Introduction
Prevalence in the use of pharmaceutical cognitive enhancers (PCE) may result in safety, health and ethical problems within the Western society. Hence, international organizations and countries formulate boundaries and rules to restraint their usage within the legal and moral framework. Even though there are traditionally cognitive enhancers like nicotine and caffeine, their peaks are small and hence incomparable to pharmaceutical enhancers as discussed in this paper. PCE include modafinil, donepezil, dextroamphetamine, and methylphenidate. Cognitive enhancers treat dementia or Alzheimer's disease, attention deficit hyperactivity disorder (ADHD), and narcolepsy. The use of these enhancers by healthy persons result in increased cognitive functioning because PCE balances biochemical that exists in the brain, which elevates alertness and attention (Garasic and Lavazza, 2016). Administration of cognitive enhancers increases the executive functioning of the brain, which improves performance in professional work and while studying. Nonetheless, administration of cognitive enhancers by healthy persons results in health problems like headaches, hypertension, depression, excitoxicity, and high blood pressure. Additionally, users are exposed to risks of counterfeit medication, overdose, and death. The ethical dilemma in the use of cognitive enhancers is that normal persons in the academic field and other working professions use them to improve their cognitive and intellectual performances regardless of the negatively associated health side effects and safety risks.
The Resultant Ethical Dilemma in the Use of Cognitive Enhancers
An ethical dilemma arises between the need to use cognitive enhancers for improved performance and the need to impose laws that ban its use because of health and safety risks that persons face during self-administration. The United Nations Convention on Psychotropic Substances listed numerous drugs that needed restriction in ratification. The list included methylphenidate within Schedule II and thus using this medication as a "study aid" may result in imprisonment or payment of liability depending on countries' jurisdiction. Since Modafinil was not part of the substances within the convention's schedule list, regulations for its usage varies with countries and may lack legal consequences (Garasic and Lavazza, 2016).
Countries ban self-administration of cognitive enhancers within the healthy population because of their adverse health and safety risks. Additionally, PCE results in unfairness within a computing environment because substance users emerge as leaders because of their enhanced performance. Users of enhancement drugs self-administer varied range of dosages. Hence, there are safety risks for persons that may try to engage in similar practices without amicable research on appropriate dosages and medications. Consequently, they may buy items, and everything was in the market without clear guidance. Such cases result in disruptive and random effect in participant's performance that may ultimately undermine the quality in available opportunities (Garasic and Lavazza, 2016).
Contrarily, cognitive enhancers immensely influence dopaminergic system to its users. Research indicates that PCE enhances emotions, pleasure system and attention potentials of the brain (Sattler, Sauer, Mehlkop, and Graeff, 2013). Hence, their use intensifies the relevance of academics and work. Some persons amicably deal with pressures that arise from increased workload and competition when they use enhancers. Hence, some professional resort to cognitive enhancers to effectively perform the tasks at workplace. University learners and instructors rely on brainpower, and thus they take these drugs to enhance their performance.
Effects of Ethical Dilemma in Nursing
The nursing fraternity is concerned that self-administration of cognitive enhancer by healthy persons results in adverse safety issues and health consequences. These concerns outweigh the benefits attained by using enhancement substances. Misusers may suffer from emesis, weight loss, sleeping difficulties, addiction, fatal arrhythmias, sexual dysfunction, and personality alteration. Also, persons using cognitive enhancers may suffer from headaches, hypertension, depression, excitoxicity, and high blood pressure. Such costs outweigh resultant benefits amongst substance users. Additionally, unintended overdose via self-medication is of nursing concern because it may result in death. Other persons may become victims in buying counterfeited off-label enhancers from the internet that will become detrimental to their health and safety.
Research indicates that prescription holders are likely to engage in illicit uses when compared to non-holders. Such misuses do not regard safety, health, and ethics. They perceive it to be socially acceptable, reduced control without the aid of stimulant, and enhanced knowledge. Non-prescription holders may engage in self-diagnosis because of attention disorder (Judson, and Langdon, 2007). Most persons that misuse cognitive enhancers are patients with psychological issues. These patients also distribute enhancers to healthy persons. Therefore, the nursing fraternity has a dilemma on how to administer these medicines without resulting in their inappropriate misuse that results in health problems and imprisonment.
