Cosmetic psychopharmacology in a global context

In this chapter we consider cosmetic psychopharmacology-referring to the use of psychotropic agents to enhance brain and mind function-in a global context. This involves not only looking at how, if at all, cosmetic psychopharmacology fits in with global mental health concerns, but also looking at its ethical status in more globally relevant terms. Given the reality of resource scarcities in mental health care, we take one of the main challenges facing the articulation of a globally relevant cosmetic psychopharmacology to be its status with regard to macro-level distributive justice concerns. We commence with an overview of cosmetic psychopharmacology and the global mental health agenda, highlighting the significance of the distinction between a right to mental health and a right to mental health care. We then discuss certain ethical concerns regarding cosmetic psychopharmacology, including motives for using it, the kind of value it confers, the notion of medical necessity and the overmedicalization concern. A relational account, informed by an African moral framework, but one that will resonate with many indigenous philosophical perspectives, is then introduced and its implications for conceptions of mental health are considered. We conclude the chapter by discussing the ethical status of cosmetic psychopharmacology in terms of the relational account, as well as how it fits in with three levels of progressively demanding claim rights to mental health and mental health care. Given the presence of more urgent needs and scarce resources, it is likely that the claim that cosmetic psychopharmacology exerts will remain at the broader level of ensuring that societal institutions are structured in such a way that they not only refrain from impeding individuals from using cosmetic psychopharmacology but also, where possible, actively support this option.