Understanding Public Perspectives in Germany Towards Illegal Stimulant Use for Neurocognitive Enhancement in Professional Roles: The Case of Doctors

Abstract The use of neurocognitive enhancement is controversial. Some social actors and scholars support its application in professions like medicine, while others view it as morally problematic and suggest prohibitive policies. To examine how the public perceives the use of substances for performance enhancement in professional contexts, together with the motivations and consequences of this behavior, we conducted two 2×2×2 between-subjects design scenario-based experiments. The experiments build upon the Agent–Deed–Consequence (ADC) model of moral judgment. A Germany-wide random sample of adults was used in Experiment 1 ( N = 1,346) and Experiment 2 ( N = 2,161). Both experiments involve scenarios in which a surgeon with either egoistic or altruistic motivation (agent–component) decides either to prepare for the surgery or to use the illegal substance “speed” for performance enhancement (deed–component) before failing or succeeding in surgery (consequence–component). Results show that the illegal substance use condition negatively impacted moral judgment, which statistically accounted for part of the association between the deed and the willingness to undergo surgery. The effect of the Deed on moral judgment and the indirect association of the deed with willingness via moral judgment were moderated by the agent and the consequence components. In summary, this research provides evidence that respondents perceive illegal substances for performance enhancement as morally problematic and that this judgment hinders acceptance of medical services. These results offer support for key assumptions of the ADC model within a healthcare scenario involving illegal enhancement, which could be investigated across a wide range of technologies. They also point to implications for professional bodies to maintain public trust.