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Open Access Open Badges Research

Psychopharmacological enhancement: a conceptual framework

Dan J Stein

Author Affiliations

Department of Psychiatry, University of Cape Town and Stellenbosch University, Groote Schuur Hospital, Anzio St, Cape Town 7925, South Africa

Philosophy, Ethics, and Humanities in Medicine 2012, 7:5  doi:10.1186/1747-5341-7-5

Published: 13 January 2012


The availability of a range of new psychotropic agents raises the possibility that these will be used for enhancement purposes (smart pills, happy pills, and pep pills). The enhancement debate soon raises questions in philosophy of medicine and psychiatry (eg, what is a disorder?), and this debate in turn raises fundament questions in philosophy of language, science, and ethics. In this paper, a naturalistic conceptual framework is proposed for addressing these issues. This framework begins by contrasting classical and critical concepts of categories, and then puts forward an integrative position that is based on cognitive-affective research. This position can in turn be used to consider the debate between pharmacological Calvinism (which may adopt a moral metaphor of disorder) and psychotropic utopianism (which may emphasize a medical metaphor of disorder). I argue that psychiatric treatment of serious psychiatric disorders is justified, and that psychotropics are an acceptable kind of intervention. The use of psychotropics for sub-threshold phenomena requires a judicious weighing of the relevant facts (which are often sparse) and values.