By Clare Murphy

Health reporter, BBC News



Drugs could be banned from certain situations, like exams for instance

According to the British Medical Association, we must at least start thinking about the ethics of altering the organ which is so central to our being before there is no turning back.

The theory is this: if people are already willing to undergo the risks of plastic surgery in search of the perfect body, who is to suggest they would not do the same to better their brains.

Scientists are painting a picture of a time when toddlers pop pills on the way to playgroup while employees are forced to quaff various cocktails to boost their productivity.

But sinister as that may sound, the benefits could be immense.

A world where everyone is that much brighter might not just make for more enlightened conversation, it could accelerate the quest for a cure for cancer or an end to famine.

"We need to balance the benefits against the risks," says Dr Vivienne Nathanson, head of ethics at the BMA.

"We're not making any recommendations - but we do want people to look up and engage with this issue before it becomes the norm and it's too late to do anything about it."

Something fishy

This is no longer a theoretical debate: to a certain extent it is already happening.

Fish oil is already widely available and handed out to children by parents who have been told it could improve school performance by prolonging attention.

The original purpose of medicine is, after all, to heal the sick, not to turn healthy people into God

Francis Fukuyama

Philosopher

At one stage the government was thought to be considering giving it to all schoolchildren, but the Food Standards Agency then reported that the justification for doing so was limited: the evidence that fish oil works in this way is as yet thin.

A much touted trial of County Durham schoolchildren, in which all GCSE pupils were encouraged to take the supplement in the run up to exams last summer, seems to have been quietly forgotten.

The exam results improved, but they have done for the last five years and the percentage climb was actually smaller than the year before.

So parents, according to anecdotal evidence at least, are looking for something stronger.

Medicines such as ritalin, used to improve concentration in the growing number of children diagnosed with attention deficit disorder, can also improve brain function in children without such a diagnosis. And it can be obtained on the internet.

Buying a brain

The BMA panel says we have to prepare for a time when these drugs are potentially as readily available as the fish oil supplements you now get from the supermarkets.

Safety concerns may not be enough to regulate supply, especially as advances mean side effects, at least in the short term, are increasingly limited, and these drugs may become a standard part of school life.

For those who can afford them. Aside from the ethical considerations of pumping children full of drugs, questions of equality are raised, as equal access is unlikely.

But then what's new, one might reasonably ask.

Richer parents are already able to spend over the odds to buy a property in the catchment area of a good school or to educate their offspring privately. Extra tuition puts their children ahead, while private music, tennis and drama lessons enrich their lives.

MIND IMPROVING DRUGS INCLUDE: Methylphenidate (Ritalin) Donepezil (Aricept) Modafinil (Provigil)

Drugs could be the obvious next step to secure that prestigious university place in an ever more competitive world.

And having glided from a top institution into the best jobs going, this generation might face a lifetime of medication.

Why you may not need much brain power to pack toothpaste caps, there are clear advantages for everyone in boosting the brain power of those in jobs with great responsibility.

A study of pilots for instance found those who had taken the Alzheimer's drug Donepezil were much more adept at carrying out complex tasks in a flight simulator than those who had not.

Doctors on long shifts may be able to save more lives if their attention was improved by an effective stimulant, the BMA paper suggests, while such medication might even become compulsory for politicians if it were proven that it could lead to better reasoned decisions on issues of national importance.

All in the mind?

But the power of these drugs and even more extreme techniques such as transcranial magnetic stimulation, which kick-starts certain parts of the brain, may be overestimated for healthy people.

After all, cognitive function is not the be all and end all. Everyone knows an intelligent slacker or a lifelong underachiever. Drugs or brain massage are never going to replace the necessity of hard studying for those who crave success, even if they make the process easier.

There may also be long term consequences.

Our brains currently have the power to filter out memories that are trivial or traumatic, but drugs may impair this, leaving us either plagued by nightmares or bored to death by insignificant incidents.

But most importantly, we need to work out how we feel about the moral dimension of this debate, the BMA insists, and the very question of making drugs available which make "normal" people become "better" people.

We may find we end up agreeing with the philosopher and ardent foe of mind enhancement, Francis Fukuyama, who wants such drugs strictly regulated.

"The original purpose of medicine is, after all, to heal the sick," he says, "not to turn healthy people into God."