Moral Issues Arising from the Dilemma
The moral virtue of using cognitive enhancement is that actors have a chance of enjoying a good life. Goals that seem unachievable and elitist are thus made possible because of enhancers (Froding, 2011). CE improves intellectual capacities of information processing, working memory, and executive functioning. Additionally, these substances enhanced affective and emotional state. Research findings indicate that participants felt an increase in mental and physical energy as persons became energized and had improved mood. There were stronger inner push and a stronger desire for commencing work and steadily progressing on to achieve goals and completing tasks. Also, persons experienced an emotional investment in work-related issues and derived enjoyment in work because they perceived work as a pleasant endeavor (Garasic and Lavazza, 2016). Hence, enhancers reduce work-related pressure and ensuring that persons achieve their ambitious goals. Therefore, persons can secure good jobs, leadership positions and desirable grades in the university.
However, students engage in the random administration of stimulants to enable them to increase their academic work for extended periods of time. Disparities in quantities of drugs taken result in an extension of academic work from 4 up to 24 hours and even more. Such self-medications are non-therapeutic and unapproved and hence can result in health and safety problems.
Bioethical Principals Arising from the Dilemma
The two bioethical principals related to cognitive enhancers arise from accomplishments attained through motivational enhancement by substance users and deteriorated value for human effort amongst persons that do not use enhancers (Kjaersgaard, 2015). Researches findings from healthy persons with a history of using cognitive enhancers attest to its improved affective or emotional state. Enhancers result in emotional changes because it enhanced the desire to perform both in academics and at work and place appropriate value in that regard (White, Becker-Blease, and Grace-Bishop, 2010). Such enhancement relieved persons from work and academic-related stress and tensions that ultimately resulted in undesirable experiences.
Because of substance use, students considered their academic work as beneficial and thus increased performance. Students admitted that these medications resulted in changes of more than one state in the four dimensions of "feeling up" that entails energized mental and physical perceptions, with an elevation of wellbeing (Vrecko, 2013). Secondly, "drivenness" that referred to the strong need to work and the need for action to expend the resultant energy that emanates from stimulants. Hence, students acquire the urge of completing assignments because of the stimulated desire for accomplishing tasks. Thirdly, in regards to "interestedness," participants had enhanced emotional investments in their work because of attaining sudden care and importance in different areas of study. Lastly, PCE felt "enjoyment" in academic work because it was pleasurable and they willingly engaged in them without being forced on them.
Secondly, the use of enhancers reduces the value of human efforts that emanate from non-substance users (Kjaersgaard, 2015). There exist clear differences in persons when using cognitive enhancers and when thinking independently. Some PCE cause persons to enhance their thinking immediately after administration whiles other medication have a longer duration or growing enhancement in the brain. In competitive environments that result in attainment of scholarship or job, all participants work tirelessly towards outwitting others. Participants in such competitive environment continuously come across encouragements aimed at improving their performance provided they abide by the set rules, which are well known by all participants. Nonetheless, users of PCE usually occur within the private domain that is not known to all participants and hence result in inequality. Since, students, workers, and researchers never declare their use of enhancement drugs, and thus they will emerge as more skilled or with enhanced performance than their counterparts. While working together as a team, such overrating may cause persons to put their colleagues at risk when they miss dosage because their performances are bound to deteriorate (Garasic and Lavazza, 2016).
Value for Personal Morality
In regards to personal morality, there are needs to enforce the burn of cognitive enhancers because their side effects outweigh benefits enjoyed by persons that abuse such substances. Currently, Food and Drug Administration (FDA) placed a requirement for manufacturers of PCE to put a warning on labels within a black box that highlights the side effects and consequences of misuse. Such notices inform patients and physicians that drug misuse may result in sudden death and cardiovascular problems. The drug has higher risks for abuse and possibility of persons attaining and distributing such drugs. Such warning raises physician's awareness regarding the extension of diversions and nonmedical uses of these drugs. For medical practitioners like nurses, there are needs for monitoring engaged in misusing prescribed stimulants, screening issues of contraindication, explicit specification of ADHD medication for clinical use and having patients acquire informed consent cautioning patients against the sale and sharing of prescribed medication (Arria, A. M., and Ribert, L., 2010).
Interaction of cognitive enhancers and other medications are other risks associated with off-label medicines for healthy individuals. Hypothesis on self-medicated actors willfully accept the adverse effects with the intentions of attaining desirable state. Nonetheless, expected side-effect to users reduces its frequency. Research in...
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