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Outstanding questions concerning the regulation of cognitive enhancement devices

机译:有关调节认知增强设备的悬而未决的问题

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The authors (Maslen et?al., 2014) propose to regulate cognitive enhancement devices (CEDs) as medical devices. Extending medical device regulations to CEDs raises some important questions that need to be adequately addressed before it makes sense to pursue this path. A first problem concerns the definition of ‘cognitive enhancement' and ‘CEDs'. Where does treatment end and enhancement begin? Secondly, since most CEDs such as neurofeedback and transcranial direct current stimulation are currently performed by non-medical health care providers, how will this regulation impact the current practice, and which requirements need to be put in place to regulate their use? Thirdly, distributive justice issues present an obvious ethical limitation. Fourthly, if CEDs are indeed prescribed off-label similar to the off-label prescription of psychopharmacological enhancers by MDs, this will pose problems regarding a lack of sufficient knowledge and expertise due to the highly specialized nature of CEDs. And finally, are we faced with unnecessary worries and unrealistic hopes when it comes to CEDs? In sum, we propose to regulate them regarding product safety and restrict them to competent adult use including professional oversight where indicated.
机译:作者(Maslen等人,2014)建议将认知增强设备(CED)作为医疗设备进行监管。将医疗器械法规扩展到CED会引发一些重要的问题,需要采取适当的措施,才有意义。第一个问题涉及“认知增强”和“ CED”的定义。治疗从哪里结束并开始改善?其次,由于大多数CED(例如神经反馈和经颅直流电刺激)目前都是由非医疗保健提供者执行的,因此该法规将如何影响当前的实践,需要制定哪些要求来规范其使用?第三,分配正义问题存在明显的道德限制。第四,如果CED确实与MD的心理药物增强剂的标签外处方类似,则标签外处方,这将由于CED的高度专业化性质而导致缺乏足够的知识和专业知识的问题。最后,涉及CED时,我们是否会面临不必要的担忧和不切实际的希望?总而言之,我们建议对产品安全进行规范,并将其限制在合格的成人使用范围内,包括在指定的地方进行专业监督。

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