Home Health Cognitive enhancement : ethical and policy implications in international perspectives
A South African Perspective
DAN J . STEIN
South Africa is arguably a particularly useful country with which to think about issues in psychiatry and psychology. First, it is a country with remarkable past and present socioeconomic disparities; providing a context for thinking about how such disparities may impact on cognition, affect, behavior, and their disturbances.1 Second, it is a country that has undergone a transformation from an apartheid system to a modern democracy; this change provides a context for considering how past traumas and a more recent focus on human rights, forgiveness, and reconciliation impact on psychological and psychiatric states.2 Third, it is a low- and middle-income country (LAMIC); although it has some features in common with the Western, educated, industrialized, rich, and democratic (WEIRD) world,3 it also has much in common with the many regions of the world that are still in process of industrializing.
Indeed, a broad range of questions in psychology and psychiatry have been productively investigated in South Africa.4 There has, however, been relatively little focus on specific questions pertaining to cognitive enhancement.5-8 This chapter will explore a number of issues that may be particularly relevant to considering cognitive enhancement in a LAMIC in general and to South Africa in particular. First, I consider the question of cognitive enhancement in a society characterized by significant socioeconomic inequality. Second, I consider the issue of cognitive enhancement as one aspect of well-being. Third, I consider the contrasting approaches of global mental health and clinical neuroscience. To start, however, I consider a conceptual framework that outlines different approaches to cognitive enhancement.
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