# Evaluating Risk and Benefit Sensitivity for Cognitive Treatments

## TL;DR

This study explores how people weigh risks and benefits when deciding whether to recommend cognitive treatments, finding that benefits are often prioritized over risks.

## Contribution

The study introduces a novel ethical judgment paradigm to assess public attitudes toward cognitive treatments and their sensitivity to risks and benefits.

## Key findings

- Participants were slightly more sensitive to benefits than risks when evaluating cognitive treatments.
- There was inter-domain stability in ethical judgments across different cognitive dysfunctions.
- Results suggest that prominent decision-making theories can explain the prioritization of benefits over risks.

## Abstract

Ethical judgments require clinicians, researchers, research participants, and patients to weigh risks and benefits. Novel treatments for cognitive deficits are rapidly emerging, but little is known about how individual differences in risk and benefit sensitivity influence ethical judgments to administer treatments. The public plays important roles as citizens, taxpayers, and consumers of cognitive treatments, yet little is known about how they evaluate risks and benefits in ethical judgments. We examined the influence of risk and benefit sensitivity on the public’s choices about treating cognitive dysfunction. We administered surveys, cognitive measures, and an ethical judgment paradigm to 425 participants recruited via Amazon Mechanical Turk. Participants were asked to choose whether to recommend a hypothetical cognitive treatment with varying degrees of risks and benefits across seven different cognitive domains. We expected participants to be more risk-sensitive than benefit-sensitive, especially when evaluating treatments that influence cognitive functions central to personal identity such as mood, self-control, and long-term memory. Unexpectedly, participants were slightly more sensitive to benefits and showed inter-domain stability across cognitive dysfunctions. Our results suggest that risks and benefits influence whether the public might recommend cognitive treatments. The relatively higher weight placed on benefits could be explained by prominent theories of decision-making under risk. Overall, this study suggests that judgment tasks can be adapted to study psychological ethical choices about treatments for cognitive deficits. Further study of individual variation in risk and benefit sensitivity and their influence on real-world ethical choices about cognitive repair could inform frameworks to enhance optimal neuroethical decision-making.