Empirical Support for the Moral Salience of the Therapy-Enhancement Distinction in the Debate Over Cognitive, Affective and Social Enhancement

The ambiguity regarding whether a given intervention is perceived as enhancement or as therapy might contribute to the angst that the public expresses with respect to endorsement of enhancement. We set out to develop empirical data that explored this. We used Amazon Mechanical Turk to recruit participants (N = 2776) from Canada and the United States. Each individual was randomly assigned to read one (and only one) vignette describing the use of a pill to enhance one of 12 cognitive, affective or social (CAS) domains. The vignettes described a situation in which an individual was using a pill to enhance the relevant domain under one of two possible enhancement conditions, one perceived as enhancing above the norm (EAN), what most people recognize as a clear case of enhancement, whereas the other perceived as enhancing towards the norm (ETN), with the individual using the enhancement having a modest, but subclinical deficit. Participants were asked how comfortable they were with the individual using the enhancement and about the impact the enhancement might have had in the individuals’ success in life. We found that irrespective of the domain to be enhanced, participants felt significantly more comfortable with ETN than with EAN, and they regarded the enhancement intervention as contributing to greater success in life with ETN rather than EAN. These data demonstrate that the therapy enhancement distinction is morally salient to the public, and that this distinction contributes to the angst that people feel when considering the propriety of CAS enhancement.