous old study on young children suggests that the ability to delay gratification (which is an executive function) predicts success later in life with far greater accuracy than any other known test does.  In the study, an experimenter gives a preschooler a marshmallow and tells her that she can eat the snack now or she can hold off on eating it for 15 minutes, until the experimenter returns.  If she waits, then she will receive two marshmallows to eat instead of just one.  The children who are able to wait for the two sweets, despite the temptation, scored an average of 210 points higher on the S.A.T.s many years later than the children who could not wait for 15 minutes.  No test of "intelligence" has similar predictive power.

It would be odd, though, to suggest that the children who found themselves unable to wait 15 minutes for the marshmallow deserve to perform measurably less well in life than the children who were able wait.  Yet that is essentially what we say when we describe the person who uses a stimulant drug gaining an "unfair" advantage.

There are plenty of reasons to worry about the increasing number of children and teens using drugs like Ritalin and Adderall to conform to the expectations that schools and parents have.  But "unfairness" to people who can concentrate easily without a drug is not such a reason.  It is instead part of a common  tendency to assume that "natural" inequities are fair and call for no rectification, a tendency that does not hold up well to critical scrutiny.