An ethical discussion of the use of transcranial direct current stimulation for cognitive enhancement in healthy individuals: a fictional case study

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique. Because of its low cost, ease of use, safety, and portability, tDCS has been increasingly investigated for therapeutic purposes in neuropsychiatric disorders and in experimental neuropsychological studies with healthy volunteers. These experiments on healthy cognition have shown significant effects on working memory, decision-making, and language. Such promising results have fomented reflections on studying tDCS to enhance or modify normal cognitive function, a concept described by some as “cosmetic” neurology. As the field evolves, discussing whether the use of tDCS in these situations is appropriate is important, including how bioethical principles may help resolve these challenges. In this article, we present some examples of the effects of tDCS on cognition in healthy participants as a starting point for this ethical debate. We envision a futuristic “Brain Boosting” tDCS clinic that specializes in cosmetic neurology and cognitive enhancement. Using the typical cases of a fictitious Dr. Icarus as a discussion starting point, we raise some issues that are both humorous and provocative about the use of tDCS in healthy people. The importance of this work is to ask relatively new questions regarding cosmetic neurology in the field of neuromodulation and discuss the related ethical conflicts.